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From: patti k (pattik1@hotmail.com)
Sent:
Tue 9/28/10 7:24 AM
Subject: The Silent Killer
Dixie almost spit out her last mouthful of hot
coffee when she spied
her watch. "Umphh! Look at that! It's almost five o'clock! We'll be late!"
she said to everyone scheduled to work at Mayfair.
"Time flies." Ponch chuckled, rising from
his chair and snarfing down
the rest of his breakfast in a few bites. "Hate to eat and run. See you
doctor.
It's been a pleasure." he said to Joe Early as the five of them made for the
door. Frank
slammed dunked his empty plate, cup and crumpled napkins
into a nearby garbage can, making its lid
spin around. Jon Baker just shook
his head at his antics.
"Likewise." smiled Joe as he watched
the group depart. When the lounge door
finally closed, he sighed. "More food for me." he said under
his breath, rubbing
his hands together. But then he remembered someone who wasn't there and
started
frowning in sympathy. "And Sharon Walters."
Early moved to a house phone to page the exhausted
nurse to the feast left
behind.
----------------------------------------------------------------------------------------------
"You're all still here?" Dixie muttered as her feet shuffled to a halt in Mayfair's
rec room.
"Of course." said the streetwise Mel. "Did it look like we were gonna let a
dead body scare
us away yesterday? Some EMTs we'd be if that ever happened."
he snorted with a smile. The others
surrounding him laughed and nodded in
agreement.
"Thanks, guys." Dixie sighed in relief. "Sorry
I ever doubted you." she told the
assembed group still getting ready for the day all about the room.
"Did everybody
find their lockers okay?"
"Yes, Miss McCall." chorused a few voices. "We wrote
who has what locker down
on the hanging wall chart in your office."
"Good deal. I'll have name
plates engraved before the week's out. Oh, and head
for the main nurse's lounge. Mayfair bought a
brunch breakfast buffet for us all.
Last names A to H, go eat. You've got twenty five minutes. The
rest of the
alphabet, you're next." Dixie barked. "The food's still steaming but the coffee's
had
it. I'll make our own pot hot and fresh back here. And it'll be well guarded."
she promised as she
headed into the office.
Roy and Johnny headed for the row of ambulances flanking three walls of
the
garage bay. They noticed one rig coming back from a run. It was a team of
corpsmen. "How'd
it go?"
"Kid bit by a dog." the older one sighed.
"Story of the hour." Gage chuckled. "You
should see the ER."
"We were there." groaned his partner.
"Go eat. Nurses' lounge." Roy
told them. "Breakfast is on the boss today.
Tell your friends." he grinned, putting hands inside of
his white pants. "We'll
restock what you've used this shift for ya so you'll get paid with the meal."
he
offered.
"Best news I've heard all day." the driver smiled. He kicked the ambulance into
gear and pulled into its assigned slot. "Thank you, sir. You're all right for a civilian."
"I'm
in disguise." said DeSoto, smartly saluting him to prove he was a veteran.
"At ease." he joked as
they drove by.
Johnny turned to face Roy. "So where's the main supply room? I didn't get
a
chance to find it yesterday."
"Over there." said DeSoto. "See the big red X?"
Gage looked
in the direction Roy was pointing. A large red cross was painted over
a locked double set of doors.
"Oh, yeah. How'd I miss that? I feel like I'm in
a M*A*S*H*unit. All that's missing are the big green
tents." he remarked. "I think I've
got the right key." he said, heading over in that direction. "What's
their rig number
again?"
"Seventeen." DeSoto replied. "There should be a cart so you can load
up just to
the inside of the door. I'll go get their carbons on supplies used."
They separated.
---------------------------------------------------------------------------------
McCall flicked
on the light over her desk and blinked at the stack of run reports
the night shift had left her.
The bundle was held neatly together with a bow tie
of cleverly arranged ace wrap. "Cute, fellas."
she jabbed at the corpsmen parading
mischievously by her door. "I feel down right homey. All that's
missing is an apple
and a spider plant."
"Wait until tomorrow." one whispered behind his hand.
"Aw, you guys don't have to do that." she groaned, embarrassed.
"We gotta spoil you,
ma'am. We don't see that many dames who aren't already
servicefolk on base. You give us something
to look at." the corpsman teased.
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Dixie capitulated by posing like a centerfold on the desk.
A cat call rang out from a new passing
man who did a double take at her on his
way to food.
Dixie obliged by blowing him a kiss.
Then she moved to her chair and got to work filing.
"Mister, I can understand that." she smiled. "I
used to be one of those servicewomen."
He chuckled and escaped into Rampart.
-------------------------------------------------------------------------------------------
"What was that?" Gage asked Roy who had joined him in the supply room.
"Never mind." smiled
DeSoto, who saw the whole escapade. "It's a military thing."
Suspicious, Johnny peeked around
the corner of the large set of doors but didn't
see anything amiss; Dixie was working quietly and
a door was still swinging
through which hungry employees had disappeared. "Oh."
They
were both immersed deep inside the returned ambulance, double checking
its inventory to the master
sheet, when Rosalie Arnold climbed on board.
"Hey. Gage." she said, feisty.
Johnny looked
up with innocent eyes full of hearts. "Yeah?"
Arnold melted some of her irk in light of his fast
budding affection. "What was with
that possessive move-in-with-me act this morning at the buffet?"
"Ponch was there. I felt threatened." Johnny shrugged, turning back to the oxygen
flow meter he
was testing.
"No need to be. I'd deck him if he tried anything." she snapped, disappearing
back
the way she came.
"Black belt, eh?" Roy smirked at his partner once she was gone.
Johnny
sniffed. "Probably. Can't wait until we start wrestling a little." he said,
eyes goggling with amusement
and appreciation.
"I'll make sure I have a Mayfair ready." DeSoto promised, changing the sheets
on the ambulance stretcher.
He was nailed in the back of the head with an oxygen mask.
------------------------------------------------------------------------------
A fireman, polishing a fire boat in its slip at Station 110 in Marina
del Rey, suddenly cursed
when the Crestliner lurched in its moorings, jarring
his hand. But then his mouth started flopping
open when all he saw beneath
the boat, was mud. "Oh, sh*t!" He scrambled to his feet and hit the
panic
button on the dock, running for the main station house on the beach avenue.
"Everybody head
to high ground! The water's receding big time! Eye glass the
horizon, man! Is there a wave?!"
His coworkers punctuated his alert with an automated evacuation recording to
all the boat owners at
the water line in the marina. Station 110's Captain Marley
started barking orders. "Grab all the doors!
Somebody take the boat all the way
out! Get as many of these civilian boaters to follow you in theirs.
Get everybody
you can entirely out of the bay! I'll go call the Coast Guard. Move our engines
straight
up the hill! Break that park's closed road chain if you have to and spin
gravel right now!"
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"What is it, Captain?" shouted one of his paramedics, rushing down the deck in
response to the panic
klaxon in the slip.
Marley's eyes finally saw it. A dark tongue of blue a mile long rearing up
a head
about five miles out to sea. "It's a G*d d*mned tsunami!"
---------------------------------------------------------------------------------
L.A. County Headquarters sounded the Emergency Broadcast System in full
activation. ##L.A. to
all Stations. Tsunami warning. Marina del Rey. Unknown
time of arrival. Unknown coastline scale. Station
110 has evacuated to high
ground. Respond to vantage points overlooking open water according to Battalion
grid assignments. This is not a drill. Repeat. This is not a drill.##
**************************************************
From: patti k (pattik1@hotmail.com)
Sent: Wed 9/29/10 1:26 PM
Subject: Chain Reaction..
Captain
Stanley was on the phone. He was listening to what
his assigned Battalion Chief was saying.
He
was surrounded by the gang, listening in on simultaneous
speaker, inside his office.
Battalion
1's voice was calm but rapid pace. ## This is how it's
going to go, Stanley. CAL-EMA says these are
the areas that
are going to be inundated: Venice, Marina Del Rey, Playa Del Rey,
Redondo Beach
Harbor, Los Angeles and Long Beach Harbors,
and the flat areas of Long Beach southward toward Seal
Beach.
There is going to be serious funneling effect down rivers, flood control
channels, harbors,
marinas, and in every bay on those beaches.
For a county, we are lucky. We have relatively little
beach front
compared to our service area size and that will work in our favor.
For the duration
of this emergency we are keeping all fire resources
within our own county borders. The National Guard
is handling all
non incorporated areas for rescue operations elsewhere. At home,
we're dividing
up the tidal wave zones by quadrangle, Hank. You, Station
127 and Station 10 will be assigned to Torrance.##
"Okay. Uh, man, this is a lot to absorb. Chief, what about Torrance's
industrial docks." Cap
said, tense.
##We don't have to worry about marinas or harbor docks, the
Port Authority has
that jurisdiction and is working with the Coast Guard.
They are mobilizing en masse as we speak. And
lifeguards are handling
the population numbers on the beaches. They only have to go
a few blocks
inland to avoid the water. I've recommended vertical
evacuation into some of the more solidly constructed
larger buildings;
hotels, warehouses. We can't do much to help beachgoers past isolated
paramedic
rescue squad casualty responses from the freeways, so we're
going to concentrate on assessing private
residences and businesses
along the flood path on all the inland waterways. CHiP will call us if
they
find beach casualties on the highways. Also, I have every helicopter
we've got already in the air
who will give reports on the scale of
the tsunami and where it's going. We will be coordinating with
local
news choppers.
##Now the Airforce, National Guard and the Navy already know they must
evacuate those areas around Reservation Point and Terminal Island.
They're helping each other.
I'm not even going to begin to tell you
how overwhelmed our HazMat and Urban Search and Rescue teams
are
going to be on high land around the industrial harbors. There are treatment
plants and oil
and natural gas refineries up and down both sides of every
channel. East San Pedro and Mormon Island
are going to be underwater
even if that wave is under fifteen feet high. The outer breakwaters won't
stop it. Our inland fire station jurisdiction there will be limited to possible rescue
operations
at the west end of the Vincent Thomas Toll Bridge. Other roads
for us to focus on damaged bridge
wise is at the Los Angeles River at
Anaheim St, Hwy 710, and The Pacific Coast Highway on both sides.##
Hank started writing rapid notes. So did Mike Stoker who also had a
very good working knowlege
of harbor and marina paralleling roadways.
"Chief, understood. What about our regular call volume?"
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##Inland counties not on the ocean are stepping up to the plate. They will
handle all non-tsunami
related fire and medical calls. As of now,
Los Angeles County Fire Headquarters is operating under
emergency
protocols and will be handling only our disaster related incidents. San
Bernardino is
on their own to tackle that forest brush fire.##
"And Station 110?" Mike Stoker asked. He knew
their captain.
Cap repeated the engineer's concern.
Battalion replied. ##They all got out
safe. They're on the hillside
overlooking Marina del Rey in an abandoned park awaiting an assignment.
Our fire boat is already sitting in water deeper than 400 meters in the
open ocean. The first
wave will pass right under them.##
"First wave?" asked Kelly with alarm.
The chief heard
him. ##There may be more. Subsequently stronger.
The USGS has identified the quake's origin. It was
in the Central
Aleutians Subduction Zone #3. A Magnitude 9.2. This is comparable
to the one that
sent the wave that leveled Crescent City in 1964 from
Prince William Sound, Alaska.##
"The
Good Friday tidal wave. I remember that." Hank said
discomforted."Eleven people died there."
##Hank.
Your hospitals to use will be Kaiser South Bay and Torrance
Memorial Medical Centers and Rampart General
Hospital. Go nowhere
else with your patients. We don't want to overwhelm the system.
I'm heading
out to Ken Malloy Harbor Regional Park.
That will be our main out-of-fire-station base of operations.
The college
there will provide shelter for any victims until they can be properly
triaged and transported.
Mayfair Ambulance has their whole
fleet and all extra supplies on the way to Staging at Casey Field
off
110. Go there, too, with everything you've got. Good luck.##
"You, too, sir. See you out
there." Hank said. He slammed down
the phone. "Marco, dump a whole bag of dry for Henry into a pot
and open his dog door leading out to the yard. He can get water
from our air bottle filling pool
when his bowl runs out. Then help
the others empty our equipment cupboards. Gang, dump everything
into the engine crew cab. We'll cargo net it in place around us if we
have to."
"Right,
Cap." they all replied.
"Let's go. Brice, Bellingham. Grab all our air bottles and stow them
on
top of the squad. Don't worry about chaining them down. We
won't be travelling fast enough to dump
any of them. We'll be
scoping the coastline on the way to Staging. Let's top off
both our gas
tanks. Stoker, leave our fuel pump unlocked outside.
Somebody might need to use it after we're gone."
Cap told them.
"And the station itself?" Brice asked.
"Lock her up. Nothing's gonna be
left here except the sheets.
All right, let's go. Move it!" Stanley hollered as the overhead intercom
began to sound another EBS announcement from L.A. Headquarters.
"How about hooking up our brush
fire trailer to the squad?" asked
Bellingham.
"That'll take too long. Randomly packing the
vehicles this way is
far faster." Cap decided. "Besides, we don't have the man power
to use all
of those saws and other extrication gear. We've got
one of each basic item per man as it is."
The gang hustled, doing everything at a run.
##*Blat* *Blat* *Blat*....IMPACT : Initial wave height
estimations are at 16
to 22 feet above full tide mark. Stand by for disaster assignments...If
landlines
go down, use HT exclusively on emergency channels according
to KMG signatures. All repeater towers
are patent. Repeat. IMPACT : Initial
wave heights are--##
"That sounds automated." Chet said,
stuffing unopened gallon water jugs
into secure niches on top of the hosebed of the engine.
"It is." said Cap. "Sam's probably nose deep sorting civilian phone calls
right now. He'll break
into the frequency if something more immediate comes
up for us before we've fully repositioned."
"Everything's immediate, Cap." Lopez fretted, adding stacked boxes
of trauma dressings to the
floor near their passenger seats. "How are they
gonna handle it all?"
"As best they can, Marco.
As best they can." said Hank, clipping the
row slotted truck-run battery charger for their HTs to
a good place
on the engine's dashboard.
On the sidelines, Henry the basset's eyes were full
of tears as the salty
smell of death started coming in to him on the wind.
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Dixie abandoned her
office, taking only a box of extra batteries for
all their EMT radios, a tunic uniform and more sensible
shoes.
Rosalie Arnold ran up to her. "Ma'am. We're ready to go. Inventory's
been stripped down
to the cobwebs." she said, keyed up, but calm.
"Good. Get going." McCall told her. "Partner up
with someone."
she told Arnold. Then she started shouting orders as she ran
across the garage to
activate their main doors. "Bring coats and
rain gear. We may be outside for extended periods overnight.
Follow
Ambulance One!" she hollered. "I'll be riding in it with Roy and Johnny.
They know the
best way to Staging!"
Inside, Roy had the wheel. Gage and he were deep in analysis.
"Are we
taking the PCH?"
"No, two of its cloverleafs may be underwater." DeSoto replied.
"I'm guessing
anything ocean level within a mile of the water."
Dixie climbed in, hugging a box of oxygen masks.
She stayed silent
while they coordinated, buckling in between them into the captain's
chair at
the head of the stretcher.
Johnny bit his lip, hanging one of their three HTs onto a hook
on
the windshield. "Wilshire Boulevard. I know that's high enough.
We pass that d*mned rusted out iron
bridge crossing enough
coming to and from the station."
"That's where we'll head." Roy agreed,
turning on their sirens.
As the convoy of Mayfair ambulances left, they could see four
helicopters
running hot on each corner of Rampart's helipad.
They were loading up critical supplies and personnel.
Dixie recognized Morton, and Early climbing on board two of them.
"Where's Kel?" she said to
herself. "I know he'd scream like a bat
out of hell from my place to get back to work at the first
sign of
trouble." she mumbled. Then she spotted his sports car in his
doctor's parking slot and
a figure, with long lanky legs in
checked pants and a leather jacket, pounding for an unclaimed
bird.
"There you are." she hissed in fierce gladness. Then
she announced a little louder to the others.
"Kel made it.
He's on board."
"We're gonna need every doctor we can get." Gage whispered.
They had only gone a few blocks west of the hospital when the
first smell of filthy saline water
flooded into their open windows.
##*Blat* *Blat* *Blat* Positive secondary wave inbound. E.T.A.
estimate via FEMA is forty five minutes to an hour. Stand by
for initial disaster assignments
from each quadrangle's Staging
Area. Casualties are high. I repeat, casualities are high. ##
came
Sam Lanier's live voice.
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**************************************************
From: patti k (pattik1@hotmail.com)
Sent:
Thu 9/30/10 5:03 AM
Subject: Staging..
A mile from staging, Brice was driving Squad 51,
for he was the
calmer of the two paramedics. ::A wise decision.:: Craig speculated.
::Or else
we'd never get there.:: Every so often, Brice would nod his
head, encouraging Bob to let off even
more of some uncharacteristic
nervous anticipation. The freeway was open in the middle lanes,
for
those to seaward, were glutted with horrified onlookers pulled over
next to the divider, like flies
on a flytrap. Some encouraged the siren
and light flashing pair of emergency vehicles from Station
51 onward
with frantically hurrying gestures. ::Those people are still in their right
mind. Maybe
they'll keep these lanes clear for other arriving services
to pass through after us.:: Brice hoped.
He turned his attention back
to his animated partner.
"How could we have missed seeing this?"
Bellingham said with
exasperation, eyeing up the sun shiny sheet of brown water boiling
over with
debris in the harbor neighborhood below them. They could
see a Coast Guard cutter easily skirting
obstacles, riding the tidal
wave's still landward flowing current. Bob only let go of the dashboard
whenever he saw a navy raft successfully pluck a family or two from
a roof of a submersed house rafting
in the violent torrent.
Craig remained unemotional. "We don't have a seismic station in the
Aleutian
chain yet. Nobody lives there."
"Our much touted, predicted future quake was on the G*d d*mned
Ring
of Fire! This tiny burp in the briny's bigger than the Great 1906 San
Francisco Earth Shimmy,
Craig. The sh*t's gone to H*ll in a handbasket
today. At least, you'd think they would have installed
a million stations
around the whole U.S. part of the Circle after the kind of lesson we got
back
in '64. Memories must have been real short in state legislature
once all the bodies were neatly buried
under perfectly mowed government
paid for sod."
"Ring." Brice corrected gently.
"Whatever! You got my gist." Bellingham
fumed. "This. Happened. Did
we deserve this? A part of me says yes. Sadly enough. Are we stupid?"
He began to nod in affirmation but then his eyes glistened in barely veiled
horror at his own
thoughts. "We continue to build houses on flood plains,
at the edge of clifftops, in avalanche zones,
near the ocean...." He threw a
careless hand out the window that was giving them a panoramic view
of the brand new utterly unstoppable oceanic flood in progress. It didn't
have the roiling violence
of a tropical or Asian tsunami. The water
simply....rose and then picked up speed, sweeping away
roads, buildings
and bridges almost peacefully before itself on a path of destruction seemingly
from horizon to horizon. Bob was cowed enough to forget to breathe for
a few seconds. He took in
a deep cleansing breath from the air vents that
weren't as yet spilling out a stench. "I wonder how
big--"
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Brice was quick to cut him off, suddenly concerned. "No, Bellingham.
You don't want to guess. Only
the press does while an emergency is
still in full swing. Disgusting habit. As for us, all we should
care about is
one single bit at a time. That you know. Preferably, in a patient lying in
front
of us. That's our function."
Bob stayed mute, squeezing his lips together in emotional pain. But
then
he spoke. "Yeah. You're right. I'm cool."
Craig could see that he wasn't and it was
beginning to alarm him. He tried
again. "Don't work yourself up, Bellingham. Hindsight is always
20/20." Craig
told him.
Bob ran frustrated fingers through his thinning blond hair and finally
let off the
last of his steam. "Yeah? Well, we'd better be spot on perfect in our
performance,
buddy, or I'm going to be seriously pissed off."
Craig's analytical armor finally cracked, just
the tiniest amount. "Yes. People
are...going to die in this. It's too big to avoid and it's been
too long since the
last one. They won't know what it is in time enough to get away." Brice
whispered,
pulling smoothly into an emergency lane to skirt a pack of slowing
cars in view of the altered shoreline.
"Maybe we can do that kind of thinking
for at least, some of them."
Bob was very quiet for
a few moments, biting his lip. "But can I?"
Craig glanced over and really looked at him. "Bob,
are you okay?"
Bellingham didn't look up. And when he spoke again, his voice was thick
with
emotion. "I lost my Uncle in '64, Craig. He...he worked at the refinery
in Crescent City. It's...probably
why I'm so off balance right now."
"I'm sorry." Brice said, turning his eyes back to the road
to give him some
privacy.
Bellingham swept up a dismissive hand. "I was....twelve or so when
it
happened. I....didn't even live there." Bob unclenched the two fists lying on
his lap. "But
we were close."
Craig smiled, genuinely. "Did you find closure?"
"Yeah, they found him.
He had saved somebody's kid by shoving him up a
tree before the wave swept him away. He's why I'm
in the fire department."
he grinned softly.
Brice did, too. "If I had a choice, if it came
right down to the wire like that,
that's how I'd choose to go, too."
Bob finally stretched
in his seat to loosen up tense muscles. "Yep. Not a bad
way to die." he agreed. "But let's make sure
anybody we get our eager paws
on, doesn't have to pick an ending."
Brice nodded his head without
a word. None needed to be spoken.
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Johnny
was keenly focused as he looked out into the bay they were driving past.
A group of fighting and crash-diving
seagulls in several locations alerted him to
abnormality. He glassed the waters with his binoculars.
"Code F's. More than
three out there." he shared quietly.
"Any still alive?" Roy asked, glancing
his way from the road.
Johnny checked again, focusing carefully into the far distance. "No. They're
all face down. Now there's a shark." He quickly glanced away, feeling nauseated.
Dixie took
the binoculars gently from Johnny's trembling hand and offered up
her thoughts. "I'll look at the
edges. Better chances there for somebody to
actually make it. We may not be able to stop ourselves,
but we can at least
call for a rescue boat to check on anybody we spot."
"Margins, it is."
He glanced over his shoulder to make sure the other ambulances
were following them without trouble.
He glanced down at a row of single family
beach houses that had proved to be absolutely no protection
at all against the
relentless force of the water from their overpass viaduct. "D*mn. The tsunami's
speed away from the ocean isn't slowing yet."
"Where's the wave front?" DeSoto asked, keeping
his eyes forward as he
navigated around driver halted cars. He had chosen a way that wasn't along
a main tsunami evacuation route intentionally. But the traffic was still
unpredictable around them
due to the gawk factor of the disaster.
Gage twisted around, peering out all of the Mayfair's
front windows. "Past us
already. The L.A. River's almost over its banks." he said as they drove over
the old wrought iron bridge crossing that was near Station 51. Soon they drove
by it. "The guys are
gone. There's daylight showing through the bay doors."
"They'd be the first ones out of the starting
gate, knowing Cap." Roy replied.
"Are we going to be working with them?" asked Johnny.
"Yeah.
We're in the same quadrangle." Roy shared.
"And we're all gonna be wearing each other's uniforms
by the time this
whole thing is over. We'll be improvising between ourselves every second,
just
to cope with what we've got from minute to minute." McCall said.
"You sound like you've done this
before." Gage guessed.
"Remember the Baldwin Hills Dam Break of 1963?"
"Oooo." said Roy.
"Thirteen years ago. I remember that as if it were
yesterday."
"I was there." McCall said.
"Two hundred seventy seven homes were destroyed
and five lives were lost. The reservoir's failure
was attributed to subsidence
caused by over-exploitation of nearby Inglewood Oil Field. I got away
with
a broken arm and a lost toenail."
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"Wait a minute, you've been a nurse for twenty five years." Johnny realized.
"Uh huh. But on that
day, I was a victim. I was trapped deeply in mud and
debris and I got to watch those people die one
by one as the water rose up
around what was left of our houses. I was lucky enough to be on the second
floor with a wall knocked out. That released some of the water pressure.
That was also how I met
Kel. He was my attending M.D. in triage. He thought
I had internal injuries and stuck to my side like
glue until we got to the E.R..
I was only cold. I went into shock on him."
"Anybody would."
Johnny gaped. "You all right with all this?"
"Yeah. I was younger and thinner skinned back then.
I'm not that way any more."
she smiled. "Working as a paramedic instructor toughened me up quite a
bit."
Johnny looked at her thoughtfully. "Still remember our paramedic pharmacology
protocols?"
Dixie angled her head. "Give me some polish. They change so often, sometimes
I can't keep up with
the hours I work." she admitted.
"Okay." Johnny said, rubbing his eyes, surveying the devastation
where the new
sea level was meeting up with the land. "For cardiac arrest, witnessed. That's if
we
aren't ordered to black tag them. What's the first drug of choice for an adult
male, say... of my
size for a work up?" he quizzed.
Dixie didn't even blink. "One milligram epinephrine 1/10,000
I.V. push, if possible.
If not, then I'd double dose down a placed endotracheal tube followed by a
10cc saline bolus to flush it all over the bronchial tree." McCall replied. "That's
after a series
of stacked shocks."
"Right. Now how about that same guy, converted after times two, showing a
brady
rate of forty, still with no breathing?" Johnny asked.
Dixie hesitated.
"That's
okay." Gage said. "We'll teach you. There aren't that many steps we can
take on anything resuscitative
before we max out on dosages and are stuck with
just CPR and oxygen ventilation. We'll cover everything
before we get to the park."
"And about pediatric dosages..." Roy told her. "They've come up with
a new ALS
thing called a Broslow tape that tells you those based on a kid's height like a
yardstick.
Covers all advanced airway sizes, too. Don't sweat it."
McCall grinned. "I'm not sweating my lack
of automatic recall fellas, I'm sweating
our lack of action up to this point. I wanna start digging
in already. How far to--"
"Casey's Field?" Gage supplied.
"Less than two miles, barring
any traffic jams." Roy replied. "Or rubber neckers."
"Well, put some wings on this thing." McCall
groused, kicking the ambulance's
side door with an impatient boot. "I'm absolutely climbing the walls
back here."
she complained.
Both Gage and DeSoto smiled widely, and began to relax.
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"You know..." said Rosalie Arnold in their own Mayfair rig to EMT Mel Turner.
"I'm starting
to be really glad the governor ordered our company to combine
with the county at the fire department
level. We're gonna be one of the first
ones out there." she grinned.
"I'm sharing your appreciation."
Turner replied. "They already have the treatment
tents up. Wow, that was fast." He followed the guidance
of a police officer's
traffic wand into the staging section of Casey's Field along the freeway marked
for them.
Rosalie thumbed her HT after setting it to Ambulance One's channel. "Mayfair
Three
to Mayfair One."
##Go ahead.## answered Roy DeSoto.
"Are we going to be cleared to independently
rove, assess, and pick up casualties
for transportation?"
##Everything wet or hazy is dangerous
to us until proven otherwise.## came
his reply.
Dixie joined the channel. ##We'll travel into
the hot zones where they need us
only after being authorized ahead of time by the fire department
I.C. or the
Head of Search and Rescue for his or her particular disaster site and not a
moment
before. We'll have plenty of people coming in by truck or chopper,
stokes or by crawling to last us
a lifetime. Don't rush it.## McCall ordered.
"Yes, ma'am. Follow orders." Arnold said, cowed.
"Now what did you hope to accomplish with that stunt, honey girl?" Mel asked,
his mouth flopping
open.
The look on Rosalie's face was haunted. "I wanted... Well, I just wanted to
hear Johnny's
voice again before it gets really bad." she whispered.
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"Hey." Mel said, reaching out to her. "You're not alone in this. Soon, we'll all
be safely together,
sorting out every one of those nasties that you don't like.
So, fire up those crude jokes of yours
'cause I'm ready. I've got a bottle
of Pepto Bismo right here." he said, snatching up a bottle he
had stashed in
the ambulance's glove compartment.
"You're crazy." Arnold grinned, shaking
her head.
"Not yet. And I'll have you know something else, too. That d*mned tsunami
isn't
gonna rattle us one bit. You know why? Because it's only people stuck
in trouble out there. What's
so scary about them? We've got a job to do."
"Right." Rosalie sniffed, agreeing. Her tears of
fear finally faded and she
wiped the last of them away.
A sharp rap on their hood from an armed
National Guardsman jolted Rosalie
into a tighter grip on the steering wheel. He spoke. "Ambulance
crew
members. Shut off your ignition and grab your gear. Leave the keys. They're
safe. Triage
is one hundred yards to your left at nine o'clock. Mobilize!" he
barked. "I'll be guiding you back
with your first patient to this same vehicle."
---------------------------------------------------------------------------------------
Roy DeSoto had intentionally picked a place in Triage that had the tents
in between Mayfair's
assembled EMTs and the rows of stretchers
full of the sick and injured being placed on the grass in
the middle of
the park behind the college. They had all been checked quickly for any
sign of chemical
contamination before being brought into the Green Zone.
He could see that already, there were over
fifty people lying there under
shock sheets and military blankets. Only a few tried to leave the area
before being gently guided back to the tents by a perimeter police officer.
Roy met every EMT's
eyes evenly. "Has everybody checked in with
the Accountability Officer?"
Nods abounded.
Okay." DeSoto said loudly. "We're gonna be the triage task force in place
because we were here first."
he began. "Mayfairs Two through Seven. You
will be triage tagging and doing two minute primary assessments
exclusively.
Go with Dixie.
"Mayfairs Eight through Fourteen, you're handling ongoing secondary
assessments, vital signs, splinting and backboarding on all delay tagged
victims. You will document
all care given onto the spaces provided on all
tags. You will be staying with me.
"Mayfairs
Fifteen through Twenty Four, you'll be transporting those most
critical with either Johnny, Dixie,
I or another fire department paramedic to
one of three Level One medical facilities. En route, you
will document all
care received and try to determine victims' identities if possible by checking
their pockets. Write everything down. Remember if it isn't documented,
it didn't happen, and that
could cause further problems down the line.
"Read any patient care notes off the triage tags the
treatment group
may have left you and write that down as well. A Triage officer will take
the number
chit from the tag as well as a physical description of your
patient right before you're cleared to
leave Triage. He will also write down
your destination. This is to start paperwork that might help
families find victims.
You'll be on a continuous round trip from this park to the hospitals and back
again.
You'll be told which destination to head to with each trip by a hospital security
dispatcher.
Study this map and learn how to get to the three drop off points
we've been assigned." he said, aiming
a tent stake at a hasty marker board
assembled for them at a command table. "To Kaiser South Bay
and Torrance
Memorial Medical Centers and also to Rampart General Hospital. Johnny
will be starting
you off. Follow him."
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Dixie started her
part of the scene briefing with her group.
"Two through Eight. Gather around me and listen up." She
led them off
towards the field full of victims that the fire department station crews, police
forces
and civilians were starting to bring in.
Johnny took the transporting group of paired EMTs with
him to check with the police
I.C. for any hazards to avoid along the patient evacuation routes.
Roy gathered the treatment bunch to him to start organizing the immobilization
equipment that National
Guardsmen had already unloaded from their fleet of
Mayfair ambulances.
McCall made sure her
EMTs had hot food and water in their hands before she
started her instructions. "This is what we've
been assigned. Primary assessments.
We determine A,B,C, and D. Airway, Breathing, Circulation and
Bleeding. Then
we tag a color to each victim according to their current physical condition. Either
a red, yellow, green or black tag. Red is top priority. They will be the first to ship
out. It
means that any person so tagged is suffering a direct life threatening condition
that will result
in death if medical treatment is not provided immediately."
"Miss McCall." started up one burly
EMT. "Do we have time for a lecture? People
are dying out there."
She eyed him up without reacting
differently. "Our Mayfair Corpsmen beat us here
by military truck. Nobody in Triage is waiting to
receive medical care. Now, as I
was saying, A for airway. Tilt the head and lift the chin and listen
for any breathing."
"But--" started up another EMT.
McCall headed him off.
"No. We are
not concerned about worsening any head or neck injuries with this
large of a disaster situation.
It's only life or death. There will be no resuscitative
efforts this early into the incident. If
a victim's not breathing after you've
opened their airway, try repositioning. Once. If they're still
apneic, tag them
black triage and move on because they're already dying."
This bothered the
shy Daisy Hoolihan. "But what if they still have a pulse?" she asked.
Dixie countered. "And what
if they aren't breathing because of a set of collapsed
lungs? Or because they've exsanguinated their
entire blood volume into a thigh
with a fractured femur that you didn't see because the skin in that
area wasn't
broken? During the ten minutes or so you'd spend ventilating that one unresponsive
non-breather
until their heart stops may mean that somewhere else, a talking,
walking child with a simple laceration
with arterial damage might bleed out and
die because you were too busy. What then? Who had the greater
chance to
survive their injury?"
The EMT nodded her head, understanding.
Dixie gave
her an encouraging wink. "It's always the one who's breathing. And if
they're breathing you know they
have an adequate pulse. Next, how fast are they
breathing? If it's over 30 times a minute, they are
in shock, tag them red. Plug any
holes they may have to stop their major bleeding and then move on.
"For the next person, say they are breathing fine for you. Check their mental status.
Can
they follow simple commands? If they can't, their brain isn't getting enough
oxygen and they're in
an altered level state. Shock is a life threat. Tag any
who fail full alertness red and control major
bleeding.
"Say they know who they are, and what's happened to them. Check their blood
pressure
manually. If you can't feel a pulse at their wrist, their BP is falling and
they are in shock, tag
red and stop any massive bleeding.
"Say you find a radial pulse, but it's weak. Check the capillary
refill in their fingernails.
If the blood returns to pink up the nail bed in two seconds or less,
tag them
yellow at this point for delay treatment. They can wait after that in this condition.
They
aren't dying. Sweep for serious bleeding and stop it."
"But what if they have broken bones? An
arm, or a lower leg?" Stan Dubois asked.
"No one with a minor broken bone has ever died right
away. Especially not
if they're perfusing well enough to clear blanching right down to the fingertips."
Dixie smiled. She went on. "If refill takes longer than two seconds, it's shock,
tag red and hunt
for hemorrhage cause it's gonna be there somewhere.
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"Now if somebody passes your A,B,C,Ds, breathing rate, mental status
check, and capillary refill tests,
tag them green. They are walking wounded
with only minor injuries. Stick a healthy bystander with
them to make sure
they don't wander off. They're gonna be rattled. Also use uninjured people
to
control bleeding on your victims for you or to maintain open airways manually.
It'll give them something
constructive and positive to do besides panicking and
it's also a good way for you to be notified
if any green or yellow tags get
worse and suddenly fall into a red tag priority.
"Our job
as primary assessors is to do the greatest good for the greatest number.
Leaving that non-breather
with a pulse is gonna be one of the hardest things you'll
ever do in your career. But other lives
you can save, will be, if you just let them go.
Don't let one almost dead victim make you cause the
deaths of other saveable ones.
"Once all the red tags are completely transported out of the area,
only then can we
consider working resuscitations. A doctor will radio us when that can happen.
The
second we get another red tag, all bets are off and we go right back into strict
triage mode once
again. Is that clear?"
"Yes, ma'am." said all of them.
Dixie eyed them up proudly. "Keep
your radios close. Contact any paramedic
with questions and concerns. Ratio's gonna be one EMT per
patient. Spend no
more than two minutes for each victim visit. That's plenty of time to determine
their color tag. You'll do fine. Okay, grab your gear and go. Move up and down the
rows. Stick
with your EMT partners by checking adjacent casualties."
---------------------------------------------------------------------------------------------
CHiP officers Poncherello and Jon Baker found themselves in the ambulance
transportation group
along with Rosalie Arnold and Mel Turner.
Johnny Gage reassured them right off the bat. "You're
being escorted wherever
you need to go by a National Guardsman per Mayfair team. He or she can also
answer questions on obtaining more fuel, and anything else you might need. It's
their assigned job
to be your gopher for both ambulance supplies and your
food or water. Just request it. Now, let's
go over triage paperwork documentation.
It won't be much. Just basic information. Gender, approximate
age, what injuries
or conditions they may have, how treated, their name if possible, any past
medical
history. Keep it concise and neat." He looked up as the first red tag
was being hustled into their
direction by a pair of Corpsmen. "Okay, everybody
pair up again at your own rigs. Here they come."
he got on his HT. "Squad 127,
Squad 51, Squad 10. They've started evaculating reds from Triage. Meet
us here?"
##On our way.## replied Brice, Bellingham and the other paramedics.
Gage immediately
reached for an oral airway from a gear bag. "Get the suction out.
This woman's got pulmonary involvement!"
he told his first team of EMTs. "Near
drowning." He had picked Rosalie and Mel's rig to accompany.
Frank and Jon jogged to their ambulance and got it ready. They with their National
Guardsman and
two corpsmen, shifted a small bloody, bandaged
child onto their wheeled bed. Instinct made them gentle.
Ponch got out a peds
oxygen mask and started using it. The corpsmen disappeared with the empty canvas
stretcher back to Triage. Jon looked up and hollered. "Patient aboard! Where's a
paramedic?!"
"Here. I'm from Station 51. Craig Brice. What do you got?" Craig said as he climbed
aboard in
full turnout. Baker disappeared into the front cab to drive the Mayfair. The
National Guardsman joined
him in the passenger seat after he closed the rear doors
and locked them.
Jon looked over at
him and noted his machine gun slung over his far shoulder. "Don't
tell me, you're here to encourage
traffic to get out of the way."
"You got that right." rumbled the soldier. "The governor's just
declared martial law."
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