heart lurched. “We will!” she gasped after the last breath.
“Hold that thought.” He looked up at one of the men standing above her and fired rapid Spanish at him. The bystander rushed to get his cellphone out of his jacket pocket then, following his directions, called a number and placed the phone to his ear. He shot out a string of what sounded like commands into the phone, then nodded to the man, who removed the phone and placed it back into his pocket.
Curiosity overwhelmed her. Who had he called? And how come he sounded perfectly American one moment then clearly Spanish the next? No time, and no breath left to ask. From then on they resumed their efforts in silence, snatching eloquent glances every time she raised her head from a breath. At least, she thought they were eloquent. She felt they were exchanging their gratitude for sharing the massive responsibility with each other. Admitting their strong attraction.
She could also just be hyperventilating.
But she hadn’t been when that bolt had hit her a few minutes ago. All right, so she had been hit by bolts like that before. But she hadn’t been a thirty-year-old then. Merely a stupid teenager who’d just discovered her sexuality and had gone about picking the most disastrous choice to be the focus of her infatuation...
Rushing feet announced the paramedics’ arrival, breaking into her untimely musings. How long had it taken them to make it here? And who had the man called? She’d lost track of time, felt as if she’d been fighting for the kid’s life for a day— drowning in his eyes all her life...
His curt words brought her back to the crisis. “Get a bag-valve mask, a cardiac monitor, the defibrillator, and cut his clothes!”
Yes, definitely a doctor. And he wasn’t relinquishing their victim to the paramedics’ care. Good—she wasn’t about to either. She was seeing this through.
“But it’s been over fifteen minutes, and if he’s still in arrest—” one of the paramedics started, but the man cut him short.
“I started CPR almost immediately.”
“But still...”
“Did no one report he’d been electrocuted?”
That stopped the paramedic’s arguments. In electrocution, since the heart had no underlying disease causing the arrest, resuscitation should continue for far longer than for any other cause of arrest. There was always hope an electrocuted victim could revive after protracted resuscitation efforts.
She delivered one last breath before snatching the bag-valve mask from a female paramedic’s hands, sealing it over the boy’s face and beginning positive pressure ventilation with 100 per cent oxygen. The man stopped the cardiac compressions to attach the cardiac monitor’s electrodes to the boy’s chest.
Following through with her ventilatory assessment, Cassandra grabbed a stethoscope and listened to the chest. “Chest rising well, equal air entry over both lungs.”
The man nodded, finger on the boy’s carotid artery, eyes on the monitor. He added his own assessment. “Still pulseless, though—heart’s in ventricular fibrillation.” He turned to the paramedics.
“Charge the defibrillator.”
In seconds they’d handed him the paddles of the defibrillator.
“Everyone, clear!” he shouted.
The first shock produced no change in heart rhythm.
“Increase the charge,” he ordered.
A second then a third shock still produced no effect. And three shocks were the limit at a time.
“Back to CPR, then,” Cassandra said. “Time for venous access and intubation.”
“Yes.” He made way for the female paramedic to take over cardiac compressions. “Which do you want to handle?”
She didn’t relish the idea of coming near the boy’s mouth again. “I’ll take venous access.”
He held her eye for a second, jolting her yet again. He understood her reluctance—sympathized? With a nod, he turned to the other paramedic. “No. 2 Miller laryngoscope, straight blade, 4.5 endotracheal tube, uncuffed.”
Whoa! Not just a doctor. A specialist of some sort. An anesthetist maybe? Whatever, the man was just too impressive altogether...
Drool over him later. Get a line into that little boy.
He finished the intubation, slipped the ETT in place, tested its correct placement and decompressed the stomach to further aid ventilation. Everything done with staggering speed and precision. It didn’t make Cassandra feel any better about her struggle to locate a vein.
“No luck?”
She bristled at his question, brought the spurt of irritation under control and made one last attempt. No go.
“Let me do that.” He reached out to take the cannula out of her hands.
She turned on him. “You got a way to inflate his collapsed veins?” His eyebrows rose at her vehemence, his hands, too, in a conciliatory gesture. “You go ahead, then,” she muttered. “Administer epinephrine though the ETT. I’ll go for the intraosseous route.”
That hard, hot energy he emitted spiked, the explicit awareness in his eyes back in full force. Still, when he talked, he was the personification of professionalism. “0.2 mg/kg epinephrine, 1/1000 solution,” he ordered the paramedic.
Her heat rose. Her concern, too. “0.1 mg/kg is the maximum initial dose via ETT!”
“No.”
“Just no?”
“Yes.”
Overconfident, imperious. She hated that in men.
“I assume you do know what you’re doing?”
“I do.”
And she really believed he did. It was probably why overconfident imperiousness looked good on him.
She turned to the paramedic. “You have an intraosseous kit?”
“No, but we have spinal needles,” the paramedic said.
“Close enough. Get me an 18-gauge needle.” The efficient man handed it to her in two seconds flat. “Ready Ringer’s lactate solution, two bags, and giving sets while I do this.”
She located the point of insertion in the boy’s tibia, an inch above the medial malleolus in his foot, inserted the needle perpendicular to the bone with a screwing motion until it ‘gave’ when she entered the marrow cavity. A centimeter in, she stopped, removed the needle, leaving the catheter in. In seconds she had her line secure and fluids pumping into the inert boy.
“Good job. No extravasation?” her resuscitation partner asked, checking whether any fluids were leaking out of the bone. She shook her head and he said, “Better deliver the subsequent doses of epinephrine via this route, then.”
They
