Welcome back, Dianna!
Our station buzzer and waist radios go off at midnight.
EMS 8. Cardiac arrest. Terminal C, near gate 34.
My partner and I rub the sleep from our eyes and restart our brains.
On scene in a near empty airport terminal, a middle-aged woman waves us toward her. Four airport security officers appear relieved by our arrival. All four scramble away from the unconscious patient’s side as I radio for firefighter assistance.
“Help my daughter, please,” the woman begs in a panic. “She just fainted.”
The daughter appears to be in her early twenties. “Ma’am?” I say, touching her shoulder.
Unresponsive. I feel her carotid artery. Pulseless.
“No,” she cries out. “Nothing.”
My partner presses defibrillator pads to our patient’s chest—one under her right clavicle, the other on her side over her left lower ribs.
“What was she doing when she collapsed?” I ask the mother as I continue non-stop chest compressions.
“Walking to our gate.” The mother pants several quick breaths. “We’re catching the red eye to Paris. Help her. Please. She’s only twenty-four.”
I swallow the sadness clogging my throat. God, please give this mother strength.
The cardiac monitor assesses the heart rhythm. The wave pattern displays on the screen, and I interpret it. “Pulseless ventricular fibrillation,” I tell my partner as he whips out our IV kit.
We defibrillate the patient. A small crowd gathers near us as two firefighters arrive on scene to help us.
“Take over compressions,” I say to the two males, and one of them does so, as my partner drills a hole into our patient’s shin for intraosseous access, the preferred and more effective route over intravenous in cardiac arrest.
I dig into our airway bag for an airway adjunct, an oxygen tank, and a BVM—bag valve mask. Iinsert the oropharyngeal airway down the patient’s throat and connect the BVM to an oxygen line to oxygenate our patient.
“Bag her,” I say to the other firefighter, and he grabs the BVM from my hand.
I whip out our med box and spike a bag, as my partner finishes the IO (intraosseous) line. We push 1mg epinephrine and 40 unit vasopressin into the line; the firefighters continue with chest compressions and bagging.
I prick the patient’s finger and a run a BGL—blood glucose level—for possible hypoglycemia.“Does she take any medications?” I ask the mother for information as well as to engage her in hopes of keeping her calm. “87 BGL,” I say, telling my partner it’s at a normal level.
“No, she doesn’t,” the mother wails out, tears covering her face. “Why isn’t she waking up?” she screams, pulling on the jacket of the firefighter bagging the patient.
“Ma’am?” I gain her direct eye contact. “Let us do our job, okay? We’re here to help your daughter.”
“Yes. Sorry.” She releases her grip on the firefighter and backs up. “Not my girl,” she cries out. “Not my Hannah. God, take me instead.”
“Ma’am, take some deep breaths and keep on praying.”
She nods at me with the saddest smile I’ll never forget.
I check Hannah’s pulse. Carotid pulse still absent.
We repeat defibrillation then resume chest compressions and bagging. We add 300mg of Amiodarone to the line. Then sodium bicarbonate.
“I took a first aid class,” some male in the near distance says. “Do you want my help?”
“No, we’re good,” I answer loud enough for wherever he is to hear.
We start another line, this one IV in the left arm, and run cold fluids in it.
“Hey, you could use my help,” that male voice again says, although this time he sounds ticked.
“Sir?” One of the security officers rushes behind me. I hear scrambling. “Move on your way.”
“I’m trying to help.”
“That’s kind of you, but they’ve got it. Please walk on.”
A hand yanks on my shirt collar at the back of my neck. I squirm forward from it with no luck, but stay focused on the care of my patient.
“Let go of her. Now.” The grip on me releases. I hear more scrambling behind me.
“Hey. Hey. Hey.” The chaos behind me fads out.
I apply new defib pads. We repeat defibrillation then resume chest compressions and bagging.
I check the carotid. Still no sign of life.
We add magnesium sulfate to the IO line. We push another 1mg of epinephrine and 150mg of Amiodarone. Then doses of Procainamide and Metroprolol.
We work the code for over twenty minutes, to no avail. I’m thinking Hannah possibly suffered acidosis, hyperkalemia or cardiac tamponade, or maybe she overdosed on some drugs. Maybe she has an undiagnosed heart condition.
“Astyole,” my partner says while viewing the monitor screen.
“What does that mean?” the mother wails out. “That’s bad? There’s only one straight line thingon the screen over there.”
“Keep praying,” I tell the mother.
“Let’s inject Narcan,” I say to my partner, thinking it could be some kind of overdose.
“You’re on my brain wave,” My partner says about the med I suggested.
We inject Narcan into the line. Unfortunately, a minute later there’s no change in the patient’s lifeless condition, and typically an overdose patient will jerk to life in seconds.
“How about some Atropine?” my partner says, and I nod, reaching for the medication.
We continue to push additional med dosages and work the full code as the two firefighters continue with bagging and chest compressions, neither I nor my partner willing to call it.
Not yet.
I can’t yet let Hannah go, and the mother isn’t ready for it.
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Dianna T. Benson is a 2011 Genesis Winner, a 2011 Genesis double Semi-Finalist, a 2010 Daphne de Maurier Finalist, and a 2007 Golden Palm Finalist. In 2012, she signed a nine-book contract with Ellechor Publishing House. Her first book, The Hidden Son, released in print world-wide March 1, 2013.
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After majoring in communications and a ten-year career as a travel agent, Dianna left the travel industry to earn her EMS degree. An EMT and a Haz-Mat and FEMA Operative since 2005, she loves the adrenaline rush of responding to medical emergencies and helping people in need. Her suspense novels about adventurous characters thrown into tremendous circumstances provide readers with a similar kind of rush. Dianna lives in North Carolina with her husband and their three athletic children. Learn more about Dianna at www.diannatbenson.com.
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