by Scott, Laura
She glanced around, a wave of panic rising in her throat. Dear heaven, where should they start? There were too many victims for one team.
“Over here.” An officer kneeling beside one victim waved them over. He was leaning on the patient’s upper right chest, applying pressure. “This one is still alive, and her injuries are the most life-threatening.”
Jenna wasn’t about to argue. The victim was a teenage girl who couldn’t have been more than seventeen, and she’d taken a bullet in the upper chest.
Her heart squeezed as she imagined Rae’s face for an instant before the practical side of her brain took over. The officer was applying pressure on the chest wound, so she bent to feel for a pulse.
“Pulse is tachy, respirations shallow,” she informed Zane as she quickly connected the portable heart monitor.
“Get us some decent IV access while I intubate her. Don’t let up on the pressure over that chest wound,” he added to the cop.
“I won’t.” The cop stayed right where he was. “Her name is Carrie Bates, and her ex-boyfriend is the shooter. Don’t know why he had to take out so many innocent victims first, before shooting himself.”
Jenna didn’t know either. It was impossible to rationalize violent behavior. Glancing around, she swallowed hard. Such a waste of human life. Trying to remain focused, Jenna pulled out the necessary equipment to start an IV, first one in one arm, then the other.
Zane grabbed the intubation supplies and inserted an endotracheal tube so they could give her oxygen. She watched him from the corner of her eye as she slid an eighteen-gauge catheter into the teen’s antecubital vein, then connected the tubing.
“Give her fluids wide open in both IVs,” Zach instructed, giving several deep breaths with the Ambu bag. “And get ready to transfuse a couple of units of O Neg blood.”
Jenna had already pulled out the first unit of blood. By the time she’d finished hanging it, she was able to help Zane with the Ambu bag, taking over giving breaths to Carrie. She eyed the monitor. Carrie’s heart rate was fast, too fast. She glanced at Zach as he assessed the chest wound. Using his stethoscope, he listened to her chest on both sides, then in the center over her heart.
“We have to get her to Trinity, ASAP.” Zane’s expression was grim as he pulled the stethoscope from his ears. “She needs surgery. I’m pretty sure she’s bleeding into her right lung. There are no breath sounds on that side.”
Jenna nodded, doing her best to ignore the panic. This girl’s life depended on them. And she intended to save her with the same effort she would her sister.
6
“A chest tube won’t work, will it?” Jenna asked. She knew a chest tube could reinflate a collapsed lung, but she suspected bleeding inside the lung was a whole different scenario.
“No.” Zane’s intense gaze met hers. “Let’s go. We can suction the blood out of her lungs in the chopper. The quicker we get her to Trinity, the faster they can take her to surgery.”
She wasn’t about to argue, knowing Carrie’s chances of survival hung on a very thin thread. Between the two of them, they hoisted their young patient onto the gurney. Jenna strapped her in as Zane gave breaths with the Ambu bag. Then he handed the bag to Jenna and pushed the gurney as she ran alongside.
Zane must’ve given Nate the high sign, or the pilot had eagle eyes, because he had the chopper revved up and ready to go when they reached the back of the helicopter.
Jenna crawled into the back hatch after they hoisted their patient inside. Zane closed the door behind her, then ran around to climb in the side door. He took the seat at the head of the patient, but Jenna was already suctioning blood from the endotracheal tube. She stared in horror as the blood came out in copious amounts, feeling a good portion of the suction canister. The contents portended the patient’s chance of survival. How were they going to control the bleeding?
Zane took the suction supplies from her hands and pressed her helmet into her stomach. She’d completely forgotten to put it on. Quickly, she donned the headgear, then connected the communication link.
“We’ll take turns suctioning. Dial her up to one hundred percent,” Zane directed.
She nodded. “How many more units of blood should I give?”
“How many O Neg units do we have?”
Good point, she glanced into the small cooler. “Three. I’ll give them all.”
He nodded his agreement and queued his microphone. “Nate, radio ahead to warn the Trinity crew we’ll need a hot unload. The cardiothoracic team needs to be on standby. We are taking her straight to the OR.”
“Will do.” Nate proceeded to call into the dispatcher.
Jenna hung another two units of blood, then took a turn with suctioning. The amount and thickness of blood coming from Carrie’s lungs was just as bad this time around.
“The bleeding hasn’t slowed. We are not gaining any ground with her.” She couldn’t hide her frustration.
“Maybe, but we are not losing any ground either. Her blood pressure is hanging in there at eighty-five systolic.”
Okay, she could take lessons from Zane and try to see the glass as half full. She battered down the feeling of doom. “What about medications?”
“Yeah, we need to add a vasopressor. Start dopamine, but use it sparingly. I don’t want her heart rate to go much higher.”
Jenna hung the medication on one IV, leaving the other for the last unit of blood. In spite of the near constant suctioning and the blood transfusions, Carrie’s heart rate spiked to 178, and her oxygen saturation dropped to the low 80s.
They were losing her. Jenna struggled to remain calm. Nate’s voice over the microphone gave a little relief. “ETA two minutes. The cardiothoracic team is waiting on the helipad.”
Come on, Carrie, hang in there for a little while longer. Jenna gave additional IV fluids once she ran out of blood. Zane finished suctioning the moment Nate landed the chopper and killed the engine.
Jenna stayed with the patient as Zane jumped down and then went around to the back. She pushed the gurney toward him, then hopped out.
Dozens of medical personnel swarmed Carrie’s gurney. Jenna knew her help wasn’t needed at this juncture, but she followed the group as they wheeled Carrie into an elevator and rolled down to the trauma OR suite. At the doorway to the OR, she hesitated, not wanting to break the sterile field. As she watched, the tone among the caregivers became more urgent.
“She’s in full-blown arrest. Start CPR!”
Jenna recognized Zane’s voice, and her fingers itched to jump in and help. But she remained back, staying out of the way as the entire cardiothoracic team took over the code blue.
“Put her under,” the surgeon yelled. “I need to open her chest, or we’ll lose her.”
Jenna couldn’t tear her gaze away as the anesthesiologist connected Carrie’s endotracheal tube to the anesthesia machine. They barely took time to prep her before cutting into the left side of her chest. Blood spurted and the OR nurses hurried to connect the suction machine.
Jenna had never seen a surgical procedure like this before. Certainly not under these dire circumstances. She could only watch in morbid fascination.
“Her blood pressure is nonexistent!” the anesthesiologist shouted over the din. “I’ve already started a second and third vasopressor. Hurry up and do something or we will have to start CPR again.”
“We’re trying.” Two surgeons worked as best they could, but when blood pooled on the floor at their feet, and Carrie’s heartbeat went from too fast to a rate that was far too slow, Jenna feared their efforts would be in vain.
“We lost her pulse,” the anesthesiologist said abruptly. “She’s gone.”
The surgeons glanced up at the monitor, and the activity in the room came to an abrupt halt.
“No.” Jenna hadn’t realized she’d spoken out loud until the attending surgeon turned to look at her. She clamped a hand over her mouth and bit down hard on her lip to keep from crying.
Zane rubb
ed the back of his neck as he edged closer to her. “We did our best, Jenna.”
“Why didn’t they keep doing CPR? Why didn’t they keep going?” She couldn’t hold back her accusing tone.
“Because they can’t do CPR and operate on her chest at the same time. The only way to fix the problem was surgery.” Zane didn’t take offense at her naïve question.
She took several deep breaths to ward off the sudden nausea. Maybe Zane was right and there was nothing more they could have done. Carrie lost her young life as a result of needless violence.
And the young girl could have been Rae.
“Come on, you’d better sit before you fall.” She was only vaguely aware of Zane moving her away from the blood-filled OR suite. He held on to her arm with a firm grip. Outside in the OR lounge, he shoved her into a cushioned seat.
“I’m fine.” Her voice lacked conviction, and it was a struggle to stay upright even in the chair.
“You’re not fine.” The sharp edge of his tone caught her like a razor. “Do you think I don’t know what you’re going through? Do you think I don’t see the resemblance between this patient and your sister? Jenna, you have every right to feel sick to your stomach.”
“I can’t believe she died.” Jenna couldn’t remain strong, not anymore. She buried her face in her hands. “Why couldn’t we have gotten there a little earlier?”
“Shh.” Zane sat in a chair next to her and pulled her into his arms. Grateful for his strength, his support, she hung on. He stroked a hand down her back. “It’s all right, sweetheart. It’s all right.”
Jenna closed her eyes, but the scene at the mall was etched forever in her mind. For a moment, she soaked up Zane’s strength. The warmth of his arms wrapping around her felt so right. At the same time, she knew it was wrong. They were flight partners, nothing more. She took a deep breath and gently pushed away from the addictive comfort of his chest. She was a paramedic, had seen many deaths. Why had she let this one get to her?
“Sorry. Didn’t mean to lose it like that.” She avoided Zane’s gaze.
“Don’t apologize, Jenna.” He reached up and slowly wiped the tears from her cheeks with his thumb. “I understand.” His touch made her feel cherished. Special. An emotion as alien to her as driving a Lexus. She hardened her heart. Zane didn’t know anything about her life.
“Do you?” She looked him directly in the eye. “This incident is awful, but it’s hardly the first of its kind. Especially not where I live. Don’t you see? This is exactly why I’ve been working so hard to get Rae into college. At least with a solid education, she has a fighting chance to avoid ending up another victim in the never-ending circle of violence.”
Zane nodded, his expression thoughtful. “Yeah, I guess I can see that.” His smile was crooked. “You’re an amazing woman, Jenna. One of the few who actually takes action rather than sitting around and complaining about how life isn’t fair.”
His compliment was so unexpected she was momentarily speechless. Her brain short-circuited. “Um—thanks.”
“Are you looking for any more volunteers to help out at the MCCT?” he asked.
She stared at him for a moment. Maybe this was his way of trying to be nice. But really, he was taking things a little too far. “I’m not gonna lie. We are always looking for help, Zane. But you’re a doctor, and I know how many hours you’re expected to work. I appreciate your thoughtfulness and offer to help, but I know you don’t really have any time to spare.”
“And you do?” Zane rolled his eyes in exasperation. “I like basketball. I happened to play in college. I could offer a basketball camp, give the kids a few pointers. Can you really afford to turn down my help?”
As much as she wanted to, there was no way in the world she could turn him down. He was right, he would be able to reach the kids in ways she couldn’t even begin to do. Zane disturbed her on a personal level, but that was her problem and shouldn’t affect the kids struggling to make sense of a violent world.
“No, I can’t,” she agreed with a weary smile. Despite her initial goal of avoiding Zane, she couldn’t deny a tiny thrill at the thought of seeing him again. Often. At work and outside of work.
What was she thinking? This didn’t mean anything. Except maybe that they were friends. Yeah, Zane was a nice guy with a killer smile. She wouldn’t mind being his friend.
“Then, yes. If you’re sure, Zane, we’d be glad to take whatever time you have to give.”
ZANE WANTED TO KISS HER. Right there. Right then. He fought the internal battle with his conscience because this was neither the time nor the place. Friends, remember? Yeah, he was supposed be her friend, not kiss the daylights out of her. With an effort, he forced himself to pull away. “Good. I’m glad.” His voice sounded odd, and he cleared his throat. “I’m anxious to help.”
“We better get back. Nate is probably wondering what happened to us.” Jenna sighed and stood.
“Take a few more minutes,” Zane advised. He could’ve used the time, even if she didn’t need it. But Jenna shook her head.
“No. What if another call comes in? Besides there may be more victims back at the mall. We should head back, just to make sure they still don’t need our help.”
Clearly, Jenna needed to see a victim who might be still alive, one who’d managed to make it. He understood and rose to his feet as well. “Okay, let’s do it.”
Zane retrieved the gurney they used for Carrie. Jenna helped him change the bloody linens and wiped down the metal frame with bleach cloths. When they finished, they rode the trauma elevator to the helipad where Nate was indeed waiting.
“Take us back to the mall,” Zane directed, once they’d stored the gurney and belted themselves into their respective seats. “There may be more victims.”
Nate didn’t argue. He banked the chopper in a steep curve and headed back to the mall parking lot, relaying to the dispatcher their plan and making sure there were no other calls waiting.
Several ambulances were still parked outside the mall entrance. Zane and Jenna split up to cover the scene better, each looking for anyone in need of more urgent medical assistance.
Most of the patients he saw had only minor injuries. Jenna caught his attention and waved him over.
“What’s up?”
“I think this guy is suffering from a severe head injury,” Jenna informed him. The patient lying on the ground appeared to be in his mid to late fifties. “Apparently, he hit the floor hard. Although there is no outward sign of an injury, he has a large lump on his head. The crew planned to transport him via ambulance, but now his neuro status is growing worse.”
Bending down to assess the patient, Zane had to agree. The patient’s name was Jim Atwell, and he didn’t open his eyes or respond in any way to light stimuli. “Good call, Jenna, I think you’re right. Do you know anything about Jim’s medical history? If he’s on blood thinners for some reason, he could be prone to bleeding in his head.”
“No clue, but he’s not carrying any blood thinner information on him,” the medic reported. “We did not find anything helpful in his wallet.”
People taking blood thinners were instructed to carry a wallet-sized card or wear a medical alert bracelet, letting medical staff know their condition. In the absence of that knowledge, the only thing Zane could do was treat the patient as if he were not on any medication. “Jenna, bring the gurney. I’m going to intubate him. We need to transport him to Trinity as soon as possible.”
She didn’t need to be asked twice, running off for the supplies and then returning a few moments later with everything. He was grateful to note the color was back in her cheeks as she dropped the flight bag at his feet.
The medics on scene had already gotten IV access. “Let’s start a mannitol infusion.” He went through the process of intubating the patient, then once Jenna had the tubes secure, he began to hyperventilate the man. “I want you to give frequent, large breaths to help prevent any further brain swelling.”
Sh
e nodded to signify she understood. Once they had everything under control, they prepared to transfer the patient to the helicopter.
Zane fell into step beside Jenna as they made their way back to the chopper. Every television station had a camera hold, and while the reporters couldn’t get close to the chopper, he could see the cameras were trained on the two of them as they stowed the patient in the back hatch, then climbed aboard.
“Cleared for takeoff,” Nate drawled.
“Try not to hit any of the television cameras on the way,” Zane joked, tightening the strap of his helmet. Jenna put headphones on the patient even though Jim was unconscious and couldn’t communicate. He noticed she always took care of the little things, worrying about the comfort of her patient above everything else.
“Aw, why not? I should get extra points for knocking them off,” Nate protested.
“Yeah, don’t we wish.” Zane met Jenna’s gaze. “Please hand me the penlight from the flight bag. I want to check his pupils again.”
“Sure.” She handed him the light, then leaned closer to see for herself. “The right one looks larger than the left.”
“You were right. He definitely has a serious head injury.” Zane was impressed with Jenna’s quick assessment of the situation. “The pupil on the right reacts only sluggishly. According to the medic on scene, the pupils were closer in size right after the injury.”
“Will he make it?” Jenna’s gaze was troubled.
“I hope so.” Zane didn’t want to lose another victim so close to the first one any more than she did. “Nate, get us to Trinity as soon as possible.”
“Will do.” All humor had vanished from Nate’s tone.
As Zane watched over the patient, Jenna took notes and made sure all the equipment was properly connected and working. In some ways she had the harder job; his was simply to keep focus on the patient while everything else was hers to manage. Zane was amazed at how well she managed to multitask.
He could admit, at least to himself, how much he liked having Jenna as a flight partner. Mostly because of her skill, although, if he was honest, that wasn’t the only reason. No matter how hard he tried to talk himself out of it, he still wanted to kiss her. Those few minutes in the OR break room had reminded him how long it had been since he’d been out with a woman. Almost a year. He hadn’t been interested in anyone since breaking off his engagement.
