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"Keep them light until I listen to his chest a little better. We've got to rule out traumatic chest
injury." Gage told him.
Mike Stoker was ready with cold water and he stood close by for the
word to begin cooling measures by the time the three firemen carried the boy over to all the medical
gear and Chet's treatment tarp.
"Start with his legs, arms and abdomen only, Stoker. A very light
wash. We don't want to chill him too fast here." said Roy. "If you see him start to shiver, stop
immediately and get him snuggly wrapped up. Keep an eye out for any active blood flow into your water.
We haven't checked him out very well yet for other injuries past these bruises and that hand."
Mike Stoker began his bathing with just an inch wide trickle from the end of the red hose's nozzle.
"Got it." said the engineer softly. "Is he resisting Chet's vents yet?" he asked DeSoto. "No."
said Roy with a worried frown. "We'll try to change that with some I.V. epinephrine real soon. Craig.."
he said, wiggling fingers for the biophone receiver.
Brice handed it over and then got busy
with Roy's stethoscope on assessing the flushed red boy's lung sounds.
DeSoto never took his
eyes off the boy while he spoke with Dr. Early. "Rampart, this is Rescue 5-1."
-----------------------------------------------------------------------------------------------
Joe Early flicked the recording machine off pause and said, "Unit calling in, please repeat."
##Rampart, this is Squad 51.##
"Go ahead on your pediatric suffocation victim, 51. I've been
updated."
##Rampart we have a male approximately four to five years of age. Unconscious and
unresponsive, being ventilated on 100% O2. He's markedly overheated with blunt force trauma in evidence.
Looks like a beating. I'll cover exactly what areas are involved after initial vital signs. BP
is 150/102, pulse is weak and rapid at 134, breaths unassisted, were at eight and very irregular.
Our victim is currently undergoing a cold water washdown over his extremities and abdomen to allow
us to start to get a handle on a very high body temperature.##
"What is it, 51?"
##Stand
by, Rampart. We've got to work around some spinal precautions to ascertain that.##
"10-4.
Let me know what you find. Has your victim shown any indication of prior seizure activity?"
##None,
Rampart. No signs of incontinence or unequal pupillary reaction are apparent.##
"Ok, 51. Start
him on an I.V. of..........
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*************************************************************** Date: Fri, 23 Sep 2005 13:25:04
-0700 (PDT) From: "Jeff Seltun" <finiterider@yahoo.com> Subject: The Saving Grace of Professionalism..
....Lactated Ringer's at TKO and another of 50% dextrose in water. Protect his airway
judiciously, 51. There's a strong possibility of respiratory alkalosis developing from your active
ventilations. They might bring on secondary hypokalemia. Are there any signs of deep tendon reflexes?##
Joe asked.
Brice checked, running a blunt scissors point up both the boy's bare feet. He also
pinched the skin sharply behind both the boy's knees while holding them bent and upright. Not one
twitch manifested. Craig shook his head.
DeSoto shared that news. "Negative, Rampart."
##Ok, go ahead and intubate him with an EOA. Sounds like he's already largely in a coma from his
exposure. What's his core temperature reading?##
Johnny took out the thermometer probe from
the child's rectum and read it under penlight. "41."
"It's at 41°c, doc." Roy told Dr. Early,
biting his lower lip.
##Continue his cooling measures aggressively, 51. Halt all irrigation when
his body temperature reaches 39°c and let it drop no lower. I want an EKG as soon as possible. If
he develops seizure activity, use a benzodiazepine variant such as Ativan 0.1 mg/kg I.V. If hypotension
sets in refractory to cooling and initial fluid boluses, initiate a Dopamine drip and titrate to
maintain a systolic BP greater than 90 mmhg. Once you've sent me a strip, continue monitoring vitals
and maintain his full 02 support. Bring him in as soon as possible.##
Roy confirmed his orders.
"10-4, Rampart. Point one mg's Ativan I.V. on posturing, a dopamine drip to raise any developing
basement BP to 90, and an EOA. Stand by for his EKG, lead two. I estimate our ETA at twelve minutes."
##Standing by, 51.##
Johnny was way ahead of Joe Early. He already had the still child's chest
dried and patched in and it was only moments before he flicked on the datascope monitor and linked
it into the biophone.
Roy spoke once more into the phone. "Transmitting EKG, Rampart."
##10-4.##
Gage, Brice, DeSoto and Kelly all leaned into the screen to read its tachy signature. Johnny let
out a worried sigh. "Frequent PAC's and look at this. Doctor Early called it right on the money.
He's very low on electrolytes."
DeSoto picked up the receiver. "Rampart, we are reading marked
flat T waves with prolonged QTs and prominent U waves on a V tach of 140 with PAC's. There is possible
evidence of Cor pulmonale manifestation."
##I concur, 51. Bolus in 100 cc's of that Lactated Ringer's.
Most likely the heat's damaged his lung tissue, causing atelectasis and that backup into his right
descending pulmonary artery. That's probably why we are seeing a poor breathing effort and the Cor
pulmonale. It is paramount, 51, if he crashes, that you avoid using sodium bicarbonate on any defibrillation.
He's low enough on potassium or magnesium as it is. Use Dobutamine 10 mcg/kg/min IV infusion for
circulatory support with your first stacking dose of epinephrine should any be needed.##
Roy
re-outlined the doctor's treatment and plan if the boy suffered a cardiac arrest. Then he added,
"Rampart, we've examined all exposed surface areas on our victim. He's got bruising of the left orbit
of his eye, right lateral ribcage, and on the skin over his right thigh with no evidence of obvious
fractures except for a midshaft bone break on his left index finger. Also, we've found that he's
slightly guarding the lower left hand quadrant of his abdomen."
##Might be splenic involvement.
I'll have a surgeon standing by.##
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"10-4, Rampart." Roy practically threw down the biophone into its case in his eagerness to get the
boy intubated and moving out.
Gage re-read the thermometer again, taking it from in between the
boy's frogged legs where he lay in his moistened shock sheets and he held up his hand. "Ok, Stoker,
that's good." he said, and he motioned for the engineer to take away the cold water stream.
Roy
took a small ambu bag from Chet's hand and fastened it to the end of the boy's esophageal airway once
he was through inserting it. He gave it a few short squeezes while Craig checked the tube's placement.
"Ok, Chet. Take this over again." he said in a hoarse whisper.
Brice gave a curt nod. "It's positioned
correctly, DeSoto. ...Ready?" he asked Gage and the others who were bundling up the boy's sheets,
I.V. tubing and EKG monitor wires away from the pooled water running around his body.
He got
all nods around the circle of quiet firefighters.
The heatstroked young boy's spine board was
lifted and laid straight onto a half height raised ambulance gurney, and soon, they started on
their way to the hospital. Marco quickly followed behind them in the rescue squad, adding his red
lights and siren to the ambulance's.
The foreman sighed as Cap stepped away from the Cadillac
ambulance doors that he had just double slapped. "I hope he makes it, mister. Cause if he doesn't,
then Marty died for nothing and my losing my job over him will just be another tragedy this company'll
bear quietly in the private sector..."
Hank just stared at him, and displayed absolutely no sympathy.
"Your poor man didn't have to die at all today! Haven't you gotten that fact in through that thick
hard hat of yours yet?! This whole rescuing situation was all ....completely... and utterly.....preventable!"
"I didn't put that car into the gravel pile! That stupid city gang did!" said the foreman, defensive
and trembling. "Why are you all looking at me like I was the one who kicked that kid around?"
Scotty, rendered angrily mute, turned his back as he began talking to the police officer newly arrived
on scene.
Cap just jerked his head for the other firemen to pick up all the medical waste
wrappers, labels and needle covers without saying another word.
He headed off to give out a station's
availability ETA to L.A. over the engine cab's chatter filled radio and soon, they were free of the
sad gravel works company, ...forever. -------------------------------------------------------------------------------------------
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**************************************************************************** From : crash200225
<crash200225@yahoo.com> Sent : Saturday, September 24, 2005 4:35 AM Subject : [EmergencyTheaterLive]
Waiting
Marco backed the squad in next to the ambulance just as the boy was being unloaded.
The intense look on both of the paramedics' faces spoke volumes. The child's condition must have
deteriorated during transport. As he followed the gurney through the emergency room outer doors,
Marco heard the sound of distant thunder. He turned back to the squad and rolled up the windows.
There was no way of knowing how long they would be there.
Not seeing Roy or Johnny in the
hallway, Marco found a seat in the nearly empty waiting room. Having left his helmet in the squad,
he ran his hands through his hair, then over his face.
The rescue had effected him more
than the others knew. His close friend had died in an 'industrial accident' several months earlier.
Though the circumstances were vastly different, the cause was the same. Incomplete training
and stupidity on the part of the supervisor. He hadn't told his crewmates about it, not that they
wouldn't understand. He knew his friends would try to console him, but he didn't want that.
The rage he still felt drown out the sorrow that would eventually surface. He just wasn't ready
to face it, not yet. When he was, he knew they would all be there for him.
Closing his eyes,
an image of the child came to Marco and his barely controlled anger threatened to overwhelm him.
He thought about who could do something so horrible to a little child, just a baby really.
He took a deep breath and let his thoughts drift back to his friend.
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--------------------------------------------------------------------------------------------- "Marco,"
Roy said for the third time, "Are you all right?"
He had become lost in his memories and had not
heard Roy calling his name. "Yes, just tired. How is the boy?"
"Dr. Early stabilized him.
He's on the way to surgery now. Johnny is getting supplies. He won't be much longer." Roy knew
they were all shaken by the rescue, but now was not the time to dwell on it. It was a kind of
unwritten rule not to mention the bad runs for awhile afterwards. They would talk about it at some
point, but not now.
Five minutes later, the three men were on the way back to the station.
Johnny seemed to fall asleep before they had left the ambulance bay, head against the window. Marco
was in the center seat and asked Roy, "You sure he's not sick or something? He's usually 'Mr.
Can't-Sit-Still'".
"He was okay in the ambulance and at Rampart. Like he said, he's bushed.
Nothing some sleep won't fix." Roy answered with more confidence than he felt. He knew how his
partner could be sometimes.
"What about Brice? He went to check on Johnny and fell asleep himself.
Maybe there is something going around." Marco reminded him.
Roy thought about it for a few moments
before saying, "I guess it wouldn't hurt to check them both out when we get back."
Neither
man saw the smirk on Johnny's face. He hadn't quite gone to sleep, but before he knew it, Marco
was shaking him. They had returned to the station and Roy had the passenger door open. He was
taking Johnny's pulse.
"Aw, Roy, Marco, leave me 'lone. Tired is all. Lemme sleep." he grumbled.
Roy shook his head and sighed. "We just thought you might want to sleep in your bunk instead
of the squad."
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"Huh?" Johnny looked around before stumbling out of the squad and straight to the sleeping quarters.
He didn't bother to strip down to his t-shirt and boxers. He dove onto his bunk and, for the second
time that night, didn't remember his head hitting the pillow.
**************************************************************************
From : Roxy Dee <laterrapincabesa@hotmail.com> Sent : Saturday, September 24, 2005 8:57 PM Subject
: The Haunted Chat~~
Johnny heard a motion in the darkness in the bunk room where he
lay. ::That's Cap. Is he restless! And Marco's none too relaxed either.:: Gage thought as he blinked
sleepers away. His roving eyes studied the ceiling and flicked to the window, which was still
glowing street light blue. ::Dawn's nowhere near yet.::
The dark haired paramedic rolled over
to eye his partner, Roy, snoring lightly nearby on the next bunk over. Immediately, his overlarge
eyes spied an HT on standby lying on the table between them ::Got you! :: Johnny grinned quietly.
::You finally went for the tired act Brice and I crafted hook line and sinker if you have a radio
in here with ya.::
Trying not to laugh aloud, he glanced over to Brice's bulk on the bed
kitty corner from him next to Chet. Craig was quiet, and his glasses were off. ::He must have continued
the joke after I "staggered" in here if Roy was concerned enough to keep close communication cover
in the bunk room after checking up on me. Wish I had been awake when he finally came in for me.
Oh, well. Maybe Chet was there watching him. I can get the play by play about what happened during
breakfast when it's light out.::
Contented with the progress of his mother hen fostering joke,
Gage flipped back over onto his back and closed his eyes in a sigh and soon returned to a much needed
slumber.
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------------------------------------------------------------------------------------ Ten minutes
later, Captain Stanley flipped back his sheets, pulled on his suspendered pants, and shuffled into
the bathroom on his boots. Hank was shocked to find that his face was covered in a sheen of fine
sweat in the mirror. Slowly, he realized that his heart was still pounding in his chest. ::Why am
I still mad? We're well done with it!:: he thought about the dead man at the gravel works. The
nightmare from which he had just awakened was still playing shadows of strong emotion behind his
eyes.
A commotion made him quickly turn on a sink flow in a pretend face wash to hide his damp
skin.
It was Marco, just as unsleepy and concealing the fact that he was actually disturbed.
"Hey, Cap. Can't sleep?" Lopez asked him as he startled at finding him up.
"Just thirsty I
guess." Cap sighed, hiding the reason why his sleep had been broken. "I'm headed into the kitchen
for some warm milk. Uh,... want me to fix ya some? Stoker told me we gotta finish up that gallon
before it goes bad on us tomorrow afternoon."
Instead of shaking his head, Marco nodded yes. "I
think I need all the comfort I can get after tonight's run." the hispanic firefighter finally admitted.
"Oh?" Cap startled. He rubbed a tightness in his chest that was coming oddly with his
boosted heartrate in a pretend scratch through his t-shirt. "Wanna talk about it?"
Marco eyed
him with a haunted look and his eyes flickered over the hand Cap was using to grip his shirt's front
in an attempt to silence the hammering under his ribs. That grip, matched his own, on his own shirt,
that was trying to do the same thing. "Yeah.." he said softly, meeting his eyes. "I ..think I need
to, Cap... And... I think you need to, too."
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Hank stopped drying his face in a towel with his free hand and ended his charade of false calm.
In a rush, whispering confidentially, Cap let loose. "Oh, it was awful, wasn't it? I-I- I really
think that I wanted to kill that foreman, Marco. With my bare hands. And I've never lost my cool
on a rescue like that before. Not ever. Not even half mentally! So why did I feel something like
that tonight? I still feel plenty angry about it now. And it's two hours later!"
Marco surprised
him by taking Hank's sudden deep admission in stride. Lopez waved it away with a dismissive hand and
a tiny smile. He touched Cap's arm, and started leading him to the more private space offered by
the still warm kitchen and rec room. "Believe me, I understand completely, Cap. I just lost a good
friend a few weeks ago due to circumstances alot like those that killed our park gravel worker.
I've been feeling a little trapped myself lately over him."
Captain Stanley's eyes radiated instant
sympathy and caring. "I'm so sorry, pal. Abou-- about him." he said as they both padded silently past
the quiescent engine and squad in the bay and then through the kitchen's swing door.
"It's
ok. I....think I'll get over it. Only I haven't figured out how yet." Marco said, looking shell shocked
and vaguely numb as they both moved over towards the refrigerator and the stove after squinting painfully
when the autolights came on.
"Think we should call a CISM counselor for a late night session?"
Hank asked frankly, opening up uncharacteristically to his troubled coworker. "I know it's been
a while since we as a shift, have called for one."
"Nah, having a shrink come to the station would
only wake the others. And embarrass us further after they nose around a little for the reason
why. Maybe we could...just have it out just between the two of us, and see if that'll do any good
before we try anything drastic enough like calling for one of them." he said, mincing a salt shaker
around pointlessly on the eating table.
Captain Stanley blinked, his back still to Marco, as he
got out two empty glasses for their drinks. Hank coughed, trying to relieve the tightness he still
felt in his jaw. The nausea which always came with any stress he dealt with began to rise and it finally
made him speak as he busied himself with the crumpled milk carton marked "Use Now." and a sauce
pan over a low gas flame on the stove. So he finally gushed, wide open.
Cap turned around,
met Marco eye to eye, and opened his mouth. "Oh, man. I was completely stunned over feeling the way
I did in front of that foreman. Blind rage, rising grief. A whole gauntlet of emotions. I- I
didn't actually know what to do with myself after we found out that our first victim had been killed
because of sheer lame brained stupidity and total inaction. I've seen people die for dumb reasons
in the past as a captain, but nothing like--" he choked off, slamming down a lump that threatened
to make his eyes water.
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"This was simply the last straw for you, Cap, and very nearly mine." Lopez said very quietly. Tears
flowed unabashed down his face as he drank the heated milk Hank finally handed out to him. "And
we've got to figure how get it all out somehow, before it makes us both too hobbled to work well
enough to save those we can still do something about."
Cap found he couldn't release his grief.
Not yet. Not even a half an hour later when Marco and he finally returned back to the sanctity
of their beds and the warm roughness of their beige woolen blankets.
Trying to ignore the weight
of stress still bearing down heavily on his chest, Cap let go of himself into an unrestful sleep.
In the blackness across the room, Craig Brice watched them both, thoughtfully analytical and soon,
privately worried.
------------------------------------------------------------------------------------------
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**************************************************************************** From: "Monster Moofie"
<monstermoof4me@comcast.net> Date: Sat Sep 24, 2005 7:01 pm Subject: Monday morning breakfast
Meanwhile, back at Rampart the night shift had just ended. Dixie had called Kel Sunday
night and made arrangements for him to come meet her and Joe for breakfast. Dix hurried and changed
out of her uniform and met Joe at the front desk.
Waving to Mike Morton, Joe and Dix headed out
and drove to the diner.
Having enjoyed a peaceful night, Kel waved to them with a smile. He
held up the pot of coffee as they approached. "I secured sustenance for you two!" he said with a grin.
"How did the night shift go?"
Joe sighed happily as he grabbed the cup of coffee Kel poured him.
"It was fairly uneventful for once. 51's brought in a kid who had been found trapped in a gravel quarry.
He was in pretty rough shape when they brought him in but it looks like he will be fine."
"I
had a few minutes to talk with Johnny Gage while he was gathering supplies following the rescue. Would
you believe they have added Craig Brice to 51's A shift?" Dixie queried Kel.
"You're kidding
me, Dix!" Kel said in disbelief.
"Nope, she sure isn't, Kel." Joe responded.
Dixie hurried
to explain further, "The really funny thing is that apparently the rest of the guys, including Roy,
tried to pull a joke on Johnny and Craig. Johnny told me he was feeling the change of season and
just in a sleepy mood so he went to bed early last night instead of staying up for movies and popcorn.
The rest of the guys sent Brice in after midnight to check on Johnny. Once he realized what was
going on, Johnny convinced Brice to set up a joke on the guys by crawling in Chet's bed and joining
Johnny in slumber. Unfortunately, they got the call out before it worked."
Kel laughed hearing
the firehouse antics. "Johnny and Brice joining together to pull a joke?! That is certainly funny!
It was hard enough when we saw Brice working with DeSoto when Johnny was out because of the hit
and run. I have a hard time imagining Brice and Gage working together, let alone planning something
together! Those two are like a cat and its prey."
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Click the MRI cardiac image to go to Page Three
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