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It was another shift. The morning for both the fire department and the hospital had been nonstop. Countless lives had been saved. Everyone had been on edge, waiting for the next emergency. That was the thing. Those situations were more under control than their lives.
Susie was walking past the base station when a familiar voice of Roy DeSoto came over the speaker.
“Rampart, this is squad 51. Rampart, we have a female patient approx. age 50 she was in v-phib counter shocked one time sinus rhythm. We have her on O2. BP is 90/50 pulse 100 and weak, but thready. Respirations 16. Patching her in, this will be lead 2.”
“Start IV Ringers, check pupil response, and response to pain.”
“Rampart, Ringers is established BP is now 100/60. Pupils equal but sluggish. Some response to pain.”
“10-4 51, Please keep monitoring the BP and transport.”
Susie walked out to the emergency entrance. It was the first break that she had all morning. Sometimes she wished for another job, but then as soon as the ambulance arrived she knew she was needed. On days like today the patients kept her sane. Other times it was the other way around.
The squad and the ambulance pulled into the bay.
Susie looked at Roy. “How is she?”
“BP is stable.”
Susie, John, and Roy took her into a treatment room.
John looked at the monitor. “V-phib again.”
He grabbed the paddles, handed them to Susie, and hit the button.
John counted out loud. “1,2,3,4.”
Susie shocked the woman, and looked at the monitor. “Hit her again.”
Susie shocked the woman again. “Flat line. Continue CPR.” She looked at Roy. “Roy, 2 amps Sodium Bicarb.”
Roy grabbed the box from the drug cabinet, popped the lids, and administered the drug into the IV.
“Bi Carb in.”
“Hit her one more time.”
John hit the button and counted for the last time. Susie looked at the monitor after giving the shock.
“1 to 10,000 CC’s epinephrine.” Roy handed her the box from the drug cabinet. Susie popped the lids, and looked at John. “Stop CPR, I’m going directly into the heart.” She stabbed the woman in the heart, and John went back to CPR. She looked at the monitor.
“No capture. She’s gone.”
The three of them looked at each other, and walked out into the hallway. Still in a daze, the handie talkie scared them as it rang out.
John and Roy ran out to the squad. A few minutes later they were back on the base station.
“Rampart, this is Squad 51.” John called out.
“Go ahead 51.” Susie told him.
“Rampart, we have a male approx. age 36 possible OD stand by for vitals.”
Susie glanced at Dixie whom walked up to the desk. “Hey, Dix, can you get me Kal or Joe, we might have a bad one here.”
“Right.” She walked away to find one of them.
“BP 95/45 respirations 10 and labored. Pulse 60 and weak. The victim is unconscious and there is no response to pain or stimuli.”
“Start IV D5W TKO administer O2. See if you can find out what the victim took.”
“Rampart, the victim appears to have roils. The victim also has evidence of aspiration.”
“Ok, 51 insert esophageal airway, and check the vitals once again.”
“Rampart, an informant at the scene states that the victim took some sort of drug before passing out.”
Joe Early walked to the base station. “What’ve you got?”
“An OD victim. He’s already aspirated.”
Joe looked at Dixie. “Dix, set up for endotrachial tube, suction. Get someone down here from respiratory. Get CBC, tox screen.”
Susie went with Dixie to get the treatment room ready, as John and Roy rushed their patient into Rampart.
They transferred the patient onto the treatment table. Susie pulled the airway out and began suctioning the man’s lungs out, replacing the airway.
“Pupils equal, but sluggish.” Joe stated.
“Possible neurological damage?” Susie asked him.
“It’s a good possibility.”
Kal walked into the room, as Dixie answered the phone. “What’ve got, Joe?”
“The tox screen shows Morphine.” Dixie told them.
“Start him on 10mg Naloxone.” Susie told Dixie.
Before they could get the new IV started the man began convulsing. Susie, Joe, and Dixie held him down onto the bed. A bottle fell out of his pocket. As they held him the seizure stopped. Dr. Brackett began checking the man, as Dixie picked up the bottle.
“Here’s the Morphine, it was in his pocket.” She handed it to Dr. Brackett. He opened the bottle, and looked inside. “Almost all of it gone.” He looked at the front of the bottle. “Susie, this has your name on the bottle.”
Susie looked at the man. “I’ve never seen him before.”
Dixie looked at the man. “I think he used to work here.” Susie looked at the man again. “Wait.” She stepped closer looking at the man’s face. “He worked in my office about two weeks ago. Yeah, that’s him, but he was never a patient here.”
“Could he have stolen it from your office?” He asked Susie.
“There’s no way. I don’t keep any of that in my office.” She told him.
He looked at the monitor. “Well at least the Naloxone is keeping his blood pressure up. I want him sent to the intensive care unit as soon as possible.”
Susie, Joe, and Kal walked out to the hallway.
“Do you think he’s going to make it?” Susie asked.
“I’d say the chances are against him.” Kal said. “Is there any way, any way possible that you wrote him that prescription?”
“I’m 100% sure I never wrote him anything like that.”
“The death will have to be investigated, until then keep on the lookout for suspicious activity. “
Susie and Joe took the man to the ICU. Only time would tell if the man would regain consciousness. This case was going to be one that she remembered for a while. She took the stairs back to the emergency room. Her mind kept going through all the ways the man could have gotten the Morphine. Did she give it to him? Did he steal it? A million different reasons ran through her mind. Walking up to the desk, her mind was still on the last patient.
Dixie looked at her. “You have a patient in treatment room one.”
Susie looked at her. “Huh?”
“You have a patient in treatment room one.”
She grabbed a chart, and glanced at it, and then walked into the treatment room. “What seems…” Before she could finish her sentence she saw Chet sitting on a treatment table.
“Well, what happened here?” She asked.
“I think I broke my shoulder, again.” Chet told her.
“Now how in the heck did that happen?” She asked puzzled.
John began smiling. “Oh, Chester B here…”
Chet interrupted him. He looked at John then at Susie. “You want me to tell the story or you, pal?” He looked at Susie. “This big brunette knocked me over with a couple of chairs in this club.”
John smiled again. “She was more your type than mine.”
Susie rolled her eyes, and began checking Chet out. “I won’t know without the x-rays, but it looks broken to me.” She looked at a nurse. “I want a shoulder plate of the abdomen, and start an IV of D5W.” She looked at Chet. “I don’t know how you get into these situations Chet, but I’ll tell you one thing you won’t be going back on duty for a while this time.”
Susie, John, and Roy walked out to the hallway. “I still don’t believe it.” John looked at Susie. “We got a response to that new club on Dowwood and Hayworth. There’s this man lying on a table, or what’s left of it anyway. We start working’ on him, and all of a sudden this woman comes up and pours a whole pitcher of beer on him. Roy tried to stop her, and before we knew it the whole place had gone insane.”
The handie talkie went off, John and Roy walked away and Susie walked back into the treatment room. The x-rays were already placed into the reader.
“Well Chet you broke your clavicle in two places, and it have to be set in surgery. I’ll see when you can have it done.”
“Boy, she really did a number on me.”
Susie chuckled. “Good thing John and Roy tried to save you when they did. I’m going to find you a room, and give you something for the pain.”
“Hey thanks. You know? I wouldn’t say this around the guys but you’re really ok, for a girl doctor I mean.”
“I’ll take that as a compliment.” She walked out to the hallway, and to the nurse’s desk.
Susie looked at her. “Kal needs you in treatment room five.”
She walked into the treatment room, and looked at a woman lying on the treatment table. “What seems to be the trouble?”
The woman looked at her, pulling a bandage from her head. “Dumb dog, tripped me and I fell into the stove. Should have gotten rid of him years ago.”
She looked at the nurse. “What are the vitals?”
“BP 120/80 Pulse 70 Respirations 15.”
“Well.” Stepping closer. “Quite a head wound you got there, but it only needs a few stitches.” She looked at the nurse. “After I stitch her up I want a full skull series.” She looked at the woman. “Did you pass out?”
“No, No I remember the whole thing. The dog just stood there and looked at me like I was the dumb one.”
She laid the woman back on the table, and began looking at the wound. A few minutes later she had the lady’s stitches finished. The x-ray technician took her to x-ray as she stepped into the hallway once again. John and Roy stepped over to her, trying to avoid the crowd of people.
Roy handed her a piece of paper. “Can you sign us out?” He turned around, and Susie signed the paper on his back.
“No rest for the weary, huh?” John and Roy almost ran out of emergency as the handie talkie went off again. Dixie walked up to Susie.
“Joe wants to see you. He’s on three.” Susie looked at Dixie. “Let me know when those x-rays come back.” Dixie glanced at her.
Susie walked through the crowd and onto the elevator. A few minutes later she was at the bedside of her former patient, now Dr. Early’s.
“His levels have gone up again.” He told her.
“Shouldn’t the Naloxone stabilize the levels?” She asked.
“The blood work confirmed, Morphine reentered his system.”
“But how can that be?”
“Maybe a friend, maybe a nurse. I really don’t know. I know one thing for sure. If we don’t find out soon we’ll have an epidemic on our hands.”
Joe and Susie began measures to prevent anyone but the staff from entering his room.
Susie walked back down to the emergency room. There at the desk she found Dr. Brackett, Dr. Morton, and Dixie standing at the desk looking at her.
“Did you treat the patient in treatment room five?” Dr. Brackett asked her.
“Yeah, I was awaiting the x-rays to come back, why what happened?”
He looked up at her. “She just died five minutes ago.”
“Subdural Hematoma?” She asked.
“No, a Morphine overdose.”
“What, how did that happen?” She asked stunned.
Dr. Brackett, Dr. Morton, and Susie walked into Dr. Brackett’s office. He threw the chart onto the end of his desk. “The nurse charted 10mg MS IV.”
Susie looked Dr. Brackett in the eye. “This is absurd I never gave that woman and IV let alone MS.”
“Are you sure?” He asked her.
Susie was mad, and looked at him. “Are you accusing me of killing my patients?”
He looked at her. “No, No I’m not. I think I know you a lot better than that.”
Dr. Morton looked at the chart. “Kal, this isn’t her handwriting. It has to be the nurse.”
“Where is she, I want to talk to her!”
“She’s already left for the night.”
“Oh how convenient. Left me holding my patient’s lives accountable.”
“Look before anything else happens, I want you know that I and the hospital take responsibility for you.”
“And that’s supposed to make me feel better? So at this point am I relived of my duties?” She asked.
“No. We need to find out what is going on. When you treat a patient get me, Joe or Mike to sign off on your chart.”
Susie looked Kel dead in the eye. “I promise I did not do this.”
“I know you didn’t, but I want to find out who did.”
They walked out to the hallway. Susie looked around at all the people and treatment rooms. She knew in her heart she didn’t do anything to kill patients. It deeply sadden her that someone could accuse her of murder. If anything she was too nice sometimes. She walked back to the desk, and had a seat at the chair. She put her head in her hands. At first she was mad at the nurse, and then she was mad at herself. Through the thinking she never heard John walked up to the desk. He noticed right way something was wrong, it was more than a patient.
“You ready to go?”
Susie looked up at him. “Yeah.”
They walked out to the car, and she got in. John now really noticed something was wrong. She was staring out the passenger window not saying a word. He put the car into gear, and then decided not to pull into traffic. Usually he made a joke, this time he didn’t.
Susie finally looked over at him with tears in her eyes. “Have you ever wondered if you the rescues you did were for nothing?”
The look on her face said it all. Something very bad had happened. “You can talk to me about anything.”
She began crying. “Johnny, I killed a patient today.”
He looked at her. “Look at me.” He lifted her face to look at him. “Look at me. Now I know better than that, and you know better than that.”
She looked at him. “A patient died. A patient overdosed on Morphine because I was irresponsible.”
She looked out the window again. “If there is anybody that tells you that their lying. You are one of the most responsible people I know. You did not kill that patient. You hear me you did not kill anybody.”
He was now mad too. Someone was doing something so spiteful that it made his blood boil. A few minutes into the ride they said nothing. Even as traffic came to a stop, Susie never looked up. John began looking around. He saw Vince, and honked the horn. Vince walked up to the car.
“Johnny, we got an accident about a mile up the road.”
“What’s the ETA of a squad?”
“Another 20 Minutes.”
Susie snapped out of the daze, and looked at John. They both got out of the car, and began walking through the stopped traffic.
“John wait.” She saw a first aid sticker on big rig. “Hey can we use your first aid kit?”
The driver looked back out the window. “Yeah, it’s there in the back.”
Susie grabbed the metal box, and began catching up to John.
“Get back please we’re LA county paramedics.” He said as they approached the first mangled wreck.
John opened the door, and looked inside at a woman. “Are you hurt any place?”
“Yeah. I think my foot is caught under the seat, and I think I hit my head on the steering wheel.”
“Ok, lean back here.” He helped her back into the seat. He began checking the vital signs that he could. Everything seemed to be normal. “The rescue squad will be here in a few minutes. I don’t think that you are hurt too bad. Now I’ve godda go check the other cars. If you need me just holler.”
He walked to the car where Susie was at. “I need your help. We have a critical patient. He took the steering wheel full force with his chest.” Both of them could hear the engine arriving at the scene.
“I’ll get the K-12, and the drug box.”
He began walking briskly through all the cars back to the engine.
“Cap, we got a badly injured man. We’re gonna need the K12 and a drug box from the squad. Better bring a backboard too.” The squad pulled up to the scene. Both men walked up to Johnny. “We’re gonna need the drug box, O2, and trauma box.” The two paramedics walked back to the squad as John walked back to the car and Susie.
“How is he?” John asked her.
She looked back at him. “Not good.” The B-shift paramedics walked up to the car. Susie opened the drug box, and grabbed the BP cuff.
She walked over the passenger side of the car, and began trying to get the door open. The others began too. Finally Susie climbed in through the window to the man. She began taking the BP. “John the BP is 80/40 the pulse is 50 and weak. Respirations 8. He needs Ringers right now.”
John handed the IV set through the passenger door, as the other men began making their way to the car. Susie began the IV, as the equipment came to life. After she started the IV she took the BP again. Over the noise of the K-12 she got John’s attention for another IV set of Ringers. She started another IV in the opposite arm. They worked their way around to the other side of the car pulling the top back to expose the front seats.
John and the men began putting a back board behind the man, and getting him out of the car. She jumped out of the passenger side and ran over to the driver’s side. They began hooking him up to an EKG monitor.
“Flatlined.” John began CPR. It was tricky. The man’s chest was almost crushed from the impact of the crash. Susie grabbed the paddles from the case, and began getting them ready. John pressed the button on the machine. “Clear.” She shocked the man, and then looked at the monitor. “Hit him again.” John hit the button one more time. “Ok clear.” She shocked the man. This time a wound began shooting blood from his chest.
“We got a bleeder.” John put his hands on the man’s chest. He looked up at Susie. “I can see his heart and other organs.”
She looked at John. “Stop, he’s gone.” John took his hands off the man’s chest, and stood up. Blood began coloring the pavement a crimson red. The other fireman grabbed a yellow blanket, and put over him. Vince walked up to the car.
“All the other victims are accounted for, and at the hospital.”
Susie stood up to the side of the car, and looked at the man for a moment. She almost walked away, and then screamed out in pain.
John quickly grabbed her. “You ok?”
She looked at him. “I caught a piece of the debris.”
“Here” He grabbed her shirt away from the car, and walked her to the open highway in front of them. “Your side here?” He asked her, and pulled her shirt up. Her side was cut and bleeding. He leaned her against the guardrail, and scooted the drug box in closer to him. He grabbed a compress and held it to her side. She began holding it on her own. Folding it back he looked at the wound. “It’s going to need stitches.” He put another compress on the wound, and taped it. “You think that you can make it to the ambulance?”
He walked her to an ambulance, and they both got in. A few minutes later they were back at Rampart.
Close to an hour later they had her sown up, and awaiting discharge. Dr. Brackett walked back into the treatment room with Officer Vince.
“What’s going on?” She asked. “We found your prescription writing thief. He was the man you guys pulled out of the car. All the prescription pads were in the glove box with your name on them.”
“Yeah, but what if other people got them?” She asked. “We called the pharmacies within a 200 mile radius, if they pass one they’ll call us.”
“And to think I was going to quit in the morning.”
Dr. Brackett looked at her. “Why is that? If nothing else pans out you could become a human can opener.”
Posted to Site 07/30/13
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