The ER

"Assault"/huntemann                                                                                                                                             Page 10

Prologue
Scene [4]

BCH Emergency Room

BCH Emergency Room
1995/04/07 16:41-17:30, Friday
         The gurney is wheeled into the ER, technicians hook up monitors, an I-V is hung. All the while, James keeps working.

         Push... push... push...

         Squeeze... burp.

         A nurse inserts a Central-Line needle, for the I-V, into the girl’s neck where a vein should be. With the heart in arrest, veins are almost invisible. CPR doesn’t do an adequate job of exposing them.

         Cardioverter1 paddles are prepared. Dr. Perkins, the ER physician, calls out, “Clear.”

         James jumps back.

         Thump... bump.

         A few feeble beeps from the monitors, then flatline. The cardioverter recharge whistle slowly works it way up in pitch.

         “Prepare EPI2 inhaler to the resuscitator and 4 ounces to the I-V,” the doctor orders.

         James resumes the massage.

         A nurse gives a puff of EPI into the Ambu bag.

         Squeeze... burp.

         Another nurse injects the Adrenalin into the bottom port of the I-V.

         The recharge whistle stabilizes high at full charge.

         The doctor picks up the paddles again and calls out, “Clear.”

         Thump... bump.

         Beep, beep, beeps fill the ER. Wiggly lines trace across the CRTs, but there is no respiration response.

         “Continue manual resuscitation. Oxygen at 10 liters per minute. Another EPI inhaler.”

         The nurse gives another EPI puff into the Ambu bag then reattaches the oxygen.

         Squeeze... burp.

         “Get her on the vent.”

         A technician rolls a large white box with dials, switches, gauges and tubes up to the gurney.

         Squeeze... burp.

         “Before we do that, let’s transfer her to the ER bed.”

         The two EMTs and a nurses lift the girl off the gurney and place her on the bigger bed. She weighs less than a hundred pounds.

         James continues with the resuscitator; squeeze... burp.

         A nurse finds another vein and inserts a second I-V. The vein is just barely findable even after the heart has restarted. Blood pressure is low.

         Squeeze... burp.

         “Remove the resuscitator so I can connect her to the vent,” the doctor says.

         James unhooks the resuscitator.

         The doctor tilts the girl’s head back and carefully pulls the plastic tube from her throat. He peers into her mouth and inserts a smaller tube down her throat past her larynx into her bronchia. Then hooks the other end up to the vent. A nurse tapes it to her upper lip.

         A switch, some lights, a flickering gauge and a few clicks and burps from the ventilator and the girl’s chest starts a rhythmic motion.

         Click, swishhhh... click, burp...

         BP climbing... 120 over 80... 150 over 90.

         James asks, “Is she still with us, Doc? Did we give her enough of a chance?” His arms are aching.

         The doctor thumbs open one of her eyelids. “How long was she down?”

         Sullivan taps his watch. “It’s been 30 minutes since we started CPR.”

         The doctor checks her other eye. “Thirty minutes is a long time for a brain to be low on Oxygen. CPR helps, but she going to need a miracle. Pupils fixed, dilated... coma.”

         Then, to a nurse, “Transfer her to the fifth floor.”


Pages: 4
Words: 512

Footnotes
1  Cardioverter – A device used to administer electric shocks to the heart when electrodes are placed on the chest wall.
2  EPI – Epinephrine, drug name for synthetic adrenalin.