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Note: Music soundtrack is high quality and slow loading in some cases. Patience. :) ************************************************************* The Story Unfolds... Season Six, Episode Fifty One, Season Finale §§ What's A Dedicated Captain Like You Doing.. §§ Debut Launch: February 6th, 2008. ************************************************************ From: patti keiper <pattik1@hotmail.com> Date: Tue Feb 26, 2008 9:30 pm Subject: Future Perfect.. The sun was already hot and high in the chalk colored sky when the awards luncheon at the fire academy next to L.A. Headquarters concluded. ::Thank G*d that finally ended.:: thought Roy as he pulled off his hat and unbuttoned his black formal dress coat. He was one of the first officers outside and he wasn't surprised at all to see a very familiar outline dressed similarly, doing the same thing. Feeling a quirk of amusement, DeSoto cupped a hand over his mouth and shouted, disguising his voice. "John Gage! Stand at attention!" he barked, sounding exactly like Battalion 14. The animated shape snapped to, just like he expected, into a rigid inspection posture, quite satisfactorily, in complete startlement. Roy drew close enough for his jacket sleeve stripes to reveal themselves as well as his features. Johnny dissolved into open surprise and total shock as recognition dawned. His face immediately beamed a relieved crooked smile. "Roy!" he called out, happy. "What's a dedicated captain like you doing in such a tedious chore bound place like this?" he asked brightly. "I could be asking you the same thing." DeSoto said wryly, taking his old paramedic partner's hand into an eager I've-missed-you-terribly grip. Johnny nodded, finally pleased in a softening way. "My men have been doing me proud. One of my paramedics at 36's is up for the medal of valor for saving three from a duplex fire." "I saw that. Last month, right? It was in all the papers." "Eh. Heh..h. Unintentionally, of course, like I told the chief.." Johnny fidgetted. He became uncomfortable, holding up a hand. "Come on." Roy disbelieved. "You loved every minute of it as finally getting another one over on Brice." Roy said, leaning forward, spot on. Gage readjusted his stance, "Well... Yes, I did. And no, I didn't hit on that lady reporter even though she was drop dead gorgeous." "So you've finally grown up since we both decided to get ourselves promoted.." Roy demurred, letting him off the hook. Johnny shot Roy a dirty look. But only briefly. "Four more years since IS a bit long." "Yeah. And so's your hair still, I see." DeSoto said, grabbing for Gage's white dress hat so he could see the lack of a cut better. Johnny avoided him playfully. "And yours. That's sure new..." DeSoto shrugged, finally standing still enough to cross his arms together companionably tucked in over his elbows. "What can I say? You started a trend everybody liked back then. They still do." "Yeah, I'm glad of that. I've been telling the guys at my station that their jacket flaps are plenty to block out any falling embers." "And having all that wet hair on your neck feels real good in a fire." Roy agreed. "I've found mine cuts down on burns. A lot." Gage threw out a hand. "There you go. I've always said that the fire department should be less like the military and--" "...more like a brotherhood. I know. And you've succeeded. Look at us." Roy finished, grinning toothily. Then he became contemplative, when he began to realize something else. "Did you know we've the current distinction of being the only paramedic pair holding simultaneous captainships? The youngest ever." Gage patted DeSoto on the shoulder and gripped it affectionately for a moment. "Yeah. Guess we did set that new standard. Just look at how many men are joining the department now.." he sighed expansively, glancing over at the recruited cadets running their skills and aptitude tests behind them on the training grounds. |
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"You mean, men and women." Roy argued. "I've got two myself signed on at home, at 10's." "Really? As paramedics?" Johnny asked, his dating appetite whetted. "No, as in regular firefighters." Roy smiled. Gage made a face as he considered that idea. "Well, can they pull their own weight with all the boys?" he asked seriously, all captain. Roy scoffed good naturedly. "They wouldn't have been signed with the county if they couldn't, now would they?" DeSoto winked, teasing Gage. "Aw, that's true. So, your two.. are they--" "...married or not? None of your business. You can't dally with anyone not your own rank at work. Same as always, remember?" Roy prompted. "Don't remind me." Gage scowled, slumping against the railing which bordered the steaming parking lot where it sizzled under a grove of spreading, spicy scented eucalyptus trees. Both firemen breathed deep appreciably. "Hey, no brush fires today.." they both said together, almost in the same breath. Then they laughed about their parallel captains' instincts and thought now going out strong in both of them. Gage continued their first line of conversation. "Huh." Johnny grunted. "It'll probably be thirty years before that happens. I'll be an old man by the time a woman finally earns her trumpets like we have done." "I don't think it'll take that long before the gender glass ceiling shatters and falls. The department's too dynamic to not utilize the best of just about everybody who's becoming a part of us." DeSoto speculated. "Don't be too sure." Gage said. "Firefighting's too popular an idea with boys who're still growing up like me, to not foster some jealous guarding of positions as they're being handed out." "Let's hope not. Smashing stereotypes was what the seventies were all about." DeSoto chuckled. "And so now we're into the 1980s. Seems strange writing down an eight on all my checks nowadays." Johnny mused, grinning oddly. "Times change." Roy said, fingering his tie. "Oh, constantly." Gage grimaced, agreeing in seconds. "I don't know how you take it as well as you do. Now that's the hardest lesson I've ever had to learn in all my life..." he said with exasperation. Roy smiled gently. "You mean, even over handling your emotions on any of your child down calls?" "Even over them." he whispered. "I hate the fact that I'm getting older already." "At thirty one?" Roy giggled. "Yeah." Gage spat back seriously. "It's gonna happen someday. But,.. I don't see any gray hairs cropping up just yet on ya." Roy teased. "Don't rush me." Johnny frowned, tactfully not mentioning the ones newly sun sparkled at Roy's temples. "So, how've you been? What's been happening with you lately? We haven't even called each other. Not once." "Not much. Well, .. that's not true.. Everything actually." DeSoto admitted. "Why don't you tell me about it.." Johnny shrugged. "We're friends. Rusty ones, but still the best of em I'd like to think." |
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"I think I will. Let me buy you a soda?" Roy asked. Johnny reached out and stabbed him in the chest slowly, with a finger. "Only if I beat you over to the closest vending machine.." he said quickly, suddenly taking off into a sprint for the nearest food building. "You're on!" Roy yelled, chasing after him. Gage and DeSoto were still very much like a pair of little boys challenging each other on the playground. The only difference now was that the two were finally at the very top of their careers, and they were still playing.. Flying off their heads, their two pristinely white captain's hats went bouncing onto the melting asphalt in awkward circles as the wind claimed them in a winning friction game move as they began to run even faster. Their ties and jackets soon billowed off, carelessly abandoned, in a bid for increased fleetness and for more breathing room in the blistering heat. Roy won the race. Gage impacted the outdoor pop machine with both palms as he stopped his flight. Breathing hard to catch his breath, Johnny sagged onto his butt onto the ground by the hanger's picnic tables. "Y--You're what..." he gasped. "Forty two now?" "Yeah.." Roy grinned, still managing his own violent air hunger while sweating buckets. "But I'm nowhere near slowing down, eh? Not even a tiny bit." he crowed. "Nice to know that I can still beat you in an honest foot race." he gasped. "Once a Viet Nam vet--" he said, plunking down next to Johnny in a like lump. "Oh, would you just shut up and let me go grab ya that pop?!" Gage griped, clawing his way weakly up to the pay slot over their heads. Roy started laughing and he couldn't stop. It became infectious. Soon Johnny was, too, in between his gulps of icy Dr. Pepper. "Wh- What's so funny?" DeSoto smiled. "You know how long it's been since anybody's told me to do that?" Gage giggled, then he burped loudly in celebration. "About four years?.." he guessed, realizing that the last one who said that, had been him. "Right first time." Roy saluted with his own glass bottle of strawberry Crush, held aloft. "I'll never forget the last time.. Remember when?" "How can I forget? We were in deep auto pilot mode that day. All day." he clarified. "Yeah.." panted Roy. "We sure were. In the worst way." and soon, both paramedic captains fell into reminiscing that rescue in a mutual shared memory as they rested. |
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---------------------------------------------------------------------------------- The emergency doors at Rampart burst open under multiple patient arrivals. An authoritative voice ripped out physician backed dictates smartly. "Squad 36, Treatment Two with your pediatric submersion. Respiratory and X-ray are standing by....110? Straight to surgery for that subdural, room 3, Dr. Welby. He's already been scrubbed in. Squad 8? Go to Room Five. We'll be delivering your partum previa right down here in the ER. ObGyn's booked solid upstairs, but we have a baby doc available for her. How far along is she now?" "Dilated twelve centimeters." replied Dwyer. The E.R. nurse calling the shots sucked in her breath. "OOo, okay, boys. Rush it." Then she turned to grasp the panting, fretting mother's hand as she was rapidly wheeled on by. "Ready to meet your second daughter? She'll be here before you know it. You're still in good hands...." she soothed, lightly brushing her sweaty forehead. The soon to be mom again relaxed into her next contraction, comforted. "Oh, thank you.." she sighed as the door closed on her room, separating them. The frantic hubbub that had entered the hospital, ended afterwards, instantly. With great satisfaction, Head Nurse Sharon Walters crossed off the latest crisis from her "now" list with a flourish of her very sharp pencil. "Check!" she said, clicking off the stop watch that she had hanging openly from within her white side pocket of her all white uniform. "Oh, rabbits!" she said, peering at its face. "That resolution set of orders was given only ten seconds faster than the last case crunch from this morning. Must do better." she muttered to herself. Right then, the elevator doors opened up and Dr. Early and Dr. Morton rushed out onto the floor, unfolding like pairs of stethoscopes from their pockets to cast about their necks. Both were clutching tone screeching pagers. Sharon yawned in farce as they got there to her side. "What took you so long, doctors? Our current emergency cases now are no longer incoming. They've already been handled." she punctuated with a crisp nod of her head. "Landsakes,.. I told the operator NOT to bother you on your lunch breaks for this." she sniffed in dismay as she settled back down onto the stool at the main emergency room desk. "I'll let the administrator know about that little oversight right away.." she promised, picking up the phone. Mike and Joe both raised their eyebrows as they skidded to a halt near her on the scuffed tiles before sullenly trodding back to the elevators to resummon one for a return trip to the cafeteria. |
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Morton muttered. "Was Dixie ever that fast on triaging when she was just starting out?" "Nope." Early said, watching the numbers fall to their level. "Well.. I'll say right now that another legacy is most certainly being born today right before our very eyes." Morton said, getting on as the doors opened. Joe joined him, suddenly sniffling as he wiped a genuine tear off his cheek. "That kinda hits you right here, doesn't it?" he said, gesturing with a closed fist, to his chest. Mike smiled and shrugged. "I wouldn't know. I wasn't even a ..a.. a.....zitfaced teenager yet when Dixie was new enough at her job... to compare anything." he answered honestly. "You're missing out." Early said, getting a hold of himself and his budding pride. "It's a miracle. Dixie's a real protege mom now. First class." "If you say so. But I do like what I see in Sharon today when it comes to crisis situations. Talk about a real pro. Wow.." Morton gaped. "We may never get to work again." he said in jest. Early burst out laughing. ------------------------------------------------------------------ The phone rang on the huge dark oak desk only for half a second before long elegant fingernails picked up its receiver. "This is Floor Five, Executive Admin McCall speaking..." she prompted. Right away, on the other end of the line, Sharon Walters began to laugh uproariously. ##I know it's been years, but I'm still not used to thinking of our hospital's own Dixie as the main paper pusher as top end coordinator...## she chuckled, snorting at her friend. McCall fired back, a warm rasp coloring her voice."Oh, yeah? Well, I'm not used to some blue smocked college graduate filling my old shoes downstairs.." she countered. "How's it going, kid?" she asked easily, afterwards. She began playing with the loosely curled waves that now rippled down her long unbound waist length hair. ##Oh, it's going. My total recall's coming in handy.## "See? I told you things would work out all right. I knew the first day I laid eyes on you that you'd be my ultimate successor. It was just too bad that a slight adolescent nursing student-to-doctor crush along with a late dying klutz gene prevented others from seeing your true potential. But I was never fooled. Who do you think signed your final promotion papers?" ##You?## Sharon asked. "Oh, I helped. Sure. But it was really all the doctors you've ever worked with who eventually decided. They all agreed that you were the only nurse out there who had that sparky drive already inborn, to head the E.R. Department." ##They did?## Dixie got firm over the phone. "Sharon Walters. I've never lied to you and I'm not gonna start doing that now. Of course it's up to the M.D. staff to choose their pitch hitter. I'm mean, they're the ones who're gonna have to come up swinging when the patients start rolling in. Who better than someone who fields the starting line perfectly, every time? Congratulations on ace-ing your first month down there at my old desk. But getting back to the subject of why you called? What's bugging you? Is it that horrible fruit machine again? I tell ya, all you gotta do is nudge it a little with your hip first to--" |
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"##It's the operators, Dix. They're toning out false priorities on the physicians' pagers again.## she groused openly. "Oh. Uh. Well... That's a problem that even I've never been able to solve. That department's sort of like a nurse's schedule. You never know where your messages are going to go. Even if they get to the right place, they're always messed up. Our operators don't know how to play "Operator" I'm afraid." she shared. "Try repeating yourself to them twice once over the phone next time you make a personnel request and see how that goes? That may work better since that's how they end up parrot speaking on their job anyways.." Dixie quipped. "They always double page." ##Oh, very funny.## Walters giggled. "Hey, now don't knock it unless you've tried it, okay?" McCall suggested. "It just may work." ##Okay, Thanks, Dix.## "Anytime. Bye bye." ##Bye..## said Sharon. Then she hung up quickly with her usual energy. |
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************************************************** From: Patti Keiper <pattik1@hotmail.com> Date: Sun Mar 16, 2008 6:18 pm Subject: Reminiscing The Past.. [(Cameo scene insert at middle by Jill "wone3")- ETL fan writer from the original ETL episode 00:51 Episode Fifteen] Johnny Gage repositioned the captain's hat on his head and he sighed, actually enjoying the heat of the growing day. "Remember the time when Dixie got so mule headed that she even outdid me?" "How could I forget?" said DeSoto, leaning back against the dew kissed soda machine standing near the entrance to L.A. Headquarters. "I wonder how it all got started for her." Johnny chuckled. "Only she knows for sure. We can only forever wonder." Roy smiled, playing with his half empty pop bottle in his hands as he rested. Memory faded to black as events of that day returned to their recollection. ----------------------------------------------------------------------------------------- Dixie McCall stretched languidly on her raft just soaking in the southern Californian sunshine. ::It's just been far...too... long.::she sighed, listening to the birds nearby playing in her apartment complex's birdbath. Max, the caretaker's cat, seemed to agree with her, stretching a single paw down from his perch on the poolside lifeguard chair. Children's laughter rang like belltones in her ears as she dozed under her sunhat and occasionally, the yips of the excited dogs watching the other tenants sharing the same pool, splashed and played on the sidelines. Sighing, Dixie let the sun fry out her aches, one by one. ::If I ever work another double shift like the one I had last night, may monkeys fly out of my butt.:: she thought. "Ohhh, I hate head colds." Dixie sniffed, ignoring yet another tickle running down her throat. She shifted on her inflatable, easing a sudden gut cramp. The tired nurse let the noonish summer's day work its magic, and ignored it. "Guess what, Kel?" she mumbled to herself, still quite alone on her side of the pool. "I'm cancelling dinner plans. This day is gonna be just ..for......ZZzzzzz...zzz.." The lulling waves returned her to a state of blissful somnolence. |
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Dixie didn't know how long she had drifted, when an uneasy pup's whine sliced through her dreams. McCall made a face. Then the kids started screaming. Dixie shot up onto her hands, blinking in the torrid sun's glare, her eyes tearing. She cast her head about towards the frightened children, shouting in alarm. "What's the problem here?!" One petrified boy pointed to someplace behind Dixie. McCall turned. One of the Miller dogs was still whining, standing rigid on a second floating rubber raft, looking at something down under the water. Dixie saw a wavering form shimmer, sprouting legs and motionless, drifting arms. "Mr. Miller!" she gasped, twisting off the raft. Dixie swam as fast as she could across the pool, shouting as she went, "Call the Fire Department Rescue Squad! My patio door's open!" she told the children. One of the oldest started running for the phone. Dixie plunged into the pool's depths, opening her eyes. It was deep at that end and Gerald Miller was no tiny teenager when she finally reached him and started hauling his spasming lanky body to the surface. She kicked through a plume of red. ::He's hit his head?:: McCall analyzed. The side cramp biting her earlier made a comeback. Dixie grunted bubbles, cursing. But then her hand caught the edge of the pool's rim and her chin broke into the air. The stench of chlorine poured into Dixie's stuffy nose and she opened her mouth, spitting out luke warm water. "Is my brother ok?" asked a tiny blond girl in active horror. Dixie threw an arm over Ger's shoulder and rolled his slack face out of the water, taking care to not jar his spine. The teenager was unconscious now and he fountained water out his nose and mouth when she turned him. ::Drowning.:: she thought. Holding him still, the nurse beckoned to the kids. "Push something over to me!" she ordered, treading water. "I need a support surface to lie him on. Even a lounger will work." But the chairs along the sunning area were chained to the fence. Dixie swore. "There! Use that." and she jerked her head towards the blue raft from which the frantic dog was barking. |
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Two young boys leaped in and shoved it close. Dixie managed to get it floating perpendicular under Ger's chest with his head splinted level in both her hands. She didn't bother to drain him further and started right in with a breath attempt. Ger gurgled, but his chest rose. McCall's fingers found the groove in his neck. ::Sh*t. His pulse's almost gone.:: Dixie kept holding the teenager's head in alignment around her jaw thrust. She lifted rushing eyes to the panicking children surrounding her."Kids, we gotta get him out. Now. Remember how to do that? Like I showed ya in kidscouts.. We're gonna make a ramp out of the pump pipe cover by the shed. All right? Go get it! I gotta keep helping him." she said, blowing another breath through the suffocating man's chest water. Ger's color had grayed before her eyes by the time they got back. "No, Ger. Keep fighting!" Dixie hissed into his ear as she pushed air into his lungs. The oldest boy ran back outside."The operator said that they're on their way! I got through!" "Terrific.." McCall grinned up at him. She used the other children swimming around her to keep Miller's head and back unjostled. Between the five of them, the slippery teen slid off the long piece of plastic onto the deck quickly. "Watch his head. Don't move his neck around..." Dixie told the older ones. |
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"He's bleeding!" cried the youngest. "It's not real bad. Head cuts are just messy." Dixie said automatically. "His neck beat's gone! His neck beat's gone!" shouted Ger's brother, knowing enough to check. "I know. He's just gone out. Don't be scared. Now. He'll need that CPR stuff I taught you all, so girls, dry him off your beach towels, especially around his chest. Then nest them about him to soak up all of this water." Dixie said rapidly, thinking ahead for future defibrillating. Hauling on a rope of floats, McCall flung herself out of the pool. She scrambled over to the teen's head and reopened an airway by lifting his jaw bone. "Michael, now take over here. Hold his chin just like this when you give your breaths, ok? Move nothing else. I'll start here." Dixie told the boy, beginning compressions. "Don't be alarmed if water squirts out after a bit. Let it come. The more of it, the better." Dixie's cramp was a vice now, and her nose ran, so she lifted one leg and crouched on her right foot to ease it. Already, McCall was sweating and beads of it stung her eyes. She glanced up as Ger's brother delivered another breath mouth to nose. "That's fine, Mike. Give those a little deeper. Keep going. Good job." McCall panted, keeping up her CPR. After each pulse check, Dixie lifted her head toward the veranda's main gate listening acutely for the sound of sirens. Dixie McCall reached down yet again to the drowned teenager's throat after another long minute. Her chilled fingers found a thready carotid. "Michael! Trade places with me. He's got a pulse. Hold his head still, in between your knees, as I keep ventilating him." she requested, keeping in line stabilization with her hold on his airway. "Keep talking to him, hon. He's in trouble but he can still hear us." Stuttering nervously, Michael leaned down to his brother's ear. "Ger. I promise I won't tell anyone what you did in the house. Just wake up, ok? Dad's gonna be so mad you jumped head first into the shallow end like we're not supposed to." McCall looked up at the nine year old, about to ask him what that house comment had meant, when the wail of sirens and squealing tires heralded a paramedic squad's arrival. It was 51's. "Johnny! Roy! Non-breathing, but with a pulse now! He was under, I'm guessing,.. less than two minutes." DeSoto and Gage flew into the yard, 02 tank clattering, with a police officer in tow, lugging the defibrillator and a backboard. "Officer, set those by his head." Johnny ordered. Then he wrapped a thick cervical collar around Ger's neck without getting in the way of Dixie's mouth to mouth resuscitation. Roy moved immediately to kick the drying blankets the children had used out of the way. "Dixie? We thought the address was familiar." |
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"Sorry for scaring you fellas but this was pressing.." she replied, delivering another breath to the boy carefully. Johnny felt the teen's distended stomach. "This getting in the way?" "More and more." Gage got busy setting up the demand valve to take over for the nearly exhausted nurse. Roy finished hooking up the EKG monitor and he put the defibrillator on charged standby. Then he set up the biophone's antennae and began a hail. "Rampart, this is Rescue 5..1.." ##Go ahead, 51## answered Brackett over the line. "Rampart, we have a male approximately fourteen years of age. Victim of an apparent diving accident." Dix waggled her head in agreement at Roy's guess at mechanism of injury as she accepted the positive pressure mask from Gage and began using it. Johnny flung open the I.V. box and grabbed out what he needed rapidly. Roy continued his report. "...He's been under active resuscitation, non-breathing now, but with a regained pulse following CPR. He's on 15 liters of assisted O2. Spinal precautions have been taken. Please stand by for the vital signs." He set the phone onto his shoulder as he tore pieces of IV tape off a dispenser to stick in rows onto his leg. ##Standing by, 51.## McCall rattled off Ger's pulse and its quality, and his consciousness level."120 and thready. No reaction to pain. Pupils, reactive, but sluggish." DeSoto nodded, getting a quick B/P while Johnny did a rapid head to toe survey after listening to the boy's breath sounds via scope. "I'm getting rales bilaterally." he said. "He took in a lot of water.." Dixie confirmed catching her breath back as she used the ventilator on their patient. Gage went on. "Negative Babinski's." he said after he ran a pair of forceps points up the bottom's of both of the teenager's feet. Dixie sighed in relief. "One point in his favor.." Gage rewrapped the stethoscope around his neck. He peered at the blood oozing from the boy's temple. "This looks minor. There's no depression." Then he looked for cerebral spinal fluid out the ears and nose. "No CSF, Roy." "Ok, Johnny. Better call out for the engine. His B/P's sixty over P." Gage jerked his head in affirmation and grabbed his walkie talkie. "L.A., This is Squad 51." ##Squad 51.## "Respond Engine 51 for medical assistance to our location." ## 10-4, Squad 51. Time out, 12:51.## Everyone ignored the broadcast tones over the frequency, double echoed through the squad's Motorola Converta-com and the HT as Captain Stanley acknowledged the run and gave an ETA. Dixie felt a wave of fatigue. "Johnny, I'm tired." she shivered. "I gotta give it up." "All right." Gage said, eyeing her up, a little self conscious because of Dixie's skimpy made-for-the-sun, two piece bikini. "Rescuing's hard work. Why don't you..uh,, wrap up, sit down and rest a while. We got it." The motorcop smoothly took over teenager's mechanical ventilations. Dixie barely felt the kids throw a flannel quilt over her shoulders, offering her their gratitude with timid pats and hugs as she parked on a lounger by the edge of the swimming pool. McCall shook her head, thinking out loud. Then she snapped her fingers. " Amy Miller, can you go get that consent form your mother's got hanging on the frig? These firemen are gonna need it to give Ger some medication." "Ok, Dixie. I'll be right back, Ger!" cried the tiny child before she ran off. DeSoto got his first orders. ##51, Start an I.V. Normal Saline with an insulin drip. I'm gonna assume he was coding longer than two minutes. I want to terminate any catecholamine release effects before they complicate things for us. Go ahead and administer 1.0 mg Lidocaine IV push to control any intracranial pressure he might have from that possible head injury. Prepare to insert an esophageal airway and send me a strip. Add 1 mg Sodium Bicarb, then turn his drip to TKO. Let me know when you've secured your airway. ## "10-4, Rampart. I.V. Normal Saline with insulin, Lidocaine and Sodium Bicarb. This'll be lead 2." |
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The reassuring sound of the Ward Pumper's deeper siren grew then fell away with the bark of her airhorn. ##L.A. Engine 51's on scene.## came Stoker's transmission. ##10-4, Engine 51. Time is 12:55.## replied L.A. Dispatch. The pool kids, except Michael, went running to fetch the other firemen to show them the way. Roy lifted his HT. "Cap, we'll need all hands and the spare O2. Active resus." ##10-4, HT 51.## Ger suddenly started to seize and his stomach rippled. Gage startled. "Is he vomiting?" he asked the police man, with his hands full of supplies. "No, there's nothing here yet. ....But.." "But what?" Roy asked, impatient. "I..don't think I'm getting a chest rise anymore.." the officer admitted. "Just started happening." "D*mn!" Johnny swore, feeling Gerald's throat for the beat and double checking the jaw lift. "Try another vent again." The cop triggered the thumb button. Despite a tight seal over skin, the demand valve failed to accomplish a finished breath. The officer shook his head. "See? Just like I told ya." Johnny flew into action. "Roy, ask for a nasogastric tube. He's really blocked and in a convulsion from hypoxia. His gums are blue. I wanna drain that distension now." Roy hurried and updated Dr. Brackett about the new developments. ## I confirm rising tachycardia on the scope, 51. Relieve that intragastric pressure with an NG tube and watch for signs of an obstructed airway..## Kel snapped crisply. Working together, Roy and Johnny inserted a well lubricated catheter into the teen's unbloodied nostril and got it down past a sudden odd resistance. Frothy pink emesis welled out of the tube's end and onto the concrete in a noisy involuntary belch. Then Ger's bulging stomach fell flatter than it had been. "Ok, try him now." Gage told the policeman as he quickly drew the tube back out again and suctioned out the boy's nose and mouth. Difficult breaths went in. Stoker, Chet and Lopez immediately knew what to do at a mere glance of the area. They shifted the backboard until it lay flush with Ger's back as Johnny and Roy log rolled him onto his side for more active suctioning. Swiftly, the head block, chest, waist and leg straps were settled and tightened into place. Leaning down, Johnny examined the stain on the pavement. It was sweet smelling. "Roy, he's been drinking...." he said flatly, not happy. DeSoto's face tightened. "He's just a kid." "I know." Roy picked up the phone again. "Rampart, we've positive evidence of ETOH ingestion." Brackett returned a long sigh of resignation and sadness. ##10-4, Roy. Then we're all the better for that insulin drip counteracting things." |
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Roy had the advanced airway prepped and gelled. "I'm gonna need one of you for a Sellick's maneuver." he told the gang. "Me." Marco volunteered and he peeled off his coat and gloves and kneeled down. DeSoto had foregone the EOA for an endotracheal tube. "Stoker, why don't you take over on the O2? Thanks, Officer Palmer.." he read from the man's name tag. "No problem." The officer stood back to begin his incident report, allowing the more experienced firefighter engineer to take over the task. ---------------------------------------------------------------------- Hank noticed Dixie McCall bundled up on her chair. "So much for the day off, eh?" he grinned for her benefit. "Nothing like a little excitement to liven up an afternoon." Dixie just coughed at Stanley's encouraging humor while avoiding the bright sun beating down on her from his direction. She felt a glove on her shoulder that made her jump. "You ok there, Dixie?" Cap asked. "Sorry. I didn't mean to startle you." Dixie afforded the helmeted captain a smile. "I'm fine. Just a little worried." "About what?" "About him." she gestured with her head. "If we can't get that airway in......" ---------------------------------------------------------- A weak, choking jolt upset Roy's positioned laryngoscope and the paramedic yanked it out to prevent a sudden mouth injury. "Marco, keep up that cricoid pressure, whatever you do. Johnny!" "I'm on it! Rampart, our victim's seizures are worsening. So's his color." ##Have you established that ET tube yet?## "That's negative, doc. We're experiencing some jaw clenching." Johnny sighed in frustration. ##Knock him out, 51, for a rapid sequence induction. Point one mg's of Vecuronium IV push. That'll paralyze him enough for you to get one inserted. Know that you'll be completely responsible afterwards for maintaining his airway with adequate ventilations.## |
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Roy, next to Johnny, gulped. "10-- uh, 10-4, Rampart." Gage affirmed. "RSI with .1 mg's Vecuronium IVP." Stoker spoke up suddenly. "Gage! Laryngospasm! I'm getting in nothing now." "What?!" Johnny felt around Marco's Sellick hold. He felt a foreboding rock stiff hardness surrounding Ger's adam's apple. "Roy, ...positive on that... Obstruction's total!" "Rampart, standby... We've a fully obstructed airway." DeSoto dropped the phone. ##Push the Vecuronium, now! Double it if you have to!## commanded Kel. ## The increase may help your clearing attempts..## Johnny straddled the dripping immobilized teen while Kelly hastily undid just the abdominal straps of the longboard, allowing Gage access to Ger's lower abdomen. The paramedic delivered four sharp upward thrusts under the teenager's diaphragm with both hands while Stoker and Chet pinned the boy's head and neck still. Roy sent the muscle paralyzer into Ger's high flowing I.V. and hung it dangling on the fence. "It's in. Is it working?" he looked to Mike Stoker. The engineer shook his head and demonstrated the 02 gushing out around the mask quickly with some triggering. Johnny tried a few more abdominal thrusts. Then he scrambled to Ger's head with a long shafted pair of Magil forceps in his teeth. He used a jaw screw to open the shaking teen's mouth to get at the deeper part of his throat. The lengthy, scissors like instrument was guided down, but stopped short only along half its usable length. Gage grimaced as he probed, biting onto a pen light so he could see what he was doing. "There's nothing here, Roy. I'm not seeing any vocal cords. It's gotta be just a laryngospasm. These aren't threading down." he said of his Magil forceps. DeSoto nodded, licking dry lips. "Second dose then, ready?" Gage nodded, backing off so Stoker could use the demand valve yet again. Roy injected a small orange labelled syringe into the rubber intravenous delivery port deftly. "It's in!" Stoker and Johnny struggled to offset the teenager's cyanosis with some chest rise, but they were unsuccessful, no matter what they thought to try. ----------------------------------------------------------------- In the base station, Brackett eyed the running EKG strip and became ansy. He had to force himself not to interrupt his hard-at-work men just for an update. ----------------------------------------------------------------- A dragging minute passed under the firemen's sweaty exertions. Then Stoker detected a relaxing jaw. "He's loose.." and then he started to force as many feebly reaching ventilations as he could into the boy's lungs. He kept it up until the ominous dark blue began to fade from Ger's face and lower extremities. Johnny snatched up the abandoned endotracheal tube that Roy had left on the teenager's chest and said, "Hyperventilate him a minute more, Mike. Then move aside." Stoker nodded. Roy lifted the phone. "Rampart, our victim's still partially obstructed and we can't find what it is. The paralytic agent's beginning to work, but we're getting vents into him only with difficulty. Johnny's attempting another intubation. Both the boy's work of breathing and his seizures, are now absent." Roy reported, seeing a quiet, fully drugged stillness, settle over his patient. Kel let out the breath he was holding. ##Avoid any stimulus that'll trigger V-fib. He's sensitive to that now.## Gage accidently poked the back of Ger's soft palate with the ET tube as he was visualizing for his vocal cords. |
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Roy's head shot up when the EKG monitor warbled an arrythmia alarm. "Brady! Back off, Johnny!" Gage froze and yanked out the tube, digging for a carotid artery in the boy's neck with his other hand. "...Stupid! ..I'm ...stupid...." he grunted. DeSoto flew to the open drug case when the boy's cardiac rate continued to sink into the forties. "Rampart!" ## I see it, 51. Point five milligrams Atropine. Speed him back up again. What I'm seeing here, is vaso vagal in origin. It's not an adverse Vecuronium reaction.## The betablocker soon boosted Ger's heartrate back up into the low, irregular seventies. Everyone sighed in relief. ## D/C trying the endotrach. I'm authorizing an immediate needle cricothyrotomy.## Brackett went on.. Gage tossed the ET tube aside. ##....Set up your supplies. Have your head man keep hyperventilating your victim as best he can. Roy, you've told me in the past that you've done one of these before ..in Nam. You've got the ball once again.## "10-4, Rampart." Roy replied back, wiping sweat off his lip. Johnny was a pure professional. He wasn't offended in the least for being asked to step down during a primary treatment action. He wanted a resolution to the problem too badly to even care. He un-papered an adapter to a 7.5 mm sized ET tube, a 10 ml syringe, and a 14 gauge needle catheter. Reaching down, he slid a finger on a free hand over the hard thyroid cartilage running down the midline of Ger's throat until he found the soft depression of the cricoid membrane. "Ok, Marco. Keep his trachea from moving around and put one fingertip,.....here.." And he guided Marco's index finger to a precise spot on the teenager's sweaty skin. "Mark that landmark and don't lose it.." "Believe me, I won't..." Lopez admitted eagerly. "Ok, Roy. We're ready for you." Johnny said looking up, screwing together the puncture lancet."Lopez has got the trachea splinted." Then Gage handed the whole rigging over to his much calmer partner. DeSoto spoke. "Johnny, could you draw up a mil of water into the syringe for me, please? I gotta trick I like to use." Johnny nodded. "Stoker, is he adequately oxygenated yet?" he said, filling Roy's needle with a pull of its plunger into another unused, sterile IV bag. "As best as he's able. His pupils are still reacting but he's a little too cold now to judge by his color." Gage fitted the syringe back into place into the guiding shaft, curious as to what purpose Roy was going to use it for. ::Not for med absorption into the lungs, Kel hasn't ordered any ET drugs yet.:: he thought. DeSoto took over pressing a finger on the landmark Marco was guarding. Then he moved his fingertip just enough to place the point of the needle directly over the membrane he could feel. He angled the syringe, end down at a forty five towards Ger's feet, and advanced the needle into the skin, all the while aspirating the plunger upwards with his pinky and ring fingers. He stopped instantly when the upward welling suctioning drew up pearling air bubbles. He smiled. "I'm in the trachea.." he announced. Roy slid a 3mm endo tube catheter inside the syringe and threaded it until it was well into the air passage below, angled downwards. He withdrew the long needle, passing it off to Cap to dispose of into the sharps bin. Johnny flew into action once again. "Ah, now I see what the water was for.." he said, listening to the teen's chest as DeSoto fitted the ET adapter's syringe and catheter's end onto a high flow oxygen circulating ambu bag. "A better visual." "Yep." DeSoto blinked. Lopez helped Roy tape the inserted tenuous airway to Ger's throat amply and then he took sole charge of stabilizing it with both hands so that it didn't budge a single centimeter out of place. "You're pure cement, Marco." Gage ordered. |
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"Solid, man. This is going nowhere." he said, watching Stoker rapidly make up for lost ventilating time. "How's he doing now?" the hispanic fireman asked, marveling at the heavy bag's ability to work through such a slender tube. Johnny took the listening ports of the stethoscope out of his ears. "He's got minimal chest rise. But it's enough to keep him alive until we get to the hospital. Nice work, pal." he grinned. "Thanks everyone." "Mike, I'll break you." Roy said. "I know just how to get the most inside without distension happening. It's a narrow band force of pressure with this sized catheter. It's just like a newborn's.." "I'll learn it for next time.." said Stoker as he traded places with DeSoto. Johnny picked up the phone. "Rampart, we have an airway.." ##Congratulations, guys. Now get him in here. I want a vitals set every five minutes in route. Keep vigilant for good or bad lung sounds, any sign of expanding hematomas, or subcutaneous air under the skin. ## "10-4. We're on our way, Rampart. The ambulance has just arrived.." Gage said with a smile. That smile fell away when Dixie McCall suddenly sagged backwards from where she was seated out of her blanket. She tumbled limply into the pool when Hank Stanley failed to catch her in time. "Dixie?!" Johnny yelled. ------------------------------------------------------------------ Cap started to get out of his turnout and helmet to go after her when Gage shouted. "I got her!" He swan dived into the shallows. Very quickly, Dixie McCall was conveyed to the surface and to the edge by many hands. She was lifted up, set onto the ground and rolled onto her back. "Dix?" Johnny shook her firmly, monitoring her carotid. He wiped streaming water away from her nose and mouth as she began coughing and moaning. McCall was almost as white as her alabaster swimsuit. "She's ok.." Gage told the others. Stoker jogged over with the engine's O2 apparatus. "I think this's just an episode of syncope, she's waking up already." he said. "Let's move her to one of those chairs and get her wrapped up before you start her on that Mike." |
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Roy looked up from where he and Marco were still watching and working on Ger. "Johnny?! What's the problem?" "I don't know yet!" he shouted, letting Stoker, Cap and Kelly transfer Dixie from the concrete to a head raised sunchair. "Let me check her out." he coughed. "Keep packaging him for transport. I'll call a second ambulance for her if I have to." Cap reaffirmed Johnny's plan, setting an oxygen mask over McCall's nose and mouth. "That's gonna be the call." He waved on Stoker to notify L.A. of their need for an additional Mayfair or Cadillac. "I don't like her breathing rate. It's labored." "Umm hmm, something's definitely going on here.." Johnny agreed. "Dix, can you hear me?" She didn't answer past a few groans. Chet Kelly continued to try to get a legible verbal response out of the nurse while Johnny got a B/P off her arm. The children were scared but they stayed out of the way, remaining maturely silent. Gage saw that Roy was ready to go. "You keep the biophone." "She stable?" "Yeah. Her B/P's no longer low. Take Marco with you for that airway support. Kelly can follow me in the squad later after the other ambulance gets here." Roy was a bulldog. "Use a landline, ok? The kids can bring out a phone to you for you to use for her." DeSoto said, shuffling along behind the gurney leading attendants, carrying the defibrillator and the drug box. "I know. I know.. Just go already. The sooner you leave, the sooner I'll find out some answers on her. Don't worry...I'll contact ya on HT as soon as I find out anything." Gage grumbled. "No, I'll do that.." Cap promised. "All right." Roy replied, waving the ambulance men on again. "I'm going..." Johnny paid no more attention to him as Ger was carted off Code Three to Rampart Hospital. ---------------------------------------------------------------------- Cap and Johnny turned back from watching Roy hustle away to find Chet inexplicably armed with a mug of steaming coffee, which he was waving underneath Dixie's nose near the O2 mask on blow by so that she could smell it. Dixie sputtered, shifting her head from side to side. "Kelly, cut that out this instant!" Hank boomed. Gage gave out an exasperated shout of mild disgust and he grabbed the cup away from Kelly. "Chet, would you knock it off!? Where did you get such a crazy idea in the first place?!" he demanded, gently replacing the mask as McCall's eyes fluttered open. "From them.." Chet shrugged. "Yeah," said the oldest child standing nearby. "It was my idea. We do this coffee trick all the time when Miss McCall won't wake up after sunbathing. She told us to so she wouldn't ever be late for work." "Well kids, I hate to break it to ya, but today is Dixie's DAY ..OFF! Thanks for all your help. We got it from here. Now, sCRAMMM!" Gage exploded. The children, all three dogs,..and the caretaker's cat, took fright and all of them ran away as fast as they could with screams, barks and a yowl. "That wasn't very smart." Hank interjected when the noise died away. "Huh?" Gage double taked. "Why not? They're out of our hair..Unlike some people.." he glared at Chet. "We don't have our outside phone yet, you twit." Cap said, smacking Johnny lightly on the back of the head for emphasis on the word, "twit." "I'll get it." said Stoker. "I think I remember a phone being in the pool party hut from last year. It most likely has a cord on it long enough to reach us.." Johnny didn't even hear him. "I'm not the twit. Chet's the twit.. Geesh, Cap. Think about it. Reviving someone with coffee fumes? Now I've seen it all." He kept glaring at Kelly. "Just what were you thinking?" he asked Chet sarcastically. "It worked, didn't it? She's almost speaking." Chet countered. "At least java's kinder on the old nostrils than an ammonia capsule. I should know. You've used enough of em on me as the Phantom in the middle of the night when I was still sleeping..." Hank just rolled his eyes and asked L.A. for the ETA on Dixie's ambulance. |
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"No...ambulance.." coughed Dixie, sitting a little straighter in her chair. A flush of growing embarrassment was staining her cheeks and erasing all of her remaining questionable clinical signs red tagging problems. "I'm......fine, fellas. Really!" she protested, peeling off her oxygen firmly. 'I'm awake, I'm aware.. I know who I am, where I am and what happened....I'm not going anywhere.." she hissed with a little of her normal heavy guns tone. "If I see that hospital one more time this week, I'll rip all my hair out for sure.." she promised. Johnny tossed his paramedic's notepad that he had been writing in over a shoulder and threw his hands up, rubbing his face in exasperation. "I don't believe this is happening, Cap.." he whined. "We gotta get her t--" Hank held up his palms. "Now, Gage, you know the law as well as I do. The little lady's obviously fully cognizant enough, legally, to decide what's best for hers----" "Little lady?!" Dixie fumed. Hank shrank in his overcoat. "Sorry. Poor choice of words? To me, everybody's little." commented the lanky fire captain sheepishly. "I apologize if I offended you but the important thing right now is finding out whether or not you're really ok. We can hash over how this is being handled afterwards, all right?" Dixie drew up a glare. "Cancel that Mayfair, Hank. I have a cold.... That's all." she said dangerously. Cap felt the back of his neck smoking from the strength of her ire. "Ok.. canceling. ." he said reasonably and fully respectful of her wish to end the medical call. "Gage, she's allllll yoourrsss." "Thanks, Cap.." Johnny was thrilled. Not. "Kelly," Cap barked. "...let's give them a little earshot distance. Come on, pal.." "Aww, Cap. I wanna stay and help out.." Chet whined. "Now, Chet!" Stanley snapped. "...coming..." Kelly peeped. The two firemen packed up the O2 and turned for the direction of the Ward just as Mike Stoker came panting up with the private phone rigged onto a bright orange extension cord. "I got it.. Hang on while I dial o--" Stanley didn't even bother to turn around. "Jolly well. The gang's all here. Now put it back. I guess she's a refusal, Stoker." "What?" "Is there something wrong with your ears or mine, Mike." Cap snarled. "Mine, Cap." Stoker bellied up. "Fine. Clean up this mess around here and cancel the second ambulance while you're at it." He began to tromp away. "Oh," he said, retracing his tracks. "You're deaf to those two for the next minute or so.." he said tossing a hand at Dixie and Gage. "I sure will be.." chirped Stoker, recognizing a pending bit of paramedic hardball to come when he saw it. He stooped only long enough to use a water puddle to wash off some blood after he had policed the area free of medical run fallout. Then he was gone, with Cap being his bigger shadow. -------------------------------------------------------------------------------- Gage willfully stopped drumming his frustrated fingernails on the arm of Dixie's poolside chair. He laced his hands together in an unconvincing show of amenability. "Ok.." he smiled, falsely fake. "Now where were we?" he purred, ..tightly. "Talking about how normal I am right now.." Dixie said, crossing her arms together. "I wouldn't call keeling over backwards into a swimming pool in a dead faint, quite normal, Dixie. Quite the opposite." he growled. "Look..." Dixie purred, just as deadly serious. "I just got done with twenty five solid minutes of aggressive, rapid CPR." Would you still be normal after doing that?" she fired back at him. Johnny gaped like a fish, then he pursed his lips, scratching his head. "Well...." he admitted, his voice sliding up a few notes on a scale. 'I-- uh, I'll give you that...... particular point." |
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