defiblover27

[defiblover27]

Simulation

In the bustling corridors of the underfunded hospital, a faded flyer catches the eye of passersby, its corners curling with age. "Volunteers Needed for Trauma Training Exercise," it boldly proclaims, beckoning those with a sense of adventure or altruism to step forward and lend their aid.

Among those drawn to the call is a 24-year-old woman, her determination evident in the set of her jaw as she approaches the hospital's trauma director. They exchange a brief but earnest conversation, the young volunteer expressing her willingness to participate in the training exercise while voicing her concerns about her comfort level with certain procedures.

"I'm eager to help in any way I can," she explains, her voice tinged with a mix of nervousness and resolve. "But I'll admit, I'm a bit apprehensive about some of the more invasive procedures. I'm comfortable with basic first aid and CPR, but I'm not sure I'm ready for things like intubation or defibrillation."

The trauma director nods understandingly, his expression one of reassurance rather than judgment. "That's perfectly understandable," he replies, his tone gentle yet firm. "Your safety and comfort are our top priorities. We'll tailor the scenario to suit your preferences and ensure you're only asked to participate in tasks you feel comfortable with."

With a sense of relief washing over her, the young volunteer nods gratefully, grateful for the understanding and support offered by the trauma director. Together, they discuss her role in the upcoming training exercise, mapping out a scenario that challenges her skills without pushing her beyond her limits.

Preparing the volunteer for the trauma training exercise is a meticulous process, undertaken with care and attention to detail to ensure her safety and comfort throughout the simulation.

As she arrives at the hospital, the volunteer is greeted by a team of trained professionals who guide her through each step of the preparation process. They lead her to a private changing area, where a set of hospital scrubs awaits her. With gentle encouragement, they assist her in disrobing, providing her with disposable undergarments to wear beneath the scrubs for modesty and hygiene.

Once dressed, the volunteer takes a seat as a makeup artist meticulously applies special effects makeup to simulate the injuries she will portray during the exercise. With a steady hand and an artist's eye for detail, they create realistic bruises, lacerations, and abrasions, transforming the volunteer's appearance into that of a trauma patient in need of urgent medical attention.

As the makeup artist works their magic, other members of the preparation team gather the necessary equipment for the simulation. They retrieve a backboard from its storage location, laying it out on a nearby gurney in anticipation of the volunteer's arrival. Alongside the backboard, they arrange a cervical collar (C-collar) and an inflatable orange brace designed to stabilize her right leg.

With the makeup application complete, the volunteer is guided to the gurney, where she lies down with a sense of trepidation mingled with excitement. The preparation team surrounds her, their movements practiced and precise as they secure her to the backboard with straps, ensuring she remains stable and secure throughout the simulation.

Next, they carefully position the cervical collar around her neck, adjusting it to provide support without impeding her breathing or movement. With gentle yet firm hands, they slide the inflatable orange brace into place around her right leg, inflating it to the appropriate level to immobilize the limb and prevent further injury.

As the final touches are made, the volunteer takes a deep breath, steeling herself for the challenges that lie ahead. Though she may be nervous, she knows she is in capable hands, surrounded by a team of professionals dedicated to her well-being. With a nod of affirmation, she signals her readiness to begin, eager to play her part in the training exercise and contribute to the hospital's ongoing mission of saving lives.

The simulation begins with the trauma team gathered around the gurney, their expressions grave as they assess the condition of the patient lying before them. The young woman, named Emily, is 24 years old, her face drawn with pain as she struggles to maintain consciousness amidst the chaos of the emergency room.

Emily's injuries are extensive, the result of a harrowing car accident that left her trapped in the wreckage for hours before help arrived. She presents with multiple traumatic injuries, including a deep laceration on her forehead, contusions and bruising across her chest and abdomen, and a visibly deformed right leg.

As the medical team conducts their initial assessment, Emily groans softly, her voice barely above a whisper as she describes the events leading up to the accident. She recalls the screech of tires and the sickening crunch of metal as her car careened off the road, the world spinning in a dizzying blur before everything went dark.

Her breathing is shallow and labored, punctuated by gasps of pain as she struggles to draw air into her damaged lungs. A rapid pulse races beneath her clammy skin, a testament to the body's instinctive response to trauma as it fights to stay alive against overwhelming odds.

The trauma team works quickly and methodically, their movements a synchronized dance of urgency and precision as they address each of Emily's injuries in turn. They apply pressure to the gaping wound on her forehead, staunching the flow of blood with sterile dressings and medical tape.

Meanwhile, others attend to her chest and abdomen, palpating for signs of internal injury while monitoring her vital signs for any indication of deterioration. X-rays are ordered to assess the extent of her injuries, with the medical team bracing themselves for the possibility of life-threatening complications hidden beneath the surface.

Throughout the simulation, Emily remains conscious but disoriented, her grip on reality tenuous as she grapples with the enormity of what has happened. She reaches out for reassurance, her eyes searching the faces of the medical team for a glimmer of hope in the midst of her darkest hour.

As the simulation progresses, the trauma team springs into action with renewed determination, their focus unwavering as they fight to stabilize Emily's condition and save her life. Though the road ahead may be long and fraught with uncertainty, they refuse to give up hope, drawing strength from their collective commitment to excellence in the face of adversity.

As the simulation progresses, the trauma director approaches Emily with solemnity, his voice gentle yet firm as he explains the next phase of the exercise. "Emily," he begins, his tone tinged with empathy, "in just a moment, we'll be simulating a critical event. We'll need to simulate your heart stopping. We'll need to cut open your shirt to begin chest compressions, and we'll place an ambu bag over your mouth and nose. You should remain still and 'lifeless' during this process. You may choose to close your eyes or keep them open."

Emily nods in understanding, her heart pounding in her chest as she braces herself for what's to come. With a deep breath, she closes her eyes, surrendering herself to the immersive experience of the simulation.

The trauma team springs into action with practiced efficiency, their movements choreographed to perfection as they simulate the onset of cardiac arrest. With a swift motion, they cut open Emily's shirt, exposing her chest to the harsh glare of the overhead lights. A sense of vulnerability washes over her, but she remains steadfast in her commitment to the exercise.

Chest compressions begin in earnest, the rhythmic thud echoing through the trauma room as the medical team works tirelessly to restore circulation to Emily's failing heart. An ambu bag is placed over her mouth and nose, delivering precious oxygen to her struggling lungs with each squeeze of the bag.

Amidst the chaos, Emily lies perfectly still, her body limp and unresponsive as she embraces the role of a patient in cardiac arrest. Though her mind races with adrenaline-fueled anticipation, she remains focused on maintaining the illusion of lifelessness, drawing upon her training and instincts to convey the gravity of the situation.

As the simulation unfolds, Emily finds herself enveloped in a surreal sense of suspended animation, her senses heightened as she navigates the fine line between reality and simulation. With each passing moment, she grows more deeply immersed in the role, her commitment unwavering as she plays her part in the collective effort to save lives and improve patient outcomes.

In the tense silence of the trauma room, Emily waits with bated breath, her entire being poised on the precipice of uncertainty. Though the outcome remains uncertain, she knows she is surrounded by a team of dedicated professionals committed to her well-being, ready to spring into action at a moment's notice to ensure her safety and success in the simulation.

As the simulation progresses and Emily remains in her role, the trauma director approaches her once more, his demeanor compassionate yet resolute. "Emily," he says softly, "we need to simulate defibrillation and the removal of the rest of your clothing. Are you okay with that?"

Emily meets the trauma director's gaze with a steady nod, her determination shining through the mask of simulated injuries. "Yes," she replies, her voice steady despite the rising tide of nerves coursing through her veins. "I'm ready."

With Emily's consent secured, the trauma team prepares to take the simulation to the next level. The room hums with a sense of purpose as equipment is brought forth, including the defibrillator paddles and a privacy screen to shield Emily from prying eyes.

With practiced hands, the trauma team carefully removes the remainder of Emily's clothing, revealing her body in its entirety to the stark fluorescent lights of the trauma room. Emily feels a pang of vulnerability wash over her, but she remains steadfast in her commitment to the exercise, drawing strength from the knowledge that she is surrounded by a team of professionals dedicated to her well-being.

As the final pieces of clothing are set aside, the trauma director approaches Emily once more, his expression one of reassurance as he prepares her for the next phase of the simulation. "Emily," he says, his voice gentle yet authoritative, "we're going to simulate defibrillation now. You'll feel a brief shock, but it's perfectly safe. Are you ready?"

Emily nods, her heart racing with a mixture of anticipation and apprehension. "I'm ready," she affirms, her voice a whisper in the stillness of the trauma room.

With a sense of purpose, the trauma team positions the defibrillator paddles against Emily's bare chest, their gloved hands steady as they prepare to deliver the simulated shock. A hush falls over the room as the trauma director counts down, his voice a steady cadence in the tense silence.

"Clear," he calls out, his command echoing through the trauma room.

In the next instant, Emily feels a jolt of electricity course through her body, sending a shiver down her spine as her muscles twitch in response to the simulated shock. Though the sensation is fleeting, it leaves her breathless with adrenaline, her senses heightened as she remains poised on the brink of uncertainty.

As the simulation continues, Emily finds herself drawn deeper into the immersive experience, her commitment unwavering as she navigates the challenges presented by the training exercise. Though the road ahead may be fraught with obstacles, she knows she is surrounded by a team of dedicated professionals ready to guide her every step of the way, ensuring her safety and success in the simulation.

As the simulation progresses, the trauma team continues their relentless efforts to resuscitate Emily, their movements a blur of urgency as they alternate between chest compressions, defibrillations, and the administration of resuscitation drugs.

With each compression, Emily feels the pressure against her chest, a rhythmic reminder of the tireless dedication of the medical team fighting to bring her back from the brink. The defibrillator paddles crackle with energy as they deliver simulated shocks, each one sending a jolt of electricity coursing through her body in a desperate bid to restart her faltering heart.

Amidst the chaos, the trauma director calls out the duration of Emily's cardiac arrest, his voice a steady anchor in the storm of uncertainty. "Five minutes," he intones, his words a stark reminder of the precious seconds slipping away with each passing moment.

The medical team works with practiced efficiency, their movements synchronized as they administer resuscitation drugs in a last-ditch effort to revive Emily's failing heart. The air is thick with tension as they watch for any signs of response, their collective gaze fixed on the monitor displaying Emily's vital signs.

Minutes stretch into eternity as the trauma team refuses to yield to despair, their determination unwavering in the face of overwhelming odds. With each passing moment, Emily feels herself drawn deeper into the immersive experience of the simulation, her senses attuned to the ebb and flow of life and death unfolding around her.

Though the outcome remains uncertain, Emily knows she is in capable hands, surrounded by a team of dedicated professionals committed to her well-being. As she lies in the midst of the simulated cardiac arrest, she draws upon her training and instincts to convey the gravity of the situation, embracing her role with a sense of purpose and determination that belies the simulated injuries adorning her body.

In the stillness of the trauma room, Emily waits with bated breath, her entire being poised on the razor's edge of uncertainty. Though the road ahead may be fraught with obstacles, she remains steadfast in her commitment to the simulation, ready to face whatever challenges lie in store with courage and resilience.

As the simulation intensifies, a sense of unease washes over Emily, a peculiar sensation prickling at the edges of her consciousness. Though she tries to push aside the feeling, dismissing it as a product of the immersive experience, a growing sense of dread gnaws at the pit of her stomach.

Unbeknownst to Emily or the trauma team, a medical student, eager to prove themselves in their new environment, has made a critical error. In their haste to assist with the simulation, they mistakenly administered a vial of real epinephrine instead of the simulated medication, a grave oversight that goes unnoticed amidst the chaos of the trauma room.

As the potent drug courses through Emily's veins, she feels a surge of adrenaline flood her system, her heart racing with an intensity that surpasses the bounds of the simulation. A sense of disorientation washes over her, her senses overwhelmed by the sudden onslaught of physiological responses triggered by the real medication.

Despite the mounting alarm bells ringing in her mind, Emily says nothing, her voice lost amidst the cacophony of the trauma room as the medical team continues their efforts to resuscitate her. With each passing moment, her condition deteriorates, her heartbeat growing erratic as she teeters on the brink of true cardiac arrest.

In a cruel twist of fate, Emily's worst fears are realized as she plunges into the depths of a genuine cardiac arrest, her body succumbing to the deadly grip of arrhythmia. The trauma team, unaware of the unfolding crisis, presses on with their simulated interventions, their attention focused solely on the task at hand.

As Emily's consciousness fades into darkness, she realizes with a sinking heart that she is no longer a participant in a training exercise but a patient in desperate need of salvation. Though the realization comes too late to alter the course of events, she clings to a flicker of hope, praying for a miracle to save her from the abyss of death that looms ever closer with each passing second.

As the trauma director attempts to speak to Emily, a sense of urgency grips him as he notices her lack of response. His brow furrows with concern as he leans in closer, his voice tinged with desperation as he calls out her name. "Emily, can you hear me? Emily?"

There is no response, no flicker of recognition in Emily's glassy eyes as they stare blankly ahead. Panic begins to rise within the trauma director's chest as he realizes something is terribly wrong. With trembling hands, he reaches for Emily's wrist, his fingers searching for the reassuring throb of a pulse beneath her skin.

His heart sinks as he feels nothing but stillness, his worst fears confirmed in the absence of the vital sign he had hoped to find. In a state of shock, he checks for a pulse again, this time beneath the cervical collar, but the result remains the same—Emily is in cardiac arrest.

A sense of urgency washes over the trauma director as he springs into action, his training kicking in as he directs the medical team to shift their focus from simulation to reality. "She's in cardiac arrest!" he declares, his voice cutting through the chaos of the trauma room. "Start chest compressions, now!"

With practiced efficiency, the trauma team pivots to the new reality before them, their movements swift and sure as they initiate CPR in a desperate bid to revive Emily's failing heart. Each compression is a prayer whispered into the void, a plea for a miracle to breathe life back into the stillness that surrounds them.

As the trauma room buzzes with frenetic energy, the trauma director's mind races with a million questions, each one more pressing than the last. How could this have happened? What went wrong? But amidst the chaos, there is no time for answers, only action as they fight to save Emily's life against overwhelming odds.

In the midst of the turmoil, Emily lies motionless, her body a canvas for the frantic efforts of the medical team as they work tirelessly to bring her back from the brink. Though the road ahead may be fraught with uncertainty, they refuse to give up hope, drawing upon their training and expertise to navigate the stormy seas of cardiac arrest and guide Emily safely back to shore.

As the resuscitation attempts continue, the trauma room pulses with urgency, the rhythm of chest compressions driving the frantic tempo of the medical team's efforts to revive Emily. With each compression, her body sways from side to side, the force of the compressions causing her breasts to shake in a stark reminder of the gravity of the situation.

Amidst the chaos, the trauma team remains undeterred, their focus unwavering as they prepare to escalate their interventions in a desperate bid to save Emily's life. With a sense of grim determination, they gel the paddles and charge them with electricity, the anticipation hanging heavy in the air as they prepare to deliver a shock to Emily's bare chest.

In a moment fraught with tension, the paddles are placed on Emily's skin, their cold metal surface a stark contrast to the warmth of her flesh. With a silent prayer on their lips, the medical team braces themselves as they prepare to unleash the full force of the defibrillator in a last-ditch effort to restart Emily's faltering heart.

A heartbeat later, the trauma room is awash with blinding light and crackling energy as the paddles deliver their shock, coursing through Emily's body in a desperate bid to jolt her heart back into rhythm. The room holds its breath as the monitor displays the outcome, the fate of Emily's life hanging in the balance with each passing moment.

But despite their best efforts, the monitor remains stubbornly flatline, a grim testament to the stubbornness of death in the face of human intervention. With a heavy heart, the trauma team presses on, their resolve unshaken as they refuse to yield to despair.

In a final act of desperation, the medical team moves to intubate Emily, their hands steady as they guide the endotracheal tube into her airway, securing her breathing and allowing for the administration of life-saving medications

As the resuscitation efforts persist, the passage of time weighs heavily on the trauma room, each minute stretching into eternity as the medical team fights desperately to revive Emily. Over thirty agonizing minutes tick by, marked by the relentless rhythm of chest compressions and the mechanical whir of life-saving equipment.

Despite their tireless efforts, Emily's condition continues to deteriorate before their eyes. Her once rosy complexion fades to a pallid shade of gray, her skin growing cold to the touch as the chill of death creeps inexorably into the room. The gel from the defibrillator paddles glistens on her bare chest, a stark reminder of the futile battle being waged against the icy grip of mortality.

A bruise blossoms between Emily's breasts, a grim testament to the force of the chest compressions that have been administered in a desperate bid to restore her failing circulation. Her eyes remain wide open, staring blankly into the void as if searching for answers that will never come.

Sensing the gravity of the situation, the trauma team pauses momentarily, their hands hovering over Emily's motionless form as they perform a vital signs check. With a heavy heart, they prepare to confirm what they already fear to be true—that Emily is beyond saving, her journey on this mortal coil drawing to a tragic and untimely end.

A cardiac ultrasound reveals the harsh reality of Emily's condition, the images on the monitor painting a bleak portrait of irreversible cardiac damage. Her heart lies still within her chest, a silent sentinel to the finality of death's embrace.

#cpr #resus #resuscitation #defib #defibrillator #hospital

[defiblover27]

Runner Down

I have decided to try and get back into writing. I found this request from a while back that I decided to flesh out. A little bit different from some previous stuff. I hope you enjoy!

Caleb is a nineteen year old college student standing at five foot eight with blonde hair and blue eyes. Caleb always made sure to take care of his body and had a strict diet and exercise regimen. Since the weather was starting to warm up he decided to hit up a heavily wooded trail near school to go on a run. He parked in the lot and began his pre-run stretches. He was in shorts and running shoes and decided that since it was so nice outside that he would go on the run without a shirt. His fit and tone torso was already begining to sweat slightly due to the heat. The first half mile went well but Caleb forgot to drink enough water and developed a cramp in his left leg. He slowed down slightly in attempt to not put as much pressure on it but continued with the run. A short while later he was almost a mile into his three mile run when he developed a sharp pain in his left arm. The pain caused him to slow to a walk and attempt to catch his breath. He could feel his heart pounding in his chest and found it hard to breathe. He began wheezing as he attempted to breathe but panic began to set in. He reached for his phone in his pocket but as he pulled it out he collapsed onto the ground. He landed face down in the dirt and felt himself losing consciousness. Before he could call for help he went unconscious as his heart rate slowed and he was wheezing face down in the dirt.. Due to the location there was no one around and it wasn't until almost three minutes later that another runner found Caleb in the middle of the path. The runner was 23 year old Amy who went to the same college and recognized Caleb from all the times they had passed on their runs. "Oh my god Caleb" Amy yelled as she rushed over to him. When she rolled him onto his back he was barely breathing. She reached for her phone and called 911. "I need an ambulance my friend is unconscious and barely breathing." she pleaded with the 911 operator. She gave the name of the path and an approximation of how far into the woods they were. The operator asked Amy to monitor Caleb. While she was doing so Caleb stopped breathing. The operator walked Amy through how to check for a pulse. "I... I don't feel anything" Amy said in a panic. The operator instructed her to start CPR and walked her through how to do it. She put the phone on speaker and followed each of the steps. She placed her small hands in-between his nipples and interlocked her fingers. She began to push down into her chest and had to give the full weight of her body to give the compressions. After giving thirty compressions she was instructed on how to give mouth to mouth. After giving the two breaths she went back to the compressions. She was instructed to continue this cycle until the ambulance arrived.

As Amy continued the CPR cycle, her mind raced with worry for Caleb's well-being. She could feel the urgency in the dispatcher's voice guiding her through the life-saving procedure. With each compression, she focused all her strength, willing Caleb's heart to respond. She knew that every second counted in this critical situation. Despite her fear and panic, Amy maintained her composure, determined to do everything in her power to keep Caleb alive until help arrived. With each breath, she hoped to see a sign of life returning to him. Time seemed to stretch endlessly as she performed the CPR, her heart pounding in sync with each compression. In the midst of the crisis, Amy's training as a lifeguard kicked in, guiding her actions with precision. She concentrated on the task at hand, shutting out the chaos around her as she followed the dispatcher's instructions to the letter. As she continued the compressions and rescue breaths, Amy couldn't help but think about Caleb's family and friends, wondering how they would react to this sudden turn of events. She silently prayed for his recovery, willing him to hold on and fight for his life. Finally, after what felt like an eternity, the distant sound of sirens pierced the air, signaling the arrival of the ambulance. With a surge of relief, Amy redoubled her efforts, knowing that help was now just moments away. She kept up the CPR until the paramedics arrived, ready to take over.

As Caleb was rushed into the back of the ambulance, the paramedics wasted no time springing into action. With practiced efficiency, they swiftly assessed his condition, confirming that he was still in cardiac arrest. Without hesitation, they began the process of intubating him to secure his airway and ensure he received the oxygen he desperately needed. The ambulance interior was a whirlwind of activity as the paramedics worked tirelessly to stabilize Caleb's condition. Amidst the chaos, Amy stood by, feeling a mixture of anxiety and helplessness as she watched the medical team fight to save Caleb's life. With each passing moment, the urgency of the situation weighed heavily on everyone in the ambulance. The paramedics continued their efforts, administering medications, and performing chest compressions in a desperate bid to restart Caleb's heart. As the paramedics worked, they quickly and efficiently removed Caleb's clothing to better assess his condition and provide necessary medical interventions. Amy averted her gaze out of respect for Caleb's privacy, her heart aching for him and his loved ones as she prayed for a miracle. Despite their best efforts, the minutes ticked by with no sign of improvement in Caleb's condition. The paramedics remained focused and determined, refusing to give up on him even as the odds seemed stacked against them.

As the ambulance screeched to a halt outside the hospital, the paramedics wasted no time in rushing Caleb into the trauma room. The medical team waiting there sprang into action, seamlessly taking over CPR as they wheeled him through the doors. With a sense of urgency, the team worked in synchronized harmony, performing continuous chest compressions and delivering defibrillations in rapid succession. Despite their best efforts, Caleb's heart stubbornly refused to respond, remaining silent and still despite the onslaught of interventions. Time seemed to stand still as the medical team fought tirelessly to revive Caleb, their faces etched with determination and grim resolve. With each passing moment, the chances of success grew increasingly slim, but they refused to give up hope, clinging to the belief that miracles could still happen. Amy stood by, her heart heavy with fear and sorrow as she watched the chaotic scene unfold before her. She had done everything she could to help Caleb, but now it was out of her hands. All she could do was pray and hope for a miracle, willing Caleb to defy the odds and come back to life. As the minutes stretched into eternity, the reality of the situation began to sink in. Despite their heroic efforts, Caleb's condition continued to deteriorate, his chances of survival slipping away with each passing moment. As Amy stood on the sidelines, her heart heavy with grief, she watched as the medical team continued their relentless efforts to revive Caleb. Despite multiple rounds of defibrillation, Caleb's heart remained stubbornly silent, refusing to respond to the shocks. Each attempt seemed more desperate than the last, the tension in the room palpable as the medical team fought against the odds, refusing to give up on Caleb despite the grim reality of his condition. With each failed attempt, Amy's hope dwindled, replaced by a deepening sense of despair. She felt helpless, unable to do anything but watch as the life slowly slipped away from her friend. The sound of the defibrillator charging echoed through the room, a stark reminder of the high stakes and the dire situation they faced. With each shock, Amy held her breath, praying for a miracle that never came. As the minutes ticked by, the medical team's efforts became increasingly frantic, their faces etched with frustration and sorrow. Despite their expertise and determination, they were powerless to save Caleb from the grip of death. Finally, after what felt like an eternity, the lead physician called a halt to the resuscitation efforts, his voice heavy with regret. The room fell silent as the reality of Caleb's passing sank in, a somber reminder of the fragility of life and the cruel randomness of fate. Amy felt a wave of grief wash over her as she struggled to come to terms with the loss of her friend. Tears welled up in her eyes as she mourned the life that had been cut short far too soon. In the aftermath of the failed resuscitation, Amy found herself grappling with a whirlwind of emotions. Anger, sorrow, and disbelief warred within her as she tried to make sense of what had just happened.

#cpr #resus #resuscitation #defib #defibrillator

[defiblover27]

Gabby’s Cardioversion

*hey everyone! I came up with a new story and wanted to try something different. Hope you all like it!*

On a chilly fall evening, an ambulance arrives at our emergency department where our usual team waits in the trauma room. In come Tracy and Stephanie with the next patient. “37 year old female, fainting episode but regained consciousness. Patient is complaining of chest pains, palpitations, and dizziness. EKG abnormal, tachy at 140bpm.” Stephanie rattles off. On that gurney was Gabby, the 37 year old basketball coach at the local college. She had fainted during practice that evening and one of her players called 911. Gabby was a tall glass of water, standing at 6’3, with a slim but toned, athletic build. She had blonde hair that was usually in a ponytail, beautiful bluish gray eyes, and had a cute tomboy appearance. Gabby was sitting in the upright position on the gurney when she was brought in, stripped down to just her purple sports bra and matching underwear (the team’s primary color of course). She had EKG electrodes stuck onto her chest, had IVs going in both arms, and had a nasal cannula in her nostrils. Coach Gabby was visibly uncomfortable, clenching her chest with one hand, groaning every so often.

Gabby was transferred onto the table, where she still sat in the upright position. “My chest…” Gabby says to herself, still clenching her chest, taking a few breaths. Dr Sarah lowers her stethoscope onto the coach’s chest for a listen. It sounded like Gabby’s heart was going to leap right out of her chest, but at the same time, there were no abnormal heart sounds, and her lungs were clear. “lets get labs going. Let’s do a CBC, BMP, tox screen, cardiac enzyme test, and a d-dimer. We gotta know what we’re up against.” Said Lindsay, taking some initiative in the situation. The team asked Gabby a handful of questions: “has anything like this happened before?” “any history of heart problems?” “any drug use?” “any other health problems that need to be disclosed?” But the answer to all these questions remained consistent- no!

“I wonder if I’m just stressed out. We haven’t had the best season, and rumor has it they’re gonna get rid of me if the season doesn’t turn around.” Gabby said, trying to take a stab as to why she was in our emergency department. The team continued to wait on labs, so the doctors decided to do a chest x ray and an echocardiogram to see if that could shed any light on the coach’s issues. The chest x ray showed completely normal anatomy, as did the echocardiogram- back to the drawing board. Since the ER team couldn’t find an obvious cause for the coach’s ailment, they decided to treat the symptoms and see if that helped. Gabby was given meds via IV to calm her heart down, and to help with her chest discomfort.

The evening droned on and coach Gabby only appeared to be getting worse. Her heart rate was still high, and her was EKG definitely off. “Something’s off with the QT interval. I know it might be subtle, but something just doesn’t look right there.” Said Lindsay, taking a long, detailed look at Gabby’s EKG. “she’s tall, so I wonder if she has undiagnosed Marfan syndrome or EDS?” Sarah suggested. “Yeah, but wouldn’t there have been a structural heart issue or something else we could work with on either chest x ray or the echo?” Lindsay rebutted. “Could be an electrical issue, but I wanna see what the labs end up saying. Is she on something? Are her electrolytes out of whack? Is there a blood clot or heart attack? There’s a lot consider.” Sarah countered. The two doctors respectfully disagreed with one another, unable to figure out what was wrong with the coach.

More time had passed, and coach Gabby’s vitals were starting to become worrisome. Her heart rate was through the roof, in the verge of v-tach. Gabby was leaning back with her eyes shut, holding her chest, moaning from the worsening pain she was experiencing. The monitors were chirping loud and fast, and only got faster. “I’ve got stable v-tach on the monitors.” Nurse Nancy tells the two doctors. At that point, Gabby’s bra was snipped off and the defibrillator pads were stuck onto her bare chest. “gabby? Your heart is in a dangerous rhythm. We have to give your heart a quick shock to make it all better, ok?” Dr Lindsay attempted to explain. “just make it stop…” coach Gabby replies, visibly uncomfortable. The doctors wanted to start Gabby off with a smaller jolt, so they went with 125j. The pads were charged up, and the first shock was delivered. Gabby’s body tensed up and her shoulders shrugged forwards. “AHH!” Gabby winced, feeling the electricity run through her. Post shock, the team looked at the monitor. “she’s still in stable v-tach. Let’s shock at 150.” Sarah decided. “Gabby? The first shock didn’t work, so we’re gonna do it 1 more time.” Lindsay explained. The defib pads were charged up to 150 joules, and the shock button was hit. Gabby jolted sharply, making strong fists with both her hands, letting out a yelp from the pain of the shock. Dr Lindsay lowered her stethoscope onto the coach’s bare chest and listened to her heart, and Sarah studied the monitors for a moment. “no change. Let’s go again at 175.” Said Sarah. The electrical whirring sound of the pads charging filled the room, followed by a weak thump when the shock was delivered. Her body tensed up and her toes scrunched up at the end of the table, showing off prominent, medium sized wrinkles in the soles of her size 14 feet. “pleaae… make it stop…” Gabby said in a worried tone, on the verge of tears. The rhythm wouldn’t go away, so it was decided to shock Gabby again at 200. Her long, slender body twitched sharply in reaction to the next shock. “am I gonna die? I don’t wanna die…” a terrified Gabby asked. “charge again to 225.” Sarah said. “no! Please…no more! No more!!!” coach gabby begged. Her chest shot forward and her back arched, but it didn’t look quite the same as the typical Hollywood style defibs since she was sitting in the upright position still. The next shock was at 250. The tall blonde winced in pain once more from the shock. She leaned back and her eyes opened wide, taking rapid, shallow breaths. She mouthed “I don’t wanna die” to Dr Lindsay, but didn’t have the energy to get the words out.

Suddenly, coach Gabby’s rapid breaths came to an abrupt stop. Her pretty blue eyes remained wide open, staring up above with an absolutely terrified expression on her face. “she’s in v-fib! Lower the bed and start compressions!” Dr Lindsay shouted urgently. The bed was lowered, and nurse Heather began going to town on Gabby’s chest. Her chest caved in, and her toned belly and abs bounced outwards. “I’m intubating. 8.0 ET and a laryngoscope.” Sarah called out. “pushing epi and atropine.” Lin announced. Heather continued pumping the coach’s chest, and Sarah got the breathing tube in, securing it with a blue tube holder. Once she was intubated and the meds were in, it was decided to switch over to the defib paddles. The pads were quickly peeled off, and the paddles were gelled, charged up to 250, and pressed up against the coach’s bare chest. Her chest was picked up and her arms flailed weakly towards the center of her body before falling limp again. “no change, charge to 300.” Lindsay ordered. KA-THUNK!!! The shock threw Gabby’s large, lanky body around on the table effortlessly, but didn’t restart her heart. ”360! Everyone….CLEAR!” Sarah called out, pressing the paddles back up against Gabby’s chest. Her feet leapt above the table, slamming back down a moment later, showing off coach Gabby’s hot wrinkly soles once more. “PEA, start compressions!” Lindsay yelled out. Nurse Jamie took over CPR this time, pumping the basketball coach’s rhythmically.

CPR, ambu bagging, and pushing meds went on for a bit. It took some time and hard work from the team, but Gabby converted back to v-fib around 17 minutes into the code. The defibs were gelled, charged to 360, and the next shock was delivered. Gabby’s body jolted violently from the controlled dose of electricity. Her eyes remained wide open, staring up above while the fight for her life went on. The team shocked Gabby another 2 times unsuccessfully, but v-fib looked like it was winning this battle. “should we crack her chest? Get better perfusion?” Lindsay asked. “I don’t know, I’m not feeling it here.” Replied Sarah. A few cycles of CPR and ambu bagging were performed, hoping to stimulate the tall blonde’s heart, but no change was noted. The team defibbed Gabby another 4 times, before flatlining after that last shock. Dr Sarah lowered her stethoscope onto the patient’s bare chest. “no heartbeat. No respirations.” Sarah stepped back, shaking her head. Lindsay did a quick bedside echocardiogram and looked over at the monitor. “no cardiac activity, down 27 minutes, pupils fixed and dilated.” Lindsay added. “it’s over. Time of death, 21:45.” Sarah said reluctantly, pulling the gloves off her hands.

The flatlined monitors were turned off and the ambu bag was detached from the ET tube while her pretty blue eyes stared up above helplessly. The EKG electrodes were plucked off Gabby’s chest, the defib gel was wiped off, and the IVs were taken out. Her body was covered with a sheet, and a toe tag was placed. The toe tag dangled in front of her big, wrinkly, size 14 soles, bringing a sad, and seemingly surprising end to the case.

[defiblover27]

Hannah’s Head Injury

Hannah Dansby was a 28 year old web+app developer. She was the cute, shy, nerdy type who had shoulder length brown hair, green eyes, and stood at 5’6 with a slim build. Sadly, Ms Dansby was brought into our emergency department recently after sustaining blunt head trauma in a high speed collision.

The young lady laid on a backboard in a c-collar. She was intubated, had EKG electrodes on her chest, and IV lines going in both arms. She had a large seatbelt shaped bruise across the front of her chest, while there was a large laceration above her right eyebrow. On the side of her head above her right ear, you could see an accumulation of blood soaking her hair in that general area, with some blood droplets coming out of the right ear. Hannah’s eyes were wide open upon arrival even though she was intubated, and was actively convulsing while medics Stephanie and Tracy wheeled her into the trauma bay. Hannah’s toes scrunched at the other end of the gurney, showing off the fresh black nail polish and the cute, prominent wrinkles in the soles of her size 8 feet. “28 year old female, restrained driver in a high speed MVC. Intubated en route, vitals all over the place. Started seizing just as we pulled into here.” Medic Stephanie tells the trauma team, giving them a quick summary of what to expect. “ok, let’s transfer her on my count. One… two… THREE!” Dr Lindsay ordered.

Hannah was transferred onto the trauma room table underneath the large overhead light. “Push a unit of ativan, and run stat trauma labs. Page radiology, I’d like to get a head CT sooner rather than later.” Lindsay barked out to the members of her trauma team. Nurse Nancy pushed the dose of the anticonvulsants and drew the trauma labs. Dr Lindsay shined a pen light in Hannah’s eyes, revealing her pupils were fixed and dilated. “well, she’s already braindead. What a shame.” Dr Lindsay announced, shaking her head. “she might be a good organ donor. But don’t let transplant surgery know just yet. We don’t need them hovering over this poor girl like a vulture.” Dr Jose added. “amen to that.” Nurse Nancy replied in agreement.

The ativan took effect and stopped Hannah’s seizure. However, Hannah’s heart also stopped. “damn it, someone start compressions!” Dr Lindsay shouted while taking a look at the monitors. Hannah’s eyes remained wide open, staring expressionlessly across the room while Dr Jose started pumping away at her chest. His compressions were intense and forceful, causing Hannah’s chest to cave in and her belly to ripple out. Her small, perky breasts jiggled and one arm hung off the side of the table, bobbing and lolling around. Blood shot out of her right ear in sync with each individual compression. What happened was the temporal bone of her skull became partially displaced and slashed open the temporal artery within the subarachnoid space. A lot of blood in such a small space is always bad, so the pressure inside her skull built up rather quickly, squeezing her brain, causing her brain death, and the only way out for the excess blood was through the ear canal.

“Epi and atropine in Linds” nurse Heather called out. “ok, I’ve got v-fib on the monitors. Charge the paddles to 250” Dr Lindsay called out. The paddles were charged, gelled, and pressed up against Hannah’s bare chest, and a shock was delivered as soon as Jose stood clear. KA-THUNK. The young woman’s broken body tensed up and flopped for a moment. “no pulse, recharge to 300.” Dr Lindsay called out, placing 2 fingers on Hannah’s neck for a carotid pulse. The defibs were readied, and shock #2 was delivered. Hannah’s feet kicked around on the other end of the table in response to the shock, wrinkling the soles of her feet. “She’s still in v-fib. Charge to 360.” Dr Jose ordered, closely looking at the heart monitor. The third shock caused Hannah’s chest to shoot up and her back to arch, while her eyes remained wide open, looking almost as if she was watching the team as they coded her.

A fourth shock was delivered shortly after, sending Hannah into PEA. Nurse Heather took over chest compressions this time, and the next doses of epinephrine and atropine were pushed into the young lady’s IV line. Medics Stephanie and Tracy stood behind the yellow line in the trauma room still watching the code. “what a shame.” Stephanie says, knowing how this code is going to play out. “yeah, I hope they find the SOB that hit her. Someone on scene said it was a hit and run.” Tracy replies. Tracy and Stephanie’s conversation is interrupted for a moment. “excuse me, coming through.” A female voice said. Sure enough, it was Dr Amy, the hospital’s transplant surgeon. “hey, is this the head trauma patient? I need an A+ liver for a hemochromatosis patient and a kidney for a little girl.” Dr Amy says, forgoing any greetings or any social graces associated with conversation. “ugh. Amy. Can this girl just die in peace?” a frustrated Dr Lindsay replies. “I know you have your patients to look out for, but I have mine to look out for. This beautiful girl woke up this morning not knowing it was gonna be her last day, and I wanna at least try for her.” Dr Lindsay added, trying to reason with the transplant surgeon. “alright, just try to make it quick so I can get the ORs ready.” Dr Amy replied, more or less disregarding Dr Lindsay’s heartfelt reply before walking out of the trauma room. “wow what a bitch.”  Medic Tracy said, surprised at the exchange that took place.

Hannah converted back to a shockable rhythm, so the paddles were charged to 360, gelled, and pressed back up against the patient’s bare chest. Hannah’s body jolted violently in response to the shock, but v-fib displayed on the monitors. “hit her again at 360. Everyone… CLEAR!” Dr Lindsay shouted, pressing the paddles onto Hannah’s bare chest. KA-THUNK. “no change, shocking again. Everyone stand clear!” Lindsay barked out. Hannah’s body thrashed around on the table for a brief moment before going limp again, but she was still in v-fib. Lindsay shocked her again, causing a quick, but violent reaction out of Hannah. This time, the monitors went completely flat. “asystole…” Dr Jose said in a defeated tone. Lindsay let out a sigh, and placed the defib paddles back on the crash cart. She started to peel her gloves off, making the dreaded announcement. “time of death, 4:07pm.”

The ambu bag was detached from the ET tube and the flatlined monitors were switched off. Nurse Nancy gently shut Hannah’s eyes for the last time, while nurse Heather started disconnecting the EKG electrodes. “let Amy know. I’m sure she’ll be thrilled…” an upset Dr Lindsay said, heading out of the room.

Hannah’s organs were able to be successfully extracted and were credited for saving 3 different lives. Unfortunately, the alleged hit and run driver that killed her has yet to be located by law enforcement. If you have any information regarding this incident, please reach out to the authorities.

[defiblover27]

ice hockey friendly

The women’s ice hockey game between the United States and Canada was a thrilling display of skill and athleticism. The arena was filled with the sounds of skates cutting into the ice, sticks clashing against each other, and the roar of the passionate fans cheering on their respective teams.

The teams took to the ice in their distinctive uniforms, the United States in their traditional red, white, and blue jerseys, and Canada in their iconic red and white uniforms. As the game began, the tension was palpable, and both teams came out with a fierce determination to win.

The players flew down the ice, each one showcasing their incredible speed and agility as they maneuvered around their opponents. The American team was relentless, with their forwards launching a flurry of shots on the Canadian goaltender, who made an impressive save to keep the score level.

The Canadian team responded with their own offensive, utilizing their swift skating and puck-handling skills to try and break through the American defense. However, the American defense stood firm, and their goaltender made several acrobatic saves to keep the Canadian team at bay.

As the game progressed, the physicality increased, with players battling for every inch of ice. Body checks and collisions echoed throughout the arena as players fought for possession of the puck. The referees were kept busy, with several penalties being called for rough play.

The crowd was on the edge of their seats as the game approached the final minutes of play. With the score tied, both teams knew that a single mistake could cost them the game. The tension was thick in the air, and every shot on goal was met with a collective gasp from the crowd.

As the game wore on, the intensity increased, and the players pushed themselves to their limits. In a split second, a collision occurred between two players. It was an American player, Jade, and a Canadian player, Riley. The sound of their helmets cracking together echoed throughout the arena, and both players fell to the ice. Unfortunately, it happened so fast that three other players toppled on top of them, not being able to stop in time. 

The crowd fell silent and everything seemed to pause. The other players on the ice were quick to help the injured up and were thankful that some got up fairly quickly. Unfortunately, two bodies remained on the ice. The initial players who ended up colliding remained sprawled on the floor. 

“Riley. Riley. Look at me. You are okay.” Jennifer, her teammate says as she knelt down seeing her friend’s eyes darting around. “Are you hurt?” 

Riley doesn’t seem like she heard her as she continues to look around before she sits up causing her to wince in pain. 

“Hey, why don’t you lie back down?” Amber, another teammate who happens to be Riley’s girlfriend as well, says. “You took a hard hit.” Amber can clearly see that Riley is not with it at all. Usually, her girlfriend is quick to get up after a collision but this one leaves the woman in a daze of confusion. 

“I’m fine. We need to get going.” Riley says wanting to stand up. 

“Look at me, Riley.” Amber says grabbing the sides of Riley’s helmet before making eye contact with the woman seeing her eyes glazed over and not really being able to focus. “Oh, you definitely have a concussion.” She whispers. “The medical staff are coming to check you out, okay?”

“I’m fine. Just help me up.” 

“I can’t do that, Riley. Let them check you out before getting up.” Amber and Jennifer try to keep Riley from moving too much as they can clearly see the woman in pain every time she moves. 

The athletic trainers from both teams are quick to make their way to the ice and to their players. Tommy, the Canadian trainer goes to examine Riley but she waves his hands off. 

“Listen, Tommy, it’s a little knock to the head. You can run your concussion protocol test but I don’t need to go to the hospital. I am fine.” Riley says, taking off her gloves and helmet, letting her blonde hair fall with the motion.

“Let me be the judge of that,” Tommy smirks. “I don’t remember you having a degree in any sort of medicine.”

“Ha ha, Tommy. Just do your thing.” As she tells him, he pulls out a pen light guiding her through different tests before taking his hands and palpating her head, neck, and clavicles. 

“As of right now, I can say you have a concussion. You need to go to the hospital for a CT scan to make sure it isn’t worse and there is no internal bleeding in that thick head of yours.”

“I’m not going to the hospital right now. I want to shower and head to the hotel room to relax and get some things.”

“Riley, it’s not up for discussion.”

“Tommy, I said I am going just not right away. There is no problem with that. I will go once we head back as a team to the hotel.”

Knowing he is losing the argument, he accepts. With that, they all stand and help Riley to her feet before a wave of dizziness and nausea comes over her making her stumble and double over. Amber and Tommy stabilize her and ask her if she’s alright which of course she says yes to. They manage to get her off the ice and keep an eye on her as she heads to the locker room. 

… … …

Simultaneously, back on the ice, the Americans are worried for their player, Jade. Jade is 65 inches tall with medium wavy black hair that contrasted her pale skin. She is the baby of her team, so imagine their worry as her teammates first by her side after the collision see her unconscious. They pull off her gloves wanting to hold her hand and not move her in case of spinal damage.

“Come on, Jade. We know you are a deep sleeper but this isn’t the time.” Sarah, the designated team mom says. “Jade, we need you to open your eyes sweetie.” 

“She’s not waking up!” Fiona yells at the trainers making their way to them. And repeats herself as they come closer but more in shock than anything else. 

When the lead trainer, Andrew, makes his way to Jade, he can already tell this wasn’t going to be good as her lips were already turning cyanotic. He talks into his radio, “I need the medics, Jose, and Samantha. Bring the AED.” He brings his attention back to the woman and starts giving out commands in the meantime. “Sarah, I need you to hold her neck like this as I remove the helmet.” He shows her how to guide her spread out fingers, getting a lot of surface area to hold the sides of Jade’s head. Sarah positions herself straddled over the young player so Andrew can easily slide the helmet off without her in the way. Once off, he checks for a pulse and breathing. 

“GET OFF!” He says frustrated he just wasted time for c-spine precautions when the girl was obviously pulseless. A shocked Sarah hops off before Andrew kneels beside Jade and starts compressions. “One… Two… Three…” 

“Four… Five… Six…” He keeps going, sweat pouring down his face, as he tries to save Jade’s life. He can hear the panicked whispers of her teammates behind him, but he can’t let himself be distracted. “Seven… Eight… Nine…” Andrew is determined to keep going until the medics arrive. He knows that every second counts when it comes to CPR, and he refuses to give up on Jade.

As Andrew counts the compressions, Fiona is on the phone with Jade’s family, updating them on the situation. Tears stream down her face as she tries to remain composed for them. The other teammates huddle close, praying and hoping for Jade to make it through. They form a circle around her and link arms wanting to give the woman privacy as they don’t want the public to have access to this vulnerable moment. Some watch as others have their backs turned to the resuscitation happening. 

“She’s been pulseless for two minutes. Continuous compressions since I got to her side.” Andrew relays to the medics, Henry and Don. Don switches Andrew out for the compressions as Henry tells Andrew to strip the player’s jersey off and attach the AED pads. Using the scissors Henry gave him, he cut away working around Don. He attached the pads to the machine and peeled away the plastic film placing one sticky pad on top of Jade’s small right breast and another on her ribs below her left breast. He places his hands on the pads pushing down to secure them even more. As his hands are there, he can feel the damage Done is doing with the compressions. 

Jade’s body sways under the forceful compressions and Don tries his best for his knees not to slip on the ice. His short stubby hands are placed accurately on her sternum. Little huffs leave Jade’s mouth every time he pushes deep into her chest. 

“Hold compressions,” Henry calls out and quickly tilts the woman’s head back, her eyes thankfully closed when he looks at her face. He struggles to open her mouth at the same time as pushing the laryngoscope down because of her tiny mouth. Don takes his hands and lifts Jade’s neck up letting her head extend more but even with this movement, it’s not enough. Don tells Andrew to hold where he is holding before using his fingers to manually pry Jade’s mouth open. Don sticks his fingers into her mouth and pushes from her teeth getting a little bit of leeway. 

“Now, Henry.” He says. “Try, now.” With the help of Don and Andrew, Henry places the metal device in her mouth before placing the 7.5 ET tube down her throat and inflating the balloon. Attaching the ambu bag, he takes his stethoscope and listens to breath sounds. 

“We’re in. Continue compressions.” Henry tells Don. “Hey, I need you to squeeze this bag enough to see the chest rise and no more. Too much will over inflate her and might cause aspiration. Squeeze twice after Don does 30 compressions,” he tells Samantha, the athletic trainer assistant. 

Her hands shake from adrenaline as she takes the bag. This frees up Henry to start attaching leads, an IV line, and push meds. 

“Do not touch patient. Analyzing heart rhythm.” The AED calls out. The rescuing team remove their hands and clear anyone even remotely close to Jade. 

“Keep bagging her every 5 seconds.” Henry tells Samantha who dropped the ambu bag and moved away. “You are the only exception in this case.”

“No shock advised. Continue CPR.” The machine calls out. 

“I’ll take over compressions,” Henry says and places his fresh pair of arms over the red spot on Jade’s sternum that was made from the previous cycles of CPR. He is quick and allows for full recoil watching Jade’s chest cave under his hands. As he watches, he can see the bruising on her ribs. There must be bleeding around her heart causing the pressure to not let her heart actually beat.

“Andrew, do you have a team doctor?” Henry asks while keeping count of the compressions in his head. 

“Yes, she’s in the locker room tending to the other player.”

“Radio her and tell her we need her HERE. Jade needs an emergency thoracotomy.” Andrew isn’t quite sure what that is and relays it over the radio.

“What the hell, Andrew.” Dr. Teddy replies back. “We are not in a sterile area or have the proper equipment to confirm we need one.”

“Medics say she needs one, Dr. Teddy. She has signs of blood build-up and she has yet to have a shockable rhythm.”

“I’m coming to check her out myself.”

“What’s her problem?” Henry huffs after hearing the conversation.

“God-complex,” Samatha replies and shakes her head knowing how the team doctor is. 

“Tell your players to all turn around so their backs are towards us. I am going to give you guys two sheets to hold up. What is going to happen next isn’t something anyone should see.” Don explains to Andrew and Samantha. 

Andrew informs the players to not turn back no matter what and just pray. Don hands the sheets to Andrew before taking over bagging from Samantha. Both the trainers unfold their sheets and stand on opposite sides over Jade. With their backs turned away from the patient they spread their sheets blocking the public from viewing this disastrous moment. 

A minute after she was requested, Dr. Teddy makes her way onto the ice with a med bag, breaking through the ring of players and kneeling down next to Jade.

“She’s been in cardiac arrest for six minutes and has yet to have a shockable rhythm. A dose of epi and atropine was pushed two minutes ago. She has bruising on her chest indicative of blood build-up which may be causing pressure in her heart. A thoracotomy is necessary.” Don relays. Dr. Teddy takes her stethoscope and places it on Jade’s chest. The cool air in the arena makes Jade feel cold to touch and her nipples hard. As Dr. Teddy listens and ultimately agrees with what the medics have mentioned. 

“Okay, here’s the game plan… You two switch roles… He is getting tired… I am going to get everything ready and proceed to make an incision. There will be a lot of blood and I would usually also add a chest tube before this but circumstances limit me. Just continue regular CPR until I tell you otherwise.”

The medics nod and Dr. Teddy puts on a yellow protective gown, gloves, and glasses before grabbing Betadine from her bag and drenching Jade’s pale chest making it a rusty orange-brown color. 

Dr. Teddy makes an incision on Jade’s left side, between her ribs, and carefully cuts through the intercostal muscles and pleura. She uses a rib spreader to open up the chest cavity. The cracks echo through the rink and everyone flinches at the crunching sound of the ribs. Samantha turns around instinctively from the noise and she wishes she didn’t. She suppresses a gag seeing the blood and Jade’s body mutilated from the procedure happening. She turns back around when Dr. Teddy uses a pair of scissors to cut through the pericardium.

As soon as the pericardium is open, Dr. Teddy sees the problem. Jade’s heart is lacerated, and blood is pouring from the wound. Without hesitation, she sticks her hand in the wound, feeling for the source of the bleeding. She quickly locates it and uses a clamp to stop the bleeding.

She looks up at Henry. “We need to cross-clamp the aorta. Get the vascular clamp from my bag, it’s labeled in a sterile bag.” Henry nods and searches for the clamp. In the meantime, Dr. Teddy thinks of different ways to make a makeshift chest tube. She knows now she really needs one to drain the blood and air from the pleural cavity.

When Henry retrieves the vascular clamp, Dr. Teddy carefully places it on the aorta, just above the diaphragm. She holds it in place, compressing the aorta to slow down the bleeding. Jade’s blood pressure starts to drop even with DOn’s rigorous compressions, and Dr. Teddy knows she needs to act fast.

“Okay, I am going to make a makeshift chest tube. I need an IV bag and a saline water bottle.” Henry doesn’t question her and grabs the additional supplies, handing them to her. She quickly does her thing and inserts it into Jade’s open chest. The blood oozes out on the ice and turns it into a crimson red as it is absorbed and spread beneath their legs.

“I need to repair the heart,” Dr. Teddy says, getting the suture kit and informing Don to hold off on compressions. 

Dr. Teddy carefully removes the clamp, watching as the blood starts to flow freely again. She quickly places his hand back in the wound, feeling for the laceration. When she does, she starts to repair the wound, working quickly and efficiently.

As she sutures the wound, Dr. Teddy can feel Jade’s heart start to beat again, weakly at first, but getting stronger with each passing moment. As she finishes the repair and takes her hand out, she looks at the monitors. 

“God-complex might have just saved her life,” Henry says, astonished by what just happened and Don agrees. 

“Her pressure is holding and her heart is beating slowly but it’s something. Prep me 2 mg of epi.” She asks and is quick to be given it before guiding her fingers back into Jade’s wet and warm heart. The syringe is plunged directly into Jade’s heart and it takes effect quickly as her heart beats quicker. “There we go, Jade. Welcome back.”

Jade is transferred to a backboard and a sterile drape over her cracked-open chest. Instead of lifting the blackboard and risking slipping on the ice, the team decided to push it on the ice allowing for a smoother and safer ride over to the steady ground. Once there they lifted her and quickly moved her into the ambulance calling the hospital to tell them what was coming in. 

The rest of the public was left in shock and tears streamed down their faces not knowing anything and coming to terrible conclusions at the amount of blood where Jade once lay. Her blood streaked across the rink and her teammates also were at a loss. 

… … …

Back in the Canadian team’s locker room. The players can hear what has happened to Jade. They silently prayed for her while also staying around Riley knowing how lucky she got. 

Riley sat on the bench, her head in her hands. Her teammates around her had concern etched on their faces. One of the veterans, Millie, put a hand on her shoulder. “You okay, kid?”

Riley shook her head, yes. “I-I’m fine. I just feel so dizzy.” Her head throbbing and her vision blurry. Her teammates were now hovering over her, babying her like she was a child which made her a bit irritated. She could hear their concerned voices, telling her she wasn’t okay and that she needed to go to the hospital.

“Riley, you really should get checked. Better sooner than later.”

“I’m fine,” Riley muttered, brushing off their concern. “I just need a minute to catch my breath. I will go once I clean off and change back at the hotel.” Everyone backed off a bit happy that the girl understood that she still had to go.

As they boarded the team bus back to the hotel, Riley’s frustration boiled over. She lashed out at her girlfriend Amber, who had been particularly insistent that she get checked out.

“I don’t need everyone babying me!” Riley shouted, tears streaming down her face. “I’m fine! I can take care of myself!”

Amber looked at her with concern, taking her hand and squeezing it gently. “I know you can, babe,” she said softly. “But we just want to make sure you’re okay. We care about you.”

Riley sniffled, wiping away her tears. “I know,” she said, her voice barely above a whisper. “I’m sorry. It’s just frustrating.” Riley wasn’t sure if it was the pain or frustration making her cry and be vulnerable on the bus ride back but she didn’t like it. It also was concerning to her teammates as she rarely shows this side of her. 

Amber wrapped an arm around her, pulling her close. “I get it,” she said. “But we’re a team, Riley. We take care of each other, no matter what.”

Riley nodded, leaning into Amber’s embrace. She knew deep down that her teammates only had her best interests at heart, and that they were just trying to keep her safe. But it was hard to accept their help sometimes, especially when she wanted to prove herself as a tough, capable player.

When they get back to the hotel, Amber and Riley head to their room. Amber told Riley she could take a shower first. Riley accepted gratefully as she could wash off the hell of the day she had. She took a quick 10-minute shower before looking in the mirror and frowning as her headache got worse. She unsteadily came out of the bathroom with a towel wrapped around her and wet blonde hair sticking to her skin. 

Amber furrowed her brow in concern, quickly getting up from the bed as she saw her girlfriend looking pale and unsteady. “Riley, are you feeling okay?” she asked, walking over to her.

“Yeah, I’m alright. Just feel off, nothing to be concerned with. I should be good for the game later.” Riley says confidently as she didn’t want to raise any flags so she can play later today. 

Before Amber could respond, a few of their teammates came into the room, led by their captain, Millie, hoping to check on their youngest player. “Is everything okay here?” she asked, her eyes scanning over Riley.

“I don’t know,” Amber said, turning to the others. “She’s acting really strange talking about playing tonight.”

The other players gathered around, all looking at Riley with a mixture of confusion and concern.

“Riley, what game?” Millie asked gently, placing a hand on her shoulder.

Riley looked as if they all grew two heads. “Us vs the Americans. I know we said to not think about it but we shouldn’t completely ignore it either.”

Millie turns to her teammate, Celly. “You need to go get Tommy and tell him it’s urgent.” Celly rushes off to find the head of their athletic trainers.

The other players exchanged worried glances, and Millie leaned in closer. “Riley, we already played the game. It ended almost an hour ago. Don’t you remember?”

Riley’s head was fuzzy as she tried to recall but was having trouble. She based her answer on the faces around her, “Yeah, of course. I remember. Sorry.”

Amber can tell her girlfriend was lying. “It’s okay if you don’t remember, babe. You got hit pretty hard. You just wanted to get refreshed before heading to the hospital, which I think you might need to go right now and not wait any longer.” 

The realization of how serious this was crossed everyone’s mind knowing cognitive damage is real in their profession. Even Riley who was adamant about being fine looked confused and nodded at the suggestion which was concerning as she usually waved concerns off.

 Millie took it upon herself to get more questions answered seeing Riley open and vulnerable at this moment. “Do you have a headache? Are you feeling dizzy or nauseous?”

Riley nodded, feeling a throbbing pain in her head. “Yeah, I have a headache,” she said. “I also feel really groggy. I’m scared.”The other players exchanged a worried glance, but they didn’t push the issue any further. They knew that Riley could be stubborn sometimes, and they didn’t want to add to her fear.

Millie sighed, her gaze softening. “Riley, we’re your teammates,” she said. “We care about you and are here with you. We will make sure you are okay.”

“How about we help you get dressed?” Amber suggested knowing Riley hates sitting in a towel with her hair wet and also doesn’t want her naked when Tommy comes in. 

“You think we are going to win the game tonight? The Americans have been doing good this season with the new players they drafted.” Riley asks again, making tears accumulate in Amber’s eyes. Millie sends another teammate to hurry up and search for any one of their athletic trainers at this point. 

“She was just fine before the shower,” Amber says desperately to Millie. Millie and Jennifer try to comfort her while keeping an eye on Riley who now keeps dissociating as well. Jennifer pulls Amber to the side hoping to calm her down knowing if she gets worked up it might work up Riley which they don’t need. 

“Okay, Riley, I got some shorts and a shirt for you to wear. Do you need help?” Millie asks, ready to intervene if needed. She kept her eyes on the girl knowing they’d all seen each other naked before as it comes with communal showers in locker rooms since joining the team.

 Riley shook her head and took the shorts first. As she stood up from the bed, the floor moved under her feet causing her to sway significantly putting her arms out hoping to steady herself with the bed. “Woah, woah, I got you…. Easy, Riles… Easy.” Millie says, grabbing her shoulders steady. When she looks at Riley’s face, she can see the color draining. Before she can react, Riley gags and throws up. Millie thankfully jumps out of the way of the projectile vomit and pulls Riles’ hair out of the way. Once done, Riley’s body immediately weakens causing Millie to practically hold all of Riley’s weight. She decides to ease Riley down to the floor against her lap and away from the vomit.  

“Talk to me, Riles. What’s going on? Are you in pain?” Millie shouts out questions feeling Riley shaking in her arms. The towel was already on the floor leaving Riley bare with only shorts on. 

“I don’t feel good,” Riley whines and nobody recognizes this childlike side of her, making them worry. 

“What do you feel, Riles?” Millie urges again and shakes the woman when she sees her eyes wanting to close shut. “Riles, you need to stay awake. What’s going on? Talk to me!”

Riley feels a warmth overcome her and she wants to succumb to the comfort but hands shake her awake and tell her to keep her eyes open. She moans and pushes away at the hands and voices. She isn’t sure if they let her be or if she fell asleep but she is brought to consciousness again when she feels a fist rub the middle of her chest making her groan in pain. She can see a lot of figures around her through her slightly parted eyes but nausea comes back as she gags not having the energy to avoid herself as it comes up. She starts choking on her vomit being laid flat on her back but the people around her are quick to shove and turn her over to her right side as content leaves her mouth.

 Riley can feel the tiredness wanting to take over again but the fist is rubbed between her C-cup breasts as she is still on her side.

When she goes to groan, a weird grunt leaves instead and she feels her body tense up. Her muscles start to spasm and her limbs start to jerk uncontrollably, making her feel like a ragdoll. She hears voices talking but their words are muffled and she can’t comprehend them. Her eyes roll back and forth, and her breathing becomes shallow and erratic. She feels like she’s floating, weightless and dizzy. The spasms continue, and she feels like she’s being electrocuted from the inside out. Riley’s mind is a jumbled mess, and she can’t think straight. She can hear her heart pounding in her ears, and her vision becomes blurry. The voices around her start to fade away as she slips into a deep, dreamless sleep. The seizure has taken over her completely, and she can only hope that it will be over soon. 

Tommy and Will arrived as the seizure was taking place and immediately dialed 911. 

“What happened?” Tommy asks, seeing Riley’s half-naked body seizing next to a pile of what he assumed was her own vomit. 

“She was lethargic and confused. She said she was feeling dizzy and threw up, practically collapsing in my arms. She kept going in and out of consciousness and I was giving her sternum rubs as I’ve seen on TV and it kept waking her up but she started having a seizure about 20 seconds ago.”

Will, hearing the conversation, told dispatch and gave the phone to Millie so he can help Tommy. Both of the trainers knew they couldn’t do much without medical drugs so they kept the seizing player on her side as she let out little grunts and gasps through her tightened jaw. Their hands stayed on her not wanting her limbs or head to accidentally thrash into the furniture or floor of the room. 

Her olive skin was glistening with sweat despite the shower she just had and her body jerking caused her breasts to move as well in such an uncoordinated fashion. It was an ugly sight to see by her team who held their breaths wanting her to be okay. Amber remained held back by Jennifer and Millie moved to stay close enough to Riley without interfering in case an extra set of hands were needed. 

Will took a moment to set up the portable oxygen tank and place a mask on Riley as she seized, knowing oxygen isn’t reaching her brain at the moment. As her body convulsed violently, foam started to build up in her mouth and would exit every time she let out an involuntary cry and moan. 

“Get me a towel,” Tommy called out and one appeared seconds later. He removed Riley’s oxygen briefly to clear her face and mask before placing it back on. “She’s turning cyanotic! Where are the medics?” 

“They are 4 minutes away.” Millie calls out. “Jennifer and Amber, go down to the lobby so you can guide them to us.” She tells them seeing Amber is on the verge of a breakdown watching her girlfriend practically suffocate. Jennifer pulls Amber out of the room while teammates gather in the hotel hallway watching their youngest player in a scary situation. 

“If she doesn’t stop soon, this is very bad,” Will mentions. “This is why a team doctor should always be around and not just at games themselves.” 

With Riley’s fingers and feet stiff and crunched in an unnatural way her limbs jerk around for another two minutes before she suddenly stops. Her body is limp with foaming now coming out her mouth in a steady stream as her jaw relaxes. Will removes the oxygen mask and takes the towel from Will to sweep the inside of her mouth getting all the saliva out of the way before she’s turned on her back. Once on her back, Tommy tilts her chin back and puts his fingers on her carotid, checking for breathing and pulse. 

“She’s tachy but has agonal breath sounds.” He takes out a pocket mask from his bag and pops it open attaching the one-way valve and switching out the oxygen mask for it. “Will start attaching the AED. I will begin rescue breathing.” 

Tommy readjusts Riley’s head position so he fully hyperextends her neck and takes a deep breath before exhaling in her mouth enough for her chest to rise. He gets into a quick rhythm breathing every five seconds for her. Her chest rises and her breasts follow the movement before relaxing. Meanwhile, Will connects the pads to the machine that automatically turns on when opened. He separates the sticky with plastic film before placing them appropriately on her naked chest before pressing firmly on both making sure they stick well. 

As Tommy continues to breathe for Riley, her body lets out these little spasms following the seizure, scaring the room into thinking she might have another one. “Come on, Riley don’t do this to us,” Will says and smacks her cheeks a bit. He doesn’t expect it to do much but it was hopeful thinking. 

“Give the sternum rub, it helped before,” Millie mentions remembering what she tried before the seizure. Will nods at the suggestion knowing it won’t hurt to try. He bawls his fingers and centers it between Riley’s large breasts before aggressively rubbing for ten seconds. The only reaction is the red welt forming in her chest. “No response to painful stimuli.”

The medics and police officers come rushing in moments after Will tried the sternum rub. Tommy continues to breathe while medics set up what they need to do and listen to Will’s update of what has been happening. 

“Alright, let me check her out.” Enzo, the primary medic, says, indicating Tommy to back away. He does a quick assessment before indicating that now there is no pulse and starts CPR. Enzo uses the red welt from the sternum rub as a marker of where to place the heel of his hands and digs deep into Riley’s chest from the first compression. “One… And two… And three… And four… And five…” Once he reaches 30, he tells Tommy to give two breaths. Tommy pulls her head back which makes her body shift and pull up as well before it’s pushed back down by Enzo. “One… And two… And three…”

While those two continue CPR, the other medic, Kenzie, sets up the leads, IV, and medication. Once she is done with those things, she takes her gloved hands and pulls down Riley’s shorts enough to expose her groin areas. Kenzie takes her left two fingers and searches for Riley’s femoral artery. Once located, she can feel a pulse from the compressions Enzo is doing ensuring they are effective. 

After two minutes of CPR, the AED machine indicates for everyone to step away as it analyzes. “Shock advised. Do not touch the patient. Charging.” The medics look at the LifePak confirming the patient has a shockable rhythm, V-tach. “Press the red flashing shock button now.”

The medics make sure everyone is clear before Kenzie presses the button causing Riley’s body to barely twitch in response. “Analyzing heart rhythm again. Do not touch the patient… Shock advised. Do not touch the patient. Charging.” The machine robotically says. A high-pitched frequency fills the silence in the air before the voice commands to push the red button again. This time, Riley’s body arches a bit, and her head sways from the electricity. 

“Switch with me,” Enzo tells Kenzie, making a smooth transition. Kenzie starts compressing, feeling the pressure of Riley’s sternum compress down into her spine. There is a bit of resistance but halfway through her first round of compressions, she can feel and hear the crack/pop of her patient’s ribs. Up at the head, Enzo moves Tommy out of the way and prepares to intubate. “Ugh, her mouth is full of fluid. Continue continuous compressions until I get this sorted.” Enzo shakes his head as he prepares the suction. Once everything is attached, he brings the machine as close to his patient as possible before turning it on and opening Riley’s mouth. In a figure-eight motion, he vacuums the saliva built up. Once satisfied he turns the machine off and lays on his stomach to work on inserting the ET tube down Riley’s throat. He makes eye contact with Riley’s dead body as her eyes are open staring at nothing. “I’m in.” He says once he checks with his stethoscope that the air is delivered properly in her trachea with the ambu-bag. 

Kenzie continues to administer deep violent compressions despite her small stature and Enzo pushes more meds having handed off the ambu bag to Tommy. 

“Enzo, we need to load her up. She probably has a brain bleed and the hospital can do more for her than just CPR. Set up the LUCAS device so we can free up and move her.” Kenzie calls out from her compressions. He nods and quickly opens the bag they carried in with the gurney. He pulls the curved green back piece from the bag first before asking Will to help. “On the count of three, we lift and Kenzie you guide it under her,” Enzo says. “One. Two. Three.” Just like that, on three, Will and Enzo each grab an arm pulling the limp woman in a sitting position for a moment before guiding her back down gently. Her hair covers her face and Tommy moves it exposing her dead-open eyes. Kenzie goes back to compressions while Enzo picks up the next piece, setting up everything so no time is wasted. He connects the pressure canister before turning the machine on. He tells Kenzie to move as he lifts this big piece over Riley’s chest and clicks it to the back piece. He guides the suction cup of the machine down towards the woman’s chest before pressing the button that starts the plunger to move automatically and rhythmically. Riley’s body succumbs to the force and her belly protrudes differently from the manual compressions given previously. With a free set of hands, the medics work to gather their belongings and set up the gurney. Lowering and guiding it next to their patient, they request the help of the police officers, giving each officer the responsibility of a limb. Tommy remained responsible for Riley’s head and breathing while Enzo and Kenzie made sure the LUCAS device remained in perfect place. “One. Two. Three.” In a smooth motion, everyone lifted and plopped the girl into the stretcher. Her arms that hung off shrugged with each compression getting in the way so Kenzie strapped them up to the velcro on the device. 

“Guys, I think there’s something wrong with her tube,” Tommy calls out. “Her chest isn’t rising when I squeeze.” 

Enzo goes to the head of the stretcher and pauses the CPR device before seeing what Tommy meant. Sure enough, as Tommy squeezes the bag, there is no chest rise… but there is a hissing sound. Enzo removes the ambu bag and covers the ET tube with his own lips. He blows in air and just like that watches Riley’s chest rise. He quickly turns the LUCAS device back on. “Manually breathe for her every 10 seconds.” He tells Tommy. Kenzie pushes more meds and before guiding her hand back down to Riley’s femoral artery. She holds it firmly in place allowing her fingers to find the pulsating point. 

“Do not touch the patient. Analyzing heart rhythm.” Everyone removes themselves and Enzo pauses the machine. “Shock advised. Charging. Do not touch the patient. Press the flashing red button now.” Making sure everyone is clear, Enzo pushes the button causing the entire stretcher to shake as Riley’s body arches under the suction up and hands threaten to escape the velcro. Riley’s head slams up and down as do her legs from the powerful shock. The machine indicates another shock is required and Enzo pushes the flashing button again. Again Riley’s body jerks against the resistance and her toes curl from the shock. It takes a brief seconds before the monitors let out a familiar beep followed by a few seconds of silence before another beep followed by another occurs. 

“She’s in sinus brady. She’s back as of this moment. Tommy, you come with us and continue to manually breathe until we can get to the ambulance for a second ambu bag Let’s go, now!” Kenzie calls out as they rush her out of the hotel room passing the teammates and staff in the hallway. Just like that they disappear into the elevator and the rest of the team stands there in shock. Not even Amber has it in her to follow her girlfriend. 

…

What was supposed to be a friendly tournament turned into one of the worst days in women’s ice hockey history for two teams as both had players in critical condition.   

[defiblover27]

Gina’s Sudden Arrest

Gina Ashford was what many would consider to be an alpha female or a “boss lady/boss babe.” She was an assertive, headstrong go-getter who had a commanding presence that some might find intimidating. But this personality helped her tremendously in the business world, landing herself a spot as the VP for a large corporation. Gina didn’t just have a strong personality- she also had looks. The 51 year old VP looked excellent for her age, looking at least 10-15 years younger, and could easily attract men young enough to be her son. She was of average height with a slim, but toned build from working out every day after work, had medium length light brown hair, and bluish grey eyes. Even though Gina had both looks and success, she was never married and never had children- her whole adult life was devoted to her career.

Recently, Gina was in our area for an important business related meeting with a few other higher ups in the corporation. The morning of the meeting, Gina woke up in her hotel room with a stiff neck, a headache, and felt a little dizzy at times. She brushed off these symptoms, attributing them to jetlag and not sleeping well the night before. Despite her symptoms, she got up, showered, got ready and headed out the door. The meeting was being held across town, maybe 15 minutes away. The company had a car waiting just outside the hotel lobby to drive her and the other executives to the meeting. During the elevator ride down from her room, Gina began to feel more dizzy. She squinted her eyes a bit, becoming sensitive to the light in the elevator, and winced in pain for a second as the pounding headache returned.

The elevator dinged and the doors opened after reaching the lobby level. Gina exits the elevator and starts heading towards the lobby’s main entryway. Her steps became a bit slow and wobbly, having trouble maintaining balance. Gina could feel her heart racing inside her chest while her symptoms intensified. Suddenly, Gina’s eyes rolled back, and she crumbled to the ground, fainting. A hotel security guard and one of the front desk agents see Gina collapse and scurry over to her aid. “Ma’am? Is everything ok?” Matt the security guard asks in a concerned tone, gently tapping Gina’s shoulder, trying to get her attention. Gina just laid on the floor, eyes closed, mouth agape, not responding to the security guard. “miss Ashford? Are you ok?” the front desk agent Emily asks, gently nudging Gina to see if she’d wake up. Matt and Emily tried multiple times to get Gina to wake up, but she just wouldn’t. “shit. We probably need to call 911.” Matt says, a bit flustered, digging through one of his pockets trying to reach for his cell phone.

Matt finally gets ahold of his phone and dials 911. “911, what is your emergency?” a female voice on the phone asks. “yeah…hi… a lady fainted in the lobby of our hotel and she’s not waking up. We’re at the Spring Towers downtown off Atlantic boulevard.” A nervous Matt utters into the phone. “alright sir, I have emergency services en route to your location. Can you tell me if the woman is breathing?” the dispatcher calmly replies. There’s a pause for a moment while Matt checks. “ok…. Yes! She’s breathing! She just won’t wake up when we touch her or say anything to her.” Matt replies anxiously. Matt the security guard was incredibly nervous at the moment, knowing something was seriously wrong. “Ok, I need you to stay on the line for me.” The 911 dispatcher instructs Matt. While awaiting further instruction from the dispatcher, Emily the front desk agents can hear Gina grunting and groaning. “Ma’am? Are you ok?” Emily asks in a calm voice, placing her hand on one of Gina’s shoulders, to which the 51 year old VP doesn’t respond.

Suddenly, Gina’s eyes shoot wide open, staring right at Emily. “Ms Ashford?” a worried Emily asks. Gina’s body becomes stiff and straight on the floor. Her head and neck become arched. Her arms were straight along the side of her body, with her hands curled. Her legs were straight, her feet were pointed downwards, and she began seizing and convulsing violently on the floor of the lobby. Matt and Emily jump back a few feet, taken aback by what they were seeing. “whoa!” Matt shouts into the phone. “sir, what’s happening?” the dispatcher asks. “you guys gotta hurry! She’s having a seizure or something!” Matt shouts into the phone. “ok, please remain calm and stay on the line for me.” The dispatcher says to Matt before giving him further instructions. Gina made eye contact with Emily while she was seizing on the ground, forever etching this moment into the young front desk agent’s mind forever. Gina kept seizing violently, grunting in pain, with her face turning bright red. This attracted a crowd of nosey onlookers from elsewhere in the lobby, who began to surround Matt, Emily, and Gina. Some people watched in shock and awe, while others whipped out their phones and started taking pictures and videos, completely violating the powerful businesswoman in such a scary moment of her life.

Finally, the ambulance pulls up right in front of the lobby, and in come medics Tracy and Stephanie. “ok everyone, let’s take a few steps back so we can work.” Tracy barked at the nosey crowd, essentially having to force her way through it. “hey! Over here!” Matt yells across the lobby, waving one of his hands in the air to get the attention of the two medics. Tracy and Stephanie see Matt and fast walk over to him. The medics get over to the two hotel employees and can see Gina still actively seizing on the floor of the hotel lobby. The two medics immediately spring into action. “push a round of Ativan, and I’ll place an oral airway.” Stephanie tells Tracy. Tracy grabs a syringe and a vial of Ativan out of the medication bag and injects it into Gina’s arm. “ativan in. No IV yet, so it might take a minute to kick in.” Tracy called out to her partner. Stephanie placed an oropharyngeal airway into Gina’s mouth in order to keep her airway open, and to prevent her from biting her tongue or lips while seizing. While waiting for the seizure meds to take effect, the two medics start snipping away at Gina’s expensive work attire and remove her Gucci high heels, leaving her barefoot, stripping the VP down to just her bra and underwear. Tracy sticks the EKG electrodes onto Gina’s chest, while Stephanie starts pushing buttons on the heart monitor to get it activated. Once the heart monitor was on, you could see that Gina’s heart rate was through the roof, while her BP was critically low.

Gina’s violent thrashing and flopping came to a slow and gradual stop once the meds started to take effect. At that point, the medics were able to set up IVs in both arms. But during this process, Gina never regained consciousness, and her vital signs were in a dangerous place. Gina laid unconscious in the lobby, eyes wide open, staring up above with a pained look still on her face. Since Gina wasn’t regaining consciousness, the medics decided to intubate her and leave the oral airway in her mouth. A 7.0 ET tube was secured in the 51 year old’s airway, and taped in place. Moments after intubation, the heart monitors showed pulseless v-tach, so Tracy snipped off Ms Ashford’s bra, and began pumping her chest fast and hard. “…5…6…7…come on…” Tracy counted to herself, pummeling the attractive woman’s chest. Stephanie was readying the defibrillator paddles, gelling them and charging to 150 joules. The paddles were pressed up against the patient’s bare chest, and a shock was delivered. Gina’s body jolted sharply on the lobby floor in response to the shock. Matt, Emily, and the nosey crowd watched in horror while Gina’s dying body reacted to the jolt of electricity. “no change, hit her again at 200.” Tracy told Stephanie after taking a quick carotid pulse. The paddles were recharged, pressed back up against the woman’s chest, and shock #2 was delivered. Once again, Gina’s body reacted violently to the electric shock. Her chest shot up for a second, and her arms flailed for a brief second before going limp once again. A woman in the nosey crowd screamed as she watched Gina react to the shock. “Still nothing. Charging to 250.” Stephanie called out, shaking her head, looking at the heart monitor. Tracy delivered a cycle of chest compressions while the defibrillator whined as it was charged. Finally, the paddles were pressed up against the woman’s bare chest, and the next shock was administered. Gina’s feet leapt up above the tile floor, slamming back down half a second later, showing off the deep, thick wrinkles in the soles of her size 8 feet.

This shock failed to restart Gina’s heart, and she was now in v-fib. Tracy resumed chest compressions and Stephanie injected epinephrine and atropine into the VP’s IV line. After a few cycles of CPR and ambu bagging, the medics decided to shock Gina again. The paddles were charged to 300 this time, and the next shock was delivered. KA-THUNK. Gina’s lifeless body twitched sharply on the floor while the nosey crowd continued watching, with a few gasping and shuddering. The strong, alpha female VP was in such a vulnerable, helpless situation- a stark contrast from her usual self.

Shock after shock failed to restart Gina’s heart, and the already dire situation was becoming desperate. “what’s happening?! Why isn’t anything working?!” Emily the front desk agent asked the medics, teary eyed and visibly upset. The two medics were so locked into their efforts that they didn’t respond to the young front desk agent. Stephanie took over CPR and started delivering deep, harsh chest compressions. Gina’s belly bounced outward while her pretty eyes remained wide open, continuing to stare up above. The medics kept up their efforts of chest compressions, ambu bagging, and meds, but Gina deteriorated further, going from v-fib, to PEA, to agonal, to asystole. The two medics were becoming exhausted after each performed multiple cycles of chest compressions. At one point, Tracy shined a pen light into Gina’s eyes. “fixed and dilated, been down 20 minutes.” Tracy said to Stephanie, shaking her head. Stephanie delivered a few more chest compressions before backing off and holding her efforts. Stephanie let out an exhausted sigh, then said “we did everything we could Tracy. I think we need to call it.” The tension in the room was palpable at that moment. Tracy paused for a moment weighing out the options. “yeah… she’s gone. Time of death, 8:42am. Let’s call the coroner’s office and get them over here.” Tracy said reluctantly.

The ambu bag was detached from the ET tube, the flatlined monitors were switched off, and the EKG electrodes were plucked off of Gina’s bare chest. The two medics picked up Gina’s lifeless body, placed her on a gurney, and then put a sheet over her body, and wheeled her into the ambulance while they waited for the county coroners office to arrive on scene. Unfortunately, Gina’s death was quite sudden, with her final moments being so violating and public.

Since no cause of death could be readily determined by EMS, an autopsy was performed. The autopsy showed that Gina had died from a rare type of brain aneurysm. A large fusiform aneurysm was discovered in the basilar artery with a 3cm dilation- which is well above the recommend threshold for surgical intervention. These types of aneurysms only occur in 3-5% of all brain aneurysm cases, and have mortality rates as high as 60% according to some studies. Sadly this rare and deadly clinical entity took the life of Tracy and Stephanie’s latest patient.

[defiblover27]

The Crash That Changed Everything

*hello everyone! I wanted to try something different here. I told chat gpt to read all of my resus stories, then come up with one of its own, and this was the end result. I thought it came up with an interesting story, and hope you enjoy!*

The sun was setting in a fiery blaze of oranges and pinks as Alexis and Brandon set out on their road trip. They had been planning the trip for months, eager to escape the stresses of everyday life and spend some quality time together. Alexis was driving, her hands gripping the wheel tightly as she navigated the winding roads that led out of town. Brandon was beside her, humming a tune as he tapped his fingers on the dashboard. Everything was perfect, until it wasn’t. One moment they were laughing and chatting, and the next, they were hurtling towards disaster. The sound of shattering glass and metal filled the air as their car was sideswiped by a distracted driver, and their lives were forever changed. The screeching of tires filled the air as the car spun out of control, the sound of metal crunching against metal echoing through the empty highway. Alexis’s heart pounded in her chest as she clutched the dashboard, her knuckles turning white with the force of her grip. Beside her, her boyfriend Brandon let out a strangled cry, his body lurching forward as the car came to a sudden stop. For a moment, everything was silent, and then the pain hit them both at once, searing through their bodies like a wildfire. It was only then that Alexis realized that their lives would never be the same again.

Alexis and Brandon’s world had been turned upside down in an instant. As the car was struck, their bodies were thrown forward with a sickening jolt. Glass shattered around them, and metal groaned and creaked under the force of the impact. For a few moments, they lay there, stunned and disoriented, struggling to make sense of what had just happened. The smell of smoke and gasoline filled the air, and Alexis could feel the heat of the engine on her legs. She was scared, and her heart was racing as she turned to Brandon to see if he was okay. He was groaning in pain, clutching his side and moaning softly. Alexis felt a sharp pain in her arm and could see blood seeping from a cut on her forehead. The realization that they were hurt hit her like a ton of bricks, and she knew they needed help – fast.

“Brandon?...” Alexis asked nervously, her eyes filling up with tears. “I’m ok babe… I promise…” Brandon replies, having a pained look on his face. “I’m so sorry babe! I didn’t mean it!” a guilt ridden Alexis cries out, taking full responsibility for the accident, even though it wasn’t her fault. While the couple checked on each other and tried to make sense of the tragedy that just unfolded, a traffic jam started to form on the highway, and several of the onlookers called 911 to alert emergency services of what had happened.

Alexis and Brandon heard the distant sound of sirens and knew that help was on the way. Soon, a team of paramedics arrived on the scene, rushing over to assess the couple’s injuries. They carefully extricated Alexis and Brandon from the car, placing them on stretchers and securing them with neck braces. The couple was in a lot of pain, but they felt reassured by the presence of the paramedics, who were calm and professional despite the chaos around them. The sound of the ambulance siren pierced the air as Alexis and Brandon were loaded into the vehicle, and they were whisked away to the hospital. The journey was a blur of pain and fear, but the paramedics did their best to keep the couple calm and stable. Once they arrived at the hospital, Alexis and Brandon were taken to the emergency room, where the usual trauma team awaited.

First to arrive was Alexis, who was wheeled in by medic Tracy. “23 year old female, restrained driver in a high speed MVC. Hypotensive and tachy, O2 saturation normal. Left humerus fracture reduced and splinted on scene, abrasions to the chest wall, head lac on forehead above the right eyebrow.” Tracy told Dr Lindsay, who would ultimately be Alexis’s doctor. “ok, let’s get her into trauma 1. Page radiology and trauma surgery.” Dr Lindsay called out to the rest of her team, which consisted of nurse Nancy and nurse Heather at that moment. Alexis laid on the backboard in a c-collar, crying, and asking about her boyfriend. Her light brown hair had droplets of blood on it from her forehead laceration, and her blue eyes were puffy from all the crying she’s done since the accident. She was stripped down to just her bra and underwear, exposing her pleasantly plump body to the trauma team. Her chest had bruises and abrasions on it, and had EKG electrodes stuck on it. “Brandon?! Is Brandon ok?!” a terrified Alexis cried out to the trauma team. “let’s transfer her on my count. One, two, THREE!” Dr Lindsay firmly ordered the team, transferring the girl onto the table, underneath the large overhead light, beginning their assessment.

Meanwhile next door, medic Stephanie wheeled in the boyfriend Brandon. “26 year old male, restrained passenger in a high speed MVC. Hypotensive, tachy, oxygen saturation normal. Blunt abdominal trauma to upper left quadrant, possible spleen injury.” Stephanie told Dr Jose, who would be in charge of Brandon. The boyfriend’s trauma team would consist of Dr Jose, nurse Ashley, and nurse Jamie, who was the new addition to the trauma team. Brandon was also transferred onto a table, underneath a large, overhead light. The tall, thin, Hispanic man laid on the table, stripped down to just his boxer shorts, in a c-collar, and also had EKG electrodes on his chest.

Next door, Alexis’s breathing became erratic and she was deteriorating at an alarming pace. Dr Lindsay started the pleasantly plump young lady on the massive transfusion protocol to get her vital signs back up to normal limits, but it only appeared to do so much. “diminished breath sounds on the left side Linds.” Nurse Heather called out to the doctor after stething Alexis for a bit. A chest x ray ultimately confirmed a collapsed lung on the left side. To help reinflate her lung, they would need to insert a chest tube, a procedure that could be quite painful in a patient that was awake. Despite her pain, Alexis tried her best to remain still as the medical team prepared to insert the chest tube. They gave her a local anesthetic to numb the area, but she could still feel the sharp pressure as the tube was inserted through a small incision in her chest. She winced in pain as the tube was slowly advanced into her chest, but she tried to remain as still as possible. As the chest tube was inserted, the trauma team could see the relief on Alexis’s face as the pressure in her chest began to decrease. They quickly attached the tube to a drainage bag, and Alexis could feel the weight of the bag pulling at the tube in her chest. It was an uncomfortable sensation, but she knew that it was necessary to help her breathe more easily. “It’s going to be ok. It’ll be ok.” Alexis kept thinking to herself. Alexis could breathe a little better at that point, but her vital signs were continuing to drop at an alarming rate. Dr Lindsay knew she didn’t have much time to get the young lady stabilized.

Nearby, Dr Jose started his initial examination of Brandon. When they examined Brandon, they found that he had no feeling or movement below his waist. They tested his reflexes and examined his lower extremities to see if there was anything to their suspicions. The results were clear: Brandon had suffered a serious spinal cord injury that had left him paralyzed. Dr Jose wanted to send Brandon over to radiology to confirm a possible spinal cord injury, and to further examine the abdominal injuries he had sustained. So without further ado, Dr Jose, nurse Ashley, and nurse Jamie took the young man over to radiology for a CT scan. Brandon’s CT scan showed a few things: he had sustained internal bleeding in the upper left quadrant, which is usually caused by an injury to the spleen, and that he sustained a spinal cord injury at the L4 and L5 level. Dr Jose paged the trauma surgery team, and off to the OR the young man went.

Back in the ER, Alexis had become unconscious and continued to further deteriorate, so Dr Lindsay chose to intubate her. Suddenly, Alexis’s monitor alarm sounded, and her heart rate dropped to dangerously low levels. The trauma team sprang into action, administering chest compressions and drugs into her IV line. Nurse Heather placed their hands on Alexis’s chest, pressing down hard and fast in a rhythmic pattern. As they performed CPR, the team also prepared the defibrillator pads and placed them on Alexis’s now bare chest. They had to clear the area to make sure that nobody was touching her before administering the electric shocks. The team member in charge of the defibrillator charged up the machine and delivered the first shock. Alexis’s body jolted in response, but her heart rhythm did not improve. The team continued with CPR and prepared to deliver another shock. As the team worked to revive Alexis, they could feel the pressure mounting. They knew that time was of the essence and that every second counted. They delivered multiple rounds of shocks, and with each shock, they hoped to see a change in Alexis’s heart rhythm, but unfortunately the young lady’s heart just wouldn’t restart. The trauma team knew that they still had one last chance to save Alexis’s life, and they quickly assembled for a thoracotomy, a surgical procedure that involves making a large incision in the chest to gain access to the heart and lungs. They knew that the chances of success were slim, but they had to try. With grim determination, the team worked to open Alexis’s chest and expose her heart. The sight was overwhelming, and Dr Lindsay’s hands moved with precision and skill as they clamped off the descending aorta near the diaphragm and began assessing the injuries to Alexis’s heart. Dr Lindsay then started direct cardiac massage, which involves using their hands to compress the heart and manually pump blood through the body. The team knew that this alone might not be enough to revive Alexis, so they also decided to use internal defibrillator paddles. They carefully placed the paddles directly on Alexis’s heart and charged up the machine to deliver a shock. The shock jolted the patient’s body, but her heart did not start beating on its own. The team continued performing direct cardiac massage and prepared to deliver another shock. They administered multiple rounds of shocks and continued to perform direct cardiac massage, hoping that Alexis’s heart would respond. But despite their best efforts, they were unable to revive her. The team knew that they had done everything they could to save her, and ultimately had to terminate the code, calling time of death on Alexis at 8:13pm while she was still in v-fib.

Hours after Alexis had passed away, Brandon was now in the surgical recovery unit. His spleen had to be surgically removed, and his spinal cord injuries were treated to the best of the surgical team’s ability. Dr Jose paid Brandon a visit after his surgery, and informed him of the bad news: that he was paralyzed from the waist down, and that Alexis had succumbed to her injuries in the emergency department earlier that night. The news was devastating for Brandon. Dr Jose knew that he would require specialized care and rehabilitation to help him regain as much function as possible, but they also knew that the road ahead would be long and challenging. Despite the grim prognosis, Dr Jose remained hopeful and determined to do everything in their power to help Brandon recover. They stabilized his condition, administered pain relief, and worked to minimize the risk of complications. They also made sure that Brandon’s loved ones were informed and supported during this difficult time.

[defiblover27]

Casey’s Traumatic Arrest

Casey Mullins was a 34 year old woman with wavy blonde hair, blue eyes, and a nice tan. The cute southern girl stood at 5’5 with a slim to average build, and had a conventionally attractive appearance. Casey had a husband Ryan, a 2 year old son Tyler, worked as a dental hygienist at an office downtown, and by all accounts appeared to have a normal, happy life.

A few nights ago, Casey left work at 6pm as always, and headed into the parking garage across the street. After entering the garage, a man in a dark colored jacked followed Casey to her car and attempted to rob+carjack her at knifepoint. She attempted to reach for a canister of pepper spray attached to her keyring to try and subdue the attacker, but the man panicked and quickly stabbed Casey 3 times- once in the neck, and twice in the chest. Casey’s eyes opened up wide, and she yelped in pain. She took a few desperate gasps while her eyes rolled back a bit, then collapsed to the ground. Casey now laid on the ground next to her car, semi conscious in a pool of her own blood. “shitshitshit! I didn’t mean to kill this bitch!” the attacker said to himself in a frantic, stressed tone, never expecting his crime to escalate to this extent. The attacker tossed the bloody knife into a nearby dumpster, and made a beeline for the staircase, leaving Casey for dead.

Several minutes later, a person heading back to their car from one of the other downtown offices were horrified by the sight of Casey bleeding out in the garage, and called 911. “911, what is your emergency?” a female voice asked. “there’s a woman covered in blood in the parking garage! I think she might be dead!” the caller replied nervously. “ma’am, I need you to remain calm for me. Can you tell me the location of your emergency?” the dispatcher replied calmly. “I’m in the parking garage on the corner of 21st and Atlantic! Send someone now! I think she’s dead!” the panicked caller shouted into the phone. “I have people on the way now. Can you tell me if the woman is breathing?” the dispatcher asked, trying to acquire more information for the incoming responders. The caller slowly approaches Casey’s bloody, unconscious body and takes a look at her torso. Casey’s chest was rising and falling slowly, so she was in fact breathing. “yes! Yes, she’s breathing! You guys gotta hurry!” the caller shouts into the phone. “alright ma’am, I have units on the way, they should be there any moment now. I need you to remain on the line for me please.” The dispatcher replied.

First on the scene was a cop in the area. It was officer Natalie- a cute, Hispanic, 30-something tomboy. Officer Natalie approaches Casey and takes a look at her. “those definitely look like knife wounds.” Natalie says to herself. “did you see anything miss? Do you know who did this?” Natalie turns her attention, asking the caller. “No! I just found her like this!” the caller replies. “alright. You can hang up the phone. Let’s step to the side for a minute and I’ll get your statement. I’m sure you’ve been through a lot this evening.” Natalie replies to the visibly shaken up young lady.

Finally, EMS shows up- the medics on scene that night were Tracy, a cute blonde 30 something tomboy, and Stephanie, a tall, thin, 20-something brunette in a messy bun. The two park the ambulance and scurry over to Casey. Tracy gloved up and places 2 fingers on Casey’s neck on the opposite side of the stab wound to take a carotid pulse. “pulse is weak and thready, and I can see she’s breathing.” Tracy says. Stephanie pulls out a pair of shears and begins cutting off Casey’s scrub top which was absolutely drenched in blood at that point. Casey’s black sports bra was then snipped off, exposing her perky b-cup breasts. While Stephanie continued stripping Casey down to just her underwear, Tracy set up 2 large bore IVs and then set up a 5 lead EKG with a portable heart monitor. “BP’s 50/palp, heart rate’s in the toilet. Let’s hang a bag of fluids wide open and get her intubated.” Tracy called out. Stephanie began setting up the IV bags while Tracy picked up a laryngoscope and a 7.5 ET tube. Tracy navigated the tube into Casey’s airway, but ran into some resistance. Tracy repositioned the tube and continued advancing it. However, the distal end of the tube ended up protruding from the open wound in Casey’s neck. “tracheal avulsion. I think you need to trach her.” Stephanie suggests to Tracy. “Yeah, the trachea is split wide open just before I get to the carina.” Tracy replied in agreement.

At that point it was decided a tracheotomy would be performed in the field. Tracy is handed the surgical airway kit while Stephanie wiped off Casey’s neck with an alcohol wipe. Tracy made a horizontal incision through the skin that was about 1.5 centimeters. The tissue underneath was bluntly dissected and the thyroid was identified so they knew to avoid it. Next, Tracy punctured through the 1st and 2nd tracheal ring with a needle, and was met with a slight hissing sound of trapped air exiting the area. Next, Tracy decided to use a guide wire to keep the trachea partially inflated/expanded to make the insertion of the breathing tube easier. Generally, the trachea and esophagus tend to collapse in on themselves when compromised via injury, and that can make intubation and NG tube insertion more difficult. Next up, the tube was navigated into Casey’s trachea, and into the correct place. Once the tube was in the correct place, the guide wire was carefully removed, and a cuff was placed on Casey’s neck to hold the tube in place.

After the difficult intubation was complete, Casey was placed on a backboard and onto a gurney, and taken into a nearby ambulance for transport. During transport, Stephanie did the driving, and Tracy was in the back taking care of the cute blonde victim. The ambulance sped down the road, lights and sirens blaring, trying to get Casey to the ER as soon as humanly possible. Tracy and Stephanie were doing everything right, but Casey’s condition started to deteriorate further. “shit, no pulse. PEA. Starting compressions.” Tracy called out, shaking her head. She placed her gloved hands on Casey’s chest and began delivering deep, strong chest compressions. Her chest caved in and her belly bounced outward from the brute force of the compressions she was receiving. “1… 2… 3… come on, don’t let that SOB win…” Tracy said, as if she was convincing Casey to not die. “what’s our ETA Steph?” Tracy asked. “gimme 2 minutes. We’re almost there!” Stephanie replied. Tracy performed a cycle of 1 handed chest compressions for a moment while injecting epinephrine and atropine into Casey’s IV line. “got a dose of meds in.” Tracy called out to Stephanie.

Upon arrival at the emergency department, Casey was still in full cardiac arrest. Tracy got on the gurney and straddled Casey, delivering strong, vigorous compressions, while Stephanie wheeled the gurney into the trauma room where Dr Lindsay, nurse Nancy, and nurse Heather waited. “34 year old female, multiple stab wounds to neck and chest. Tracheotomy on scene, lost a pulse en route. Down 2 minutes, epi and atropine x1” Stephanie said, giving the trauma team the rundown of the case. Tracy hopped off the gurney but continued compressions for a moment before Casey got transferred onto the table underneath the large overhead light.

Once on the table, Heather resumed CPR and Tracy stuck around and provided some ambu bagging. “start her on the MTP. I need 4 units of unmatched o-neg, 2 of platelets, 2 of FFP. I think we need a right chest tube as well, so let’s get a chest tube tray set up.” Dr Lindsay ordered, taking control of the hectic situation. Nurse Nancy began scurrying around the room gathering the necessary equipment for Lindsay. The doctor lowered her stethoscope onto Casey’s bare chest and listened to her lung sounds. “ok, no breath sounds present on the right side. That knife probably nicked her lung. I’m gonna need that chest tube tray.” Lindsay called out. Nancy quickly set up the chest tube tray for Lindsay, and she promptly began the procedure. Blood shot out of the tube and onto Lindsay’s yellow trauma gown once it was placed. “what a mess…” Lindsay said, taking a look at her trauma gown. “yeah… you should see how bad that parking garage looks. Whatever that knife hit, it was something major.” Medic Stephanie added, who was watching the trauma code on the other side of the room.

A second dose of epinephrine and atropine were pushed into Casey’s IV line, but PEA turned into an agonal rhythm, then agonal to asystole over the coming minutes. “thoracotomy tray. I need to see what’s going on in there. Nothing’s working.” Dr Lindsay says decisively, knowing the cute blonde was running out of time.

Betadine was splashed onto Casey’s chest, staining it an orangey-brown hue. Lindsay asks for a scalpel, and elects to access Casey’s thoracic cavity via a clamshell thoracotomy. Lindsay made a cut in between the 4th and 5th rib on each side of Casey’s chest, then connected the incision in the center of the chest near the sternum. Lindsay made a deep cut, already slicing through the underlying fat and subcutaneous tissue, so the only thing that needed to be incised was the intercostal muscle between the ribs. Lindsay cuts the muscle and gets a decent opening, then reaches her hand into the cut to move the lung out of the way to make room for the spreader. Next, Lindsay divides the sternum horizontally with a gigli saw as fast as she can. With the sternum finally divided, the rib spreader was placed into the cut, and Casey’s chest was pried open.

Once Casey’s chest was opened, Lindsay placed vascular clamps on the descending aorta near her diaphragm, and on the right pulmonary hilum. Lindsay wasn’t sure if there was tamponade or not, so she felt Casey’s motionless heart for a moment. It felt very tense and rigid, but was still unsure, so she incised the fibrous lining of the heart. Thick, gooey blood immediately exited, and Casey’s motionless heart began to twitch frantically now that there was some space for it to move a little. “she’s in v-fib. Charge the paddles to 20.” Lindsay called out. The large, spoon shaped paddles were handed to Lindsay, and the first shock was delivered. A dull, wet thump was heard, and Casey’s torso flopped quickly in response. “no change, charge to 30.” Lindsay called out, shaking her head.

The internal paddles were placed around Casey’s weakly twitching heart, and shock #2 was delivered. Her body jolted sharply in response, but v-fib was still on the monitors. “nothing. Let’s hit her again at 30. Everyone…. Clear!” Dr Lindsay shouted. The electricity ran through Casey’s dying body, causing her toes to scrunch at the other end of the table, showing of the cute, silky wrinkles throughout the soles of her size 9 feet, as well as the fresh pedicure on her toes. “still nothing. Push epi and atropine, resuming internal compressions.” Dr Lindsay called out, reaching her hands into Casey’s exposed chest cavity. Lindsay could feel Casey’s heart fidgeting around in her hands, but it was very weak at best. Lindsay vigorously massaged Casey’s heart for a bit. “5…6…7…8… still v-fib…” Lindsay counted out loud, looking at the heart monitors.

Dr Lindsay and the trauma team shocked Casey 5 more times, maxed her out on drugs, and coded her for another 15 minutes, but unfortunately, Casey passed away in the emergency department, with her time of death being called at 7:04pm while she was still in v-fib.

The ambu bag was detached from the tracheotomy tube, the chirping, beeping monitors were shut off, and the EKG electrodes were removed from her chest. The remaining equipment was being removed when officer Natalie showed up. “hey trace, hey Steph. How’d our stabbing victim do? Can I get a statement?” Tracy pulled back the curtain to the trauma room to show officer Natalie that basic postmortem care had started on Casey. “damn it. What a shame. I was going through her belongings and it looks like she’s got a husband and a 2 year old at home.” Officer Natalie says, shaking her head, a bit upset over the senseless murder. “did you get the guy that did it?” Tracy asked. “we got him on camera, but nothing yet. Looks like he dumped a knife in one of the dumpsters, so CSI is gonna try to find that and get some prints.” Natalie replied.

At this point, the police are still investigating Casey’s murder. We ask that you keep her and her family in your thoughts and prayers, and respect their privacy at this time.

[defiblover27]

Christine’s Malpractice Case

Every year, there are thousands of medical malpractice cases reported in the United States. Ranging from surgical or procedural errors, to misdiagnosis, to anesthesia errors, and many other possible factors not listed. We all have a certain level of trust in medical professionals because of their many years of training and education. However, these professionals are people too, and are prone to making mistakes from time to time. Unfortunately when medical professionals make a mistake, it can have major consequences for their patient- leading to further injury, disability, or even death. Sadly, one such case took place at our hospital recently.

The patient was Christine Rossi. She was 47 years old and stood at only 5 feet tall, but her big personality made up for her lack of height. She had a pleasantly plump figure, beautiful brown eyes, shoulder length brown hair, was olive skinned since she was of Italian descent, and always had a fresh mani+pedi. She looked good for her age since she never had kids, and she was never married- but definitely married to her career as a medical malpractice attorney.

Christine’s case began when she was brought into our emergency department one evening straight from her office. She was wheeled into trauma 1 sitting up on the gurney, stripped down to just her bra and underwear. She was wearing an oxygen mask, had EKG electrodes all over her chest, and had IVs going in both arms. “hi, I’m Dr Lindsay. Can you tell me what’s wrong?” Dr Lindsay, the ER attending from that evening asked Christine in a calm, inviting tone. Christine was gasping for air and had one hand on her chest. Her eyes were absolutely bugging out at times, and she was visibly uncomfortable. “my chest…” Christine utters to Lindsay. “your chest hurts? How long has it been hurting you?” Dr Lindsay asks in response. “since yesterday… but it got worse- a lot worse just now…” Christine tells Dr Lindsay.

On the heart monitors, Dr Lindsay saw that Christine was tachycardic, hypotensive, and had an abnormal EKG. The EKG showed unifocal PVCs with ST elevation. The doctor ordered some blood tests: a CBC, BMP, tox screen, and a stat cardiac enzyme test. An echocardiogram and chest x ray were also ordered while the blood was being drawn for the labs.

While the blood samples were sent off to the lab, the chest x ray was performed first. The only thing that was abnormal was some swelling and irritation in both lungs. This can be caused in part by Christine’s rapid, labored breathing, but it can also be associated with blood clots in the lungs, heart attacks, or fluid buildup in the lungs (for example, from pneumonia, covid, and sometimes severe bronchitis). The chest x ray definitely provided some good information, but it didn’t give Dr Lindsay the whole picture, so an echocardiogram was ordered. The echo showed right ventricular hypertrophy. Basically, the right side of her heart was enlarged and working much harder than it should. With the stat cardiac enzyme lab still pending, a dose of nitro was given for chest pain, and cardiology was called for consultation.

The two members of our cardio team to arrive were Dr Rachel, one of our cardiothoracic surgeons, and her cardio resident Dr Sarah. “hey guys, I appreciate you coming down. I think she’s having an acute STEMI and needs the cath lab, just waiting on the cardiac enzyme test to come back to confirm. What do you think?” Dr Lindsay says to the 2 cardio doctors. Dr Sarah looks at Dr Rachel, waiting for her to do the talking. “don’t look at me! What do you think of Dr Lindsay’s assessment?” Dr Rachel told Sarah, trying to get her resident to take some initiative. “I um… I agree.” The resident replies hesitantly. “why do you agree? Go on!” Dr Rachel tells Sarah. “well… um… the EKG shows ST elevation. And uh…. The patient has angina pectoris and shortness of breath.” The resident replies, nervously, and without confidence.

Nurse Nancy walks into the room with a few pieces of paper. “labs are back.” She says, handing the papers to Dr Lindsay. “Cardiac enzymes are high. This is definitely a STEMI.” Dr Lindsay says thinking out loud. “ok, let’s get her to the cath lab. We need to start a central line and get a stent in her.” Dr Rachel called out to the rest of the ER team. “what… what’s going on?” a nervous Christine asked, still breathing heavily. “you’re having a heart attack and we have to put a stent in, ok?’” Dr Lindsay tells the nervous lawyer. “a heart attack?!” Christine asks in response, surprised at what she’s heard. “am I going to die?!” Christine continued. “you’re in great hands! We’ve seen plenty of heart attacks like this. We’re going to place a stent, keep you here for a day or two, and you should be good to go.” Dr Lindsay replies with relative confidence, oblivious to the fact of what was to come. “Can you call my mom? I’m scared…” Christine asks Lindsay, still short of breath, visibly in pain from the crushing pressure she felt in her chest. “of course! We’ll have one of the nurses reach out to her, ok?” Lindsay replies, reassuring.

Over the following few minutes, Christine is taken up to the cardiac catheterization lab. She’s laid flat on the table and her bra is removed, allowing her large, D cup breasts to spill out. “alright Christine, our resident Dr Sarah will place the line and the stent. We’ll be getting started shortly.” Dr Rachel tells the nervous attorney. “the resident? I don’t want her to practice on me…” Christine protests, having a gut feeling against having the resident perform the catheterization and stent placement. “don’t worry ma’am, me and Dr Lindsay have done these plenty of times. Sarah will have plenty of adult supervision!” Dr Rachel tells Christine, attempting to add a little comedic relief to the urgent situation. Christine still had a bad feeling about it, but ultimately agreed to let Sarah perform the procedure.

The upper right portion of Christine’s chest was splashed with betadine to sterilize the area. The resident identifies the superior midpoint of the clavicle, and moves down a few centimeters. This is the location of the subclavian vein, so it’s important that the correct location be identified in the early stages of the procedure. Next, a local anesthetic is injected into Christine’s chest to numb the skin and some of the underlying tissues. She winced in pain, feeling a pinch and a burn from the injection. It normally takes 45-60 seconds for the local anesthetic to numb the area effectively, so in the meantime, an ultrasound was set up. This is to further confirm the location of the subclavian vein, and to follow the catheter’s path once placed. Next, a hollow needle was advanced through the skin. Christine could feel the pressure of the needle being inserted, but no pain. The resident Sarah advanced the needle slowly into the beautiful attorney’s chest, looking at the ultrasound monitor. Eventually, the needle was in the correct depth and blood was aspirated. The needle was held in place for a moment while the blunt guide wire was maneuvered through the needle and into the subclavian vein. While inserting the guide wire, Sarah pulled it out and inserted it again quickly, unnoticed by Rachel or Lindsay. However, everything seemed fine at the time. But in that moment, unbeknownst to everyone, Sarah introduced an air bubble into the central line, which would now become a ticking time bomb.

Eventually, the guide wire and catheter were sent to the correct location, and the occluded coronary artery was identified. A small stent was navigated into the central line and carefully and methodically navigated to the correct location. Once the stent was in place, it was placed and opened, restoring blood flow to the previously blocked artery. After confirming the placement of the stent via ultrasound and x ray, the guide wire was removed and a port was left in the initial site to leave the central line open for the duration of Christine’s hospital stay.

After the procedure was completed, Christine was brought back to an exam room in the ER to wait until a bed opened up in the recovery area. “how’re you feeling?” Dr Lindsay asked. “I definitely notice a difference. Thank you��” Christine replied, no longer breathing heavily, and seemed a lot more calm than earlier. “look who’s here!” nurse Nancy says excited, bringing Christine’s 70 year old mother Marie into the room. Marie hurries over to the bed as fast as her 70 year old body can, and gives her daughter a hug and a kiss. “How are you doing sweetie? They said you had a heart attack!” the concerned mother asks. “I’m doing a lot better mom! Thanks for coming.” She replies, with a smile on her face. “we’ll leave you two alone. It’s been quite a day, right?” Dr Lindsay said, exiting the room with nurse Nancy.

Approximately 2 hours go by. “something’s wrong! Come in, quick!” 70 year old Marie shouts to the ER team while scurrying out of the exam room, visibly worried. Dr Lindsay, nurse Heather, and nurse Nancy head into the room. The heart monitors are chirping loudly, showing that Christine is severely hypotensive and tachycardic. Christine’s eyes are shut, but she’s groaning. “christine? What’s wrong?” Dr Lindsay asks, doing a gentle sternal rub, to which Christine doesn’t respond. “she passed out and won’t wake up! What happened?!” Marie asks in a panicked tone. “We’re gonna get to the bottom of this, ok?” Dr Lindsay replied. Heather shined a pen light into Christine’s eyes and both pupils were fixed and dilated. “Pupils blown Linds” Heather tells Lindsay, shaking her head. “lets get her intubated! Get cardio back down here NOW!” Lindsay shouts, wondering what the hell just happened. “christine? Can you squeeze my hand?” Lindsay asks, receiving no response. Marie was holding her daughter’s other hand and talking to her while chaos ensued. “get me a 7.0 ET tube!” Lindsay shouted.

The ET tube was being navigated carefully into the woman’s airway by Lindsay. “no pulse, starting compressions!” Heather called out. “damn it!” Lindsay said frustrated, finishing her rapid sequence intubation. Heather delivered deep, violent chest compressions on Christine while her 70 year old mother continued to hold her hand and stroke her hair. “she’s in PEA. Push epi and atropine. And where the hell’s cardio?!” Dr Lindsay shouted again, frustrated. While Lindsay ambu bagged and lead the code, Heather continued delivering CPR. Christine’s chest caved in, and her belly jiggled outwards. Her breasts shook and trembled from the residual force of the compressions being received.

Dr Rachel and Sarah enter the room and are shocked, seeing their seemingly stable patient having her chest pumped violently. “what happened?!” Rachel asked, stunned. “I figured you two might try to figure that out for us. Any ideas?” Lindsay replied sternly. “what do you mean? She was fine a little while ago!” Rachel replied. “sarah even did a good job on her first stent placement and central line.” Rachel continued. “wait! This was the first time she ever operated on someone?!” Marie shouted, overhearing what was said. “ma’am… believe me, she is absolutely qualified. And every procedure has its risks.” Rachel replied, jumping to Sarah’s immediate defense. “did she kill my baby girl?!” Marie asked, becoming teary eyed. “Ma’am, why don’t we bring you to a private waiting room while the doctors work.” Nurse Nancy suggested, trying to gently direct the 70 year old woman out of the room. “no no no, I’m not going anywhere! That’s my daughter!” Marie shouted, tears running down her face, still holding her daughter’s hand as her chest was being absolutely pummeled.

The heartbreaking scene was interrupted by Dr Lindsay announcing that v-fib was on the monitors. “alright, charge the paddles to 200.” Lindsay called out. Nancy gently made Marie back away from the table because of the impending shock. The paddles were pressed up against Marie’s bare chest, the ambu bag was temporarily detached, and the shock was delivered. Marie’s body flopped on the table while a KA-THUNK was heard in the room. “still no change, charge to 250.” Lindsay called out, shaking her head a bit. After a cycle of compressions, the next shock was delivered. The electricity ran through the 47 year old’s limp, lifeless body, causing her to twitch sharply in response. “no pulse, let’s hit her again at 300.” Lindsay responded, looking at the monitors. “please… save my baby! That’s my little girl!” Marie begged the team while living every parent’s worst nightmare. “paddles charged.” Heather called out. The defibs were placed back onto Christine’s chest, and shock #3 was promptly delivered. Christine’s feet kicked up above the table and slammed back down half a second later, showing off the deep, soft, silky, prominent wrinkles throughout the soles of her size 7 feet. “still nothing doc.” Heather said, having 2 fingers placed on Christine’s neck for a carotid pulse. The paddles were recharged, and in a moment’s notice, Christine was shocked at 360j. Her body reacted more violently to the stronger shock, with her eyes opening up halfway, staring blankly up above. “PEA, resuming compressions.” Dr Lindsay said, taking over CPR for Heather.

More meds were pushed while CPR went on. However, it took another 6 minutes to produce another shockable rhythm. Nonetheless, when v-fib appeared on the monitors again, the paddles were recharged to 360 joules, and Christine was shocked again. Marie’s lifeless body twitched abruptly in reaction to the shock while her eyes remained open, staring blankly at the ceiling above. After another cycle of chest compressions, the next shock was delivered, causing Christine’s toes to curl, once again showing off the deep, soft wrinkles in the soles of her feet. But unfortunately at that point, the code started to become more redundant: CPR, shock, meds, repeat.

It was now 24 minutes into the code and Christine was still in v-fib. Her complexion was a ghastly pale color, her skin was ice cold to the touch, and there was a huge bruise on the center of her chest from all the CPR she’d received. At that point it was Dr Rachel doing CPR while Lindsay still ran the code. Lindsay looked around the room, eventually making eye contact with Rachel. Lindsay shook her head at Rachel, knowing Christine wasn’t coming back. Dr Rachel backed off, and nurse Heather detached the ambu bag. “what’s going on? Why are you stopping?” Marie asked the team, still holding her daughter’s hand. “I’m so sorry ma’am…” Dr Lindsay said, before Marie interrupted, “no no no! Shock her again! Keep pounding her chest! There’s gotta be SOMETHING you can do, right?!” Dr Lindsay paused for a moment, then said “I’m so sorry ma’am. We did everything we could. Your daughter’s heart won’t restart, and her brain has been deprived of oxygen for so long.” Marie started to cry at the point, practically crumbling to the floor. “time of death, 8:45pm.” Dr Lindsay said, peeling her gloves off. “no no no!” Marie wept. Nurse Nancy scurried over to try and console the woman while Heather began basic postmortem care.

The monitors were switched off, the EKG electrodes were disconnected, and the ambu bag was detached. A toe tag was filled out and placed on the big toe of Christine’s left foot, dangling in front of her beautiful, wrinkly soles. Her body was covered up, but Heather lowered the blanket down to Christine’s shoulders so Marie could have as much time as she needed to grieve her daughter’s tragic passing.

Since the exact cause of Christine’s death was unknown, an autopsy was ordered. The results of said autopsy concluded that Christine died from an air embolism that traveled to her brain. Essentially, air was introduced in the central line by Sarah, and it eventually traveled to the brain and got stuck in the smaller, more delicate vessels there. With these findings in mind, Marie was able to sue the hospital for Malpractice and received a hefty settlement payment. It was an absolute tragedy that Marie witnessed the death of her own daughter, and it was also a bit ironic that a medical malpractice attorney died from medical malpractice.

[defiblover27]

Feel Like Flying

So I decided to do something a little different and played around with chatGPT. And honestly I was quite impressed with what it was able to come up with. So here is a new story that I edited with the help of the software. The point-of-view is also a little different so be warned that it might be somewhat upsetting. Please let me know what you think and maybe try it out for yourself.

Enjoy!

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April is a 23 year old female who loved nothing more than the rush of adrenaline that came with performing stunts during halftime shows. She had been practicing for weeks with her team for the upcoming game against their biggest rival, and she was determined to make it perfect. On the day of the game, the stadium was filled with excited fans, and April could feel the energy buzzing through her veins. As she and her teammates prepared for their performance, she could sense the tension building. Finally, it was their turn to take the field. The crowd roared as the cheerleaders began their routine, and April felt her heart racing with excitement. It was time for the big finale, the basket toss. April took her place at the front of the group, bracing herself for the launch. Her teammates threw her high into the air, and for a moment, she felt weightless. But then, something went horribly wrong. She felt herself falling, her body twisting as she tumbled towards the ground. Her teammates failed to catch her as she landed with a sickening thud, and pain exploded through her body.

As April lay on the field, the medical team quickly ran out and assessed her injuries and began stabilizing her. One of the medical personnel called out instructions to the others. "April, can you hear me? Are you okay?" April moaned in response, her face contorted in pain. The paramedic quickly turned to her colleagues. "We need to stabilize her back and neck. Get the board and the collar." One of the paramedics retrieved a backboard from the ambulance, while another held April's head steady with a cervical collar. "Okay, on the count of three, we're going to roll her onto the board," said the first paramedic. "Ready? One, two, three." The team gently rolled April onto the board, keeping her spine as straight as possible to avoid exacerbating any potential injuries. They secured her head and neck in place with the cervical collar. April faded into unconsciousness as she went limp on the back board. "We need to get her out of her uniform and intubate her," they said. The medical team carefully removed April's uniform, being mindful of her injuries, and exposed her chest. One of the paramedics prepared to intubate her, and secured the 8.0 ET tube with a blue tube holder. The paramedic at the head pressed two fingers into the side of her neck through the front of the c-collar. Feeling no pulse he said "Let's get her hooked up to the monitor and start CPR," said the paramedic. The team then began performing chest compressions on April, providing rhythmic movements to her chest while giving rescue breaths through a bag valve mask. The crowd watched in stunned silence, some holding their breath, others whispering prayers for April's survival. "Charging the defibrillator," said the paramedic, as they placed the defibrillator pads on April's chest. They checked for a heartbeat and, finding none, continued aggressive CPR as the defibrillator recharged. In a moment they delivered another shock to her body through the defibrillator pads. The medical team continued performing chest compressions as they set up an IV in her left arm and pushed a round of drugs. "Let's continue CPR while we get her onto the stretcher," said one of the medical personnel. The team continued to perform chest compressions and provide rescue breaths as they carefully lifted April onto the stretcher. They quickly wheeled her toward the waiting ambulance, still performing CPR as they rushed her to the ambulance. They secured the stretcher in place and continued CPR on April as her heart refused to restart.

As the ambulance rushed towards the hospital, the paramedics frantically worked to resuscitate April. One of the paramedics was administering chest compressions, while the other was in control of the ambu bag, defibrillator and pushed any meds they needed. "Charging to 200," said the second paramedic, as he adjusted the settings on the defibrillator. "Clear." The team quickly stepped back, giving April room as the defibrillator paddles were applied to her chest. For a moment, there was a flicker of hope in their hearts. But it was short-lived. April's heart remained stubbornly still, and her body showed no signs of responding to the CPR and defibrillation. "We're not getting a pulse," said the first paramedic, his voice tense. "A fall from that height, and how she landed." The other paramedic cut him off "She still has a chance, we are not giving up on her." The team continued their efforts, their movements becoming more frantic as they tried to revive April. But no matter how hard they worked, there was simply no response. As they neared the hospital, the team prepared April to be wheeled out of the ambulance by placing the heart monitor on her legs and placing the saline bag next to her head.

As April was rushed into the emergency room, the medical team continued their efforts to revive her. The team worked quickly, with the sound of the continuous beeping of the EKG machine and the frantic shouts of the medical staff filling the room. "Let's get a central line in and administer epinephrine!" called the head of the medical team. "We need to keep pushing!" As they worked, April's family arrived at the hospital and was directed to the emergency room waiting area. They were anxious and worried, and the long wait felt like an eternity. Finally, the door to the emergency room opened, and a nurse stepped out. "I'm sorry," the nurse said gently. "We're doing everything we can, but her condition is critical." April's family was ushered into the room and watched in horror as the medical team continued their resuscitation efforts. They saw April's body on the bed, with EKG leads attached to her chest, and a breathing tube down her throat. As the medical team continued their resuscitation attempts, April's family saw them apply the defibrillator paddles to her chest, with gel spread over her skin to increase conductivity. With each shock, April's body jolted and spasmed, causing her family to flinch in pain. They also saw how vigorously the medical team was performing CPR on April. The force of the chest compressions caused her body to shake and convulse, making it seem as though she was fighting for her life. Throughout it all, April's family stood helplessly by, tears streaming down their faces as they watched their beloved daughter and sister being subjected to such a traumatic experience. Despite the family's hope and the medical team's efforts, April remained unresponsive. Her body lay limp, lifeless, and cold on the bed, with the only signs of movement coming from the medical team's frantic attempts to revive her.

April's family watched anxiously as the medical team continued their resuscitation efforts. They could hear the sound of the defibrillator charging up, and then the high-pitched beeping noise as it was applied to her chest.

"Clear!" one of the doctors shouted, and then they all stepped back as the shock was administered. April's body jerked and convulsed in response, her chest rising and falling rapidly as they resumed CPR. As they watched numerous round of medication being adm"We need to try again," another doctor said, applying more gel to the defibrillator paddles. "Clear!" they shouted once more, and the shock was delivered. April's body shook with the force of the defibrillation, but she remained unresponsive. The medical team continued their resuscitation efforts, performing CPR with intense force, sweat pouring down their faces. "Come on, April," one of the doctors muttered, their eyes fixed on the EKG monitor. "You can do this." The medical team administered drugs through the central line, hoping that they would somehow revive her. The force of the CPR was intense, causing her body to shake violently on the bed, her feet and legs swaying from side to side with each compression. The medical team worked frantically, the sound of the monitor beeping in the background. The family members were silent, their eyes fixed on April's still form, praying for some sign of life. "Come on, April," one of the doctors said, their voice strained with effort. "You can do this." After a few moments, there was no change in April's condition. The medical team continued with the chest compressions and resumed the CPR. Her body was still limp, and her breathing was non-existent. After a while April went back into v-fib. "Clear!" the doctor yelled again, administering another shock to her chest. April's body shook violently, and her head thrashed from side to side. "We need to get a pulse," another doctor said, their voice shaking with the effort of the resuscitation. They worked tirelessly, administering shock after shock, each time with the same violent reaction from April's body. The family watched, each shock taking a toll on their emotions. After several more attempts, the medical team finally stopped, their faces etched with exhaustion and defeat. "I'm sorry," the doctor said softly, looking at April's family. "We did everything we could, but we were unable to revive her."

As the doctor spoke the heartbreaking news of April's passing, her family members were inconsolable. They cried and hugged each other, saying their goodbyes to their loved one. After a few minutes, they slowly left the room, still sobbing and holding on to each other for support. The medical team waited for them to exit before they began the process of cleaning up April's body. "Let's get her cleaned up and prepped for transport to the morgue," one of the doctors said, their voice somber. The team carefully removed the EKG leads, central line, and other monitoring equipment from April's body. They then cleaned her up, removing any excess fluids or blood, and covered her with a white sheet. "It's always tough to lose a patient," another doctor said, shaking their head. "Especially someone so young." The team worked quietly, their movements solemn and respectful. They knew that they had done everything they could to save April's life, but the outcome was beyond their control. After the cleaning process was complete, they covered her with the sheet and placed a toe tag on her right big toe. They wheeled her out of the room, leaving it empty and silent.

#cpr #resus #resuscitation #defib #defibrillator #accident

[defiblover27]

Heart Break

Here is a new story that was commissioned by a follower. If you ever have any ideas as to what you would like to see my inbox is always open.

TW: Suicide, if you or anyone you know is in need of help please reach out to those that can help.

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Another beautiful day at the beach with a small crowd of beach goers. This beach would be filled shoulder to shoulder in a few weeks when all of the spring breakers arrived. For now it was maybe a couple dozen people relaxing. The lifeguards in the tower were also a bit more relaxed since their weren't meant to be many problems and no rowdy college students. That was until a surfer came running up to them. "Hey, I think there's something out there, kind of looks like a body." the surfer announced. One of the lifeguards grabbed his binoculars and scanned the water. Going back and forth he didn't see much, a few nice waves and a few people in the water. "Shit" he muttered under his breath as he came across what looked to be a person floating face down in the water. He ran out with his coworker as she drove a jet ski out toward where the person had been seen. As they got closer they could tell it was a young woman but something was off about the situation. The young woman appeared to be fully clothed. "I remember her." the female lifeguard announced. "She was sitting on the beach and I didn't think anything of it, I never saw her get in the water." They approached her floating body as they pulled her onto a board attached to the back of the jet ski. They flipped her over and she appeared to be in her early twenties at most with tight blue jeans, and a white t-shirt on that revealed a black bra underneath. Her lips were already turning blue and her complexion was ghostly white. "She might still have a chance, how long ago did you see her on the beach?" the male lifeguard asked. "I don't know maybe thirty minutes, I don't know" she responded as they sped toward the beach. The lifeguard pushed her long brown hair off of her face as he sealed his mouth of hers and began giving her rescue breaths. Each one caused a small amount of water to pour out mixed with some mucus and foam. As they made it to the beach they quickly grabbed her under her arms and dragged her inland. As they dragged her white adidas on her left foot to get covered in sand while her right foot was only covered by bright pink socks. Laying her down on the warm sand the male lifeguard quickly checked for a pulse by shoving his fingers into the side of her neck. "Nothing, get the defib." he announced as he centered his hands in-between her small b-cup breasts. With each violent compression more foam and water poured out of her mouth and her small body shook on the sand. She was maybe slightly over five foot with an attractive athletic build. One of the beachgoers nearby had already dialed 911 and the sirens could be heard in the distance. A crowd began to circle around her as they watched the lifeguards fight for her life. As the defibrillator arrived the two lifeguards continued to pound away at Amy's chest. They quickly snipped away her white shirt exposing her small breasts behind her black bra a single snip in the center of the bra caused it to fall to the sides as her breasts were exposed for everyone to see. Quickly they attached the leads of the heart monitor and awaited an initial rhythm. As they waited thoughts began to race through both of their heads. Why is a young fully clothed woman dead on their beach? How long was she out there? Her skin was cold to the touch and her lips were completely blue. "She's probably in hypothermia" he thought to himself. His thoughts were interrupted by a flatline on the monitor as the young girls heart sat silent in her chest. "Damn it, no shockable rhythm" he muttered under his breath.

He continued to beat violently on her chest as he felt her ribs pop under the immense pressure. After multiple rounds of CPR the monitor began to bounce around as it showed v-fib. Luckily this time there was a shockable rhythm as the paddles were charged. He took the paddles in his hand and spread a large amount of gel on them before placing them on her bare chest, pressing the shock button her lifeless body twitched on the ground before going still again. At this point the lifeguards switched positions as they continued their desperate fight. The beach goers watched in complete silence, a few of them began to pull out their phones and take pictures or record videos. The ultimate invasion of privacy as Amy lied lifeless on the sand totally exposed for the whole world to see. Again the monitor bounced around as they recharged the paddles and shocked the young woman the electricity coursed through her dying body as her chest flopped on the warm sand. Her cold dying body reacted more violently to this shock than it did the first one. Again there was no response as they continued CPR. "Where the hell is that ambulance?" the male lifeguard called out. "This is the East Point beach right?" one of the people in the crowd asked. "Fuck, no its the West." he responded madly. The person in the crowd fumbled for their phone as they called 911 to update the location. Amy had been under intense resuscitation for ten minutes while the ambulance and police were headed the opposite direction. Again and again her chest caved in rhythmically with each compression. Her entire body was under the will of her rescuers. Every once in a while they glanced at the monitor praying that it would show some sort of good news for the young girl. For eight minutes since updating the location no shocks were able to be given. Finally they got a chance as they charged the paddles and applied more gel. As he pressed the paddles into her chest her exposed body shook on the sand. Her arms flung out to the side aggressively before going still again. The monitors went flat once again as the medics finally arrived on scene.

"What do we got." one of the paramedics asked as he set down the defibrillator. "Early twenties female found unresponsive in the water. Being CPR for the last twenty minutes and delivered multiple shocks. Unknown downtime but she is cold to the touch." he replied. "Alright lets intubate and we will see what we can do." the paramedic responded. His partner took over at the head as he pried open her mouth and put the largynscope in. Next he carefully maneuvered the ET tube before securing it with a blue holder. Taking out his stethoscope he confirmed placement as he bare chest rose with each squeeze of the ambu bag. "I'm in." he said softly. At that point they resumed aggressive CPR as they started an IV to inject any drugs as well as fluids into the dying young woman. They also quickly snipped away her blue jeans to expose her down to just her one shoe and a white lace panties. Her bare chest glistened with droplets of water and the extra residue of gel from her previous defibrillation attempts, a blueish-purple mark was forming in-between her breasts from the force of compressions that she had received. As the compressions continued to pound in her chest her body rippled on the warm sand. Onlookers were in a state of silence as the grave reality started to wash over them, for the past fifteen minutes they had watched a young woman die in front of them as the lifeguards did all that they could to save her life. "v-fib on the monitor, charge paddles to 300 please" the paramedic said as the unit was charged. After signaling that it was charged the paddles were picked up and yet another heap of gel was spread across them. Pressing them into her chest the gel oozed from the sides, pressing the shock button her chest bounced off the sand before crashing back down again. Her breasts and abdomen jiggled with the impact of crashing back down. "No change charge to 360." the paramedic announced in a calm tone. The same procedure was followed as he pressed the cold paddles on her chest. Her nipples were erect from being exposed to the air and the currents of the defibrillator. Again her exposed body bounced around on the sand before going still again. "Asystole, resume CPR and push another round of epi" he announced as he took over bagging at her head. Her breasts shook around as her belly jiggled from each individual compression. For another three minutes the young woman remained in asystole before going into v-fib once again. The young woman was shocked four more times as her body shook around on the ground. For the next twenty minutes the young woman was put under intense resuscitation attempts as the fight for her life became futile. The paramedic shined a light into her eyes as they stared blankly back at him. "Fixed and dilated" taking out his stethoscope he order for compressions to stop as her moved it around her chest. "Her body is back to normal temp, she's been down for near an hour and has maxed out on epi, pupils are fixed and dilated. I'm gonna call it." he announced as the crew backed away. The paramedic called the hospital to get an official time of death from a physician. After acquiring it they began to remove the equipment from her bare body. As they packed everything up they noticed a note tucked into her bra. The note explained that she had recently lost the love of her life after she found him cheating on her and couldn't handle life anymore. The note left an eerie feeling as they wondered what could have been done to prevent this tragedy. The coroners office arrived shortly after to claim the young woman's body and the note allowed them to notify her family.

#cpr #resuscitation #resus #defib #defibrillator

[defiblover27]

Saturday Night Lights

I was scrolling through some old DM's and found an old suggestion that I forgot to flesh out. Here is a short story that I hope you all will enjoy!

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John is a 22 year old male standing at 5 foot 10 with an athletic build, he always loved playing sports when he was young and is currently in his senior year of college. John is the star running back for his school and is predicted to be one of the first picks in the draft next year. His team made it all the way to the bowl game and were predicted to win, this would be his second bowl title. Toward the end of the fourth quarter they were down 14-20 and had less than two minutes left. On a huge final second play John was handed the ball. He rushed down the field and broke multiple tackles. He was running faster than he ever had before in the hopes of securing his team the win. He crossed the goal line as the crowd erupted in cheers. He tossed the ball into the crowd and looked around, if his kicker could make the PAT they would win. Before this could happen John suddenly collapsed in the end zone. His fellow teammates tried to brace him as he fell but he was pure dead weight weighing over 200 pounds, after falling he sprawled out on the field with his back on the ground. The training staff quickly rushed over to him. They tried to get his attention and were shaking him to wake up. With no response one of the trainers stuck two of his fingers on his carotid artery. He was petrified when he did not feel any thumping on his fingers. He immediately centered his hands in the center of John's chest and began CPR. The other teams training staff noticed what was going on and rushed to help. They quickly cut off his jersey and unstrapped his pads. In a matter of seconds John's toned upper body was completely exposed. They continued CPR as they carefully removed his helmet since they weren't sure if he had hit his head. His chest caved in with each compression as he began to lose coloring in his skin.

Sara and Dave were in the arena when they heard what was going on. They quickly drove the ambulance onto the field and got all of their equipment out. When they approached John he was under intense CPR and they had no idea what had happened. They quickly set up the heart monitor and attached the leads to his bare chest. After booting up the monitor displayed v-fib as Dave grabbed the paddles off of the unit. He spread conductive gel across the paddles before placing them on his chest. As everyone backed away the first shock was delivered at 200J. John twitched on the ground before going still again. With no response CPR was resumed as Sara quickly intubated him and secured the tube with a blue holder. The paddles were then charged to 300J. As everyone backed away the paddles were placed back on his chest and John was shocked for a second time. His hands formed loose fists as his head lolled to the side. "Still no response, one more and then we gotta go." John announced. Sara was finishing placing a c-collar on John as she nodded her head. One of the trainers continued CPR as a bright red mark was starting to form in the center of his chest. The defibrillator was charged to 360J as they backed away, the third shock caused his chest to rise and fall quickly as he slammed back down onto the turf field. Dave pressed his fingers into John's neck for a moment. "I got a pulse, lets get him out of here." he announced. The training teams were relieved as John's heart began beating on its own again. They helped load him into the ambulance before Dave and Sara sped off to the trauma center.

The ambulance ride was rather uneventful as John began to stabilize but remained unconscious for the entire trip. Dave removed the rest of his uniform leaving John in only his compression shorts and cleats. His toned muscular body was covered with a white blanket as Dave squeezed the ambu bag every few seconds to keep John breathing. As they entered the trauma center John's heart rate began increasing rapidly. As they lifted his large body over onto the trauma bed he entered a v-fib arrest. They immediately charged the defib paddles to 300J. The paddles were gelled as John's chest was caved in rhythmically over and over again. The first shock sent his arms out to the side as they fell off oft he bed. With no effect CPR was resumed as his arms bounced with each individual compression. A round of meds was given as the paddles were charged to 360J. As they backed away from his body the paddles were placed back on his bare chest. Shock number two sent his chest into the air before crashing back down. This time John entered asystole as intense CPR was resumed. Dr. Michael ordered a full lab work up and also called for a ultrasound to determine if there was any damage to John's cardiovascular system. In a few short moments John was stripped down naked as his legs shook from side to side with each compression he received. His nude body was covered in tubes and wires as the trauma team did everything that they could to save his life. It took an additional six minutes of continuous CPR and multiple rounds of drugs to convert John back into v-fib. "Alright let's go again at 360 please" Dr. Michael announced to the team. The paddles were taken off the unit, gelled, and placed back on his chest. Compressions stopped for just a moment as the ambu bag fell against the side of his face, the shock coursed through his dying body as his arms and legs flailed. With no response CPR was resumed as the paddles were recharged. "Push another round of epi please" Dr. Michael commanded his team. Another shock was administered as his chest flopped around on the table. "Damn it still no change, charge again" John had now been down for over fifteen minutes in the trauma room. "Doctor, his parents are here" a nurse announced as she stepped into the room.

Dr. Michael stepped out of the trauma room and found Mr. and Mrs. Smith standing there visibly distraught. "How's our son? Is he going to be okay?" he was bombarded with frantic questions. "John's heart stopped beating again once he arrived here, we have been doing continuous CPR for over fifteen minutes in combination with drugs and electrical shocks to his heart. I think it would be important for you all to come be by his side." Dr. Michael told John's parents knowing that he most likely would not survive. As they entered the trauma room John came crashing back down from another defibrillation. "Flatline doctor." one of the nurses announced. Dr. Michael turned toward John's parents "We are going to take an ultrasound of your sons heart, it hasn't been beating for almost twenty minutes despite all of our efforts. We are going to be checking for any signs of electrical activity. You can go up beside him and hold his hand." This wasn't common practice but given the circumstances Dr. Michael made an exception. He took the want in his hand and ordered that compressions stop. A generous amount of gel was applied to the wand as it maneuvered over his heart. "Mr. and Mrs. Smith John's heart does not have any electrical activity, I'm afraid there is nothing else we can do." Dr. Michael told the parents. They cried in each others arms as they began saying goodbye to their son. "Time of death 17:47, thank you everyone" Dr. Michael said as they began detaching the ambu bag and electrodes before turning off all of the machines. They placed a toe tag on his right foot and then covered him with a sheet up to his neck as his parents remained in the room until he would be transported to the morgue. His death was ultimately ruled as sudden cardiac arrest that kills thousands every year and has no relation to the overall health of the individuals. A vigil was held in the following days as the campus community mourned the loss of their beloved friend and teammate.

#cpr #defibrillator #defib #resus #resuscitation

[defiblover27]

Alexa is a 23 year old woman standing at five foot two with an athletic build and a sun kissed tan. She has bright blue eyes and dirty blonde hair. Alexa and her husband John were expecting their first child and couldn't wait to spend the rest of their lives together. It was a cool wet morning and John had left for work, he is supposed to take time off in two weeks for the birth of their child. Alexa awoke to a strange feeling and felt around the bed. She was shocked when her hand felt wet. Sitting up slowly she realized that her water broke. She slowly got out of bed and grabbed her phone. She tried again and again to get a hold of John but kept getting his voicemail. "John, call me back my water just broke, I need you." She began to panic since she was alone and decided to drive to the hospital herself. She grabbed her bag that they had packed weeks ago for the hospital stay and slipped on her shoes. She left the house in just sneakers and a white night gown. After getting in her car she tried calling John again and once again got voicemail "John, I am driving to Mercy now, please hurry" She drove as carefully as she could but felt the panic setting in. She stopped at a red light and once it turned green began to drive. The cross traffic light never turned red and a semi-truck noticed Alexa's car a little too late and slammed on its brakes. Alexa as t-boned on the passengers side and her car smashed together like a tin can. The car rolled a few times before landing right side up. The driver of the semi jumped out of his barely damaged truck and rushed to Alexa's car. She had been knocked unconscious from the impact. The trucker dialed 911 and pleaded for them to hurry as he stared at Alexa. His eyes drifted down as he noticed her large pregnant belly "oh my god... she's pregnant." The 911 dispatcher tried to calm the trucker as she dispatched all necessary personnel. Since Alexa was pregnant two ambulances were dispatched for the fastest response time.

Sara and Dave were the first paramedics to arrive as the police had closed off the intersection and the fire crew was working on ripping the roof off of the car. After removing the roof of the car Sara climbed into the back seat and placed a c-collar on Alexa. She had a strong pulse and responded to painful stimuli. Her left femur bone was protruding out of her skin. They carefully maneuvered a backboard behind her and dragged her out of the vehicle. They placed her on a gurney and began to stabilize her. They snipped off her white nightgown leaving her completely nude on the gurney with own her sneakers on. They placed electrodes on her bare chest and listened for a fetal heartbeat. They were able to find the fetal heartbeat and moved on to bracing her left leg with a large orange brace. There was significant cuts and bruises over her entire body and a large gash on her forehead. They rolled her into the back of the ambulance as the second EMS crew arrived. One of the paramedics from that crew got in the back with Sara as Dave sped away from the scene. Two of the police cars on the scene escorted them to the hospital. In the back of the ambulance Sara started an IV and started fluids. After a few minutes Alexa's eyes started fluttering. "Wh...where am I?" she let out softly. "You've been in a car accident, you are in an ambulance right now we are taking you to Mercy Hospital. How far along are you?" Sara responded. "My water broke this morning" Alexa replied "please... save my baby" Alexa let out softly before drifting unconscious again. Sara performed a sternum rub and called out to her "Come on sweetie wake up, you have a baby to take care of" Alexa didn't respond to the sternum rub as the monitors showed PEA. Sara began strong deep chest compressions as the other paramedic quickly intubated her and secured it with a blue holder. "Update Mercy let them know we have a traumatic full arrest and her water broke this morning" Sara called out to Dave as he radioed the hospital. Sara pushed a round of drugs and continued CPR. Within the next minute they were wheeling her out of the ambulance and into the ER. They took her straight to the trauma room as Sara gave the briefing. "23 year old female, water broke this morning, t-boned by a semi, lost pulse about 2 minutes ago and given one round of drugs still in PEA". They transferred her over to the bed and positioned the overhead light as a nurse took over CPR. "Alright give it two more minutes and then we have to get the baby out." Dr. Micheal informed the team. Cpr continued for another minutes as her petite pregnant body shook on the bed. V-fib was established as the paddles were charged to 200 joules and gelled. Once they were charged the cold metal was placed against her bare chest and the shock was delivered. Her body twitched with the shock before CPR was resumed. With no response the paddles were charged to 300 joules. One paddle was placed between Alexa's breasts and the other slight below and to the side of her left breast. The shock caused her pregnant belly to bounce off the table slightly before going still again. The shock sent her back into asystole as the team continued fighting for her life. The OB on call Dr. Johnson spread betadine across her large belly before slicing her open. He used his hands to tear open her belly and had one of the nurses hold it in place. Within a minute he was able to get the baby out and the first cry of the newborn brought the spirits of the team up a little bit. They then remembered that the newborns mother was dying on the trauma bed.

Aggressive CPR continued as her now empty abdominal cavity shook around from the sheer force. The nurse felt her broken ribs jerk around with each compression. Another round of drugs was pushed through her IV as CPR continued for another minute until the drugs took effect. As the monitors began to show v-fib the paddles were charged to 360 joules and gel was reapplied. Placing them on her bare chest the shock rippled through her body causing both her arms to fall off the bed. CPR was resumed as her arms bounced up and down as they dangled off the bed. Her battered body laid lifeless as they backed away for the next shock. The paddles were charged to 360 joules as they were placed on the gelled areas of her chest from the past defibrillations. After pressing the shock button April's body shot off the bed before crashing back down again. "Still no change, charge again to 360" Dr. Michael ordered, as the paddles were being charged Alexa's nude body shook around on the table from the force of the compressions. Her empty stomach cavity was being packed with surgical gauze as they attempted to control any bleeding from the emergency c-section. The defib unit sounded off that it was charged as Dr. Michael took the paddles in his hands a nurse squirted gel onto the paddles. Rubbing them together he spread the gel before bringing them down onto her bare chest right over top the gel that glistened on her chest from previous attempts. Once everyone backed away he pressed the shock button. Alexa's chest shot off the bed and came crashing back down again, her belly shook side to side before going still. At this point Alexa converted into asystole as CPR was resumed on the new mother. An ultrasound was called for to assess any injuries that they might have missed internally. With compressions still ravaging her chest Dr. Michael moved the wand around and found that there was a large collection of blood directly around her heart and obvious damage to the aorta. "Prep a thoracotomy please, she has to meet her new child." Dr. Michael asked almost taking this case personally. The tray was moved toward the bed as betadine was squirted over the whole of her chest. They elected for a clamshell thoracotomy to gain access to her thoracic cavity. Slicing away the medical team went deeper and deeper as blood spilled out of the young woman's chest. After a few moments Alexa's chest was pried open and now she was cut open from just above her vagina all the way up to her breasts and to the side. Upon entry to the thoracic cavity a large amount of blood rushed out and was quickly filled with fresh bright red blood. Suction was applied to gain a line of sight as Dr. Michael quickly attempted to suture the aorta. After this was done he took his hands and started squeezing her heart. With each squeeze the line on the monitor jumped and showed the efforts of Dr. Michael's hands. After giving another round of drugs Alexa converted back into v-fib. The internal paddles were charged to 20 joules and lowered into her chest. The large sppon shaped paddles wrapped around her twitching heart. As the ambu bag was dropped and dangled from her mouth the shock was discharged. Alexa twitched on the table as the electricity hit her. Her heart continued to twitch inside her chest as the paddles were recharged to 30 joules. Using one hand to compress her heart Dr. Michael held the paddles in the other. Once the unit was charged everyone backed away and the higher shock was delivered. This time Alexa's toes scrunched showing off the wrinkles on her small feet and her hands formed loose fists. There was still no change but blood began to pool in the cavity. The suture to the aorta came undone so Dr. Michael repaired it for a second time. After the repair the paddles were charged to 40 joules. The cold metal was placed back in her chest and the shock was delivered. Alexa's shoulders srunched inward as her arms flailed out. Once again they were unable to convert the young mother.

Dr. Michael looked at the clock and realized they had been coding the young woman for almost 30 minutes. At that point he took out his penlight and shined it into her beautiful eyes that stared blankly back at him. "Pupils fixed and dilated, she's been down for almost 30 minutes, and her injuries are catastrophic. Does anyone object to calling this code?" Dr. Michael asked the room fell silent. "Time of death 12:17 PM. Thank you for your help". Dr. Michael announced. Alexa was pronounced dead as her heart twitched inside of her exposed thoracic cavity. The young newly deceased mother was detached from the electrodes, the ambu bag was detached, and they attempted to clean up the graphic code the best they could. Finally they placed a toe tag on her right big toe that draped in front of her small foot. They then closed her eyes for the final time. April's husband was now left with a child that he would have to raise on his own and had no clue how he would do it. All he knew is that he would try his best to raise that child to be just like their mother.

#defib #female #defibrillator #cpr #resus #resuscitation

[defiblover27]

Lydia’s Last Game

Lydia Lyons was a 23 year old basketball player in her first professional season. She was a star center at a major division 1 college, a high draft choice in the WNBA draft, and a major contributor to her team on both sides of the ball, putting her in the conversation for rookie of the year.

As with most basketball players, she was quite tall, standing at 6’6 with a toned, athletic body. She had light brown hair that was usually in a ponytail, had pretty blue eyes, and was fair skinned. Lydia was the perfect combination between cute tomboy and amazon goddess.

Last week, Lydia’s team was playing an important game on the road. If her team won, they’d clinch a playoff spot for the first time in 10 years, so the pressure was on. Prior to the game, Lydia felt some fluttering in her chest and felt like she had to catch her breath every so often, but didn’t think anything of it, attributing this to nerves since this was an important game. Nonetheless, Lydia suited up with her team and took the floor to begin the game.

Lydia was off to a hot start in last night’s game. In the first quarter, she was attacking the paint aggressively, scoring 10 points predominantly through dunks and close up shots, while also dishing out 3 assists, and snatching up 5 rebounds. Her team had a comfortable lead after the first quarter, but the opposing team started to feel the urgency of the situation and wanted to change their game plan, worrying that Lydia would run them out of the own building if things didn’t change.

In the 2nd quarter, the opposing team decided to double cover Lydia in an attempt to limit her offensive output and make sure a defender was on her at all times. This slowed Lydia down a bit, only scoring 4 points, with 0 assists, and 2 more rebounds in the 2nd quarter. At halftime, Lydia’s team was up  38-27, and Lydia was leading her team with 14 points, 3 assists, and 7 rebounds.

In the halftime locker room, Lydia felt a lot more drained than she normally does. The fluttering in her chest returned with a dull ache this time, and she felt like she had to catch her breath a couple times. “It’s ok. It’s gonna be ok, it’s just nerves. Just 2 more quarters to go and I can relax.” She thought to herself, completely unaware she’d be toe tagged and under a sheet in our hospital morgue just a couple hours later.

After a brief intermission, play resumed for the second half. The 3rd quarter was a back and forth affair. The opposing team scored 2 quick three pointers, cutting Lydia’s lead down to 5 points. Lydia’s coach called a time out before their team’s ensuing possession, and urged the team to step up their perimeter defense to make those three pointers harder to come by. On the ensuing possession, Lydia hit a 3 pointer of her own, and on the opposing teams next possession, she generated a turnover by a heads up defensive play, leading to a fast break dunk and 2 more points, bringing her team’s lead back up to 10. Overall, the 3rd quarter continued to be a back and forth contests.

The 4th quarter was a different story. Lydia’s team began to struggle defensively, and Lydia was feeling absolutely gassed. She was dripping in sweat, had a pasty complexion, and was breathing rapidly. “you can do it. Just a couple more minutes to go. You’ve fought through worse pain before.” She told herself, not realizing a ticking time bomb was counting down inside her body. She was chugging Gatorade on the bench during stoppages in play like it was going out of style, and felt dizzy at times. Regardless, she continues to play.

Even though her team struggled defensively, she continued to produce offensively despite being double covered. The opposing team made it a close game, but Lydia played an excellent 4th quarter, adding an additional 10 points, 4 assists, and 6 rebounds, leading her team to a huge victory and their first playoff spot in 10 years. Lydia came up clutch in that game, ultimately ending up with a triple-double: 26 points, 12 assists, and 14 rebounds.

After the game, her team swarmed her and gave her hugs, high fives, and all sorts of compliments. Lydia had a huge smile on her face, ecstatic about her performance that night, and looking forward to her team’s upcoming playoff game.

In the locker room post game, Lydia’s smiles dissipated. While changing out of her sweaty, game used uniform, the pain in her chest felt sharper and more painful than before. “a shower will probably hit the spot. It’s probably nothing.” She told herself. While in the shower, she experienced more pronounced heart palpitations, had another dizzy spell, and was experiencing nausea. “I dunno, I just need to take it easy tonight when we get back to the hotel.” She thought.

After her post game shower and changing into fresh clothes, the team headed back to the bus that would take them back to the hotel from the arena. During that bus ride, Lydia lost consciousness. Her teammate sitting in the seat next to her tried to talk to her and realized she didn’t respond. The teammate looked over and thought Lydia was sleeping. “hey sleepy head! The nights still young!” the teammate said jokingly, tapping Lydia lightly, to which Lydia did not respond. The teammate grew concerned: “Lydia? You good?!” she asked, giving Lydia a bit of a nudge, but she didn’t respond again. “Hey! Doc! Get over here!” the teammate shouted, alerting the attention of the team’s physician.

The team’s physician scurried over to Lydia’s seat, with her teammates now growing concerned, standing up from their seats trying to see what was going on. The team doctor tapped Lydia on the shoulder. “Lydia? Hun? Is everything ok?” they asked, to which they didn’t receive a response. The team doctor then lowered their stethoscope onto Lydia’s chest to listen to her heart and lungs. “no no no! Oh no!” the team doctor said, becoming a bit panicked. “What’s wrong doc?” “is everything good?” two players asked. “Get this bus to the nearest hospital RIGHT NOW!” the doctor shouted at the bus driver. “what’s wrong?! Is she ok?!” the team’s coach asked the doctor. “ok, can someone help me get her out of her seat? I need to get her on the floor of this bus immediately!” the doctor shouted to the rest of team. “you’re scaring me doc, what’s wrong?” Another player asked. “is there an AED on this bus?!” the doctor asked the bus driver. “AED? What’s going on?” the driver asked. “guys. Lydia’s heart stopped beating and she’s not breathing. We need to get her to a hospital, and move her so we can start CPR!” the doctor replied urgently. Some of Lydia’s teammates became visibly nervous, while a few started to cry.

One of Lydia’s teammates helped the doctor move Lydia from her seat and onto the floor of the bus. This was easier said than done, considering this was 6 feet 6 inches of dead weight that had to be moved, all while the bus driver sped off towards the nearest emergency department.

Once Lydia was on the floor, another team member tracked down the bus’s AED and first aid kit, while the team doctor removed Lydia’s shirt and bra, and began performing deep, strong chest compressions. “1… 2… 3… come on Lydia, don’t do this…” the doctor said, more or less thinking out loud. While performing chest compressions on Lydia, the team doctor walked one of the teammates through setting up the AED. Once the pads were stuck onto her bare chest, the AED began analyzing the rhythm. “SHOCK ADVISED.” , the machines monotone voice called out. “alright, I need everyone to back away!” The team doctor called out. “ok, everyone…. CLEAR!” she shouted, while pushing the shock button. KA-THUNK! Lydia’s long, slender body shook slightly in response to the shock. “ANALYZING RHYTHM.” Said the machine’s voice recording. “RESUME CPR.” The machine continued a moment later. The team doctor locked her hands back onto Lydia’s bare chest, and began pushing down hard and fast with the heel of her hand, while part of her other hand covered Lydia’s small, A cup breast inadvertently. Lydia’s chest caved in rhythmically while her toned abs and belly bounced out, recoiling from the residual force of the chest compressions.

After a cycle of chest compressions, the AED advised a 2nd shock. The team doctor advised everyone to take a few steps back, and the next shock was delivered. Lydia’s body trembled on the floor for a moment, and the current of electricity forced her eyes open. Lydia’s eyes were half open, staring lifelessly off to the side. “ANALYZING RHYTHM.” The AED voice said. “I’m pulling into the hospital now!” the bus driver shouted, making a sharp turn into the hospital’s main entrance. “RESUME CPR.” The AED continued. “damn it. Come on Lydia!” the team doctor shouted, resuming chest compressions. Lydia’s head bobbed and lolled in sync with the chest compressions while her pretty blue eyes stared off blankly.

Once the bus pulled into the main entrance, a few players exited the bus and hurried into the ER, grabbing ahold of a few emergency department staff members. In the coming seconds, a few nurses waited outside with a gurney while a doctor hopped onto the bus to see what was going on. The ER doctor started peppering the team doctor with questions. “what happened?” “how long has she been down?” “any medical conditions?” “illegal drug use?” etc. The team doctor felt overwhelmed, tears rolling down her face. “I don’t know! I really don’t know! I haven’t done CPR on someone since my residency. I deal with sprained ankles and torn ACLs… not THIS!” she replied, teary eyed with a lump in her throat. The ER doctor felt sympathy for the team doctor. “alright, it’s ok. We’re gonna take it from here, ok?” the ER doctor said.

The ER doctor and a couple of the teammates lifted Lydia’s limp, motionless body off the floor of the bus and carried her out of the vehicle, and onto the gurney that waited just outside. The team doctor and the rest of the team watched in horror as their star player was carried off the bus, eyes still half open, onto a gurney. Once Lydia was placed on a stretcher, one of the ER nurses started delivering deep, strong, violent chest compressions on the beautiful young athlete.

Once in the ER, the rest of the basketball team was told to wait in the waiting room while the ER team did its work. The team watched Lydia receive CPR while she was wheeled into a location off in the distance. Once she was out of sight, all they could do was wait and hope for the best.

The emergency department staff wheeled Ms Lyons into an open trauma room, where some staff members were already waiting. “23 year old female, sudden cardiac arrest, down approximately 5 to 7 minutes- who really knows. Shocked times 2.” The ER doctor called out to the team. “ok, let’s transfer her onto the table on my count. One, two, THREE!” the attending physician continued.

Lydia was now on the trauma room table under the large overhead light, getting her chest pumped by one of the emergency department nurses. With CPR resumed, the team started barking orders at each other. “let’s get her hooked up to the monitors!” “I need 2 large bore IVs” “run stat trauma labs!” “we need a chest x ray!” “I want an echo!”, and so on. The star basketball player laid lifeless on the table amongst the room’s organized chaos. The trauma team was sticking her with needles, putting EKG electrodes on her chest, and drawing labs to get started. The IVs were set up first, and Lydia was immediately given a dose of epinephrine and atropine. The heart monitors were good to go just a moment later, and displayed coarse v-fib.

With CPR still ongoing, one of the nurses removed the rest of Lydia’s clothes, her shoes, and her socks, essentially stripping her completely naked. “she’s been down a few minutes. Let’s get her intubated. 8.0 ET tube please.” One of the nurses called out at the head of the table. The nurse opened up the young athlete’s mouth and placed the laryngoscope in, and began trying to navigate the tube in. “come on… come on…” the nurse said, thinking out loud. The nurse was fiddling with the tube, having a tough time with the intubation. “I can get past the cords, but can’t get down to the carina…” the nurse said, shaking her head. “this is a bigger girl. Try a bigger tube and see if that works.” The ER attending replied, handing the young nurse an 8.5 ET tube. This time, the nurse was able to place the tube and secure it in place with a blue tube holder.

After intubation, the team decided it was best to shock Lydia and then perform a chest x ray and echo post shock. The team charged the defib paddles to 300 joules, gelled them, pressed them up against the star player’s bare chest, and shocked her. Lydia’s body twitched and shook for a moment before going still. “no change, still in v-fib. Resume compressions. And let’s get that echo. We may not have time for the x ray.” The attending called out. With ongoing CPR, an echocardiogram was performed. “ok, massive tamponade. Get me a thoracotomy tray please. I need to open her chest.” The attending called out, sensing the urgency of the already dire situation. “where’d all that blood come from?” one of the nurses asked. “not sure, but we need to find out ASAP!” the ER doctor replied.

Betadine was splashed across Lydia’s bare chest, a quick, crude incision was made. The cut began in the 5th intercostal space just to the left of her sternum, extended laterally across her chest, underneath her left nipple and small, perky A cup breasts, and ultimately ended just shy of her left armpit. Layer by layer, the team cut through the underlying tissue and placed the run spreader in. They cranked the knob on the rib spreader, prying the young lady’s ribs apart forcefully. Cracking and popping sounds filled the room during this process. Finally, Lydia’s chest was opened and external CPR was ceased.

A vertical incision was made in the pericardium in order to relieve the tamponade and deliver the heart. But after the cut was made, fresh, bright red arterial blood rushed out, blocking the line of sight in an instant. Suction was applied to the area, but it only did so much. Since the team realized a potential bleed was the culprit, blood products were called for in an attempt to begin transfusions. A vascular clamp was placed on the descending aorta near the diaphragm to redirect blood flow to Lydia’s heart and brain, but the bleeding still continued after the cross clamping. It took several more attempts worth of suction to create a satisfactory line of sight in the thoracic cavity.

With that line of sight established, the ER doctor wrapped their hands around Lydia’s strong, athletic heart and began pumping away. They could feel Lydia’s heart weakly twitching in their hands, along with warm blood on the gloves and the arm portion of their trauma gown. A wet, rhythmic squishing sound was heard during internal massage. The team performed a few cycles of internal massage and pushed another round of drugs, but v-fib still persisted, so they decided to shock Lydia with the internal paddles. The large, spoon shaped paddles were charged to 20 joules and lowered into Lydia’s chest around her fidgeting heart, and a shock was delivered. A dull, weak thump was heard in response to the shock. Lydia’s heart contracted weakly for a few seconds, then began twitching spastically again. Internal massage was resumed, and the team recharged the paddles to 30 joules that time, and lowered them back around her strong, athletic heart, and released another jolt of electricity into it. Her torso flopped limply on the table, with her beautiful blue eyes staring lifelessly above. Unfortunately, there was still no change.

At that point, the ER team resumed internal massage, and the attending physician decided to investigate a bit further to see what could be causing the massive tamponade that led to Lydia’s cardiovascular collapse. The physician started feeling around Lydia’s strong, muscular heart to feel for any holes or tears in either the atria or ventricles, but all 4 chambers were intact and showed no signs of rupture. The doctor then checked for any great vessel abnormalities, but the thoracic aorta and its associated vessels were intact, as was the superior vena cava, and the pulmonary arteries+veins. The ER attending couldn’t find any noticeable cause for the massive bleed with their preliminary examination.

Since Lydia was still in v-fib, the team decided to shock her again with the internal paddles. The blood soaked paddles were recharged to 30 joules and lowered back in to shock Lydia’s heart again. The jolt of electricity caused Lydia’s feet to kick up for a moment before slamming back down, showing off the thin but prominent wrinkles all throughout the soles of her huge, size 15 feet. Lydia’s heart continued to quiver erratically in plain sight, with v-fib still displaying on the monitors. A cycle of internal compressions and another dose of meds were pushed intravenously while the paddles were recharged to 40 joules this time. The next shock caused Lydia’s long, slender legs to shake a bit while her shoulders shrugged quickly due to the increased intensity of this shock.

Lydia’s heart stopped for a moment, then started twitching again, but this time it was twitching much weaker than it did previously. The patient was in fine v-fib now, so internal massage was resumed and the large, spoon shaped paddles were recharged for the next shock. The next shock was also at 40 joules, and caused Lydia’s arms to flail for a moment, with her hands making loose fists. Unfortunately, Lydia became asystolic after this shock. One of the nurses checked Lydia’s pupils and noted that they were fixed and dilated. At that point, the ER team ceased their resuscitation efforts and called time of death on the star player at 10:17pm.

The flatlined monitors were switched off and the ambu bag was detached from the ET tube. The EKG electrodes were plucked off of Lydia’s bare chest, and the thoracotomy equipment was removed, only leaving a large, crude gash in her left chest. Lydia’s eyes were shut for the final time, and a toe tag was filled out and placed on the big toe of her left foot. The tag dangled in front of the thin, rough wrinkles in the soles of her big feet. Lydia laid cold, pale, and lifeless on the table with a detached ET tube hanging from her mouth. It was hard to believe she dominated a professional basketball game just a few hours earlier. Now she was under a sheet, and taken up to the hospital morgue.

After Lydia was transported to the morgue, the ER team had to have the difficult conversation with the all the players, coaches, and team employees in the waiting room. The attending physician told the team that despite their best efforts, Lydia passed away in the emergency department, and the cause of death was not immediately known to the ER team, so an autopsy was requested. Naturally, the teammates, coaches, team doctor, and other team employees were shaken up and saddened by the news of Lydia’s shocking death.

Lydia’s autopsy revealed several noteworthy findings. First and foremost, her cause of death was determined to be a ruptured coronary artery aneurysm. There was a massive tear in the posterior aspect of the left coronary artery, while there was an unruptured aneurysm of circumflex artery, with 12cm dilation- for reference, these aneurysms typically rupture around 8-10cm. There was also necrotic myocardium along the sides of the left ventricle. The odd thing about these findings is they tend to occur in older patients who have a history of arteriosclerosis, heart attack, and smoking. Since Lydia was a young, healthy athlete, this warranted further investigation. The further investigation was able to determine that Lydia had an undiagnosed case of a connective tissue disorder known as Ehlers-Danlos syndrome (EDS). EDS is an inherited syndrome that affects the skin, joints, connective tissue, and arterial walls. Common characteristics of this syndrome are thinner than normal skin, abnormal stretching of the skin, abnormal scarring, joint hypermobility, and weaker blood vessel walls. Generally, this is a condition diagnosed during childhood and adolescence, but if the patient remains asymptomatic, it may go undetected. This is also a condition that has to be specifically tested for, so it may not always come up on a routine physical. Unfortunately for Lydia, she had this condition for years without knowing it.

With Lydia’s cause of death determined, the team and Lydia’s loved ones were able to get some closure in regards to her death. The team decided to hold a moment of silence in honor of her untimely passing before their first playoff game. Sadly, the team was unable to win their playoff series, but after the season, the WNBA awarded Lydia rookie of the year and MVP posthumously in a kind gesture, recognizing her accomplishments.

[defiblover27]

The Bachelorette Party

Bachelorette parties are supposed to be a fun get together in honor of a woman’s upcoming marriage, usually involving the bride and a few close friends and family members.

Becca was set to marry the man of her dreams, Ryan, after 3 and a half years of dating. Becca was a 27 year old brunette with brown eyes, was of average height and build, was fair skinned, always had her makeup on point, and had perky c cup breasts.

Becca and her fiancé had planned a smaller wedding, and wanted to keep their circle smaller for the wedding and related festivities to limit drama, which was exactly the case for both the bachelorette and bachelor party. For Becca’s bachelorette party, she was only inviting 3 other people for a night out at the local casino. The lineup included her younger sister Maddie, and her best friends Kate and Carly.

Maddie was a 22 year old who had had brown hair and brown eyes like her older sister, but had a taller, skinnier build, had a nose ring, a half tattoo sleeve on her left arm, and B cup breasts. Next up was Kate, a 27 year old conventionally attractive blonde with blue eyes, who had a skinny build, a tan complexion, didn’t wear much makeup, and had perky c cup breasts. Last but not least was Carly, a 26 year old brunette with a short pixie cut and green eyes. Carly had that cute, innocent, girl next door look and had a smaller, petite build, and sported C cup breasts as well.

As mentioned earlier, the 4 ladies had intended on going to the local casino for a night of drinking, gambling, and fun, but unfortunately, fate had other plans for the bachelorette party. The group has piled into one car- Carly’s car, since she was the group’s designated driver. While on their way over to the casino, a semi truck had taken a curve a little too hard and fast, striking the 4 ladies head on while frantically trying to avoid the truck.

The front of the car got crushed up, and the vehicle was forced backwards into a barrier, throwing all 4 ladies around violently inside the vehicle. The steering wheel slammed into Carly’s chest, with a cracking sound being heard instantly from her ribs and sternum taking the brunt of the impact. Over in the passenger seat was our to-he bride Becca. She was thrown around quite violently as well, striking her head on the ceiling, and the passenger door window, before falling unconscious. In the rear, passenger's side backseat, Maddie screamed in pain, feeling her left thigh get crushed while simultaneously being thrashed around. A loud snap was heard, and she saw bone penetrate her pants, sticking out in plain sight, causing her to scream loudly, terrified by what she just saw. Last but not least, Kate felt the armrest in between the two back seats slam into the upper right quadrant of her abdomen really hard, before being forced back, experiencing whiplash.

After this awful wreck, 911 was notified by multiple other onlookers in nearby vehicles. Emergency services began swarming the scene in the coming minutes. The police were securing the scene and directing traffic around the bachelorette party’s mangled vehicle, while the fire department and EMS began to get acclimated on scene. A firefighter came up to the driver’s side window and took a peek inside the vehicle. Carly was gasping for air and clenching her chest, Becca the bride was unconscious, Maddie was crying hysterically in pain, and Kate was groaning in pain, drifting in and out of consciousness. “please… help us…” Carly uttered in a weak, breathy voice to the firefighter as they approached the vehicle. Meanwhile off in the distance, the driver of the semi that hit the ladies head on stumbles out of his vehicle, not a scratch on him. The driver reeked of booze and weed, and kept mumbling things to himself. The accident was already his fault for taking that curve too fast and striking the ladies, but he exacerbated things by being intoxicated. He was subsequently handcuffed by one of the cops, and was sitting on the step of one of the ambulances, being examined by a medic. “oh my god, did I fuckin kill them?!” the truck driver shouted out loud, watching fire department and EMS personnel surround the crushed up car.

The medics began assessing all 4 ladies, but the bride to be was in the worst shape. A weak carotid pulse was felt on Becca, and her pupils were sluggish. A c-collar was immediately placed on Becca, and she was carefully navigated out of the vehicle and into a backboard. The medic and fire fighter set the backboard down on the ground for a moment and started setting up a portable heart monitor on Becca, placing IVs, and removing most of her clothes and her shoes. With Becca’s level of consciousness and unstable vital signs, it was decided that rapid sequence intubation was the next best step. The medic opened Becca’s mouth and blood started dribbling out. Her mouth and airway had to be suctioned out a few times, but her mouth and airway were sufficiently clear enough for the 7.0 ET tube to be inserted. The tube was quickly inserted, and held in place with a blue tube holder, and an ambu bag was attached. The firefighter began squeezing the ambu bag gently every few seconds while the medic began fluid resuscitation on Becca. But suddenly, Becca’s heart monitor began beeping loudly. “Shit, she’s in v-fib. Starting compressions!” the medic said, as they began pumping away on the bride’s chest. Another medic scurried over with a set of defib pads, and stuck them onto Becca’s chest. The pads were charged to 250 joules, and a shock was delivered in a moment’s notice. A horrified passer-by in a car saw Becca’s limp, battered body jolt around on the backboard as emergency services attempted to revive the beautiful bride-to-be. The shock failed to revive the beautiful brunette, so CPR was resumed. Becca’s chest was pummeled with deep, strong compressions while the electrical whirring sound of the defib pads recharging could be heard. Once the defibs were ready, a second shock was delivered. Becca’s lifeless body trembled and shook, but remained in v-fib. Her ET tube filled with blood, so chest compressions were resumed while her airway was suctioned out. The suction tube made a slurping sound while draining the blood from the flexible, plastic tube that protruded from the patient’s mouth. It took a few attempts at suctioning the airway out before Becca’s airway was secure again. The team then decided to shock Becca a 3rd time. The bride’s eyes opened up from the increased strength of this shock, and her body tensed up for a moment. Becca let out a grunt- this is called an agonal breath, before going limp and flatlining. Becca’s eyes were open, staring blankly up at the evening sky, with a detached ET tube+tube holder taking up half her face. The defib pads and EKG electrodes were still littered across her chest. One of the medics shined a pen light into Becca’s eyes, discovering her pupils were fixed and dilated. “no pulse, no respirations, fixed and dilated pupils, asystole on the monitor...” one of the medics called out, shaking their heads. The more senior of medics replied “she’s gone, what a shame… time of death, 7:46pm. Notify the coroner’s office please.” The emergency workers shut off the flatlined heart monitor and placed a cover over Becca’s body. Instead of having a blast at her bachelorette party, Becca was now laying dead on a backboard, under a sheet on the side of the road, with her cute, wrinkly, size 7 feet sticking out.

While Becca’s code took place on the side of the road, the other 3 ladies were extricated from the vehicle and transported to the local emergency department, completely unaware Becca had passed away.

The first to arrive at the hospital was the driver, Carly. Carly was awake, alert, and struggling to breathe. She was on a backboard with a c-collar and donned an o2 mask. Tears rolled down her face since she felt a sharp, tearing pain in her chest every time she inhaled. You could see her neck muscles flex as she tried to draw in air with absolutely everything she had. Carly’s blood pressure was hypotensive, with a reading of 70/39, was tachycardic with a heart rate of 142bpm, and had an oxygen saturation that had dropped all the way to 87%. Carly was handed off to the first trauma team, and she was whisked off to a nearby room to begin examination and treatment.

Next up to arrive was Kate the blonde. She was also on a backboard and had a c-collar on, but did not have an oxygen mask on. Kate was awake and alert, groaning in pain with one hand on the upper right portion of her abdomen. One of the ER nurses moved Kate’s hand for a second and took a brief look, noticing a large, purplish bruise just below her ribs. The nurse palpated Kate’s belly, to which she winced in pain. The nurse was quickly able to determine that Kate had exhibited abdominal guarding. The young lady’s vital signs were: BP 83/42, pulse 136bpm, and o2 saturation 99%. Kate was then handed off to the 2nd group of ER personnel that waited in a nearby room.

Last but not least, the bride’s little sister Maddie arrived. She was awake and sitting up on a gurney, but her leg was in a splint, and the compound fracture/laceration was covered with some larger gauze pads. Since Maddie was in tremendous pain and had stable vitals, she was given intravenous oxycodone for pain management, and 5mg valium for anxiolytic purposes. Maddie was awake, but seemed a bit groggy from the pain+anxiety meds. She was taken into the last of the remaining trauma rooms where her examination commenced.

Over in trauma 1, the team started off by running trauma labs, doing a chest x ray, and performing an echocardiogram. The chest x ray displayed multiple rib fractures on both sides of the chest, and a left sided tension pneumothorax with right sided tracheal deviation. The echocardiogram displayed no signs of tamponade, but showed a major ventricular septal defect. Essentially, the muscular layer separating the 2 large, bottom chambers of Carly’s heart has been torn, creating an abnormal connection between both ventricles, and disrupting blood flow in and out of the heart. This particular injury is associated with a high mortality rate, and has to be treated urgently in order to increase the likelihood of a desirable outcome. With that in mind, the team opted to get Carly up to the OR ASAP and let the surgical team place the left sided chest tube during the surgery. The team placed a cover over Carly’s torso and began rushing her out of the room. “surgery? What’s going on?” Carly asked in a weak, breathy voice, to which nobody responded. Carly tried to reassure herself, thinking “it’s going to be ok! We’re all going to be ok! And we’ll have the bachelorette party once everyone’s better.”, completely unaware that Becca had already passed away on scene.

While the trauma team handed off Carly to the trauma surgery team, Kate was being examined in trauma room 2. Unfortunately, she was losing blood at a massive rate and had been started on the massive transfusion protocol. Kate also fell unconscious and was intubated by the ER team since arrival. Her tan complexion faded to something more pale and ghastly, and she became cool to the touch. She laid underneath the large overhead light, eyes gently shut, with a blue tube holder and ambu bag visible. Her chest had EKG electrodes scattered all around, and there was fresh ultrasound gel on her belly. An abdominal ultrasound displayed a massive retroperitoneal hemorrhage in the upper right quadrant of her abdomen, but it was unknown as to whether the liver, IVC, or other blood vessels were the source of such a bleed.

In the third trauma room, Maddie was being examined by the emergency physicians. They reset the compound fracture in her leg and ordered a follow up x ray to get the extent of the damage in her right leg. It was also noted that blood flow was also obstructed heading towards her right foot, so her right leg appeared discolored. This is a scenario known as compartment syndrome. Essentially, the  main artery which carries blood to the lower leg and foot was squeezed by the fractured bone and swelling in the area. Compartment syndrome is a surgical emergency, and needs to be dealt with urgently in order to restore blood flow to the affected area. With that in mind, the trauma team paged orthopedics and trauma surgery for consultation.

Speaking of surgery, Carly was now up in the operating room. The surgical team sedated and intubated her, and also placed a chest tube to alleviate the tension pneumothorax. Carly’s oxygen saturation improved somewhat, but her vital signs remained unstable overall, remaining hypotensive and tachycardic. The surgical team elected to perform a modified daggett procedure. This is an open heart surgery in which the heart is stopped, placed on cardiopulmonary bypass, the left ventricle is incised once the heart is stopped, and the tear in her ventricular septum is patched shut. Generally, this procedure is reserved for patients that have stable vital signs, but the team felt the risk was necessary in Carly’s case. Betadine was squirted across the middle of Carly’s chest in anticipation of a median sternotomy. A vertical scalpel cut was made beginning at the very top of the chest at the manubrium of the sternum, extended inferiorly several inches, continued past the xiphoid process, and ending a few centimeters below the diaphragm. The underlying fat and tissue was exposed after a 2nd incision with an 11 blade, and a sternal saw was procured. The saws blade was placed above the sternum, and the surgeon began breaking apart Carly’s sternum, working their way down slowly but surely. A high pitched grinding sound permeated the OR while the electric saw cut through one of the hardest bones in the body rather effortlessly. After the sternum was divided, a finochietto spreader was placed, and Carly’s chest was cracked open nice and wide, with her strong, young heart visible for all to see. With the chest cracked open, the next step was to begin setting up the equipment for cardiopulmonary bypass.

While the OR team was starting Carly’s surgery, Kate had deteriorated further and went into cardiac arrest. The first handful of minutes of Kate’s code were rather uneventful. She had converted to PEA, was given 2 doses of epi and atropine, and had a down time of 6 minutes. Kate’s chest was being pumped repeatedly by one of the ER nurses while one arm dangled off the side of the table, bobbing in sync with each individual compression. Her chest caved in and her belly bounced outwards from the force of the strong chest compressions she was receiving. It took another round of drugs and 3 minutes worth of efforts, but Kate finally converted to a shockable rhythm. The paddles were charged to 300 joules, gelled, and pressed up against Kate’s bare chest. Once everyone backed away, shock #1 was delivered. The blonde’s body flopped quickly on the table in response to the dose of electricity, but no change was present on the monitors. CPR and ambu bagging resumed for a few moments while the paddles were being readied for the next shock. This time, the paddles were recharged to 360 joules, and the next shock was delivered. The stronger shock caused Kate’s feet to kick up above the table and crash back down, showing off the cute, delicate wrinkles in the soles of her size 8 feet. This shock sent Kate back into PEA unfortunately, so aggressive resuscitation efforts were resumed.

While Kate was fighting for her life, Maddie was taken up to the operating room to fix her leg. The surgery entailed a fasciotomy in order to restore blood flow to her leg, and surgical reduction with internal fixation of her fractured femur. She was sedated and intubated on the table, ready to go. The first step of her procedure was the fasciotomy. A large, 20cm incision was made on her medial thigh away from where the laceration from the open fracture protruded. The underlying subcutaneous tissue was dissected in order to expose the underlying fascia of her thigh. The next step was a longitudinal incision in the fascia itself along the line of the initial skin incision in order to expose the compartment. A small, transverse incision was then made over the intramuscular septum, with the incision extending over the anterior and lateral compartments. Following this step, the superficial peroneal nerve was identified in order to be protected and avoided, as severing/injuring this nerve can cause irreversible damage and complicate the procedure. Next, the fascia lying on top of the anterior compartment was incised further via extending the transverse incision over the intramuscular septum. Once this was done, the compartment was released successfully, and blood flow was almost instantly restored. With the fasciotomy complete, the team’s next focus was the femur fracture.

While Maddie’s surgical team shifted their efforts to the next portion of the surgery, Carly was a few doors down in a neighboring operating suite. While setting up the heart-lung bypass machine for Carly’s surgery, her vital signs started decreasing at an alarming rate. The team had to stabilize her vitals sufficiently in order to start the heart-lung bypass portion of the procedure. The OR team administered vasopressors intravenously in an attempt to increase her blood pressure and heart rate, but all the drugs seemed to do was buy Carly time instead of fixing the problem. Ultimately, Carly became pulseless, converting to v-fib. Internal massage was started immediately. One of the surgeons wrapped their hands around Carly’s weakly fidgeting heart and started squeezing, desperately trying to bring the young lady back. One of the surgical nurses detached the ventilator and attached an ambu bag to the breathing tube and began artificial respiration. The internal paddles were charged to 20 joules, lowered into Carly’s chest, and a shock was delivered once everyone stood clear. A dull, wet thump was heard in the operating room, but the shock failed to convert the young lady out of v-fib. The large, spoon shaped paddles were recharged to 30 joules and lowered back into Carly’s exposed chest cavity, promptly delivering the next shock. Carly’s body jolted more sharply this time due to the increased strength of the shock. Carly’s heart twitched for a moment, then stopped, then restarted. “sinus bradycardia on the monitors. We got her back.” One of the OR nurses said, feeling a bit relieved. With a pulse restored, the team upped Carly’s vasopressor doses, kept up fluid resuscitation, and began prepping her for bypass.

Back in the ER, Kate was still being coded. Her total downtime was 23 minutes, and she looked white as a ghost on the table. Through the blue tube holder, you could see that Kate’s lips were turning a paleish shade, and there was a bruise forming on the center of her chest from the lengthy resuscitation efforts. The trauma team had shocked Kate unsuccessfully 6 times since they converted her back to v-fib for the 2nd time. The heart monitors still showed v-fib, so the team recharged the paddles to 360 joules, and delivered yet another shock into Kate’s lifeless body. Her body thrashed around on the table before going still, but no change was shown on the monitors. The team shocked Kate yet again, but this time, Kate became asystolic. One of the ER nurses also noted fixed and dilated pupils. At that point, the trauma team made the tough decision and terminated the code, calling time of death at 8:53pm. The ambu bag was detached and the monitors were shut off. The EKG electrodes were disconnected, and a toe tag was placed before Kate’s body was covered up.

In the few hours after Kate’s death, Maddie was moved to the surgical recovery area, appearing to start her long road to recovery while Carly was still in the operating room being worked on. Carly’s ventricular septal defect was closed via multilayered suturing, and the ventricle incision was closed with a patch and fibrin glue. The surgical team began weaning the young lady off the heart-lung bypass machine. Fortunately, Carly’s heart was able to be restarted, and her chest was closed via sternal wire, and the skin incision was closed with suturing. She was then moved to the ICU for observation.

Both Maddie and Carly survived this ordeal after many months of healing and physical therapy. The two were naturally devastated when they were informed of Becca and Kate’s passing. What was supposed to be a fun night unfortunately turned into a tragic, painful memory for the 2 ladies.

[defiblover27]

I know that I have been away for some time but writing this today reminded me how much I love to write these stories for all of you. I hope you enjoy and look forward to sharing more soon. Graphic Warning!

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The holidays are a time to spend with family and celebrate. That was the plan for the Wilson's thanks to the long weekend they were headed down to their vacation home to spend time together as a family. There was a total of five adults in the family. The father is Mike Wilson who is 53 years old and had what many referred to as a "dad bod" and stood at five foot ten. His 49-year-old wife Kelly was an elementary school teacher standing at five foot four and had a slim build. The happy couple had three kids together. The eldest Connor was 26 years old and had recently landed his dream job working for a top law firm, when he wasn't working, he was at the gym and is very muscular and toned and towered over his dad at six two. The middle child was their first daughter Kylie who is 22 years old and was set to graduate at the top of her class. She went to college on a tennis scholarship and had a girl next door look to her with C cup breasts and long blond hair and matched her mother at five foot four. The youngest of the family is April a 20-year-old female standing at five foot two and was a competitive swimmer at her college. She was almost anorexic skinny and had B cup breasts with mid back length dirty blond hair.

The family loaded all of their bags into the car and hit the road. It was going to take about three hours to get to the vacation home. An hour had already passed and they were all laughing and singing along to the radio. It was rare for the entire family to have time together so this weekend was special to all of them. They were driving down the interstate when suddenly a semi truck broke through the barrier and headed straight towards them at a high speed. Mike paniced and veered to the right to avoid the collison. In doing so he positioned the car to be t-boned by the semi. The car crunched inward and skidded down the road about twenty feet before stopping. All of their bags flew around the car and the family thrashed around from the impact. Mike and Kylie took the brunt of the imapct and were knocked unconcious. Connor groaned in pain as he reached for his phone to dial 911. The operator dispatched several EMS and fire departments to the massive crash. Within a couple minutes the fire department arrived on scene. The truck driver hobbled out of his truck to check on the Wilson's. One of the firefighters pulled him to the side as the rest of the crews went to work extracting the family. They were able to pry open the front passegers door and Kelly started to scream hysterically "My husband, check on my husband please." The firemen reached across Kelly and pressed two fingers into his neck to check for a pulse. Finding none he knew that he must have been killed on impact. "We will take care of your husband but first we have to get you out." he said calmly attempting to console her. Kelly was able to get out of the vehicle with little assistance and complained of arm pain and had a large gash to the right side of her head where she must have slammed it on the side window. The sat her down on one of the steps of the firetruck and dressed her head wound.

The fire department had to use the jaws of life to pry the door off of the back passenger side door. Upon entrance Connor on the right side was the only one conscious but his legs had been pinned to the seat in front of him. After careful maneuvering they placed a c-collar and blackboarded him out of the vehicle. His left arm had a bone sticking out of it and he couldn't move his legs. They moved him ten feet away from the car before placing him on the asphalt. Next, they had to extricate April who had been sitting in the middle of the two siblings. She had not been wearing a seatbelt and was face down on the console in front of her. They placed a c-collar and extricated her with a backboard and placed her a few feet from her brother. They cut off her blood-soaked white top exposing her perky breasts and severe bruising to her chest and abdomen. The had a large gash across the top of her head which was dressed her right leg was fractured badly so an inflatable brace was put onto stabilize it. Finally, the fire department attempted to get Kylie out. She had a piece of glass lodged in the left side of her neck and her left arm had been crunched together and was likely beyond saving. Upon placing a c-collar and extricating her they placed her by her little sister and snipped away her hoodie and placed leads across her chest.

With all of the family members extricated they placed a yellow sheet over Mike and waited for the coroner's office to arrive. Three ambulances were on scene with multiple crews attempting to stabilize the remaining four family members. After bracing Kylie's left arm in an orange inflatable cast and placing gauze around the shard of glass in her neck, they started an IV in her right arm. After starting fluids, the paramedic at the head felt for a pulse. "No pulse, start CPR please." the medic called out as the monitor went into v-fib. The other paramedic centered their gloved hands in the middle of her bloodied chest and began deep rhythmic compressions. Her breasts shook which each compression and her stomach pushed outwards. The defibrillator was charged to 200 joules and gelled. Placing the two metal paddles on her chest the first shock was delivered. Her body twitched with the electricity before going still. There was no change on the monitor so the defib was charged to 300 joules and a round of epi was pushed as CPR continued. The second shock was sent through her dying body causing a sharper reaction as her back lifted slightly before crashing back down. Her breasts rippled with the impact before her heart went still and asystole traced across the monitor. Deep violent chest compressions were resumed as the desperate resuscitation attempt continued.

Connor was stabilized and loaded onto a gurney before being loaded into the back of one of the ambulances. His mother was escorted into the ambulance as they blocked the car and her two daughters from her view so that she did not see the graphic scene. The mother and son talked on during the ride and started crying together not knowing the full extent of what had just happened. Connor was not in only his black boxers and had leads across the chest and an IV with fluids flowing into him. He remained stable throughout the trip.

April was losing blood at a rapid rate and the paramedics had little that they could do to help. The gauze on the top of her head had to be replaced every minute or so. They decided that they best that they could do to save her was to get her to the hospital. Luckily a med evac helicopter had landed at the time that they had loaded her onto a gurney. They loaded her into the ambulance and the flight team took over. Upon taking off the flight medic placed a foil sheet over her and intubated her to maintain her airway. Shortly after takeoff April deteriorated into v-fib. The flight medic cracked out the Lucas and placed one piece under her back and the unit above her chest. He snipped away her bra as her small breasts fell to the sides. The plunger was lowered to her chest and upon being flipped on the unit gave perfect compressions. Epi was pushed into her IV in and the defib pads were placed on her bare chest. After it charged to 200 joules the Lucas was stopped and the shock was delivered her small body twitched with the shock before going still again. The Lucas continued CPR as the defib was charged to 300 joules. The second shock caused her chest to press against the plunger of the machine and fall back down. There was still no response as the flight medic muttered "come on girl you're too young for this" as he charged the defib to 360 joules and delivered the third shock. Her body shook with the shock and then returned to its original position. The monitor showed normal sinus rhythm as the flight medic let out a sigh of relief "now hang in there girl were almost there" the Lucas remained on April in fear of another arrst.

"Shocking" announced the paramedic as the fifth shock was delivered to Kylie as her battered and broken body bounced on the roadside. She had been in full cardiac arrest for 11 minutes. As her body went still her heart began to beat slowly and then began to normalize. They scooped her into the ambulance and rushed her to the hospital. Less than three minutes into the ambulance ride Kylie went into her second cardiac arrest. One of the paramedics began CPR by placing his hands on the fresh bruise from where her chest had been compressed for over ten minutes. The paramedic at the head continued ventilations with the ambu bag that was attached to the ET tube which was secured by a blue tube holder. A round of epi was pushed and it took almost a minute for v-fib to be acquired. They charged the defib to 360 joules as they gelled them and rubbed them together. Placing the cold metal paddles on her bare chest they shocked Kylie once again. Her legs kicked up and her toes crunched up showing off the wrinkles on her small feet before relaxing again. With no change they recharged the defib as CPR continued. The second shock was delivered as her right arm shot off the gurney and her left stayed in place due to the orange brace. After the shock Kylie luckily converted to normal sinus. The paramedics prayed that they were almost to the hospital as Kylie had now experienced two full cardiac arrests and they were unsure if she would survive or not.

Connor was rolled into the hospital and placed in the large trauma room that had six beds each separated by a curtain. Once he was transferred onto the trauma bed they cut away his boxers leaving him nude on the bed. They ordered scans of his entire body and wanted to get him a CT scan. They log rolled him onto his side and pressed on each vertrebrae. The doctor knew that he was most likely paralyzed due to catastrophic spinal cord injury. Connor began to drift in and out of consciousness as his heart monitor displayed bradycardia. The medical team attempted to stabilize his heart rate but he completely loss consciousness. They then elected to intubate Connor to preserve his airway. There was a dark bruise starting to form on his abdomen right where his seatbelt was. "Shit, he might have internal bleeding too, get an ultrasound set up, this guy is in much worse shape than I thought" the attending ordered.

Kelly had her head wrapped in gauze and was given a sling for her arm until x-rays could be taken. She was in her own room when she saw her daughter April being wheeled past her room with a large machine on top of her. "Oh my god, is April okay?" she asked the nurse. "The doctor's are doing everything they can for your family, I need you to stay calm, I will go check out what is going on and come back okay?" the nurse replied leaving the room. Kelly agreed but thoughts kept racing through her mind.

April was wheeled through the hallways of the hospital to the trauma room and placed on a bed directly across from Connor. "20-year-old female t-boned by a semi-truck, she wasn't wearing a seatbelt. Went into cardiac arrest in flight which lasted four minutes in total, one round epi and multiple shocks required. Stable since." The med flight medic said as they removed the Lucas and transferred April onto the bed. She now laid completely nude on the bed with wires and tubes across her body. A round of x-rays and blood tests were called for, upon checking her pupils they requested a neuro consult after noticing her left pupil was blown and her right was sluggish. After the x-rays were completed, they palpitated her abdomen which was firm to the touch as she likely had internal bleeding. The x-rays showed that April had multiple broken ribs and her right leg was broken in two different places. Her complexion was starting to fade, and her oxygen levels were decreasing. Upon further assessment it was noted that her lungs were not inflating properly so a chest tube was called for and was to be placed in her right side. Betadine was splashed on the side of her chest and the attending made quick work of the placement. A large amount of air rushed out before thick dark red blood poured onto the floor. As this happened April's heart gave out and she went into PEA. CPR was immediately started, and the first round of drugs were pushed. After three minutes April converted to v-fib as the defib pads were ripped off her chest and the paddles were charged to 300 joules. The attending took the paddles in his hand as a nurse applied gel to them. Rubbing them together the unit alerted that it was charged, he placed the paddles onto her bare chest as everyone backed away. Her arms flung outward, and she formed loose fists as the shock coursed through her body. There was no change after the first shock so CPR was continued. Her arms that had fallen off the bed bounced with each compression as her body shook on the bed. A moment later the defib was charged to 360 joules and were placed back on her battered body. The increased voltage caused April's petite chest to bounce off the bed before slamming back down. The second shock had the same effect as the first as a male nurse resumed CPR on the young woman. The paddles were gelled and charged for the third time and placed on her chest again. This time her arms scrunched in and her left leg jumped off the table before crashing back down. The third shock sent April into asystole as CPR was resumed.

At the same moment that April was receiving her third shock Kylie was being rolled into the hospital doors. Unfortunately, Kylie had crashed once again and was in asystole. The paramedic straddled her on the gurney to continue compressions. Her right arm dangled off the side of the gurney and bounced rhythmically with each compression. As they rolled Kylie down the hallway she was taken right past Kelly's room. At the sight of her daughter being resuscitated she jumped off the bed and followed them. The paramedics and Kelly entered the trauma bay as they gave the update "22 year old female involved in MVC suffered an arrest on scene lasting 11 minutes and then coded again in the rig for 6 minutes, entered her third cardiac arrest as we rolled her in." They transferred her onto the bed directly next to Connor with a curtain separating them. CPR was taken over as drugs were pushed. A chest tube was started on the right side as Kylie passed her two minute mark. A round of drugs were pushed and a few moments later she converted into v-fib. The paddles were charged and gelled and placed directly onto the same spots that still glistened with residual gel from her past defibrillations. Her body bounced around the bed as her mother watched in horror. With no effect CPR was resumed and the paddles were recharged.

A nurse approached Kelly telling her that she couldn't be in the trauma bay. "These are my children" she yelled. The nurse urged her to return to her room but ultimately allowed Kelly to stay in the corner. She watched as Kylie was defibrillated two more times before returning to asystole and CPR resumed. She watched her body take a beating from the intense resuscitation. As she tried to look away she noticed that April was a few beds away. As she went around the curtain April came crashing back down from a defibrillation and her body shook with the impact. April had now been down for over ten minutes as she returned to asystole. It was all becoming too much for the mother to watch and she turned her back. She saw Connor laying flat on his bed as a nurse pressed their fingers into his neck. "No pulse begin CPR" the nurse said. She now had three children in full cardiac arrest. One in their first cardiac arrest, the next in their second cardiac arrest, and the last in their third cardiac arrest.

Connor deteriorated from bradycardia to v-fib as a nurse centered their hands in the center of his tone chest. Each compression caused his ribs to cave in as they fought to get his heart to beat again. The defib was charged to 200 joules as the paddles were gelled. Placing them on his bare chest they discharged. His whole body of which he was unable to move on his own now twitched on the bed from the electricity. With no change the paddles were charged to 300 joules and he was shocked again. His body shot off the bed and crashed back down. The only body part that stayed in place was his head that was kept in place by his c-collar. Connor was shocked another two times before converting into asystole. More drugs were pushed into his frail dying body as aggressive CPR ravaged his chest.

In the bed next to Connor they were squirting betadine across Kylie's chest as they made one last desperate attempt to save her life. The scalpel slid across her skin separating it. Layer by layer they cut away until they could see her ribs, a saw was called for as they cut away at her ribs to gain access into her thoracic cavity. As they entered the cavity a large amount of blood poured out onto the floor. The attending took his gloved hands and wrapped them around Kylie's still heart. He used his own hands to beat her heart for her. Each compression showed up on the monitor as the doctor was able to watch his own work. A syringe was inserted directly into her heart as drugs were used once again to convert her into a shockable rhythm. It took two minutes of internal massage for Kylie to convert into v-fib. Once she did the internal paddles were charged to 20 joules. The spoon shaped paddles were placed directly on her heart. Pressing the shock button her body barely twitched as her heart took the full force of the shock. There was no change after the first shock so internal massage was continued as the paddles were recharged to 20 joules. The next shock let off a dull wet thunk as Kylie fought for her heart to beat again. With still no change a nurse took over internal compressions while the attending looked for the cause of her arrests. He found that one of her arteries tore off of her heart. He carefully sutured it back on and charged the paddles to 30 joules. The bloodied paddles were placed into her chest one more time as her heart was shocked with everything the medical team had. Her toes scrunched as her hands bounced. Her body went still after the shock as did her heart. Kylie had now been down for 18 minutes during her third traumatic full arrest. "Does anyone have any ideas?" the attending asked as the nurse continued internal massage. The room fell quiet as the attending shined his light into her bright blue eyes. "Fixed and dilated. Time of death 5:38 PM. Thank you everyone." The attending announced as the nurse removed their hands from her chest. The monitors were switched off and the ambu bag was detached. The closed her eyes for the last time as they draped a toe tag on her big toe. Finally they placed a white sheet over her ravaged body.

A few beds down the newly deceased womans sister April was still fighting for her life. She had been down for almost twenty minutes, she was shocked twelve times and received numerous rounds of drugs with continuous CPR. The neuro consult finally arrived to the horrific scene as he did a quick assessment. "There is brain matter coming out of her skull, her pupils are blown. I think she's gone." he said as he walked away. The attending wanted one more attempt. He took a large syringe and filled it with epi. He placed it directly over her heart as he slowly lowered it into her chest. After pushing the epi April converted to v-fib at her 22 minute mark. He gelled and charged the paddles to 360 joules. He placed them back on her bare chest and shocked her. Her body flopped around on the table before going still. With no change April was shocked three more times. The final time the attending rubbed the paddles together and muttered "come on, you're too young for this" something she had already heard. He placed the paddles on her chest, pressing them into her he pressed the shock button as her chest heaved into the air and came crashing back down. The monitors went flat for the final time. At the 27 minute mark of April's code she was pronounced dead. "Time of death 5:48 PM" the attending announced. The nurses cleaned April up just as the others had just recently cleaned up her older sister. They placed the toe tag and draped the sheet over her body.

Connor was a much less exciting cardiac arrest. After the eight minute mark of his code they were unable to cardiovert him for the next nine minutes. After they had maxed him out on drugs he converted to v-fib one more time. The shocked his nude dying body four times before he ultimately flatlined. "Time of death 5:58 PM." the attending announced. Again a group of nurses disconnected everything and gave the same treatment to Connor as they did to his younger sisters.

As all three children of Mike and Kelly laid dead in the trauma room a nurse went over to a corner where she found Kelly on the ground. Upon trying to wake her she noticed that her lips were blue and she was cold to the touch. A doctor came over and confirmed that she must have passed away over fifteen minutes ago. Any attempt to save her at this point would be futile. They moved her onto the bed next to April's body and placed a toe tag and covered her with a sheet after pronouncing her dead. All four family members would later be moved to the hospital morgue where there father had already been transferred to. The entire family perished in a tragic accident on a day that was supposed to be filled with fun and memories.

#resus #resuscitation #defib #defibrillator #cpr #crash #ambulance #accident

[defiblover27]

Here is a brand new story that I hope you all enjoy. Leave comments below on what you think, do you like this style, do you want another part? Enjoy!

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I remember a cold dark night driving home after getting a few drinks after work. I remember something running out in front of my car... maybe a deer... I don’t remember. I remember trying to avoid hitting it but then my memory stopped there. I remember hearing a voice “Ma’am, ma’am are you okay.” it was a male voice, and I could hear him banging on my driver's side window. There was an intense pain in my chest and I felt lightheaded and excruciating pain in my left leg. “Hello, I need an ambulance a young woman just crashed her car.” That’s right I must have crashed into something when avoiding the thing in the road. It felt like an eternity before I remember anything else but remember being startled by the noise of metal crunching. There was a sudden pop and cold air rushed in. I think they just ripped my door ff of the car. Two fingers were shoved into the side of my neck for a few seconds. “She’s got a pulse.” Then something stiff was wrapped around my neck before they lowered me onto a hard board and scooped me out of the car. They placed me on a gurney as they cut off my shirt and pants revealing my c cup breasts behind my lace bra and panties. They carefully removed my shoes as I felt small sticky pads being placed all over my chest. “Open fracture to left femur” There was something wrapped around my leg that held it in place. The placed a piece of gauze on my forehead and secured it with tape. My eyelids were pried open as a light shined in “pupils equal and reactive” a voice announced as a cold stethoscope was placed place to place around my chest. “Diminished breath sounds, better intubate” They carefully open my mouth and slide a long metal blade in. Then a long plastic tube is shoved down my throat. I feel a small bulb inflate in my throat and then a strap being placed around my head as the tube is secured in place. Air is then shoved into my lungs without me trying. I guess I should let them do the work for me. There was a blanket that was draped over my body only leaving my head exposed as they rolled me into the ambulance nearby. I feel the ambulance start to speed away from the scene. The blare of the sirens is quickly interrupted by some sort of rhythmic beeping. One beep after the other, it's almost calming as I focus all my attention on it. It's hard to focus over the wheezing noise of the ambu bag that forces air into my lungs every couple seconds. There is a quick prick in my left arm as an IV is inserted and secured with tape. A quick rush of warmth enters my arm and runs through my body. They must be giving me fluids. "You're doing great sweetie, we're almost there" the paramedic says in a calm voice as they stroke my hair out of my face. A couple moments pass before I remember anything else. I remember the beeping of the machine getting faster and faster. All of the sudden the paramedic sounds worried "Come on sweetie don't give up now, she's fibrillating step on it." Fibrillating? What does that mean? I get my answer as the paramedic rips the blanket off my chest and places their gloved hands between my breasts and forces downward over and over again. The pain is immense as I fell my ribs cave in as my heart is compressed from the force. Over and over again the pain grows. There is a popping in my ribs as a few give way and break from the force. This doesn't seem to bother the paramedic as they continue to compress my frail chest. After thirty compressions they squeeze the bag connected to the tube in my throat as my lungs are fill with air. Again they compress my chest, they stop for a few seconds as they administer some sort of drug into my IV. I remember the burning sensation as it travelled up my arm and into my heart. It felt warm, I knew that each moment that my heart wasn't beating was another moment closer to it never beating again on its own. I don't remember how long they repeated the cycle of compressions and ventilations but remember when my heart began twitching inside my chest. "V-fib charging to 200 joules." I wish I knew what all of this meant. There was an electric whining that

filled the back of the ambulance and a squirting noise. Two large cold metal paddles are placed on my bare chest. They have some sort of gel on them. "Clear" Suddenly a course of electricity is shot into my chest. My heart stops twitching for a moment before it beats once, and then twice, and then a third time. "There you go sweetie now stay with us." The beeping of the machine is rhythmic again as I feel my heart beating but it feels sore and weak now. I remember praying that we would be at the hospital soon and that they could help me. I don't remember the rest of the ambulance ride but I remember when we got to the hospital the back doors of the ambulance swung open as cold air rushed in. They rolled me out and into the hospital where it was substantially warmer. They rolled me down the hallways and turned into a room as one of the paramedics told the medical team what was going on. "Female mid-twenties victim of a single MVA protruding left femur fracture, intubated on scene. Coded en route shocked one time to restore normal sinus. Given fluids and one epi during cardiac arrest." They lifted me onto the bed by the backboard that I was strapped too before they cut off my under garments and I was then nude in a room full of strangers. Normally that would have disturbed me more if it wasn't for the fact I knew they were trying to save my life. I didn't care what I had to go through in order for them to do that. A male voice started directing the team as he ordered scans and tests. I remember gloved hands pushing around on my belly "possible internal bleeding into the stomach cavity." That can't be good. There was also a small round object that was placed on different spots of my chest. "Diminished breath sounds on the right I want a chest tube stat." There was something squirted onto the right side of my chest and then a prick and slicing movement that hurt like nothing I had ever felt before. Then a large tube was shoved into the side of my chest. There was a splattering noise as something rushed out of my chest and onto the floor. "There's a lot of blood, let's get those x-rays done now please." Everyone except for the nurse controlling my breathing backed away as something was hovering over me. There were multiple clicking noises from what must of been the x-ray machine. "Get an ortho consult down here for the leg." For a moment I began drifting off but was startled by the nurse at my head. "Stats are dropping, come on sweetie we really need you to fight now." I tried to gain control of my heart as I felt it beating erratically in my chest but couldn't seem to do anything. "She's coding, someone start CPR" My heart gave out again as gloved hands were centered in between my breasts once again and I was given CPR. It didn't seem to hurt as badly as the first time but the fear of my heart stopping for a second time.... what if they can't restart it this time. I feel my body rock back and forth with each compression, I wonder what my battered nude body must look like under such actions. The warm sensation enters through my IV again as they push a new round of drugs to control my heart. "V-fib, charge to 200" That worked last time, hopefully it works this time too. The large cold gelled paddles are placed on my bare chest as they back away from my body. The electricity courses through me as I feel my left leg kick off slightly but my right does not move due to the large stabilizer it is wrapped in. "No change, charge again to 300" Shit it didn't work this time, I remember starting to panic as the CPR continues and the machine charges again. "Stand clear, shocking". Again my body is shocked but this time my chest comes off the bed slightly before crashing back down as my breasts shake. "Asystole, continue CPR and push another epi." A new larger set of hands are felt on my chest as they force my chest in and out. I feel both my arms shake off the bed and bounce around with each compression. This doesn't seem to bother the medical team as they continue to try and get be back. I don't know how long the CPR continued but I

do remember the hands changing a few times. So many people gave me CPR as they attempted to bring me back. This is the one point in my life where an entire room of people are focued completely on me. "V-fib charge to 360." The same whining of the machine and squirting of gel is heard as they place the paddles on my chest and shock me. My arms shoot around and my hands form loose fists and then relax again. Again CPR is started and I go through the same process. CPR, breathing, shock, drugs, more CPR and shocks. I loose track again of whats going on but remember what the male voice said "She's been down for 32 minutes..." He is cut off by somebody else. "V-fib, she has one last chance." This is the chance I need. I focus on the whining of the machine and the gel, how they rub the paddles together. The ambu bag drops to the side of my face, the hands leave my chest. The paddles are placed again, pressed into my chest, SHOCK. My body heaves into the air and crashes back down again. Time stands still I feel something in my chest, beat, beat, beat. "Normal sinus" Finally my heart is beating again. "Get her to the OR to stabilize her injuries. She was down for an extended period of time and might have brain damage. We might have gotten her back but..." That's the last thing that I remembered from that day. That must have been yesterday as now I am in a room by myself surrounded by beeping machines and a ventilator. Nurses come in periodically and check on me "Your family will be here soon" I don't want them to see me like this, all I can think about is what that doctor said. They got me back for now but...

#cpr #defib #defibrillator #resus #resuscitation #accident