Disclaimer: Emergency! is the property of Mark VII and Universal. No infringement of copyright is intended. I'm just gonna take the fellas on a spin in the squad, and will return them safe and sound at the end of the day.
Authors Note: I am absolutely not a physician, nurse or paramedic. Some research on my part has yeilded what I hope are accurate and appropriate medical sequences. If I have somehow incorectly stated some medical protocol or procedure, please leave some constructive feedback. Part of life is learning, and I'm always eager to do my share. Thanks for reading, and please enjoy.
Men of Action
"Good morning, good morning, good morning!" sang out Paramedic Firefighter John Gage as he strolled into the day room of L.A. County Fire Station 51. Stepping up to the stove, Johnny grabbed a mug and filled it with coffee before turning to face the other men who were all sitting around the kitchen table sipping coffee. Everyone was present and accounted for except Captain Stanley. Johnny figured the Cap must be in his office getting ready for roll call. There was a round of "hello's and hey Johnny's from the assembled men, and Johnny settled himself into a chair to sip his coffee before the group were called to line up for roll.
Roy sat reading the morning paper. Johnny nudged him saying "Hey partner, how were your days off?"
"Great" Roy replied without looking up from the newspaper he was perusing.
"I had the best date yesterday with this adorable little chick I met at the bowling alley." Johnny began by way of starting up conversation. His mouth no sooner finished uttering the last syllables before the tones and klaxon blared in the station calling the squad to a man down call.
Gulping his coffee one last time, Johnny sprang from his seat in the direction of the apparatus bay, Roy hot on his heels. The two paramedics lept into their shiny red squad. Captain Stanley acknowledged the call and turning, handed the call slip through the squad window to Roy, who after giving the paper a brief glance passed it on to Johnny. Looking at the address, Johnny directed his partner as the squad began to roll out of the bay; "turn left, then two blocks down at the light make a right." After leaving the garage, Roy flipped on the siren, and obediently followed Johnny's directions turning left onto 223rd street with lights flashing and siren whaling.
"Wonder what we got." Johnny speculated as he carefully watched for the appropriate street sign to appear through the windshield.
"No tellin" Roy said noncommittally, "I hate these man down calls. It could be just about anything."
"There it is, turn right" Johnny said, gesturing for his partner to turn at the upcoming intersection. "Should be one block down, and turn right." And the tires on the squad squealed around the corner.
Four short minutes later, Squad 51 rolled up to a brick ranch house set on a large lot. Roy drove the squad into the long circular drive. Almost before the vehicle stopped rolling, Johnny had swung the passenger's side door of the squad open, hopped out of the vehicle and flinging the right middle bay door open, he grabbed the drug box and defibrillator. After putting the truck in park, Roy raced around the squad and seized the O2 and Biophone, whereupon both men laden with equipment trotted for the front of the dwelling.
Johnny shifted the defibrillator from his right hand to hang down under the drug box he cradled with his left arm, and using his right knuckles Johnny knocked firmly at the door with a loud call of "Fire Department!." The men waited for a few moments, but there was no answer. After knocking a few more times, the men growing concerned tried the door handle. Surprisingly the door was open, and with another loud shout of "Fire Department? Did anyone call for the paramedics?" from Johnny, the two men gingerly entered the home. No one answered, and the men separated to begin searching for a potential victim.
Johnny went down the hallway to the men's left, and Roy directed his search to the right where a couple of closed doors were visible. "Always feels so strange to walk though someone's home when it seems deserted." Johnny mused as having found no victim in what looked like a den he moved on down the hallway.
Roy opened the first door he found, and saw he was looking into some sort of small apartment. "Hmm…. Looks like a mother-in-law's quarters." He thought as he entered further in the room. "Glad my house isn't big enough for one of these!" his mind commented. Finding no victim, he left the room and continued on to open the next door he'd seen.
Johnny entered the second room, a large bedroom with an unmade king sized bed. He looked over to the bedside table and noticed the telephone off the hook. "Hmm….what's this?" Johnny thought. "Hello! Anyone here?" he called into the room. Nothing! Johnny went around the large bed to look in the floor on the other side, and found an elderly man lying there, telephone receiver resting on his open hand. "Roy! He's in here." Johnny called, and he stooped to begin his initial patient survey.
The man looked to be in his late forties. He was dressed in white pajamas, which accentuated the bluish grey tones of his pale skin. Johnny quickly determined the victim was not breathing and then reaching out, he rested two fingers on the victim's neck where the carotid artery would be. There was no pulse. Shaking his head, Johnny reached into his assessment kit for his pen light. Gently lifting the man's eye lids, he flicked the beam of light into first one eye then the other. "Pupils fixed and dilated." He said aloud inside his head. Heaving a heavy sigh, he sat back on his heels.
Roy rushed into the room behind Johnny just as Johnny sat back on his heels. "What have we got?" he inquired of his partner. From his vantage point, Roy made a hasty visual examination of the victim as he spoke, Roy noticed a trickle of liquid oozing from under the man's seat, and he easily appreciated the smell of fecal matter permeating the area.
"He's dead." Johnny said softly.
Roy sighed heavily. "I'll go call for the sheriff and coroner" he murmured before turning to walk back outside to the squad.
Johnny slowly stood up, and reaching down he picked up the cases he'd dropped on the floor. Turning on his heel he too left the man alone in the room.
After waiting for the proper people to reach their scene, Roy and Johnny now free to go called themselves back into service, and slipped into the squad for their drive back to the station. Neither man spoke for a few moments. The adrenaline which had spurred them to action was beginning to wear off, and finding their victim already dead had been at the very least disappointing. So neither man felt much like small talk at the moment.
After riding for a couple minutes in silence, Johnny sighed heavily. "Geeze, it's rough when we get there too late. Ya know, I keep thinkin if we'd just made it there a little quicker."
"We made good time Johnny, right around four minutes." Roy consoled. "Poor guy was probably dead before the dispatcher finished typing in the address."
"Yeah, I guess." Johnny replied despondently. "Still….."
Just as Roy stopped the squad preparing to back into the station the radio toned the paramedics out again. "Squad 51, respond to a child choking at 650 E. Carson, cross street North Avalon Boulevard, time out 09:57." Sam Laneir's easy vocal cadence intoned. Roy turned the squad back out on to 223rd street siren whaling, lights flashing. Johnny quickly scribbled the address and time out on a call slip, and clipping it into the sun visor, he pointed for Roy to turn.
Three minutes later, the squad raced into the parking lot of a grocery store. The paramedics bailed out of the vehicle quickly dashing to the side compartment to retrieve Biophone, drug box, O2 and should it be required defibrillator. Hurrying into the market, the two men found a crowd of people gathered. "Excuse us, coming through" Roy yelled over the fray as he and Johnny unceremoniously shoved their way through the onlookers. When they had reached the center of the group they found a boy of about eight lying motionless on the floor. The child was extremely cyanotic, and Roy noted no attempts at respiration.
A lady with long blond curls sat weeping over the child. Her unintelligible sobs were heart wrenching. Johnny quickly grasped the woman's shoulders, and gently helped her to her feet moving her away from the youngster saying "Excuse me miss, please let us look at the boy." Glancing around the crowd of bystanders, Johnny saw a kindly looking grandmotherly type, and directed the younger woman toward the bystander requesting "please, would you stay with her for a minute." The older woman nodded, and Johnny turned away from the distraught lady to help his partner with the child.
Roy had begun to look closely into the child's throat and easily saw the problem. A large wad of pink bubble gum was obstructing the boy's airway. Roy quickly reached for the suction unit mounted on their O2 cart, and with a bit of luck managed to dislodge and retrieve the gum.
Johnny felt for a pulse, but found only a faint flutter under his finger tips. After ripping open the front of the child's shirt, he quickly grabbed the defibrillator paddles. Turning on the Datascope monitor he quickly placed the paddles in contact with the child's chest. "V Fib!" Johnny said as the scope's screen showed irregular wavy lines. Setting the dial on the device to deliver 100 joules Johnny quickly pressed the charge button. Roy had swiftly grabbed and opened the conductive gel, and as Johnny held the paddles out to him, Roy applied the goo for Johnny to spread on the paddles by rubbing them together.
Whining and then whistling could be heard from the defibrillator, Johnny put the paddles onto the child's chest in the appropriate places, "Clear!" he warned, and as he pressed the buttons the child's body arced slightly upward with the electric charge. The discharge complete, Roy and Johnny both glanced back to the screen of the scope. Smaller wavy lines could be seen. Increasing the charge to 200, the defibrillation was repeated. But there was no change.
Tossing the paddles aside, Johnny began CPR, using the BVM (Bag Valve Mask) Roy had attached to the Oxygen and handed to him, he administered several forced breaths, and then began chest compressions. As he worked, Johnny peered up into the crowd of onlookers making eye contact with a benevolent looking elderly man. "Sir, please come down and help me." He kindly but firmly requested, though it was more of a command really. When the man knelt, Johnny quickly demonstrated how to get a good seal with the mask, and the proper way to squeeze the bag to ventilate the child. Breathing secured, Johnny continued compressions.
Roy grabbed the Biophone and quickly called Rampart. He informed them of the patient's age, and vitals….or lack of vitals in this case. Orders for an airway, and an IV followed with an amp of sodium bicarbonate were issued. Efficiently, Roy moved the Good Samaritan away from the child, and inserted the OPA (Oropharyngeal Airway). Attaching the BVM to the OPA, Roy again requested the elderly gentleman begin bagging the child.
Johnny continued chest compressions, and verbally cued his helper when to squeeze the bag.
Quickly, Roy placed the EKG leads on the boy's chest. Next he started the requested IV as an AC access ( antecubital - in the inside bend of the child's elbow) using a 16 gauge needle. (big one…ouch!) with the requested D5W. After establishing the line he injected one amp of Bicarb and the two paramedics looked at the scope. "Still showing V Fib" (Ventricular Fibrillation) Roy said. Grabbing the paddles Roy now prepared to shock the child's heart. He pressed the charge button on the defibrillator, and the machine whined to life until the whistling noise came indicating a sufficient charge had built for administration. When Roy had applied the paddles to the appropriate areas of the child's chest he said "clear!" and checking to see that their helper had taken his hands off the boy, Roy pressed the buttons to release the charge watching as the child's body arched beneath the paddles.
Breathless with exertion now, Johnny peered at the Datascope monitor as the small wavy lines diminished to one long slightly wavering flat line. "Asystole!" Johnny gasped. But Roy had seen the scope too, and was now relaying the information to Rampart. Epinephrine was ordered, and injected. But the child seemed to be slipping away.
The Mayfair ambulance EMT's had arrived at the market by now, and Johnny signaled to one of the men to take his place on CPR. Roy gathered up the medical gear while Johnny helped the other EMT lift their patient onto the gurney. Johnny nodded to Roy as he stood, and stepped over to the now very distraught women they'd found kneeling over the prone child earlier. "Miss, is this your son?" he softly inquired of her.
She didn't reply, only nodding her head affirmatively, tears streaming unabated down her cheeks.
Taking her gently by the elbow, Johnny spoke softly again saying "we'll be taking your son to Rampart General Hospital. You can ride in the front of the ambulance if you want."
Again, there was no verbal response. The woman only numbly nodded again, and walked with Johnny to the ambulance.
Roy climbed into the ambulance with their patient, and Johnny closed the doors with the traditional double tap indicating it was now safe for the driver to pull away.
Shoulders slumping, Johnny walked sadly back to the squad. He knew there was little chance the child would survive. He'd been down too long before help arrived. Dejectedly Johnny climbed behind the wheel of squad 51 and turned the little red truck to trail the ambulance as they sped from the parking lot siren's moaning out their forlorn cry for all to hear as the doomed mission of mercy hurtled toward its' destination.
A few minutes later at Rampart, Dr. Brackett solemnly called time of death for the young boy. Johnny and Roy trudged from the exam room heads down in frustrated sadness at the defeat death had given them yet again today.
Glancing at his watch Roy said "11:35! It seems like that call lasted an eternity!"
"Yeah, no kiddin." Johnny agreed sullenly. "This day sure hasn't started off well, has it?"
Sighing heavily Roy shrugged his shoulders saying "Happens like this sometimes. Come on Junior, let's re-supply before we get another call." And both men walked to the nurses' station to replenish their drug box. Dixie wasn't working today, so the men found another nurse to sign off on their supplies, and wearily departed the hospital.
Half way back to the station the radio called them out for another run. This time it was a welfare check. Both men groaned aloud. Rarely, a welfare check would end with someone being found alive and perhaps injured. More often though the medics would arrive at their destination to discover the intervention was far too late. Today fit into the second category. Arriving at a small neatly kept home, the paramedics knocked in vain for several minutes. When a police officer arrived, they forcibly entered the residence to discover an elderly woman lying in a puddle of bodily excrement long congealed. She was DRT (dead right there) and it was obvious for all to see.
Roy and Johnny donned disposable gloves, and helped the coroner place the poor women into a body bag, and lift her into the back of his van. Removing the gloves, the two paramedics again climbed into their rescue vehicle and drove toward the station.
"Ya know Roy, this day is just not turning out all that great." Johnny moaned as they drove. "I started out today in a wonderful mood, but it's pretty hard to hang on to when no matter how hard we try, or how much action we take…..we still seem to be unable to help. It's like running into some giant invisible wall today!"
"I hear you Junior." Roy said glumly as they neared the station once more.
"Beep beep beep" sounded the radio. "We can't win!" Johnny said as he picked up the microphone preparing to acknowledge the call. "Squad 51 stand by for response…" Laneir's voice warned. Next the men heard the station tones, followed by instructions for station 51 to respond on an entrapment in an elevator. Johnny made a note of the address, then slipping the paper into the sun visor clip of the rescue squad; Johnny's attention was once more focused on directing his partner and navigating through traffic. As they hurtled toward their next call Johnny heard Captain Stanley acknowledge for the engine, and next Johnny acknowledged for the squad.
Engine 51 reached the scene first. The three story apartment building was relatively new looking, and seemed fairly well kept. Stanley jumped down from the engine followed by his two linemen. Engineer Stoker waited in the engine to see what the situation inside would require. Hank Stanly entered the front lobby of the building in time to see the elevator doors slide open and several passengers disembark. A frazzled looking security guard hurried up to the fire Captain saying "we got it to move now, everything's all right. Sorry to have troubled you sir."
"It's no trouble at all sir. We're here to help. I'm just glad it turned out you didn't need us this time." Captain Stanley said, and he reached into the pocket of his turnout coat to pull out his handi-talkie. Raising the antenna he depressed the send key of the radio and reported "L.A., the situation at scene has been resolved. Engine 51 out 5 minutes. Cancel squad 51." After hearing the acknowledgement "10-4 engine 51." The Captain slapped the antenna back into his hand set, and slipped the radio back into his turnout pocket. Turning to his linemen he directed the group back toward the engine "come on guys; let's get back to the barn."
Roy could just see the apartment building coming up on their right when they heard the call from Stanley come over the radio. Both men sighed heavily. "Well, at least we aren't gonna have to deal with another fatality" Roy reasoned as he flipped of the siren.
"True enough….this time." Johnny replied. It was evident in Johnny's vocal inflection that his mood was darkening as the day's events unfolded.
The noon hour was rapidly approaching, and both paramedics were hopeful things would slow down long enough for them to grab a bite to eat before it became supper time. This time, the fates were kind to them. After backing into the station and bringing the vehicle to a stop, both men rapidly scrambled from the squad directing their hungry selves into the kitchen. It appeared their station mates had been sitting down to a lunch of tuna salad sandwiches, chips and fruit. The famished paramedics hastily helped themselves to food, and by the time the engine backed into the apparatus bay Johnny and Roy were well into the first half of their sandwiches.
Chet Kelly strode into the kitchen to find his two shift mates hurriedly scarfing lunch. "Hey, save some for us!" he good naturedly groused. Neither of the paramedics looked up. They could get toned out at any second, and both men knew they should eat while they had the chance. Time for small talk could be made if and when they were allowed to finish at least this meal today!
The other men found seats at the table, and began to eat lunch as well. When Johnny and Roy came up for air after the initial feeding frenzy, their shift mates asked them about their morning. It seemed the engine crew had busied themselves with chores and a ladder drill earlier, not having a single run in the earlier part of the day.
"Ah, that's a fine thing!" Johnny grumbled as he began building himself a second sandwich. "We've had the morning of death here, and you guys have been lounging around taking life easily."
"Hey Pal, Cap hasn't let us lounge anywhere this morning." Marco defended between bites of his lunch.
"What do ya mean by morning of death?" Chet asked, curious now because he hadn't really ever heard Johnny use such dark language to describe a shift. "It couldn't be all that bad."
"Oh yeah?" Johnny inquired through a mouthful of sandwich.
"Gage! Chew and swallow, or spit it out before you choke yourself to death." Captain Stanley ordered glaring at his junior paramedic's bulging cheeks.
Chet grinned wickedly saying "yeah Gage, then you really could call it a deathly morning."
After slurping his milk to swallow his mouthful of food Johnny said "HA HA Chet! You are so NOT funny!"
Roy interrupted with "No it's really not Chet. Johnny wasn't kidding."
Then the two paramedics began to describe their morbid morning. With consideration of their shift mates currently partaking of their noon repast, the paramedic duo omitted certain grisly details, but when the discussion had wound down all in the room agreed it had indeed been a tough morning for the rescue team.
"We have rushed around all day! Jumping into action for what? It's frustrating I tell ya!" Johnny complained. "Seems like the harder we've worked today, the less good we've done!"
But the fire gods had been too kind to Station 51, and the tones began to sound for a warehouse fire. Everyone jumped to their feet, and hastily evacuated the kitchen jogging for rescue vehicles. Siren crying the squad led the crew out of the station in the direction of their call.
Arriving on scene engine 51 was comanded to lay lines from the hydrant and set up to pump. Captain Stanley ordered his linemen to pull hose, and cover the warehouse's front doors. The paramedics were dispatched to treat two injured men who had been retrieved from the warehouse.
Roy and Johnny after receiving their assignment returned to the squad to gather equipment. Quickly the paramedics slid the cases from their vehicle, and trotted over to engine 36 where two sooty men lay on a yellow drop blanket receiving oxygen from a fireman from 36's. Kneeling beside the first victim, Roy looked up to inquire of the lineman helping the victims "what'da we got?"
"Looks like smoke inhalation." The lineman responded relinquishing the victims to the paramedic. "I'm gonna get back to the fire if you guys got things here."
"Yeah, we got em. Thanks Jim" Roy replied to the fireman. Roy opened the drug box to collect equipment for taking vitals. Johnny began checking out the second victim. Shortly, both men started to regain consciousness. The oxygen was doing its job. Johnny contacted Rampart relaying vital statistics. Treatment of maintaining oxygen therapy was ordered with a request for transport. Roy slipped the handi-talkie from his coat pocket and requested an ambulance.
Both victims were improving dramatically from the oxygen and Johnny who was accustomed to being in the center of the fray could be seen glancing longingly over his shoulder at the burning warehouse. But the fire it seemed was now contained, and the men of 51's were preparing for overhaul of the building. Sighing Johnny turned to Roy inquisitively "you got things here? I can go help out Cap and the guys."
"Yeah, go ahead." Roy responded. Their victims were to be transported, but no I.V.'s had been ordered and the paramedics wouldn't need to travel in the ambulance with the patients. When the ambulance arrived Roy helped the attendants load the victims, bid the men farewell, and went to help clean up the aftermath of the fire.
Two and a half hours later, now thoroughly smoked and soot covered, the crew of station 51 climbed aboard their rescue vehicles on their way back to quarters. The building had taken longer to mop up after the fire than it had to actually extinguish the blaze originally. As the two rescue vehicles departed the scene, inside the squad Johnny turned to his partner saying "Ya know Roy, we've run our tails off this entire day, and that's o.k. I'm not complainin, but at the end of all the action life saving came down to a little oxygen and time."
"You're right Junior." Roy replied tiredly. "Every now and then being a man of action means very little at all. I mean, sometimes it's the little actions that count most, like strapping on an oxygen mask….and we didn't even do that here. So our big action scene ended up being us hanging around waiting."
"Guess that's how it goes some days, huh." Johnny said and both men settled into comfortable silence, each alone with his own thoughts.
If they had spoken again, both would have had to admit they'd come to similar conclusions in their thoughts. The day had been long and rather grim, taking a physical and emotional toll on the paramedics. But, at the end of the day, even as minute as their contribution had been, the two knew there had been lives which had been improved with Roy and Johnny's action, no matter how inconsequential the firefighter/paramedic's had perceived that actions to be.