Chapter 3
The Golden Hour
Unit 1076 moved swiftly down the road, piloted by the directions of Mizu (as the girl eventually introduced herself) whose pounding excitement was manifest through her quivering voice, trembling hands and overall personification of panic.
The crew members dealt with their nerves in their own way; Tensin took long draws from his cigarette while tapping the steering column unendingly, Sitoshi positioned his head in his hands near his knees and shook his leg while Hiro breathed deeply, closed his eyes and meditated.
Most harrowing of all was that Mizu's directions were taking them closer and closer to Alucard, who at the moment, was dormant while the two supernatural beings were still positioned above his shoulder.
"Turn right up here!" she pointed.
76's headlights rounded the corner and set its beams upon a wrecked vehicle smashed head on into a large piece of rubble from what looked like a corner stone off a damaged building. From what Tensin could imagine, the stone piece fell right in front of the vehicle's path as it was driving away at high speeds.
After parking nearby they disembarked and, having been familiar with these scenarios, retrieved their needed supplies and equipment in advance and ran them up with the stretcher with Hiro assessing the vehicle first.
The driver, Mizu's father, who she identified as Hideki, was slouched against the back rest, localizing pain at his chest, bleeding profusely from his forehead and groaning unbearably. Hiro shined his light in to have a better look then noticed a peculiar break in the steering column.
Gathering all of the visual evidence combined with tenured wisdom he concluded as thus; the driver was not wearing his seat belt when the head on collision occurred which thrusted him forward with enough force to break the steering column with his chest, bend over the dash board and strike the windshield with the top of his head which filleted the flesh from his skull when he fell back.
Hiro's index of suspicion lead him to logically assume these likely inflictions; whiplash, coup counter coup (brain striking the front and back ends of the skull), chest trauma, internal bleeding, spinal injuries, ruptured internal organs and brain damage.
Tensin, in the meantime looked in the back and found the elder sister of Mizu laying lengthwise across the backseat adopting a position of comfort, heavily pregnant with her hands on her face and lamenting terribly. Though it was a positive sign for a patient to make such complaints, indicating a patent airway and higher levels of consciousness, he noticed one leg was shorter than the other, signifying a broken femur bone which possibly could have transferred damage to the pelvis.
All these structures are high vascular areas.
Sitoshi was about to enter the vehicle but Hiro stopped him by saying, "Hold on, the airbags haven't deployed."
"Don't worry I'm on it." responded Tensin who was able to get an arm under the mangled hood and disconnect the battery.
After that, Hiro requested Tensin's help to retrieve the driver, who required the most attention. His breathing was labored, each response to a question was an unnatural moan of distress, his eyes rarely opened and he would require the most stabilization before transport.
Sitoshi had his shears in hand, reassured Mizu's sister, who revealed herself to be Sakura, to stay calm as he cut her pant leg from the hem to the waist revealing an obvious deformity of her right thigh.
Sakura, understandably in immense discomfort, also complained that any attempt to sit up right shot pain throughout the rest of her body. With permission, he palpated her lower sections at the hips. The sound of crepitus combined with her sudden vexations upon doing so indicated a broken pelvis.
The picture was finally painted in his mind. She was also unrestrained in the fast moving vehicle and, when it impacted, sent her knees slamming into the back of the front seat putting the stress on her lower appendicular skeleton, breaking one femur, which in turn transferred up to the hip joints, cracking and fracturing the pelvic bone, leaving her in the pitiful state we now behold her in.
Aside from the risk of loss of limb what she said next chilled Sitoshi to the bone, "I don't want my baby to die too!"
This further complicated her predicament when discovering she was at thirty eight weeks gestation which also called into question the well being of her baby which could have slammed against the inner walls of the uterus creating a sleuth of horrendous possibilities too great to count at the moment.
She wept while grabbing his sleeve, "Please…I'm scared!"
Fortifying his resolve, he looked into her face and said with a tone to more reassure himself than her, "Don't worry, everything is going to be fine."
Suddenly during this moment of triage, a sound broke through the night's air. A sound so sweet and strange; the sound of a woman singing?
Sitoshi withdrew from the back seat while Hiro and Tensin, who had Hideki's hemorrhages controlled and secured to the back board atop the stretcher, looked up to a large crane and saw a peculiar sight.
"Is that…an angel?" inquired Tensin.
"Maybe God does look after us."
Sitoshi then observed, "Look, the monster is walking towards it!"
This was a most welcomed relief for their safety. Sitoshi ran to the unit, withdrew a pelvic binder and traction splint then hurried back. He slid the binder under and around Sakura's loins then synched it tight to keep her pelvis stable and reduce if not stop any internal bleeding. Then as a standard precaution in all trauma patients, applied C-collar to her as well.
He requested further assistance in which Hiro gave his counterpart permission to leave because additional work on Hideki could be performed by one individual.
Tensin came to them with Sitoshi informing, "We need to get the traction splint on her and I need help getting her out too."
They wedged a backboard underneath her as a means to slide her out, then laid her down on the ground. Sitoshi's heart was full of sorrow because any and all manipulations caused the young girl to cry and beg for them to stop.
Tensin then pulled out a flat plastic stick and handed it to her, who asked, "What's this?"
"It's a bite stick."
"For what?"
"We need to pull the leg straight and it's gonna hurt like hell." he said then strapped the ankle harness around the ankle joint.
Quivering, the terrified expectant mother expressed, "No please don't touch it!"
Tensin adjusted himself at her feet, took her ankle in one hand, calf muscle in the other then said, "I'm sorry to do this but it's gotta be done.' then to his partner, 'Sitoshi get ready with that thing." He then leaned back and used all his weight to pull the leg straight.
Sakura's eyes bulged and she shrieked a lament so fierce it astonished Sitoshi that it was a product of human vocals. The rookie quickly girded the traction splint in its proper place, hooked the winch to the ankle harness and began cranking.
With a face as white as marble and sweatier than a dog's tongue in august she covered her mouth and begged with all sincerity and earnest of the soul, "Please Just Cut The Leg Off, Or Just Kill Me!"
He kept cranking allowing the pulley to provide sufficient torque and pulled the two misaligned segments of the broken bone into a straight line, which once it was so, her screaming stopped and relief was near instant.
"Let's get moving." instructed Tensin while strapping her down.
But, as they were about to lift their patient up, a terrible screech above and beyond anything in the natural world attacked their eardrums and screwed itself into their brains. All three crew members grabbed their ears and collapsed in pain. Sakura whose condition was unbearable enough as it was clapped her ears and shrieked while her father, who was barely conscious, had opened his eyes and yelled out.
Then, as soon as it had appeared, the screeching stopped with just enough time for them to see the tendrils of Alucard swell, hemorrhage then pop off his body, crashing to the earth. One of which was set on course to land on top of them but had struck a nearby building, changing its trajectory landing behind them. Protecting themselves from the rubble that followed they looked to see that the severed tendril was now blocking the intersection they used to get on scene.
"What the fuck was that?!" moaned Tensin rubbing his ears and popping his jaw.
Sitoshi pointed towards the firmament, "I think it was that angel thing."
"Stupid bitch!" he raged.
Hiro was quick to correct, "Whatever she did, she dismantled the giant."
"Maybe a little warning next time!" he murmured.
"Yeah I agree,' concurred Sitoshi, "That hurt…"
"Enough, it's time to go!" ordered their superior.
The father was loaded up first, which sent Mizu crying over his broken state. Sakura was placed on the bench with a blanket on top and secured by Sitoshi's hand. Tensin had Mizu sit up front with him to keep her out of the way of the other two techs as they worked.
Tensin had to find a new path which unfortunately put them on the avenue that led closer to Alucard. The nerves were getting the best of Mizu as each intersection was blocked on either left or right from fallen buildings.
"Why are we getting closer to that thing!?" shrilled the young girl.
"Every road is blocked off, gotta see if there's a clearing somewhere to get it turned around."
"WATCH OUT!"
Overhead the figure clothed in white struck the beast down upon the head causing it to collapse and devastate the vicinity. The ambulance was in the path of the shock waive; Tensin hit the brakes and felt the concussive blast shift the unit backwards on skidding tires. Redirecting the wheel in the direction of the slide, Tensin kept the ambulance upright as it was whipped around.
"I am not paid enough for this shit!" he gnashed silently while pulling a U turn.
Hiro and Sitoshi were recovering from the maneuver, Sakura had nearly flipped over the bench but was caught by her caretaker's hand which in the moment antagonized her injury causing a fit of weeps and gales. Hiro checked on Hideki whose vitals displayed a blood pressure of 104/66, pulse of 132 BPM and O2 saturations of 86% even on oxygen.
His breathing was rapid and shallow with an occasional cough in between. Hiro, opened up his shirt, revealing a horribly discolored thoracic cavity, then used his stethoscope to auscultate his breath sounds. He heard crackles in the lower quadrant of the left lung and diminished breath sounds in the right.
He called up to the driver and informed, "Try to keep her steady I need to hit him with a decompression needle."
"You gotta a tension Pnuemo?" Tensin called back.
Withdrawing the needle from his bag Hiro affirmed the diagnosis, which is known as Tension Pneumothorax, a condition when the lung is punctured and air is escaping and building up within the chest cavity forcing the lung to collapse which most likely attributed to his low saturations. The treatment Hiro was about to perform involved perforating the chest cavity to let the air escape.
He wiped the injection sight with an aneceptic towelette, popped the cap off the needle, angled it directly over the mid clavicular line at the second intercostal space, inserted the needle into the thoracic cavity, withdrew it while its catheter stayed in place and taped it off and could hear the air seeping out.
He was suddenly thrown over his patient and had to catch himself then tossed back and tumbled into Sitoshi who barred them from falling upon Sakura. After that they hit a hard bump that tossed them up and down.
Hiro called up while climbing up to his feet, "What's going on out there!?"
"I'm trying Hiro!' shouted Tensin, 'There's a fucking fight going on between two demons and a giant monster, and there's shit falling from the sky!"
Sitoshi recovered to check up on Sakura who was moaning and crying while yelling pleadingly, "Please God save my baby!,' then directing her attention upon her father she pointed and shouted, "You did this you stupid bastard! We should have left when they told us to, it's all your fault and I hope you die!"
Sitoshi, had a sudden snap in character and took control of her hysteria, grabbed her hand and sternly said, "Hey listen to me! We're here to help you and we're doing everything we can! But you need to stay calm and take deep breaths."
Hiro ignored the commotion and ripped open a packet of electrodes to get Hideki hooked up on the twelve lead cardiogram. Then called to Sitoshi, "Hey can you get him started on an IV?"
Nervously he ripped open the drip set, hooked it up to a bag of saline then attempted to find a good vein in the arm. Tightening the tourniquet he felt once more but the landscape of flesh was flat and devoid of any bouncy bumps.
"I can't find a good vein." he reported with the shame one feels for continuously letting down his superior.
Hiro ran his fingers over then rechecked Hideki's systolic pressure, "Forget it he's 98 over palp, they've probably gone flat."
"How do we get him fluids?"
"Get an IO going instead." he replied while tossing him the drill and IO needle.
Sitohsi's hands shook but did what was expected of him. Moving up the arm he felt the prominent edge of the humoral head at the shoulder, wiped it clean with an alcohol prep, put the drill in place hit the trigger and sent it spiraling home into the bone marrow.
Sitoshi took a saline flush, attached to the port, aspirated it, then pushed it through to disperse the marrow. After that the saline lock was hooked up with fluid running through the line freely.
"Fluids are up." he informed in which Hiro opened the lock all the way and squeezed the bag for rapid infusion.
Tensin continued to navigate through the war zone of urban fantasy as the creatures of the supernatural realm continued their sparring session. Mizu curled in a ball, clenched the handle into a death grip and trembled.
As chance would have it Tensin found an open intersection…on the other side of Alucard's form. The only way to reach it would be to drive through the battle. He sat and debated with what little time he had.
The girl looked to him and counseled, "Maybe we can find another way around."
He leaned back and called out to the others, "Hold on to your asses."
Mizu sputtered, "You're not actually going to…"
He hit the gas lurching the unit forth and shifting rapidly. Hiro and Sitoshi held on tight while Mizu shrieked and cover her eyes. All the while Tensin was praying rapidly under his breath, "God in heaven I never asked for anything and I never cared, I know I'm not perfect but please in your mercy cut me a break and let this work!"
76 made a few lucky swerves, narrowly dodged past the monster who was stepping and crushing every conceivable area of surface around them. Miraculously the ambulance blew past them unscathed, Tensin pumped his fist and cheered, "You see that shit? Yeah Fuck You! WHOO!"
Mizu on the other hand requested a change of shorts. He looked back and asked, "Hey, we might have a way out, how's things on your end?"
Hiro continued to work and watch the EKG and replied, "Not good, he's in severe shock and his sinus rhythms aren't promising. But we're managing." Sakura was groaning for attention in which Sitoshi came to her side.
"It hurts so bad!" she moaned, "Don't you have pain killers or something?"
Hiro overheard them then said, "I'm sorry, but whatever I give you will go to your baby."
Sitoshi put a pillow under her head then pondered and gave her 6ml of oxygen via nasal cannula.
Hiro commented, "About time you thought of doing that."
"Yeah I think I'm getting the hang of this." he said while taking her blood pressure manually. After a moment he dinted his eyebrows when getting his reading he asked her, "How are you feeling?"
"A little loopy, why?"
"Your numbers are 94 over 72."
"Is that bad?"
"It's lower than normal, and your pregnant which means you should have fifty percent more blood volume."
Hiro chimed in, "A broken pelvis can lead to a lot of internal bleeding, check that binder and keep an eye on her.' then turning to the cab, 'Tensin how's our exit?"
"I think I found a clearing out this way, we should have a straight shot out of Murai from there."
"Ok let us know if anything changes."
As they turned the corner Mizu gasped and covered her mouth, "Oh my…"
Tensin sighed as they drove past the remnants of the military efforts. The broken fuselages of jets and tank hardware were strewn about the road. As the wheels turned to move around the obstacles, Mizu had her eyes glued upon the wreckage in terror. She saw the lifeless bodies of pilots sitting upright in their cockpits. There were a few burning bodies laying face down next to their ruptured tanks, most likely they climbed out to escape but burned to death in the process.
They just got past it when Hiro called up, "Tensin I need your help, Hideki went into a full arrest!"
Fantasy Vs. Reality
-The crew spent too much time on scene especially if it's that dangerous. The backboards, binders and splints are one thing, but IV's can wait till were loaded and going.
-An ambulance can't maneuver or accelerate that well. Even the van styled ones Japan and Europe uses are big, taller than they are wide and aren't ideal for tight turns and high speeds. They most likely would have tipped over.
-IO's sound painful but I've seen them performed on conscious people and they take it pretty well. Depends on tolerance and technique of the one doing it.