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..........S T O R Y T I M E
The following excerpt is taken from 'Time and Space' book 1, 'Story Time'.
..........E X C E R P T
CHAPTER 26
GAME OVER
Meanwhile, Terry Morgan was upstairs in his bed dreaming of outdoor adventures. Maybe he got the characters confused and the details of Dean Clark's story embellished to an extreme degree, but it didn't matter.
As the schoolteacher's vivid imagination led him and his virtual friends into the Lovett Lake outlet where they eventually got trapped, his natural heart developed slight arrhythmia as his body chemistry adjusted to cope with the life-threatening challenges it thought it was dealing with.
The 'Code Blue' alarm started a chain of events that affected the activities of dozens of doctors, nurses, technicians and administrators at the medical facility. It would, of course, also affect the four people seated at a table on the first floor snack bar.
The automatic alarms on the hospital equipment attached to Morgan's body had been reset to a high level due to the frequent fluctuations that appeared to be normal for him. As the Story Time dream continued through to its catastrophic conclusion however, his heart rate suddenly ramped up, becoming dangerously erratic. His condition rapidly worsened and within just minutes the schoolteacher's future was in jeopardy.
Josie was the first person to respond to the alarm. The nurse was in the storage room explaining the procedures for logging in restricted medications to a new member of the medical staff when it happened. It only took a few seconds for the two nurses to scramble to Terry's bedside. Josie started an examination of her patient and then momentarily froze as she stared in disbelief at the monitoring instrument. The EKG reading, a visual measure of the electrical current of the heart, was indicating erratic heart function. The blood pressure line was close to zero and the oxygen saturation level had plummeted from a safe level of ninety-two down to sixty-eight in just a matter of seconds. The instruments were clearly showing that Terry's cardiovascular health was deteriorating rapidly and his distressed heart was in a ventricular fibrillation condition.
Oh my God, Phyllis, we need the crash cart in here now! Go call it in! Call a 'Code Blue'! Let's get everyone up here. I'm starting compressions."
The rookie turned to leave and then stopped to hear further instructions shouted at her from Josie, "We need Johnson and...and better call in Burgess too from the second floor. This one's a keeper, Phyllis. Hurry!"
"What about Dr. Karlson? I thought he was..."
"He left yesterday for a conference...now go!"
Josie examined her patient more closely while rhythmically pushing on his chest. Before her eyes, she watched as Morgan's fingertips acquired a bluish tint and then, only moments later, the ominous, dusky color of death. The area around his lips also changed in seconds from a pale skin color to a morbid blue-gray pallor.
Hearing a noise, Josie looked up in relief to see a nurse who had been on her lunch break come running into the room. She acquired the same look of awe after just one glance at the heart monitor.
"Tara, he needs an airway resuscitator hooked up right away."
"I'm on it."
Another nurse arrived and immediately started to hook up an extra IV to a vein in the antecubital area of the educator's left arm.
"Is that a 16-gauge IV?"
"18-gauge, Josie. Want a 16?"
"Please, I'm sure we're going to need it, Lois."
"Will do."
"The Ambu bag is on and fully functional, Josie."
"Thank you. Tara, I need you to enter the time record and then continue to manage the resuscitator."
"Check...commence code mark...10:52 a.m. minus one minute?"
"Close enough, now, where the heck are the techies?" Josie hollered to a room housing half a dozen ghost-like bodies. "Where's Kathy when I really need her," she murmured as the room continued filling with additional staff. She glanced at the patient's heart monitor again; saw something new and terrifying, and reached over to turn up the volume.
Terry Morgan was now in full cardiac arrest.
"Patrick, take over compressions for me."
"Sure, Josie." The male nurse then placed his hands on the patient's chest as Josie removed hers, the artificially applied heart pulse not losing a single beat during the exchange.
"The patient's in V-Fib. Are the paddles here yet?" Josie hollered without looking up. "Come on, we need to shock him now."
"Not yet," hollered a male voice from amongst the crowd of jostling bodies.
"Lois, do we have a pulse with those compressions? We need to make sure we're getting blood to his brain to prevent cerebral hypoxia."
"Affirmative, Patrick's doing a great job. I can feel a pulsation with each compression."
"Be sure to keep the resuscitation bag going, Tara. He needs oxygen." Josie then turned and moved several steps to a chest, opened the second drawer and retrieved a vial of Lidocaine.
"Oh my God! Would you look at that," remarked the rookie RN when she returned and glanced at the monitor.
"Airways?"
"Clear!" shouted Tara.
"BP?"
"Nothing!" confirmed Lois.
"Is that Lidocaine, Josie?" a doctor asked as he rushed up to the nurse.
"Yes, Doctor Burgess, I...I've got 100 mg ready to administer by IV."
"The Crash Cart's here," someone hollered above the chaotic din.
"Do it...hurry, Josie," urged the doctor who then turned to face the nurses, intern and technicians now fully surrounding Morgan's hospital bed. "Steve, fully expose the chest and apply the conductive pads. I need to make sure we have full skin contact. By the way, where's Johnson?"
"Assisting Osgood. A new arrival is hemorrhaging on the third floor. I just came from there," replied the intern.
"Damn it!"
Seconds later, after Josie administered the drug, the doctor hollered to the room full of people, "We're losing the patient and we're short staffed so let's continue to stay focused. We only get one chance to save this man's life."
"Backboard is positioned under the patient, doctor."
"Steve, get ready to relieve Patrick after defib. Oh, and adjust that conductive pad closer to the clavicle."
"The paddles are ready, Doctor."
"Give them to me and charge to 360 joules."
The defibrillator then emitted a humming sound that increased quickly in pitch.
"We're at 360!"
"Clear! Stop compressions, clear the oxygen and move aside everyone."
The defibrillator paddles were pressed firmly against the patient's chest and the shock delivered. The jolt caused the torso to arch upward momentarily followed by a settling of the pale corpse onto the hard fiberglass backboard.
"Hold off on compressions for a few seconds Steve. Do we have any rhythm change on the monitor?"
"Negative, doctor, still V-fib."
"No pulse, I can't feel a thing."
"Damn! Charge up again to 360. Prepare for another shock. Let's give him some Vasopressin, Josie."
"How much?"
"Forty units, now!"
"Shouldn't we resume compressions, Doctor Burgess?"
"Not yet, Steve, not yet, damn it! I want to see if we get rhythm."
"It's in. Vasopressin is in."
"Good." The staff all noticed the doctor's face was almost trance-like with his intense focus on the fate of the patient now fully in his hands. "Okay, continue compressions, Steve, we need to get those drugs working into the heart." Under his breath the doctor was anxiously muttering, "Come on! Come on!"
"Charge holding at 360 joules, Doctor."
"Any rhythm yet on the monitor?"
"Negative."
"Let's shock again. Okay, Steve, back away."
"Yes, sir."
The doctor's anxiety was even more evident now by his sweaty brow and nervous handling of the defibrillator paddles. "Clear!"
The physical evidence of the second application of electrical current to Terry Morgan's inert body was identical to the first. The room fell eerily silent and all eyes remained focused on the EKG monitor looking for any sign of a heart rhythm.
"Steve, continue your compressions. Let's hope to God the drugs do their thing."
"Yes, sir."
"Josie..."
"I'm sorry sir, nothing...wait."
"What is it?"
"It's weak and erratic but we're recording a slight rhythm."
"Aw, damn, that's not good enough."
"I still don't feel anything," said Lois.
"Shock him again, doctor?"
"Not yet, let's see if this weak pulse develops into a decent rhythm first. Steve, do you need to be relieved?"
"No sir, I'm fine. Maybe we could induce hypothermia to buy us more time?"
"Oh hell, Steve, that's med-school textbook stuff. Besides, we're out of time!"
"Sorry, Dr. Burgess."
"We're losing what rhythm we had, doctor," warned Josie.
"Oh, what the heck, prepare for one more jolt. Back away, Steve."
"It doesn't look like he's going to make it, does it?" remarked the young intern.
"Get that damn oxygen tube out of the way," warned the exasperated physician. "The last thing we need right now is a fire."
"Sorry, Dr. Burgess."
Josie suddenly shouted an alarm, "Doctor, look! Look here!"
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