Still, Still, Still --A Christmas to Remember Ch. 3
Disclaimer: Still don't own them and still not making a profit. I also don't own the words to the Christmas song Still, Still, Still!
A.N. Once again, I have no medical knowledge and the information used to treat Sammy has been googled.
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Previously: "Oh my God Sammy No" Dean yelled out in panic as he saw his brother's body convulse rigorously from the shock of standing in the electrified water.
Dean's mind automatically kicked into soldier mode the moment he saw his brother begin to convulse. He had to get the electrical wire away from Sammy or he would most definitely lose his brother. He automatically stripped his jacket off and threw it on the ground to stand upon to keep his own feet out of the water. He then removed his shirt and wrapped it around his hands to insulate himself, thankful that the rain has just quit falling. He couldn't afford to allow the cloth to get wet. He quickly reached out to grab a hold of the wire and slung it quickly towards the ditch not caring about possibly being shocked himself, his only thoughts were for Sammy. Afterwards, he jogged to the back of the Impala and grabbed the wooden handles that they used for the axe heads. He quickly placed the wood under Sam's arms and pulled him away from the electrified water.
"No, No, No, No, No" he muttered as he bent down to check on Sammy. He didn't know how much voltage his brother's body had sustained from the severe electrical shock but knew that any little amount was too much. He bent down and ripped open Sam's jacket and placed his hand upon Sam's chest to feel for any movement in his chest.
"Son of a bitch he's not breathing" Dean gasped as he pushed Sammy's head back at an angle and forced his mouth open. He quickly gave two breaths and then watched for the rise of Sam's chest. Seeing nothing, he placed his fingers near the breastbone just below the heart and started CPR. He quickly did fifteen compressions and then gave Sammy two more rescue breaths. He did the rotation another two times before stopping to check for a pulse. "No damn it" he yelled as he felt nothing with his fingertips and started CPR once again. After two more rounds of compressions, he was relieved to find a faint pulse beneath his finger tips when he checked Sam's radial artery. As he held his hand in place on the artery, he pulled out his phone with the other hand and quickly dialed 9-1-1.
After the operator picked up, he gave her the information that she would need to get help to them as soon as possible before hanging up even though she had asked him to stay on the line. Feeling the shivers starting to wrack his own body with the adrenaline fade, Dean knew he couldn't leave Sammy lying on the freezing road. He gently pickled up his baby brother and placed him on the back seat of the Impala. He then rushed to the open trunk and pulled out two insulated blankets. He quickly bundled Sammy in one and then wrapped the other around himself as he sat back to wait for the ambulance. He thanked God that they weren't too far out of town so help should arrive fast. He had only been sitting a couple of minutes when he heard the sound of a siren blaring in the distance. "Their on their way Sammy, you're gonna be okay kiddo."
As Dean cradled his brother to him, he looked up just in time to see the ambulance come screeching to a halt with it's brilliant blinking red lights ablaze. He saw two people dressed as EMT's climb from the back, each carrying a box in their hand. He breathed a sigh of relief as they quickly approached the car. Sammy was finally going to get medical attention.
"Sir, can you tell us exactly what happened?" Alicia asked as she pulled a stethoscope from around her neck and placed it to Sammy's chest while grabbing his wrist to take his pulse. Alicia was a stocky woman of medium height at about five foot six with piercing brown eyes. She had curly brown hair which she wore pulled back into a ponytail that hung midway down her back but Dean could see the gentleness in her face.
"We, hit-hit the electric pole when I lost control of the car and it cau-caused the electric line to snap and fall into a water puddle on the ground. When Sammy got out-out of the car, he stepped into the puddle where the line ha-had fallen" Dean explained with a stuttering voice as the seriousness of the situation weighed heavily upon his shoulders.
"I'm on it" the other paramedic said as he pulled of Sam's shoes and socks. He knew it was vital to find the entry and exit wound to learn just how far the electrical current had traveled through the young man's body. He winced in sympathy as he saw the large burn mark on Sam's left foot indicating the point of entry. The skin was charred and angry looking from the substantial burn on the foot. "Alicia, we need to find the point of exit" Jerry said as he watched his female partner taking Sammy's pulse praying that the current hadn't traveled too far. Alicia nodded as she quickly applied an oxygen mask over Sam's nose and mouth to aid with his labored breathing. It was obvious the stress of trying to pull in air was overtaxing his severely traumatized system.
Jerry worked off Sam's jeans to check his legs while Alicia started pulling off his sodden shirt to check for any signs of exit. "Got it" Alicia stated as she found the exit wound just above Sam's right hip. Like his foot, Sam's side was severely traumatized and burnt where the current had left his body. The skin was somewhat charred and angry looking indicating that Sam most likely had deep tissue burn. Jerry opened his medication box and pulled out some burn cream and sterile bandages to do what little he could to treat the burns knowing that it wouldn't be nearly enough. He worried about the length that the current had traveled through Sam's body. It would most likely have caused organ damage and the kid before him just couldn't afford that kind of damage to his body.
Being a man of fifty five years of age, Jerry hated seeing cases like this where the victim was relatively young and so severely traumatized. He had seen other patients who had received a less severe shock to their bodies like the young man before him and most of them didn't survive.
After they stabilized Sam as best they could, Jerry ran back to the ambulance to get the gurney. He and Alicia pulled Sam from the back seat of the Impala and carefully placed him on the gurney and then rushed him to the back of the waiting ambulance with a stunned Dean following quickly behind. After Sam was placed in the ambulance, Alicia pulled out some thermal blankets and placed them over Sam as she hooked him up to a cardiac machine. "This man is throwing PVC's at an alarming rate" Alicia said as she watched the readout on the machine. "We've got to get him to the hospital ASAP."
Jerry instructed Dean to climb into the ambulance and then climbed in himself. He was worried that the boy before him was falling into shock with they way he was acting so sluggish. His face had significantly paled upon arrival and he was shivering, whether it was from the cold or witnessing what his brother went through, Jerry wasn't sure. Upon closing the doors and making sure everything was secure, Jerry thumped his hand near the front of the ambulance to let the driver know they were ready to transport.
As the ambulance raced towards the hospital, the EMT's continued working on Sammy. Jerry started an IV to administer fluids while Alicia monitored his breathing which had become more labored even though Sam was receiving oxygen through the mask covering his nose and mouth. After a minute or two, she noticed that his breathing had almost completely stopped.
"Jerry, he's going into respiratory distress" she called out as she opened up the trauma box and pulled the intubation equipment from it. Both Alicia and Jerry were aware of the fact that most electrical shock trauma victims eventually suffered from diaphragm paralysis due to the interruption of cervical motor neurons to their central nervous system. The diaphragm automatically slowed down it's functioning as the nervous system became confused.
"Oh God, Sammy" Dean whispered as he watched Jerry and Alicia begin to frantically work on his baby brother once again. He knew things had just gotten worse as Sammy stopped breathing once again. "Please don't give up little brother" he whispered as he watched Jerry prepare Sammy for intubation.
Jerry took hold of Sam's head and put it in what was referred to as the sniffing the morning air position with the neck slightly flexed and the head extended. While Jerry got Sam's head into position, Alicia pulled on a pair of sterile gloves and opened the package holding the sterilized laryngoscope and endotrachial tube. She put the scope in the right side of Sam's mouth as she moved his tongue to the left for better access. She advanced the scope forward until she was able to see cartilage at the back of Sam's throat. As she advanced it a tad bit further, she could finally see the small triangular opening between the vocal cords which was where the tube needed to be placed. She then opened the sterilized package and gently inserted the endotrachial tube into Sam's mouth until it advanced through the vocal cords. Once the intubation was confirmed by bilateral breath sounds. She inflated the cuff and then secured the tubing to Sam's upper jaw with tape to hold it firmly in place and then hooked it up to the portable ventilating machine which they kept in the ambulance.
Dean was taking deep breaths trying to calm himself as Alicia finished the intubation to keep from throwing up. He had never seen his brother have a tube shoved down his throat and it was something he never wanted to witness again in his lifetime. He had to close his eyes as the tube was pushed even further or risk gagging and distracting the EMT's who were working on his baby brother.
"He's intubated" Alicia confirmed as Jerry finally released the secure hold he had on Sam's head and placed it back into a more relaxing position so as not to overstrain the muscles in his neck. She glanced over to the heart monitor that Sam was hooked to and saw that the PVC's were getting worse. "Damn it, he's gonna crash" she called out just at the ambulance pulled up to the ER bay.
Jerry quickly threw open the back doors as a doctor came rushing up. "We got a male in his early twenties. He's suffering from a severe electrical shock. He's coded once already and he went into respiratory distress on the way in" he said as he reached in to pull the gurney with Sam on it out. They were just starting into the hospital when Alicia shouted. "He's coding." They immediately stopped the gurney and Alicia climbed up on top and straddled Sam's stomach as she quickly began CPR. She felt the gurney moving once again while she worked as Jerry and Dr. Steven Daniels pushed them into the hospital and behind the swinging treatment doors.
Dean was following behind the group when he heard Alicia say that Sammy had coded. His heart thumped rapidly in his chest as he realized Sammy's heart had quit beating. He saw black spots beginning to dance in front of his eyes and took calming breaths knowing that he couldn't pass out now, he had to remain with his brother. He saw Alicia climb up on the gurney and begin CPR as Jerry and the other man started pushing them inside the ER doors. Dean made to follow them but was immediately stopped by a male dressed in scrubs.
"I'm sorry sir, but you'll have to wait out here" the orderly informed Dean as he tried to make his way into the treatment rooms.
"But he's my brother" Dean pleaded as he tried to push the man out of the way.
"I understand that sir, but you'll only be in the way. The best thing you can do to help your brother right now is fill out some admittance forms so the doctors will have his medical history." The orderly led Dean over to the nurses desk where he was given five different forms to fill out.
Dean held the papers in his hand and looked at them trying to figure out what they were for. The writing looked foreign to him as his eyes shimmered with tears and the lines on the paper blended together. He quickly swiped his eyes and then tried to pull himself together for the sake of Sammy. It took him quite a few minutes, but he managed to get all of the forms filled out. As he sat in the chair waiting with his knees bouncing up in down in nervousness, he suddenly realized that he needed to call Bobby and inform him of what happened. Bobby would want to be there since he had become a father figure to them. Dean pulled out his cell phone and scrolled down until he found the correct number. He hit the button and waited for the man to pick up. He felt a small amount of comfort when he heard Bobby's voice come over the phone.
"Singer here, what can I do for you?"
"Bobby, it's De-Dean"
Bobby could hear the anxiety in Dean's voice and immediately knew that something was wrong. Assuming that Dean had lost his temper again, Bobby immediately went into angry mode.
"Dean, you better have not went off on that brother of yours again. Damn it boy, when are you gonna realize that Sam lost his daddy too."
"I kn-know that Bobby"
"Well you damned sure aren't acting like it. Tell me Dean, how many times have you struck out at Sammy in anger? Just how many times have you used the kid as your own personal punching bag?"
"I didn't me-mean"
"Yeah, well Sammy's face sure is paying the price for something you didn't mean to do isn't it/ Do you know how badly you hurt that brother of yours by locking him out of the room last night boy. He was coming up to try and make amends. Instead of allowing him that small comfort, you shut him out! Just before I went to bed last night, I could hear soft sobs coming from the living room as Sam tried to hide his pain. Dean you're going to lose that kid if you don't get your head out of your ass and start acting like a brother instead of a stupid ass bastard."
"Bobby please" Dean sobbed as the words hit close to home, making him realize just how truly awful he had been to Sammy over the past few weeks. He felt tremendous guilt consume him as he openly began to cry.
Hearing the sound of Dean's cries coming through the phone, Bobby immediately became extremely anxious knowing that something bad must have happened for Dean to show his emotions so openly.
"Dean, what is it? What's wrong boy?" Bobby asked with a shaking tone to his own voice.
"It's Sammy Bobby, he's hurt real bad. God, we need you Bobby, please."
"Dean just tell me where you are and I'll be there as fast as possible."
"We hit some, some ice Bo-Bobby, The car, it, the wire fell, he stepped, Oh God Bobby, it's bad."
"Dean, tell me where are son?" Bobby shouted with anxiety about to overwhelm him.
"We're at…at…" Bobby heard the sound of what he assumed to be the phone falling to the floor.
"Dean, Dean, answer me kid" he shouted praying that Dean could get himself together long enough to tell him where they were.
"Are you there sir?" a female voice asked as Bobby waited impatiently for somebody to pick up the phon
"Yes, please can you just tell me where you are?" Bobby pleaded as he started his old blue Ford pickup and pulled out of his driveway.
"Yes sir, I am a nurse at Sioux City Memorial Hospital." I assume you are some kind of family to this young man.
"Yes, I'm the boys uncle. Can you please tell me what happened?" Bobby asked as he made a right turn on the road out of his driveway to head towards the hospital.
"I'm sorry sir but your nephews were involved in a serious accident. Their car hit an electric pole causing the line to snap. I'm sorry to say that the youngest of the two received a severe electrical shock as he stepped out of the car. All I can tell you is that the doctors are trying to stabilize him right now."
"Oh God, Sammy" Bobby mumbled as he felt tears starting to fall from his eyes. "Tell Dean that I'll be there as soon as I can" he said before pushing the button on his cell phone to end the call. As he drove like a bat out of hell towards the hospital, Bobby prayed that things weren't as bad as they sounded for Sammy.
TBC