Chapter 4

The truck was moving just as Julie had instructed, fast and smooth. Johnny managed to get another set of vitals on his patient and a set on Roy. Roy was holding his own just fine, the other guy was slipping.

With nothing more he could do at the moment except to hang on for the ride, Johnny began to take in their benefactor. Julie was now slumped down on the floor of the truck bed her head bouncing on the back of the cab as they moved. Her once white bandages were now saturated with blood and covered with dirt from helping with his patient. From time to time Julie would close her eyes and lean back against the cab but after just a minute or two she would be leaning forward and looking around again. John was sure the headache she was getting from bouncing her head off the metal of the truck had something to do with getting her to move.

Frank sat in the farthest corner of the truck bed with his legs folded in front of him and his arm on the top of the tailgate. His gaze was behind them and Johnny was wondering what he was looking at. They could no longer see the fire but the smoke swirling upward was still easy to see. This was the first time since John had graduated from the fire academy that he had driven away from a fire while it continued to burn out of control and not a single person was fighting it. As much as he had to agree with what Julie had told Chet, he still felt derelict in his duty and was sure Chet still did too, but still, what could any of them have done. John vowed to get a shovel to keep in his truck for such cases in the future and while he was at it maybe he should start picking up some more first aid supplies too.

John had actually figured out that he could go to Roy's house and use his saws to make four of those leg splints out of a single four by eight foot piece of plywood. That's when Chet stuck his hand holding the CB mic through the window.

"We've got the Doc on the radio." Chet spoke excitedly as he held the CB mic through the window and Julie was quickly up and on her knees with Johnny's help. Julie then leaned close to the mic and Chet understanding her bandaged hands by now held it close to her mouth and worked the talk button for her.

"Doc, we're coming in hot with a real bad one. We have a lacerated femoral artery and probable fractured femur." Julie then proceeded to read off vital signs on the critical patient as well as Roy DeSoto, as Johnny held the note pad where she could read it.

"The ambulance left an hour ago to take that burn patient into the burn center." Doc Frick reported over the radio. "Do we need to turn them around so they can take this patient too?"

"Na, Doc, they're too far out. I think this guy needs to be air lifted out anyway. That's the only way we're going to save his leg."

"I take it you've had to put a tourniquet on," Doc surmised, putting the pieces together.

"It was either that or lose him before we could get him loaded."

"We'll be ready for you when you get here I'll get Life Flight on the way."

"Doc, if we could get our hands on some IV fluids it could make the difference on this one," Julie added.

"Yeah, it sure sounds like it but how on earth are we supposed to get some IV solutions to you?"

"Wally should be on his way out here to fight the fire we left for him. He could pick them up from Ozella and meet us on the way."

"This is Wally, I'm coming close to Middletown; I should be there in two minutes." The new voice on the radio made Julie smile.

"This is Ozella, Doctor Frick, What do you want me to get ready?"

"And to think my dad used to complain about a party line." Julie's face was filled with hope as she listened to Dr. Frick list off the supplies Ozella needed to gather before telling Julie to start two IV's if she could and run them wide open.

Then, as if an afterthought, Dr. Frick asked, "Julie, how on earth are you going to start those IV's?"

"You taught me Doc, how do you think I'm going to start them?" Julie answered then stuck her head through the window to talk to her brother. "Watch for Wally, he'll be making a supply drop as we pass each other." She then pulled back into the back of the truck and looked at John. "I'm guessing you're not certified to start an IV in this area?"

John looked as her as the realization of what she was saying sunk in. slowly and regrettably John shook his head to confirm what she had said.

"You better pull those bandage scissors out then and cut these bandages off."

John moved for the bandage scissors then paused and looked at Julie. "Just what's under those bandages?"

Julie looked at him with a glare of defiance, then let out a deep breath. "Burns, second degree."

John looked over the area covered with bandages including the impression of bandages on her chest and did the math, "I'm guessing that at least 20 to 25 percent of your body is burned, if you know anything at all you've got to know that you need to keep those burns covered to prevent infection."

"This man's life depends on me being able to start two IV's, I've got to have at least a thumb and forefinger to do that, and that's if you do everything else except the needle puncture."

"I can do that, let's get you a finger and a thumb," John was willing to compromise that far and was amazed at the difference from the last time they tried to help out in this area. "Are you right or left handed?"

John was sure Julie was right handed because that was the arm that was bandaged up to the armpit. When Julie confirmed his hunch he carefully felt through the bandages to find the thumb and was relieved to feel that there was padded material between it and the rest of the hand. Then he carefully clipped the bandages and even more carefully cut them away from the thumb. As he did so he was pleased to find that there were a few layers of bandaging next to the skin that were still clean. Once he pulled the bandaging away from her thumb he was surprised to see that there were no burns on her thumb until he reached the webbed skin between the thumb and the forefinger. Being very careful, John then nipped away and the top layers of bandaging covering the rest of the hand there were fluffed up pieces o gauze pads between each finger so John started to gently pull them away from the forefinger. There were more than a few blisters on the next finger, a slight majority of them were ruptured and the fluids from inside the blisters were causing the bandage to stick to the skin.

Julie flinched a time or two in evidence of the pain John was causing her but didn't say a word. This was the first time he'd looked at her long enough to see the dilated eyes. "How much morphine did they give you and how long ago?" John asked as he pulled a tube of burn cream from the top tray of the first aid box. Using the cream to loosen the bandages John was just about to reapply some bandaged to the worst of the burns on the forefinger when he felt the truck decelerating quickly.

John was able to quickly wrap a sterile 4x4 around her finger and then apply tape before Chet was opening the hatch and lowering the tailgate. As soon as the tailgate was down Chet lifted an oxygen canister into the back of the truck and Frank was quick to slide out onto the tailgate and out of the way. When another man was there handing in a box filled with four glass bottles of IV fluid and a handled tray that contained everything else they could possibly need to get the IV's running.

John started barking out orders as if they were back in LA County. "Chet, get that oxygen hooked up and on this guy," he called as he pulled an IV set up from the tray and quickly opened it. Inserting the tubing in the top of the bottle, John started to ramble a little.

"We don't use these glass bottles anymore. The bags are a lot safer in the field and you can place the bag under the patient's shoulder and let the pressure keep the fluid flowing while you transport."

"Yeah, I know that," Julie responded, looking on helplessly as John did everything. "But the bags are still more expensive than the bottles and in this part of the world money talks louder than safety and convenience. You can hang that bottle from that hook there." Julie then pointed with her bandaged hand to four eyebolts that were fastened aboard that was then fastened to the roof of the camper shell. The eyes of the eyebolts had been pried open just enough to easily slip the wire hanger attached to the IV bottle through and the eyebolts were spaced enough to keep the bottles from banging into each other and breaking while they transported.

"Do you need me anymore?" the man who had handed over the supplies asked.

"I, I, I'm g, g, going with W, W, Wally," Frank informed Julie and John was quick to see the Julie shared eye contact with the man they were calling Wally.

"I'll keep him out of trouble and see to it that he gets to your dad's place once we get that beast out," Wally assured then quickly shut the tailgate before leaving and going back to his truck and pulling out in the opposite direction.

"I should have gone with him," Chet commented when he moved closer to the patient so he could place the oxygen mask on his face.

"That's okay, Wally can handle things and if he needs help he has his radio, a radio that's a far sight better than my old CB,"." Julie instructed as she was moving in and with her newly freed finger and thumb was looking for the best veins.

As soon as John had bled the fluid into the tubing of two bottles of fluid he handed the ends to Roy to hold while he moved in to help prepared the veins for Julie to stick.

"Let's get a blood pressure cuff on to help blow up these veins; they're going to need a big needle to get blood through."

"You're right," John responded as he applied the cuff, "but it's better to get a small one in to get the fluid going and make the veins bigger by the time we get him to the hospital."

"Yeah, I know, but I think I can get a 16 in there," Julie pointed to a vein that she had found.

John was skeptical but chose not to challenge her. After pulling the packaging open and carefully placing the needle hub in Julie's fingers John hovered over her and followed her instructions to rub the vein from the wrist toward the blown up blood pressure cuff and was amazed as she slipped the crowbar of a needle right into the vein. John then took over with getting the IV hooked up and taped down while Julie started looking over the other arm for another vein.

Once again John managed to do everything but put the needle in place and Julie once again surprised him with her skill at getting the needle in the vein. Once the second needle was taped down and both IV's were running wide open, Julie gave her brother the command to move out.

John looked into the cab at that moment and noticed the man behind the wheel was focused straight ahead and as rigid as a board before moving into action to get the truck moving again. Remembering the last time he, 'moved out' Johnny braced himself in preparation of a quick start.

Once things were stable again in the new movement and John had double checked the IV starts to make sure all was flowing well, he turned to Julie. "You did real good getting those veins. I would think you would be hard pressed to get the practice in an area like this."

Julie just grinned at the praise she was getting. "Those of us that are IV certified get together once a month to practice on each other. There are also a couple of us that travel to the Red Cross Blood bank once or twice a month where we can get a lot of practice drawing blood. That's where I learned the trick of milking a vein. I also learned how to pin one down so that it doesn't roll on you. Doc also has me doing house calls once a week or so to collect blood samples from some of his less mobile patients." Julie let John and his partner know she wasn't some country hick when it came to finding a vein. "I know what I'm doing. Judging by the way you tied those down after I stuck 'em you must not be too bad yourself."

"Well, I've got to admit I learned something; I've never seen that milking technique you used before." Johnny continued to praise Julie as he offered up the crooked smile that was well known in the halls of Rampart General.

Julie's brother had one thing in common with the Paramedic whose name he shared, he knew how to drive fast and still be safe behind the wheel.

When they backed up to the door marked as their emergency room Chet opened the hatch from the inside and then the tailgate before jumping out and reaching up to take hold of the back board. By now it was no surprise that Roy, Julie's brother, remained in the cab with both hands on the steering wheel and his eyes facing forward.

A gurney was wheeled through the doors and it was no surprise that Doc Frick was right behind it already dressed in scrubs. What was surprising was that he was in a wheelchair. On the back was a pole holding an IV that was connected to his arm and his leg was raised and resting on the support on the wheelchair.

Dr. Frick pushed himself out of the wheelchair pausing only long enough to untangle his IV line from the handles of the wheelchair before hobbling over to the gurney. "How's he doin'?" he asked as he checked the man's pupils and took notice of the message written on his forehead.

"His blood pressure is up ten points since we started the IVs and his color is better," Julie reported.

"Good! Let's get him straight into surgery. I need six units of O neg for him and get an update on when that jet is going to get here. Clark there can tell you who to call to pick up the team at the airport." Dr. Frick then lowered himself back into his wheelchair and took control of the wheels to follow the gurney back into the hospital. Just before he was inside far enough to allow the automatic doors to close he looked over his shoulder.

"Get that other patient into x-ray and I'll get to him as soon as I can. You wait there with him," he instructed Julie. "We're going to have to change those bandages." With those orders barked out the doctor then moved on.