LITMIR.BIZ

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she truly comprehended that she was feeling the very essence of life, and while her essence was strong, Richard’s was slipping away.

      It didn’t take trained medical experience to know that.

      “I think it’s his hip,” Mark said, standing. “Can’t tell for sure, but that would be my guess for a primary injury. Everything else going on is probably a result of that. Look, I’m going to run to the truck for my bag. I’ll be back right back.” He didn’t wait for her reply. He simply turned and ran down the footpath with a stride and strength she couldn’t have possibly matched. Which left her there alone. Richard Whetherby’s only lifeline for the next minute.

      “Richard,” she said. “It’s Angela. Angela Blanchard. I’m here with Mark Anderson, one of the doctors from the hospital. We’re going to take good care of you, get you all bundled up and take you to the hospital in just a couple of minutes.”

      No response, of course. No movement either. Because of that, Angela wanted to feel Richard’s life force again, just to reassure herself. So she laid her fingers back on his pulse point, but couldn’t find the faint rhythm she’d felt before. Anxiously, she tried again. Moved her fingers from side to side, up and down a little, yet still couldn’t find his pulse. Suddenly, it hit her like that proverbial lightning bolt! “Mark,” she screamed, rising up on her knees to position Richard’s head back a little. She’d taken a CPR class years ago but hadn’t ever practiced it except on a dummy. But now…“Mark!” she screamed again as she forced Richard’s stiff jaw open and bent to give him a breath. Actually, she gave him several… couldn’t remember how many, but she knew it had to be several. Then she reared up, threw off the coat covering the man’s chest, pulled his own coat open, placed one of her hands on top of the other, went to the critical spot in his chest she remembered from her instruction, and started to pump. “One, two, three…” she said aloud, fearing she wasn’t pressing hard enough, or that she was pressing too hard. She remembered something about bad positioning and broken ribs and punctured lungs.

      “Angela!” Mark said, dropping down beside her.

      “I couldn’t find a pulse,” she gasped, scooting aside while he took over the chest compressions. “So I…” Rather than finishing the sentence, she positioned herself at Richard’s head, counting each and every one of Mark’s chest compressions. “Is it thirty to two?” she asked.

      He nodded. Didn’t look at her. And as she counted down the thirty, she got ready for the next two breaths, repositioned Richard’s head, drew in her own deep breath, then laid her mouth to his. She and Mark alternately repeated their resuscitation efforts for the next few minutes… minutes that felt like an eternity, neither one of them uttering a word as they concentrated on what had to be done. Then, finally, in the distance, came the wail of a siren. A flash of relief passed between them in the fleeting glance they allowed themselves.

      “Where are you?” a voice from the road yelled.

      “Twenty yards down the footpath,” Angela yelled.

      “Angela,” Mark said. “Can you hold the flashlight, and keep his head tipped back once I get it into position. We need to get him breathing, and I’m going to insert an endotracheal tube into his throat.”

      The first paramedic resumed the chest compressions, the second broke out the equipment?the tubes, the oxygen, the heart monitor. At Mark’s prompt, he handed the ET tube to Angela, who turned it over in her hands, not sure what it was.

      “When I ask for it, hand it to me. Until then, just keep the light steady, and make sure that his head doesn’t slip. Normally I don’t have to get belly down in the snow to do this, and it’s going to be a little tricky.”

      “I can do this,” she whispered, more for her own ears to hear than for Mark’s. But he heard anyway.

      “I know you can.” He gave two good squeezes to the resuscitation bag, which had replaced the mouth-to-mouth efforts. “Oh, and when I get the tube in, hand me a stethoscope.”

      It was all procedural, very matter-of-fact, which amazed her. Step one, step two, step three… a methodical plan they all knew, but she didn’t.

      “And once I get the tube in, be ready to hold it while I check to make sure it’s in the right place.”

      Now, that scared her a little, but she nodded, hoping her nervousness didn’t make her look like one of those dolls with the bobbling heads.

      “Ready?” he asked, squeezing the resuscitation bag one last time. Then signaled for the paramedic to stop the chest compressions momentarily.

      It happened in the blink of an eye, but she took in everything. Mark positioned Richard’s head, she positioned the flashlight. Mark lowered himself flat in the snow, she took hold of Richard’s head and held on for dear life. Then Mark took some kind of instrument from his pocket… she couldn’t remember its name, but she’d ask him later… opened Richard’s mouth even more, then asked for the tube. Instinctively, she moved closer as she handed it to him and, without fanfare or effort, Mark simply slid that tube into Richard’s mouth. Not the esophagus, she told herself. This tube was for breathing, so it went into the trachea.

      For the first time she wondered about the anatomy of it, wondered what separated the two as they were in the same area. Wondered how Mark differentiated.

      “Stethoscope,” Mark said. “And hold the tube for me now. Don’t let it move.”

      Angela was immediately in the snow, not on her belly, but close to it, as Mark rose to his knees to listen. The IV paramedic who manned the equipment, and who was also preparing to start an IV, attached the resuscitation bag to the tube, gave it a couple of good squeezes, and Mark nodded.

      “Tape it in place,” he told Angela, as the paramedic dropped a roll of white tape down to her.

      “Tape it?” she asked.

      Chest compressions were starting again. Mark was busy doing something with a syringe. The IV paramedic was attaching a bag of fluids to the tubes coming from Richard’s arm. So many things were going on and Angela felt more lost than ever in all the procedures. Even the simple ones, like taping the tube.

      “Lasso the tape around the tube then anchor it on both sides of Richard’s face,” Mark explained with all the patience of a good teacher.

      So easily said, yet such a daunting thing to do. For her. Still, she taped the tube in place as Mark attached the syringe to a tiny tube sticking out of it.

      “Blowing up the cuff,” he explained. “The small tube leads to an inflatable cuff on the actual breathing tube—endotracheal tube is what it’s called?and when air is inserted into the small tube, it gives the endotracheal tube a tight fit to the tracheal walls so it doesn’t slip or let air get in around it.” He completed the task, then reattached the resuscitation bag to the tube and fell back into the rhythm of thirty compressions, two breaths.

      All of this in mere seconds. Angela was amazed. And exhausted by the time they’d stabilized Richard enough to lift him onto the stretcher.

      “Don’t you have to shock him or something?” she asked. She’d seen it on TV. Rush in, get the paddles, shock the heart. But they weren’t doing that here.

      “We’ve got good oxygenation established to his brain, and it was done quickly. The purpose of CPR is not so much to revive the patient but to keep them oxygenated long enough to get them proper help. The hospital is two blocks from here… better to try the cardioversion there, in a more controlled environment.”

      Cardioversion… something else to look up.

      As Mark explained all this to Angela, the paramedics whisked Richard to the ambulance. And by the time Mark paused for a breath, and Angela had picked up their discarded coats, the ambulance was pulling away. “That was so fast,” she whispered. Ten, maybe fifteen minutes, tops, from the time Mark had first spotted him. It was amazing!

      “Thanks to you,” he said, taking her coat from her, brushing

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