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************************************************** From: Jeff Seltun <finiterider@yahoo.com> Date: Thu, 20 Apr 2006 16:41:51 -0700 (PDT) Subject: Chaos Night.. Rampart was anything but quiet. Dixie was fielding five ambulance patients as they poured in the red flashing light filled entrance. "How many more?" she asked the latest set of attendants bearing in yet another bus accident victim. Sam, a cauliflower eared veteran, sighed and shrugged. McCall grumbled under her breath. "Ok,. uh. Let me take a look at them all again before I start giving out destinations.. Hang on.." Dixie blinked when she realized that all of them were broken legs. "Front end crash?" she guessed, mumbling to herself. Then she ran plans off out loud as she awaited the two doctors she requested by emergency page. "He can wait, she can wait, she can wait.. Ah, tib/fib? Let's wait, too." "Right here in the hallway, Miss McCall?" asked one of Station 10's paramedics. "Yep. We're triaging here since you didn't have time to there." she told him. "Keep your victim's I.V. TKO. His EKG's looking good." Dixie looked up. "Who's got the short of breath?" Station 99's medics raised their active rain wrapped HTs. "Us. We do." "Ok, you first. Into Treatment Four. I've got a defib set up and an intubation tray. Dr. Early will be right with you." she promised. "Dixie? What do you have?" shouted Kel, jogging out of an opening elevator. "Bus crash. Transfers from Mount Sinai Hospital. They're at capacity. I've got four lower leg fractures, and one possible cardiac slated for Joe in Four." Dixie told him, handing off her phone notes that still had wet ink from all of her scribbling. It had been only four minutes since she received word that her department would be receiving the overflow. |
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The waiting teams of paramedics were patient, keeping up on their vitals sets as the two organized their response. "Ok..." said Brackett. Then he looked up. "Joe. There's an SOB in Four." "He conscious?" asked Early, hurrying out of the cafeteria annex corridor near them, where he had been eating a very late meal. "No.." said Dixie and one of 99's medics at the same time. "All right. Where's his run sheet?" asked Joe. "Under his pillow." said the second paramedic through the door he had been holding ajar in anticipation of Joe's arrival. "Ok, get it out for me, wouldya boys?" Joe smiled. "Thanks, Joe. Sorry about dinner.." shouted Kel as he checked the run sheets on two of Dixie's wall parked gurney patients. "No problem. Guess it's time to start earning my pay." said Early. The white haired doctor disappeared into the red priority room. Brackett looked at the trauma on the legs of two, seeing blood stains under their sheets. "Surgery for these." he pointed. "I've got surgeons on standby up in the suites. The head OR nurse'll intercept you. She goes by the name of Carol Evans." "Evans? Right.." said a newer paramedic from 24's. Dixie couldn't help but smile as she remembered all over again that her good friend and ex-second in command of the ER had been promoted upstairs only last month. "And I wish her all the luck.." McCall whispered warmly under her breath. "You said something?" Brackett asked as he listened to some fast breath sounds on his remaining two patients. "Nothing critical. You want these two in Three? It's clear. I just had the headache case moved to the floor." Dixie told Kel. "Yeah, you read my mind. That room's closest to the portable X-ray." Dr. Brackett said. "Is Mike on the way?" "Yeah,.. He said he's hitting some traffic.." said Dixie. Kel frowned as he checked the pedal pulses and Babinski's on the two waiting to transfer into the room. "Wouldn't that be ironic if he's driving by the scene of this very same accident?" "I'm trying not to think about it." McCall said. "Uh, oh." she said, glancing up at another flash of red lights as they pulled up at the ER entrance and killed their sirens. She saw two very, very sooty firefighter paramedics get out of a Mayfair in a hurry, carrying two large bore I.V.s. "What's 110's doing here? I heard Mercy copy their call." she grumbled. Sharon Walters apologized. "Sorry, Dix. Mercy's just declared an all full status. I was going to tell you but..." said the dark doe eyed, light blue smocked young nurse intercepting the new team at the doors. "Oh, terrific.." Kel said. "Dix, would you--?" "Yep." said McCall, giving the order for the two remaining leg cases to go into Treatment Three. "Gimme your orders you wrote down. I'll have the labs started ahead of time on these two for you." Dr. Brackett went running for the new arriving patient, who was dark with ash and being bagged. "Is he a burn case?" he asked the two paramedics. "No. Smoke inhalation." said one of the paramedics. "He was converted from full arrest four minutes ago." "Couldn't get a tube down?" "Didn't have time. He was a load and go right now. Orders from our Battalion Chief. We were lucky enough just to get these I.V.'s in, doc." said the gasping exhausted, smoke stained firefighter. "How big was your fire?" "It's a crack house. Single story. This guy's got a friend still coming. He was a little out of touch with reality due to better living through chemistry but he was conscious and stable." said 110's senior medic. Brackett sighed, painfully aware of a growing problem with Rampart's own available remaining bedspaces. "Ok, take him into One. I'll join you. Sharon.. have respiratory therapy called to bring down a respirator for him. Looks like I'll have to intubate him myself." said Brackett. "Then call the administrators and let them know about our own rapidly diminishing patient bed capacity. Get an exact count of how many we have left and let me know directly!" "Yes, doctor." Walters said swiftly as she held the door open for the fire case and Dr. Brackett both. |
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The hospital staff began to hasten around Dr. Brackett, settling into a new mode of activity without having to be prompted. Automatically, L.A. County Fire Department's air fleet was notified of a possible re-routing relay operation, from Rampart's parking lot, for the moment the hospital was declared full. The only other option after that was flights out of the city into the surrounding suburbs to all of the Level Two trauma centers. "Let's hope it doesn't come to that." Dr. Brackett murmured, "or all the fire departments in the area will have to take on those extra long transports themselves untilizing the private ambulance services." Kel Brackett shouted the moment the doors closed shut on all of his room's staff and his fire case. He had glanced at the EKG monitor Walters just hooked up. "Boys, stick around a minute." he told Squad 110. "I'm seeing--" "Doctor.. he's in full arrest.." said Sharon, handing the paddles over to Kel. The two paramedics took over the man's ambu bag and chest compressions. Dr. Brackett gelled his paddles and drove down the first shock to the man's clammy skin. ::Dixie. I hope you're faring with your cases better than I am right now. My batting average is awful.:: thought the sweating doctor. ----------------------------------------------------------------------------------------------- Dixie had her hands full in Treatment Three. One of her leg cases' morphine dose had worn off and it was taking everything she and two orderlies had to keep the large man on the bed. She told a passing nursing assistant, who had run into the room at the commotion, to call security for extra help. McCall looked up, with an angry thought, even as her voice began a calm, placating reassurance she hoped would relax the man. ::Doctor Morton. Where the h*ll are you?:: she demanded privately. ------------------------------------------------------------------------------------------------ Doctor Morton hit the ER entrance doors at a dead run, slamming his palm into the emergency release switch to make the doors fly open faster. "All right. Where's the worst?" Five sets of fingers pointed down the hallway. Mike skidded to a halt, his Levi jacket still on, and it was then he saw the retreating backs of two security guards rushing into Treatment Three. He followed them there, moving fast. "Doctor!" yelled Dixie. "This guy has bilateral leg fractures. He's not combative. Only in pain." "I got him!" said Morton, drawing up a fast injection of MS into a syringe. "His I.V.'s gone..." Dixie said, holding the man's fighting head. "Then we'll have to do this the hard way.." "I.M.?" "Yeah.. Hold him down people.. Tightly. Dixie, cut away his pants." McCall did so as the man grunted and screamed and tried to throw off both of his splints. Morton delivered the narcotic, double dose into the man's hip, and rubbed it. And then he helped the four men hang onto the man while they all waited for the medication to take effect. "How's victim number one?" Mike gasped, looking over his left shoulder at the other gurney in the room. |
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"Stable.." said Dixie, backing away to recheck that person's vitals status. "She doesn't have spiral fractures like he does." "Just how many new people did we get in the last fifteen minutes?" Morton asked sarcastically, getting concerned despite his frustration. Dixie sighed, trying to catch her breath. "Five from a bus crash. One from a house fire. Who knows how many more we'll be getting. Mercy's full and so's Mount Sinai." Morton whistled under his breath. "Helicopters on standby?" "Yes. The fire department's been notified." McCall answered. "Where's Joe and Kel?" "Joe's with a possible cardiac in Four. Don't know where Kel is. Last I saw, he was working over 110's redirected SI case in the hallway." Dixie replied. "Ok, first things first. This guy's gotta settle down. Boys, go ahead and strap him down. I'm authorizing restraints for his own safety." ordered Morton to the orderlies and the security guards. They did so. A minute later, the man sighed and passed out and Dixie automatically opened his airway and slapped on an oxygen mask. "How much did you give him?" she asked with wide eyes. "Fifteen milligrams." Morton grinned openly. Dixie let out a surprised look of admiration and shook her head ruefully. "He's a big boy..." said Morton. "Milt, go ahead and put in his oral airway. Take his vital signs and give me what you got." Then he dismissed the security pair. "Thanks. We'll call you for the next one." he told them bruskily as he got to closer work on his two patients. The two guards departed, adjusting their uniforms and finger combing their hair back into place before exiting the room. |
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------------------------------------------------------------------------------------- Station 51 was quiet by comparison. The gang was.... ************************************************** From: Patti or Jeff or Cassidy <theaterhost@voyagerliveaction.com> Date: Fri Apr 21, 2006 1:28 pm Subject: Sweet Tooth. ....just finishing up with the dinner dishes. Stoker and Kelly had long since disappeared into the bowels of the locker room, where they had set up handyman's tools and of all things, a sewing machine. Johnny could hear it echoing clearly around the ceiling in the large bay surrounding the fire vehicles. And his curiosity was nearly getting the best of him...for the second time. Roy noticed his discomforture. "Oh, now don't go starting that up again. Cap'll eat you for a snack for sure." Gage abandoned his soggy dish towel and snagged another dry, crisply folded one from the utensil drawer to replace it while he dried the last pot. "Can a guy help it if he's curious about just what the heck his friends are working on? Aren't you dying to find out just what kind of contraption is so good that it makes a full Battalion Chief order up a new fundraiser event, our Water Day, just to finance it?" "No." said Roy, blandly, pulling the rubber stopper out of the sink. The water there started gurgling with a noisy suck down the drain. "We're finished here. How about some ice cream everybody?" "Here. Here." said all the rest of the gang appreciatively. Even Bonnie barked from her place on one of the bright yellow orange varnished kitchen chairs. "Ok, I'll dish them up." said Roy, smiling. He pointedly ignored his partner's growing restlessness about the preverbial project carrot, dangling just out of sight of his nose, in the other room. "Cap? Chocolate or vanilla?" DeSoto asked, looking up. "You need to ask? What color is my coffee in the morning?" he gruffed. "Brown." "White." said both Roy and Gage at the same time. |
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Marco, working on a crossword puzzle nearby, started chuckling. "Shows how observant you two are." he teased. "Roy, he wants chocolate. Cold enough to stand a spoon in it. Just like the java he pours into his mug and always leaves in the freezer for a few minutes before he drinks it." Johnny made a face. "Eeoow. Cap... Iced coffee?" he shivered. Roy opened the freezer, found Cap's chilling coffee pour about which they had all been pondering, and handed it to him. "Sure, best thing since Sunday morning breakfast sometimes. Especially in the summer. Would you be drinking hot coffee with a sunburn as bad as Cap's?" he whispered on the side to his partner, pointing even as Hank rubbed an itch gingerly on a still painful ear. "Uh,... NoooOO." Johnny said, his voice moving up a scale. "Actually, I think I'd rather prefer lemonade, heh, heh." he said, rubbing a few fingernails on his water drop dotted uniform shirt to polish them. "We don't have any." said Roy, tightening his lips into a scowl. "And quit fidgetting. You're making me nervous." Johnny threw up his hands, stalked over to the couch, scooping up Bonnie along the way, and he plunked down onto the leather couch, starting to stroke her cinnamon and black streaked coat agressively, much to her obvious delight. "Oh for Pete's sake, guys. Doesn't anybody even care what Frankenstein-ian invention those two are crafting up in the changing room?!" he said to the room at large. Nobody answered. They were all enjoying Johnny's comical reactions too much to end it so soon. Roy finally offered up a tidbit. "Whatever it is," he said, licking frosty but melting Baskin Robbins off of his fingers. "We get to take it into Rampart for the next stage of testing tonight. It's gonna be done by Brackett himself if he's not tied up." DeSoto told Gage. Johnny's hand on Bonnie's back stopped stroking and the tiny yorkie yipped in dismay, shoving her nose back under his palm eagerly to demand a resumption of attention. "Oh, sorry, girl." said Gage, guiltily plying in once more. "What's gonna be done?" "Hush, Gage. You'll see it at the end of your next patient call after you get in to resupply." Hank said with finality. "Honestly? Your nosing's getting more annoying than my kids' nagging at me to buy them something from the new mall one of these days." said Cap, accepting his bowl from Roy with a smile. "Thanks, Roy." "Anytime.." DeSoto whispered, thoroughly enjoying Johnny's self made predicament. "And yeah, I'll get you some Solarcaine for your ears then, too." "Thanks. You read my mind." Cap said appreciatively. "I'm a good paramedic." Roy told him. "I would sure hope so." Hank fired back. "Or you wouldn't be working here." Right then, Stoker and Kelly walked briskly into the kitchen. "Ah ha!" said Chet in discovery. "I thought I smelled Cap's coffee curdling in the cold. It IS time for dessert. Anything left?" "Tons." said Roy. "Help yourselves." he told them. Chet rubbed his hands together and cleaned them free of what looked suspiciously like glue to Johnny on a damp dish towel. "I put them both in the rear squad compartment, Roy. Inside a spare stokes." "Ok, I won't forget they're there." replied the sandy haired paramedic, putting the finishing touches of his own two scoops of both vanilla and chocolate into his carved wooden bowl. Bark! said Bonnie. |
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"Oh, yeah.." said Roy, setting the ice cream crusted scoop down onto a saucer for Bonnie to enjoy. The dog was out from under Johnny's hands in an instant. Chet burst out laughing. "Roy, that's mean. What if her tongue gets stuck?" "I rinsed it a little.." DeSoto told him. "What do you take me for? A sadist?" "Yes." said Johnny. "The worst kind for not sharing privileged information..." he hissed through his lips as he jerked a pro-offered ice cream bowl out of his grinning partner's hands. Roy didn't rise to the bait. "Patience is a virtue..." he said, holding up a lecturing index finger. "You'll see everything soon enough. And you're gonna love it." DeSoto promised him. "Yeah... I do." piped up Marco. "Not you, too..." Johnny glared in irritation at Lopez. "They demo'd it for me this afternoon in between kids during a pause in all the water games. I think it's a really, really good idea.." Lopez said, slurping up his ice cream as only a hose jockey could. Gage glommed onto the hint. "AhhhhHHhh. It's a device of some kind. Something that a firefighter's gonna be using eventually." Johnny smiled brightly, finally thinking himself the cleverest of all firemen. "Duhhh." said Chet. "What else would we have fundraised for in a firehouse?" said the curly haired Irishman sarcastically. Johnny's face fell into irritated dismay and got even worse when Cap laughed hugely out of his newspaper. ------------------------------------------------------------------------------------------------------- It was hours later, and the gang was deep in slumber when the automatic lights came on, rocketting them out of bed and into their attached suspenders and boots. EEE.Ooo.OoowwwwWWWwww. ##Station 51. Foam 127. Station 9. Tanker fire. At the intersection of 101 and Riverside. 101 and Riverside. Time out: 0306.## "What time is it, Cap?" sniffed a sleepy Chet. "Listen up, you twit. Sam just said it over the airwaves." Hank replied, equally fuzzy as both men rushed for the trucks. "And for that, I should make you enter this one into the log book for lat-- oww." Cap winced as he bumped a sunburned shoulder against the doorframe as he went out after the others. Kelly dashed under his arm as Hank froze in pain. "You shoulda worn sunscreen like I told ya, Cap!" Chet said gleefully. "Mother's keeper.." muttered Hank as he yanked open the Ward's passenger side door. |
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Station 51 rolled out. ----------------------------------------------------------------------------- Soon, they were very near. And Cap had received an update. He thumbed the truck to truck mic. "Guys.. I've just been told it's a diesel truck. Overturned. Possibly propane." he advised everybody and the squad. ##10-4, Cap.## said Johnny through the patch. ::Oo, this'll be a fast one if we don't have any serious injuries. Then it's back deep into slumberland for all of us..:: he thought happily. Hank's voice boomed out once more on the main channel. "Don't get out until we're all sure what we're facing!" he ordered. As the Ward and Dodge turned onto 101, the gang could see smoke, but no fire up on the Interstate. ::That's odd.:: thought Cap to himself, running through his options on how to fight a truck fire when it couldn't be seen so very well in the night's utter darkness. ::Huh. It would have to hit lightpoles.:: he sighed. He toggled L.A. "L.A., Engine 51..." ##Engine 51, this is L.A.## "Respond Light Truck 90 to our location. Mile marker....34. Eastbound." ##10-4. 90's ETA is six minutes.## Hank held up his glove for Stoker to hold them off a goodly distance from the roiling black smoke to keep a very healthy and safe breathing margin. He got out and sniffed the air. "That's not fuel." he told the others as they gathered around him, donning full scba. "That's--" Headquarter's voice burst through their Converta-Com. ## Engine 51. L.A.## "L.A., Engine 51." Cap mic'd quickly. |
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##An L.A.P.D. patrol car's just confirmed that your tanker is carrying a single payload. 10,000 gallons of....pancake syrup.## "Pancake syrup?" Chet asked incredulously. L.A. went on.## There's a report of one minor driver injury on the shoulder.## "10-4, we'll keep an eye out for the victim. Engine 51 out. Ditch the air tanks, boys. Don't think scorching carbon's gonna do all that much harm to us in the short term." laughed Cap. "Smells like burning marshmallows.." said Marco, grabbing some hose. Cap, was still standing by the LaFrance's cab. Stoker had handed him the HazMat book without asking and was helping him riffle through it. Gage caught on, determining their wind direction. "Yeah. How in the world DO you put out a pancake syrup fire?" Roy shrugged, grabbing out the biophone, oxygen and the light dressing case. "With batter?" Everybody shared a laugh. Roy and Johnny soon found their dazed, scuffed truck driver. A male. And they set to work assessing him while the others worked to snuffle out the hidden fire hissing softly under the smoke rising up from the large, slowly spreading pool of superheated tree sugar. |
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Soon, the fire was knocked down and Cap cancelled the foam truck and second alarm assignment. The Battalion Chief arrived. "What happened?" McConnikee asked. Cap couldn't help himself. "Fire." "Oh?" said Battalion, starting to smile. "This had better be good." "Oh, it is." Hank chuckled. "We've just this guy who's a little singed, but unharmed." Soon, the veterans of the hose were joking about hot maple syrup and going back home to get containers. Then, Vince arrived on scene. He had shown up for traffic control but had missed a few transmissions. "So, what happened?" The Chief and Cap looked at each other. "Fire." Hank informed him cheekily. Then Battalion bent down and scooped up a fingerful of the glop and ate it. "Tastes like Mrs. Butterworth's." |
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"You're kidding." chuckled Vince. "Would I be eating anything on the ground like this, mister, if I was?" laughed the Chief. Nearby, Johnny was pumping up a BP cuff on the man they had laid down onto the ground for safety's sake. A passing motorist, sliding by the now declared unhazardous crash site, hollered out. "Is he gonna die?" to the working paramedics. Gage looked up in utter shock and irritation. "Sure he dies...in about 80 years..." said the angry paramedic to the annoying bystander. Roy got fed up at another one who was rude enough to open his mouth while they were loading up their patient into a Mayfair. "What happened?" asked the second motorist. DeSoto erupted. "Plane crash!" he shouted back. The driver shot Roy a pissed off look and rolled up his window again. "Nice.." admired Gage as he buckled in their man. Of course Vince arrived belatedly to hush up all the coasting gawkers with his intimidating bulk. Before the double doors of the ambulance were shut firmly by Hank, Chet shared a gem with everyone. "Hey.. who's up for some pancakes for breakfast? That truck smells real good.." Even the bruised, sticky, and blanketed trucker laughed. |
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************************************************** From: Patti or Jeff or Cassidy <theaterhost@voyagerliveaction.com> Date: Sun Apr 23, 2006 2:37 pm Subject: The Shattering.. Dixie McCall and Doctor Brackett were in the ER nurse's lounge, nursing steaming cups of satisying Folgers instead of screaming, fighting, leg bleeding people for once. "So, did he live?" Dixie asked, smiling with her eyes closed while she gave herself a java treatment strictly by inhalation. Kel was so tired that he was almost mesmorized by the way the flourescent lights in the room glowed off the steam curls wafting around Dixie's eye lashes. "Which one?" he chuckled. "Mr. 'Bus M.I.' or the street bum on the curb who suffered a stroke watching the first guy stagger away from the accident site?" "Both." McCall amended. "They'll be fine. The first was just a junctional problem and the second is responding to steroidal and anticlotting measures." "That's good. All my leg cases are gonna recover, too. Except perhaps for mine. I ache all over." she complained, finally taking a gingerly sip of her stale coffee. "Tell you what? We both get off in two hours. Why don't you grab your swimsuit out of your locker and I'll fire up the hot tub on the deck. Just for you." "Hhmm. Tempting. Do I have to cook?" "Lord no. Not after a night like tonight. That's what takeout's for." grumbled Kel. Dixie's eyes twinkled. "Deal. But first you and I gotta take care of one more thing before we go. Remember you said you'd--" The breakroom door opened. It was the dark eyed Sharon, calmer now but still with dishevelled hair. "Dixie? Roy and Johnny are here. You asked me to let you know when they dropped off their latest patient.." Kel finally remembered his prior arrangement. "Oh, that's right.Thanks, Ms. Walters. We'll get right with them. Do they have a stokes with them?" Sharon looked sideways, thinking for a moment. "Uh,. Sort of." she said mysteriously. "Does what looks like a sheet covered DB count?" |
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Brackett and Dixie burst out laughing. Kel's mirthful mouth split open in amusement and he gleefully got to his feet to rinse out both his and Dixie's drained coffee mugs in the tiny sink next to the fruit vending machine. "Those two." Brackett smiled. "You think a couple of firemen wouldn't get embarrassed about wheeling a CPR manikin into the emergency room." Sharon frowned. "Now why would they be doing that?" still holding the door she had cracked opened. "Wanna find out?" Kel asked her. "Sure. I've got a few minutes. Oh. Uh. Dixie. Carol says hi, and all our treatment rooms have been cleaned up and are ready for the next wave to show up." Walters reported. "Shhh." Dixie hissed. "Or you'll curse us with more patients too early. We haven't had a decent chance to catch our breaths back yet." "Sorry.." Sharon apologized while she ducked out of the room to show the two senior staffers where DeSoto and Gage had holed up. Brackett and Dixie soon followed her to meet up with 51's paramedics, padding down the still disarrayed hallway, piled up with extra supplies and gurneys. The waiting room, thankfully, was back down to normal density for walk-ins. And Morton and Early were deftly thinning down those numbers as they met their cases as they came to them. Kel tapped his watch at them and held up ten fingers. Joe and Mike nodded their understanding. Sharon took them to the vacuum isolation room, now brightly lit with its windowless door propped wide open. Johnny Gage was leaning over the single center bed while he manhandled every inch of something wrapped around the training manikin's torso. The disguising sheet was shoved down around the doll's ankles and Brackett could see that everything Chet and Stoker had sketched out for him had been made and was in order. "Did you remember the defibrillator battery?" Kel asked Roy. |
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"Yeah. I got it." replied Roy. "I pulled one out of the recharger we keep in Cap's office." Gage chattered, high speed. "Ok.. I'm truly fascinated. Now what is this invention of Stoker and Kelly's, you guys? Some kind of splint?" Johnny said, pointing to the thick band of white canvas tarp encircling the Andy's chest. He could see the ends of it feeding into some kind of gray painted metal board and mechanism lying under the rescue doll that stretched from its head to its waistline. "Not exactly, Johnny." grinned Kel. "Do you remember the old style thumpers we used to use out in the field? You two did utilize one the very night the paramedic program became officially ratified during that mudslide mining tunnel incident." he said, plugging the bulky battery into a terminal at the head. "Yeah. I remember em." said Gage. "I remember I didn't like them too much for all the damage they did to someone's sternum, all for the sake of automated circulation. I can still hear the sound of crunching bones even to this day." he grimaced. Brackett said nothing for a moment and pulled out a compression meter common to an electronic Resusci-Annie and plugged it into Roy and Johnny's station manikin, right into the cable port. "Gimme thirty, Johnny. Do the best CPR you can manage and I'll get a strip of it. I'm gonna show you something." "Ok." Johnny shrugged, stepping up onto the gurney rungs. Roy opened the doll's shirt and Gage started in after getting a landmark through the new invented band. "Need ventilations?" "Nope. Just those." Roy told him. After a half minute of compressions, Johnny stepped back and waited for Brackett to show him the paper strip he had made off the manikin. Feeling cocky, Gage even folded his arms up with confidence, grinning. "Gonna be in the green. Every one of them. Stoker was a good teacher." "They are." Brackett said, looking up. "But, did you ever notice this line on the graph paper?" Frowning, Johnny looked. "Well what does that squiggle mean?" "It's the line for intrathoracic pressure. And that solid, darker line above it is the point where passive refilling of a heart starts to occur on any relaxation period following a compression cycle. Do you see where your trace's at?" Johnny squinted. "Yeah.. it's.. it's somewhere around 12 millibars." "That's right. On averaging. Now did you know that the passive pressure inside someone's chest needs to reach 23 millibars in order to have any blood return, at all, to the heart during CPR? That's what this solid yellow line means on the second graph grid located below the one you're used to seeing." Brackett told him. The implication struck Johnny like a blow. "What? You mean I wasn't doing a good enough job with my CPR just now?" "You were according to the standards that we have in place currently. You did the required fifty/fifty up and down depth ratios, the required rate and position with only the usual consequences of a cracked rib or two." Kel said, crossing his arms together thoughtfully, waiting for his point to sink in. Roy was already smiling. Gage looked confused. "But that means--" he began. "That's right. Your patient was still nonperfused ineffectively despite of everything you did." Brackett told him. Johnny's mouth fell open in shock. Roy leaned forward. "Johnny, haven't you ever wondered why we only manage to save two percent of all our witnessed cardiac arrest cases whenever CPR's used?" he told his numb partner. "Well, sort of. It was in the back of my mind. But to tell you the truth, I never really gave that particular statistic much thought.." Gage said quietly. Dr. Brackett frowned in agreement. "That's because having such a low number's so incredibly depressing. No one wants to think about it for very long. But your station fireman and station's engineer did." Dr. Brackett shared. "That's what this meeting's all about." he said, throwing a hand over the bed. "Roy, would you hook up that thumper next? Don't worry about the band. It won't effect our readings. Sharon, would you help him set it into place. It'll be good practice for you." "Sure doctor." said Miss Walters. "Ok." said Dr. Brackett. "Now we'll run the same thirty compressions using purely mechanical means with the thumper. Ready? Johnny, when it's done, tell us what's on the strip below the compression depth telemetry." Kel ordered. Kel hit the start switch after setting up adult chest compression depth controls. Soon, the trace was complete. "What does it say?" Dixie asked with curiosity, swinging away the piston arm when the test interval was over. Gage sighed, his new dismay apparent. "Hardly better than mine. Somewhere around 15 millibars pressure." "Umm hmm." nodded Kel. "And that's only because the machine delivers compressions with absolutely perfect timing with no hesitations or different delivered depths to the sternum." "Well, how about changing the way we do CPR nowadays to something else? Maybe thirty to two? Instead of five to one? That way maybe intrathoracic pressure can build back up in the circulatory system over time." Roy suggested. "Not enough time's being devoted in studies to examine that angle, Roy." said Brackett sadly. "It may be thirty five years or so before anyone gets frustrated enough with all the poor CPR save counts to actually re-examine and question the status quo because the people who matter are continual suckers for established tradition and methodology. Especially in the firefighting and medical fields. There's bound to be tremendous resistance to ANY new CPR idea when that day does come." "But that thumper still didn't do good enough.." Sharon whispered, just as stunned as Johnny as she saw that the readings had stayed the same dismal pressure as Johnny's hands on CPR. "You mean we've been thinking we've been successfully maintaining these CPR needy people all these years with manual CPR and by automated thumpers when actually we weren't doing them a d*mned bit of good?" Dixie rasped in shock. "There've been no confirmed cases of a CPR turn around when it was used all by itself until a defibrillator could also be used to correct the heart conductivity problem." Kel answered. "Our CPR attempts do help... But only a little bit." "I don't understand." said Johnny. Brackett held up a hand. "What happens to someone's blood when they exercise?" Johnny was quick on that one."Carbon dioxide builds up and oxygen levels drop as the body demands more to sustain itself. Breathing picks up and the heart rate accelerates to meet increased need for metabolism." "Exactly right. Now make that same person cardiac arrested and lying on the ground. What's happening now?" Kel challenged. Johnny, Sharon and Dixie looked blank. Roy replied. "Nothing. Oxygen isn't being used up because there's no circulation. Carbon dioxide isn't building up as fast as it could be like it does with a person who's still breathing. Oxygen need at this point isn't so critical. That's probably why the way we do CPR now seems to get enough oxygen to the brain to gain at least our current two percent survival rate with defibrillating capability." "Precisely. At the moment of arrest, some of that still oxygenated blood gets to the brain and then any subsequent movements of a person's body helps minutely to get that last fully oxygenated heart's full sized volume where it belongs. But then, the heart gets emptied on the compressions and the super long pauses we take starting I.V.'s and intubating people drops off even that tiny bit of faint circulation to an arrested brain." "And that's why the two percent.." Johnny said with stunned realization. "Yes." said Brackett softly. "Now look at this.." he said, turning on a button to a machine box attached to Kelly and Stoker's invented manikin board. The canvas band began to shrink until it just snugged around the chest. Then it began to regularly compress and release the whole ribcage; its top, sides and all, like a hangman tightening a slip noose. Kel adjusted it for the proper rate and for a single thirty compression sample cycle. Gage nearly tore the paper strip printer out of the Annie reader getting the third test result. "Oh.. " he peeped. "It's showing 30 millibars. That's incredible!" |
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Sharon blinked and startled into a smile. "You mean the heart hypothetically is refilling after every compression now?" "Yep." said Brackett. "I was intrigued when Stoker and Kelly came to me with this circumferential band compressing idea, but I honestly didn't know how well their device would actually work, until today..." he said. "And quite frankly. I'm very.....very pleased with what I'm seeing here." Gage was stupified. "Wow, what about the force being delivered? Aren't all of Andy's ribs getting pulverised right now?" he said, flipping on the new board's power switch again to see a repeat demo. "Nope." said Roy. "Put your hand under the band while it's working like this." Johnny looked at him askance. But finally did. "Hey. It doesn't hurt at all. It only feels like a snug hug when it's bearing down pressure." "That's because the band's got a larger surface area. Not just a tiny piston's circle or the palms of somebody's hands on a sternum." said Kel. "The lungs are also getting squeezed and released right along with the heart." |
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Roy grinned. "So some breathing's also being done by this thing and providing a slight bit of adequate carbon dioxide and oxygen exchange.." he told his partner. "Do you realize what we've just seen here? This band machine's gonna revolutionize the whole fire department, probably nation wide!" Johnny gaped. "I had a notion.." said Kel, his eyes very merry. "Doc, we gotta test this out in the field. Roy, does this thing set up pretty fast?" Gage wanted to know, getting into it eagerly. "Yeah.. takes about as long as a thumper does." DeSoto replied. Johnny's face brightened into an excited beaming, but then it fell into dismay a second later. "Doc, what about ventilations? There's no time for much chest rise here." Brackett chuckled. "You're forgetting the lung squeezes. He's already breathing somewhat. You won't need to ventilate anyone under this band when it's active much at all. I'm speculating that only a six to eight times a minute assisted breath rate'll be needed on pure oxygen." "We gotta test this some more.. See what it can do on a real person!" Johnny said. "I've already made those plans and got permission from the hospital administration to try out our next step." said Brackett. "Sharon. Go get one of today's med student donor specimens from downstairs. I think they're still in the prep room, waiting for tomorrow's physiology lecture." "The adult male?" "Or the woman. Makes no difference. Anyone who's the best unchilled will work for our purposes optimally." "Right away, doctor." Johnny ansed, pacing the tiny confidential room, rubbing his lips in barely contained excitement. "Oh, Roy.. this is ...this is absolutely astounding. Do you realize how much money could be generated for the sake of the fire department when folks'll start marketing this thing?!" He immediately checked himself. "Oh, and.. for the hospital as well....heh." he amended. "And also for our spreading paramedic program.." Dixie added in wonderment. The few minutes it took for Sharon to procure the cadaver seemed endless. But then she came. "Did you put a chux under her?" Dixie asked Sharon. "Yes, ma'am. I have fresh sheets, too. And suction if we need it." answered Walters. "Ok.. Let's hook her up." said Brackett, opening the corpse's lab hospital gown for her physical shift onto the invention's working metal board. It took only a short time for them to fit the new band into place. Johnny had a thought. "How long has she been dead?" |
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"About twenty four hours. We'll still receive good data despite of all her degraded internal chemistry changes. We needed someone past the rigor mortis stage." Brackett nodded. "Ready? Roy, turn on the new unit and the paper tracer." Roy did so. Johnny's eyes bugged out. "Oh, my..she's.." And he automatically reached for the body's carotid artery before he stopped himself. "Regaining a good color?" grinned Brackett. "I knew she would.." Dixie actually grabbed a fingernail and did a capillary refill check. "I got some?" she asked incredulously. "Yep." said Roy, checking the other hand. "And all this lividity's travelling." DeSoto noticed. "See here on her stomach where we've touched her?" "She's getting a pulse also. Down to the wrist." Brackett added, checking it. Johnny was stunned utterly speechless. "Oh, boy. We gotta tell someone, doc. We gotta tell someone today about this whole thing." he muttered, falling into a seat next to the body's bed. "We've got a long way to go before we demonstrate anything, Johnny." said Brackett. "What Firemens Stoker and Kelly have done here's a very novel start but any device based on their idea created commercially's gonna be crazy expensive: a very high price tag per use factor just to gain EMS a few more pink corpses in the field. And that my fine friends, will no doubt be given a very, very low priority by any brainchild organizations because their hands are already full regulating and promoting our still infant staged paramedic program." Johnny was unbowed. "How much above the two percent you think we might gain with this band device when it DOES get developed by the powers that be for those folks who were witnessed arrests and receiving CPR?" "High. Johnny. High." smiled Brackett. "I'm guessing around a thirty percent save rate in conjuction with the usual cardiac arrest protocols." Gage goggled. Roy pushed the next happy thought. "Ok. So it'll take more than just a few years to push anything more on this band thing. What are we all gonna call it when all the talking sessions DO begin in meetings a decade or so down the road?" The room erupted in thoughts. "Robobeat?" "Heart belt?" "Autopulse?" suggested Johnny, Dixie and Sharon. "I don't know." said Brackett, pleased, turning off the band's cycling motor. They all watched as the woman's skin waxed once more into the original chalk and purpling pallor it had been when they began the test. "My guess is that the honor of naming anything will fall to the highest paying sponsor and developer. In any case, Stoker and Kelly will be well compensated eventually for their role in making this prototype for the county to see. The hospital can definitely keep Kelly and Stoker's machine safe here in storage until its final stage paperwork can be presented and pushed for the appropriate legislative and marketing levels when the time is ripe." "Wow.." is all Johnny could dare himself to say. He was still shaking in reaction at the profoundness of all of it. |
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Brackett set a comforting hand on Johnny's shoulder. "Would you thank Chet and Michael personally for me for making two bands for the machine. This second one we'll have to throw away." "Sure.. sure doc. Heh. I'll tell them that. And a whole lot more, too. I didn't know those two had it in them to do this kind of thing!" he gasped incredulously. Roy smiled. "Well, you know what they say about all the quiet types and clowners of the world.." "What do they say?" scowled Johnny, getting mad that his still flying high enthusiasm was due to someone else's good idea and tremendous luck. "I'll leave that answer up to your infinite and ultimate wisdom, junior. Come on, let's help the doctor and nurses return this room back into working order. We can take Andy back out in his stokes the same way we got in." DeSoto sighed. "Oh, yeah? But then we've got a cake to get to share with everybody here and at the station to celebrate. The chief's gonna freak when he hears that this invention's actually gonna work." Johnny crowed. The two paramedics and the hospital staffers respectfully packaged up the donor body for the return trip back to the morgue. They washed up, disinfected everything, and went on with their respective work shifts with very light and happy hearts. The experience in the isolation room had utterly banished all signs of fatigue and stress in absolutely each and every one of them. |
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************************************************** From: "Cory Anda" <andacory@hotmail.com> Date: Thu Apr 27, 2006 6:04 pm Subject: End of Day.. Dr. Brackett sighed two hours later as he finally reached the cool, dark sanctuary of his private office. ::I'm through for the night. Good riddance. Let the younger, fresher doctors play all the be-the-hero roles this morning. Dixie and I are gonna hide.:: he thought with a tired smile. He was barely settled in his chair with his feet up with both burning eyes buried deep beneath his leather jacketed arm, when the door flung open to admit a fast retreating Dixie McCall. "Kel! They're after me!" she said, slamming the door shut and leaning with all of her weight against it. Dr. Brackett didn't even move. "Are you off the clock?" "Yes. I punched out in the locker room, while begging a cigarette off of Carol. But hers are all gone." "Then you're Scot free. You can let go of the knob. The door locks now. Had it installed yesterday, right after an amorous druggie tried to get to know me a little bit better past just the usual doctor to patient relationship." Click! snapped the lock as Dixie turned it. The hurrying footsteps that had followed her, wandered away finally, a few seconds later. "Who were they?" Brackett asked, his voice muffled. "I'm not gonna tell you. You'll only get mad. Then you'll go out there to fix their problem yourself and not get paid for it." Dixie explained. Kel sighed unhappily. He was the very picture of fatigue. But one hand snaked into a drawer and pulled out a pack of Menthol 100s for Dixie. He gave them to her with a tattered book of matches without even stirring from his comfortable slumped pile in the chair or opening his eyes. Dixie chuckled low in her chest. "Thanks, Kel. But now that I've got em, I think I'm way too tired to smoke. I just might black out on you if I even try." And she tossed them right back into the open desk drawer with a practiced flip. McCall exactly matched Kel's sag by sliding into the guest chair, opposite the desk from him. She slung her legs over the cushy orange arms as she slipped off her thick, tan, high heeled pumps. "Ooooh. This feels so good." she melted, letting her head fall over the seat's back. She began loosening the straight pins out of her bun to release her long, flowing frosted hair out of its constrictive style. Both nurse and doctor let the sweet silence, now filling the room, stretch between them for long treasured moments. |
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Then an unintentional thump on the wall from the hallway made Dixie jump. McCall flew up, startled, to her bare stocking feet. "Ahh!" She immediately winced with a tension headache. "You wouldn't happen to have any morphine in that cigarette drawer, would you? Or a valium?" she said, sitting down tightly, still holding her newly throbbing head. Brackett opened his eyes, pulling his arm down. "You know the answer to that one, Dixie. All pharmaceuticals must be regularly stored in the--" "...in the locked cabinet at Emergency's front desk. Yes, I know. That was just one hundred percent pure wishful thinking on my part. I'm trying to trick my head into believing that I'm actually on the way home right now." and she let out a small groan of pain. Kel got up from his chair, smiling gently. He padded over to stand behind her, in his own stocking feet, and he started to massage her still knotted up and tensed shoulders and neck. "So, how are you coping without Carol as your second in command these days?" "To tell you the truth, Kel, after today, I don't think I can take it any more." she whimpered without any tears. "Our two mutual triage incidents today only proved to show just how much I've relied on her all of these years to help me out, in running the place. I just didn't realize how much I really needed her, until she was gone." Dixie said grumpily. Kel chuckled softly. "Do you think Sharon's gonna be the right candidate to fill her shoes? She's come a long way from being that awkward, giggling candy striper, who always tripped over herself whenever things got a little busy." "She's the one." Dixie sighed. "Of that I have no doubt." "Oh? What made you finally come to that conclusion?" "Because I see in her exactly the way I used to be." Dixie said, letting Kel massage away the night's stressful memories. "She's a good nurse, and she'll be an even better leader eventually. I think I've just forgotten how long it takes to shape a promising protege' for the assistant head nurse spot. Carol picked it up instantly, probably because she spent so much time over in..uh,..in ...Nam. Roy even ....r- remembers seeing ...her." McCall's words grew slower and slower as actual sleep started threatening to overtake her. "Dixie?" he smiled. Dr. Brackett lingered a touch on the pulse at Dixie's neck. "Are you still here?" he teased. "Barely.." she whispered, falling completely limp and pliable in both of his soothing, massaging palms. Kel kissed the top of her head affectionately. "Believe it or not, I've got you calmed down now. You're below seventy." he said, letting her go with a last shoulder squeeze. "So, you wanna just hang out and watch nonexistent cobwebs grow here at the hospital? Or are you ready for us to begin our late evening/early morning time out at the Green Pagoda?" "Food. Now. Please." she said, letting him put her shoes back on. "There's no debate. Not any more. My nicotine shot nerves can just go straight to--" "I promise you fried wantons in fifteen minutes." Kel grinned, helping her back onto her sore feet as he opened the office door to the loud distinctive sounds of a still very busy waiting room. |
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"When I get my brain and blood sugar back, I wanna get excited all over again about that resuscitation device Station 51 cooked up, ok? So start preparing your skin shivery lecture all over again. I still can't believe what can and might happen with that device of theirs soon. But honestly? Your voice's about all I have the energy for right now." "I'll change dinner to egg drop soup and green tea. That way you won't have to chew anything." Dr. Brackett promised her as they walked out of the emergency doors to the parking lot and paced slowly for Kel's dark green sports car. "Perfect." she sighed, linking her arm into his. "I wanna be soup, too, in your hot tub." "Already arranged, hon. I had the landlady fire it up ten minutes ago." "You're such a good friend." Dixie burbled sleepily, almost weepy with tiredness. She leaned her head heavily on his arm and let him support her. "You're not so bad yourself as one, either. I like fussing over you, Dixie. Haven't you learned that by now?" he told her."You always make my day." he said, opening the passenger door for her. "No matter how bad it gets." Both of them smiled when they saw that the sun had already started rising for the new day. ::Thank God, it's Monday.:: McCall thought, buckling in. :: At last. Now we can both just collapse, and rest for a good.. lonnggg while.:: |
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