It was a minute later and Johnny's
professional side had finally made
a comeback. "Listen, we can still salvage this whole day, Liz.
you let us make things up to you?"
Liz just looked at him. "This drill? How?"
can change the rules of the game." Johnny shrugged. "It's already too
late for us timer wise. We've
got nothing more to lose."
Lopez started chuckling. "Say, yeah. We can break scenario character."
Stanton eyed them up doubtfully, unconvinced.
"Let's do this for Kate, huh?" Gage said encouragingly.
She started a half grin, beginning to bite. "Well, what can we actually
do that hasn't already
been done? He's not exactly a trauma case." she
said throwing a careless gloved hand in Marco's direction.
Gage started wearing a sh*t eating sideways smirk. "Tell me, what
would happen if a patient's
primary care shifts from a higher skilled
level EMS responder to a lower one?" he asked, turning
on the suction
and draping the Yankauer tube over Marco's blanketed lap.
"That can't ever happen.
That's abandonment." Liz frowned.
"Yep." Gage said. "But what if it's not voluntary? You'd be
stuck with it,
right? So let's stick her with it." he said significantly. "We're gonna make
hands too full of a problem to take over. You'll be holding a sick me."
Liz glanced over her shoulder
at the closed peek window. "You know,
I think this might just work." she chuckled. "Okay, fake a
tangle yourself up under the gurney. There's a set of railroad tracks
coming up and we
can use that as our new emergency. I'll say you hit
your head and I'll start hollering after we hit
the bump. Ready?"
"But she already knows it's a fake run." Lopez insisted.
"Not if I start
to panic a little." Liz shared. "I never panic. It'll catch
her off guard."
grinning, shoving the biophone out of the way to make
room for himself. "Marco, you're the same as
before. Stick that mask back
on. And turn that IV dial up again to a slow drip. We gotta make this
real for her."
Liz eyed the view out the back window. "Okay, we're almost there."
said looking at the Spirit of 76 gas station ball rotating on a street
corner where she knew it would
be. "Get set.."
Subject: One Bang Up Job
From: patti k (firstname.lastname@example.org)
Sent: Sat 7/10/10 4:16 AM
"One more thought." Johnny said, holding up a finger.
hurry." said Liz, eyeing up some railroad signs they had just passed.
"How do we tip off my partner
that our stop isn't real? He's still following
behind us in the squad." Gage asked.
mojo. You guys can communicate nonverbally in subtle ways
between each other by now, I hope." she
On the ambulance cot, Marco started snickering.
Gage's mouth flopped open,
but then it closed again with a click of his teeth
when the ambulance suddenly thunked over the expected
rail road tracks at
the next intersection.
"There's your cue, pal." Lopez told him, flopping
limp and back into character.
"Don't blow it."
Liz threw up her hands silently in an expectant
and impatient,"Well?" gesture.
Johnny made a face and dropped to the jammed space between the
rider bench and the stretcher. He wormed his head under the cot rail
on the floor and made sure his
arms were pinned into immobility against
the metal. Then he kicked a foot against the side of the
ambulance to simulate
a skull crack. He cried out in fake startlement, then noodled into stillness.
Liz knelt down into the same small space, grabbed either side of Gage's
head as if to stabilize
it, and started hollering. "Pull over, Kate! Pull over!!
"What's wrong? Time
for a fake a code?" the younger EMT jokingly asked as
she suddenly curbed and tire jammed the Mayfair
rapidly by the side of the
boulevard. The cab peek window shot open and she made half hearted
contact with Liz, but with the radio mike already in the other hand.
"Not him! Not that! Get back here. It's the other one. I don't think he was ready for|
Stanton hollered. She used the new ache in her back to fill her
face with a strangled grunt of pain.
"I think he's unconscious." she gasped with
"I don't know.
A fall? I heard a crack and then he was down. I didn't see it. I was
watching the d*mn*d cardiac
Kate glanced down and saw Liz's hands stuck in a spinal immobilization move
a very quiet Gage's head. She saw that the stethoscope around his neck
had snagged awkwardly on the
cot frame and that his upper body was
trapped underneath the cot. The smile wiped clean off her face.
sh*t." she said and thumbed the radio mic. "L.A. Mayfair 3. Respond an engine
to...Wilmington....and Gilmore. Paramedic with a head injury. No
collision involvement." she reported,
rushing out of the cab.
##Mayfair 3, L.A. 10- 4. *Beep. Beep. Beep.* L.A., Engine 51. Mayfair
a first responder fall and injury at the rail road intersection of Wilmington and Gilmore.
Wilmington and Gilmore. Squad 51 is already on a follow.##
Hank's puzzled voice came over
Gage's radio. "Engine 51, 10-4. KMG-365."
##Time out : 15:07.## confirmed L.A.
already in full frantic mode. The sudden Mayfair stop he knew, was not in
the scenario plans. "Johnny?!
Marco?!" he ran out of the squad and to the rear loading
doors of the Mayfair just as the white uniformed
Kate got there.
"It's not your firefighter. It's your partner. He fell I think, going over the
tracks." Kate told him.
"My partner's got his C-spine." she said as they flung open the doors.
DeSoto shouted again as he climbed in. "Johnny? Can you hear me?" He looked down,
reaching hands under
the cot to Gage's stomach in a breathing check. Then he froze,
seeing something. Johnny's shoes were
off and his ankles were crossed casually
together as if he were taking a nap. Gage twitched a big
socked toe subtlely.
Roy did a double take. Then he suddenly caught on when Liz didn't look up
at him from
where she was twisted on the floor between the bench and cot. "No reaction to voice."
said Stanton to Kate urgently, tuning him out. Raising a pair of suddenly relieved eyebrows,
said. "Okay, I'll... get a spine board and collar." he almost grinned. "Uh,,, don't
move him yet.
I'll be right back!" Then he ran out of sight and began opening squad
compartment doors in a big
show of hurrying a little.
Kate was small enough to squeeze in under the ambulance cot. "I'll
check him out." she
said, tense. Her penlight was already in between her teeth. "No blood so far."
for Gage's neck around Liz's gripping hands and dug a few fingers in. "Carotid's fine.
Color's good. He's still breathing all right around your jaw thrust." she concluded. Then she
back Gage's eyelids and used her light. "Pupils... equal and reactive." Then she
began to carefully
feel around his hair and skull. "No DECAP BTLS." She pinched
the skin on Johnny's upper arm. He grunted.
"Reactive to pain, Liz."
"So far so good." Liz said. "What next?"
"Get this fireman out
of here and off of him." Kate said about Marco on the ambulance cot,
squirming backwards and back
outside to free herself again.
"Tricky. He's tangled up." Liz grunted, still holding C spine on
Johnny with her
forehead buried against the mattress of the cot.
"We can't wait for the engine
crew, this man's status is abnormal." she said about Gage.
"How's Marco?" Liz asked.
glanced up and saw worry there in Lopez's face. "Did you hurt yourself any, too?"
"No. I.. I'm
fine. What the h*ll happened?"
Kate took in a deep breath and reached over Marco's stomach for
an oxygen line
and a fresh mask from a wall port and basket."We think your paramedic hit his head
when we were going over the railroad tracks."
"How bad is he?" Marco asked.
are stable. We'll know more once we get your cot out from on top of him."
Kate replied, ducking back
down under the cot to set the mask over Johnny's nose
and mouth. She groped blindly with her other
hand and found the suction tube to
grab as well. This she left draped over Johnny's shoulder.
"I'll get out of your way then." Lopez said, starting to unbuckle himself.
"No. Mr. Lopez. Don't
move. The cot's locked on its bracket and besides, there's
no room between her and me for you to get
out with the foot rest up. Hang tight."
Kate told him.
Unseen by Kate, Liz winked at him.
Marco subsided back into sitting up on the pillows. "Okay. If you say so. Johnny?
If you can hear
me, they're taking really good care of you."
"Just relax.." Kate joined in.
it back just then with sandbags, the wooden long board and a collar.
"How's he doing?" he asked Kate.
"Liz's got a good manual airway hold on him under there and I've put him on O2.
He can feel pain,
"Then he's not totally out?" Roy nodded.
"No, sir. Want to take over?" Kate replied.
Roy shook his head. "You know more than I do. You're in charge."
Kate swallowed dryly as she hung onto the foot of the cot carefully. "Okay, uh.. |
Collar first. Then
sandbags to replace Liz's hands. Then let's get this cot out
of here. Marco's still on it. It'll be
safer that way. If we move slow, Johnny's
head and neck won't be jarred. When the engine crew gets
extricate him the rest of the way onto the long board."
"Sounds like a plan." Roy
agreed. "What now?"
Kate bit her lip, nervous. "Uh,.. Oh. I can do this." and she crawled over
Marco's legs long enough to deattach his lead snaps from the electrodes
on his chest. Kate grabbed
a fresh set of stickers and climbed back
down to squirm in next to Gage under the cot. "We...can keep
Johnny's heart rate...using the monitor."
"Smart thinking.." Liz said. She watched
as her EMT partner unbuttoned Gage's
shirt long enough to get an EKG trace going. "White, right, red
left and black down
below, remember?" Stanton asked Kate.
"Yeah, for a two lead." Kate said,
finally starting to shake in reaction to the emergency.
"You're doing fine." Liz said. "Nobody's
Kate laughed nervously, thinking some more with a frown.
"I don't think he warrants
a nasopharyngeal. He's too awake for that."
"You're right. He'll gag. And that would be a bad
thing since he's still on his back."
Liz agreed. "I've got a hold on him. He'll stay open until we
get him sand bagged."
Roy concentrated on listening to Johnny's heart and lung sounds. "He's clear.
still hasn't vomited yet. But might when he's moved." he hinted.
"I've already got the suction
ready, sir." Kate reported. "It's near his shoulder."
"Good." DeSoto said to boost her confidence.
"Here's the collar. He's a regular.
I don't think we'll need a second ambulance. We can reorganize
him boarded and on the bench with the two of us crouched in other spaces by
captain's chair. Liz'll drive. Marco, once he's collared, go ahead and crawl out.
I'll need you to
drive in the squad." Roy told Lopez.
"You got it. I'll fill in Cap and the others, too, once they
"Kate." Roy said, reading the young EMT's name tag. "This is the first pair of
bags. Make sure you fit them nice and snug around him. Liz'll let go only when
you've set these to
replace her grip."
"Collar's on." Kate said from under the cot. "Gimme them." she said, reaching
up a hand
from underneath the frame.
Liz and Roy grinned at her scene aggressiveness and dropped
them one by one with
a plop onto the floor within her reach. EMT Stanton hollered out. "What's his
O2 flow at?"
"Fifteen liters, Liz." Kate replied. "Okay. I'm set. Let go of his airway..now."
Swiftly, Marco shot out of the Mayfair and onto his feet. He had already grabbed
own started I.V. bag into an elbow, cradling it like a football. He threw it into Roy's
helmet and wore its strap fastened onto his belt like a carrier. "Let's
get the cot out." he said
eagerly, reaching for its lock lever quickly.
Inch by inch, Liz, Roy and Marco pulled the cot
off of Gage and thunked it down onto the
pavement. It was quickly forgotten and shoved out of the
Kate got right back into the emptied Mayfair and resumed a jaw thrust hold on
to reopen his airway. Gage gasped strongly inside the oxygen mask over
his face to feign easing breathlessness.
"Oh, he got a little hypoxic, Liz." she
Liz replied. "It was only for a few seconds.
He'll be fine. He's on pure oxygen." she
"I'll do the hold." Roy volunteered at Kate.
"You've still got his vitals in your head.
Go ahead and call Rampart with a report. You've got my
Reluctantly, Kate let go of Johnny's head and jaw, trading places with DeSoto.
Liz began to organize an I.V. set up for Roy to use without saying anything much,
pretending to hurry.
Kate fumbled with the biophone briefly before she found the correct dials. She picked up
"Rampart, this is Mayfair Three..How do you read?" she asked. Not happy,
she kept a hand on Johnny's
stomach, monitoring his breathing rate.
Dr. Brackett's voice appeared, strong and confident. ##Mayfair
Three, this is Rampart.
Kate took in a shaky breath and began to talk.|
"Rampart we were in mid transport of a mock with Squad
51 when one of their paramedics
hit his head going over railroad tracks. I've a male, age 20 -25.
Responsive to pain only.
Pulse 78, respirations 20. Eyes PEARL. He is being manually airway supported,
C-spine is partially immobilized. We're awaiting extra hands for long boarding."
Three. Is the second paramedic present on your scene?## Kel wondered.
"10-4, Rampart. He's authorized
me to c-call you." Kate studdered.
##Understood.## Kel smiled, recognizing an extension of a
mock exercise then.
##Mayfair Three, keep monitoring vital signs, treat for shock, have him fully
and then bring him on in. The paramedic'll handle his NS I.V. start TKO. ## he said,
grave and concerned. He shrugged at Dixie's questioning glance through the window glass
from her place at her desk.
Roy called out loudly. "I.V. Normal Saline. TKO. 10-4." he confirmed.
##Good job assessing this one, miss. Head injuries can be tricky.## Brackett said to Kate.
tabs on his CMS while boarded and do a complete neural check on all limbs
every five minutes, a Babinsky's
and capillary refill.##
The young EMT just about teared up in relief. "10-4, Rampart. Our E.T.A.
is less than ten
minutes." Kate told him as she heard the first signs of Engine 51's sirens approaching
"Mayfair Three out."
"Okay, take over." Roy said as soon as she hung up the phone. "And
I'll get that line going.
Marco, how's yours? Did it infiltrate or backup any?"
Lopez reported, showing DeSoto a running drip chamber. "I was careful. I'll go
tell the others about
our situation." he said.
"All right." Roy said, letting go of Gage's face and jawline around the
Kate grabbed hold. "Kate, you're in charge of the spineboarding when they get here.
on his head, okay."
"Yes, I..uh, I remember that from classes, sir." Kate said. "How's
he doing to you?"
"He's okay." Roy said truthfully, tossing a head at the monitor Kate had set
up on Johnny.
"See that? It's normal sinus rhythm, completely regular. He's not shocky. I'll grab
for your next call in vitals set. You can get the next one two minutes from now. By then,
engine crew'll be here to help us out."
Right then, Johnny started coughing.
how much he remembers." Roy ordered. "Johnny. Hold still. You were
in, letting go of his jaw. "Can you breathe okay like this?"
Gage groaned and opened his eyes."Uhhhh."
Then he swallowed.
Kate glanced up. "He's controlling his airway okay." she shared with Roy. "I've
head between two sandbags. Don't try to move, you might have hurt yourself falling.
you know who you are?" she asked, peering down.
Roy just watched, snicking up the BP cuff on one
of Gage's arms.
Johnny slurred a response through the hissing oxygen mask. "....captain john
gage of.... station 51." he whispered hoarsely.
"Oh, boy." Roy breathed. "Off his nut still."
"Shhh." Liz shushed, glaring.
Kate continued. "What day is it?"
"Good." said Kate. "Do you know where you are?"
"In a Mayfair?"
One you were supposed to be supervising." Marco retorted.
"My head hurts." Gage said, ignoring
"It's gonna. How about your neck?" Kate asked him.
"It's... okay." Johnny peered
up as Kate checked his eyes again.
Then he smiled. "Thanks."
"You're very welcome. Now shut
up and let me take care of you." Kate
Gage's eyebrows quirked in barely hidden amusement.
Kate Brown was livid. She rounded on Liz Stanton.
"You mean that part was faked, too?!"
head wobbled in sarcasm. "Sure was. Those station guys wanted
to make it up to you so I went along
Kate was so worked up she was almost hyperventilating. "Nasty. Of all
the low down--
"Hush up, hon. You can't tell me you didn't learn a lot just now." Liz said.
"He faked a convulsion on the way in. In front of me and everybody!" Kate
noise in the nurse's lounge had attracted attention. Dixie McCall came
barreling through the doors.
"All right. What's going on here? The two of you
are making enough noise to raise the dead."
fake dead you mean." Kate sighed, finally mousing down. "Sorry, Dixie.
I've just been had and I don't
like it one bit."
McCall blinked at her. "You mean Gage's second mock run, don't you?
told me about it."
"Well yeah." Kate huffed.
"It felt real, didn't it?" Dixie countered.
"You used all your skills to their stretching
Dixie grew firm
and icy direct.
"Then feel honored. Johnny and Roy know just how to do that with new EMTs.
they don't carry on a spur of the moment mock like that for just anyone."
Kate's mouth flopped
"That's right. Either they or your EMT partner are seeing good things from you
just need a tiny bit of shaping in the skills department. That's a real good sign
this early in the
game." Dixie admonished mildly with a gentle smile. "Now come
on, let's all share a cup of coffee
and then you and I can go over just what you
thought went well and what you felt that didn't." McCall
"Okay, ma'am. You were one of my instructors." Brown sighed sheepishly.
"I was one of your guest speakers. Brice was your instructor. And he's enough|
to intimidate anyone
into self doubting themselves."
"And so came Paramedic Gage's mock." Kate thought with revelation.
"Yep. All of us usually have to do some serious damage control after Craig's
been at it with
an EMT class." Liz said, accepting the pour Dixie offered. She
dug in and opened six sugar packs and
laid them neatly on the table in front of
her. "We need to seriously sweeten everything afterwards."
Kate finally let down her guard. "Including your tooth?"
"We haven't had lunch yet." Liz grumbled
at her partner.
Dixie chuckled. "I'll order pizza. My treat." and she got up to dial
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