I'd been doing this long enough to know what I'd be dealing with. They radioed it in about the three teenagers from the church fire up in Windrixville. There were little children in the church but they were all okay, these three teenagers had rescued them.

So I knew what I'd be dealing with and in what order. The least of the injured teenagers was the one with smoke inhalation and a possible concussion, but you never knew with concussions. Then there was the one with the burned arm and smoke inhalation. Then there was the one with possible paralysis, third degree burns, smoke inhalation. The first one had regained consciousness en route, the second had never lost consciousness, and the third has been unconscious since he was dragged out of the church.

I told the nurses to get three exam rooms ready, to get saline and plasma and type O negative blood ready, to get the burn supplies, the antiseptic ointment. They were rushing around getting everything. I was waiting. I could hear the sirens as the ambulances pulled into the side parking lot and up to the double glass doors and the EMT's rushed in, the three stretchers all in a row.

The first two would have to wait while we stabilized the one with the third degree burns and question of a spinal cord injury. He came in with plasma that was started in the field and an oxygen mask on, despite that his lips and fingernails were slightly blue.

"Get the vitals on him! Start another line! Free flow normal saline once it's started! Change that mask to a non-rebreather, jack the O2 up to 15 liters! Nurse, what's the pulse ox?"

"90% with the non-rebreather,"

"Call respiratory! Is the line started?"

"He doesn't have any veins, his arms are all…burned,"

"Try the legs, his jeans protected him…"

He had one line going, the EMT's took the only available line in one upper arm, but we got his jeans off and his legs weren't burned at all, so there were some veins there we could use to pump saline into him. Burn victims lost a lot of fluid, it sent their fluid balance and electrolytes all out of whack. Throughout all of this, starting lines, poking and prodding him, turning him over, undressing him, he didn't wake up or stir at all.

Respiratory came down, got a pulse ox, started a neb treatment. He started to cough, which I knew was a good sign, it meant he was clearing some of the smoke from his lungs himself, and I watched the pulse ox go up on him. The normal saline was flowing into a vein we got in his foot, it was going in at 900cc per hour. His lips and fingernails had lost that bluish cast, and his vitals were more or less stable. Now the nurses could dress the burns after they cut his T-shirt off him. I watched them, watched as they draped the gown over him and buttoned it up around the IV's, watched them clean and cover the burns that were on his chest, neck, shoulders, arms, and back.

"We need an x-ray of the spine, a chest x-ray, a head CT, a blood type and cross, and a BAS stat, got it?" The nurses nodded, jotting down the orders in their special short hand, calling the lab and the x-ray tech.

I tested his reflexes while we waited for x-ray. He had what I expected with lower spinal cord injury. He had reflexes that were present, that didn't go to the brain to cause a reaction. I wished he was conscious so I could ask him if he could feel any touch or pressure below the middle of his back, where the beam had fallen on him.

X-ray was ready for him and they wheeled him away and I went to the next one, an angry looking tow head blond with a badly burned arm. His vitals were fine, and he put up with me but scowled the entire time. The nurse came and cleaned and dressed his injury and I called up for a bed for him and the other one. I didn't think the third kid would need a bed, but we'd see. I could probably send the third one on his way.