"Ambulance six at Speer and Broadway."
"Ambulance six respond to Le Crepe restaurant at 14th and Larimer on a party short of breath."
"14th and Larimer. Copy and en route."
"Watch for Pumper-1 responding with you."
We were less than two minutes away. The pumper crew should have the story by the time we arrived. As soon as we pulled up I grabbed the bag and headed inside with my partner while the firefighters brought the stretcher. The Captain met us at the door and reported a young female was having an apparent allergic reaction and was barely able to breath. When I got to her side, she was supine on the floor, wheezing audibly, her color was ashen and her lips were cyanotic. The firefighters were just getting the oxygen on her.
Bending over her so she could see my face, I asked, "Are you able to talk?"
She shook her head 'no'. The poor girl was terrified.
I listened to her chest with my stethoscope and verified she was barely moving air. Respiratory arrest was imminent if we didn't fix it quickly. "What's her pressure?' I asked my partner.
"Systolic is 58 and the monitor shows bradycardia at 32."
Damn, I thought. Her heart's about to poop out.
While my partner was trying to get an IV started, I leaned down and took her face in my hands to make her look at me. "Miss, my name's Kevin. I'm a paramedic. I need to do something to make it easier for you to breathe. Do you understand?" Her eyelids were at half-mast but she nodded her head.
"OK, Miss, listen to me. I'm going to pass a plastic tube through your nose and into your airway. It's going to be very uncomfortable for you but it's important that you don't fight me, OK? As you feel the tube entering your nose, just keep swallowing. Do you understand?"
She didn't respond at all this time. She was loosing consciousness and I needed to move quickly. I took a 6.5 ET tube out of my bag and smeared the end with lidocaine gel. Tilting her head slightly forward, I passed the tube through the nostril and into her throat. She didn't even flinch; she was out. Her efforts to breathe were weak but still effective enough that by putting my ear to the end of the tube, I could follow the sound of her breath to the opening to the larynx. On the next inhalation, I pushed it through, advanced it down into her trachea and inflated the cuff with ten cc's of air. A firefighter already had the bag hooked up to the O2 and ready to go. I began to inflate her lungs but I was pushing against a lot of resistance.
"Her veins are collapsed," my partner said. "I can't get a line in her. Should I give her .5 of epi sub-q?"
"I don't think her circulations is good enough to disperse it. Give me 10 cc's, I'll push it down the tube." I squirted the epinephrine down the tube and continued to inflate her lungs. Gradually, the resistance eased and I was able to get more air into her. I checked the cardiac monitor and saw that her heart rate was picking up and was now at 86. As her brain began to re-perfuse, she started to wake up and began coughing against the tube in her throat.
As her eyes focused on my face I said, "Miss, you're starting to breathe better now. Do you understand?" She nodded her head.
"I know you don't like this tube in your throat but we need to leave it in place until we get to the hospital."
Turning to the fire crew, I said, "OK, guys. Let's get her into the ambulance. Captain, thanks for you help. Good work as usual. Have one of the waitresses put this girl's meal in a carry-out carton so we can get it analyzed for allergens at the hospital."
By the time we arrived at the emergency department, the patient was fully conscious. I gave my report to the triage nurse as we moved her into a treatment room. The Doc quickly auscultated her chest and confirmed she was moving air well and her level of consciousness was good. She leaned down to the patient and said, "Miss, you're doing OK now. We're going to take this tube out and it may make you want to vomit." The cuff was deflated and the tube removed without too much discomfort.
I breathed a little sigh of relief. "OK, Doctor Haddad, I'll go write my report."
"Thanks, Kevin. Nice work!"
The rest of my shift passed without anything nearly as intense. I turned the rig over to the next crew and headed through the ER on my way to the parking lot. As I passed one of the treatment rooms, a hoarse, raspy voice called "Kevin!" I looked in and saw it was the young lady with the allergy. She was sitting up, dressed in one of the hospital's high-fashion gowns and looking so much better with some color in her cheeks and some life in her eyes.
"Hi! Glad to see you're doing so well. Are they going to cut you loose pretty soon?"
"Yeah, when my mom gets here to pick me up." She could only speak in a whisper; pretty common after having a tube pushed through your vocal cords. "Doctor Haddad said you saved my life. I just wanted to thank you. I wish there was some way I could show my appreciation."
"You're more than welcome. It's what we do."
"I know, but I want to say thank you anyway. My name is Millie," she smiled holding out her hand. "Doctor Haddad told me your first name but she said it was against policy to give out full names."
I took the offered hand. "Yeah, it's just a way to help keep our work in the workplace. You know, a certain level of anonymity. My last name is Mendel. What's the allergy that caused all this?"
"I'm allergic to iodine. I didn't order anything with seafood but there must have been some in what I ate. I intend to see that the restaurant pays all my medical expenses."
"I doubt you'll get much of an argument from them, Millie, especially if they're looking at a possible big, fat law suit. Well, I'm really happy to see you're doing so well. Nothing personal but I hope we don't meet again." It's an old joke in the business but it gets a laugh anyway.
I left and headed home by way of the Red Garter bar for a couple of beers and some socializing. I was hoping Darla, one of the ER nurses would be there. We've been close friends for years and sometimes she's amenable to a tumble in the hay if I look like I'm pathetically in need. We'd been an item at one time but wound up deciding mutually that, while we loved the sex, living in the same space didn't suit either of us. I asked Luis, the bartender if he'd seen her and he said she was going to be out of town for a few days attending a trauma conference. It looked like a quiet night ahead.
After my shift the next afternoon, I was on my way to the parking lot across the street from the hospital when someone called my name. I looked around and saw a young lady waving to me as she got out of her car and crossed the street. It took me a few seconds to place the face ... it was Millie, the girl with the allergy.
"Millie! Hi, how are you feeling? I see you got your voice back." She was wearing jeans and a pale yellow tank top, both of which she filled out very nicely. Really a great looking girl with short-cropped black hair, beautiful pale blue eyes and a face you might see in a fashion ad. Add a few freckles across her nose.
"Yeah, just a little sore throat but, believe me, I'm not complaining," she laughed. "Kevin, I'm really glad I caught you. I was wondering if you'd like to come over to my place for dinner some time." She saw the hesitation in my face. "Umm, you could bring your girl friend or your wife or whoever. I just wanted to show my appreciation somehow."
"I don't have either, Millie. It's not that, but it is kind of an ethical dilemma for me. Let me explain. What you went through yesterday was a terrible thing, physically and emotionally very challenging. It's not uncommon for someone who went through what you did to feel a strong attachment to anyone who helped them through it, but it can make them emotionally vulnerable. If it was perceived by anyone that I somehow took advantage of that vulnerability, not only would I feel terrible about it, I could lose my job. Believe me, if I had met you under any other circumstances, I would have been wracking my brain to come up with a way to get to know you a lot better. I can't tell you how much it means to me to hear you express you thanks, it rarely happens in this business, but I have to say no thank you to your invitation."
She looked just a little bit put out. "Is that a rehearsed speech?" she asked mildly.
"No, Millie, it's not. Please don't think I'm being patronizing and please don't be angry with me. I happen to think you are a very attractive woman in every way and the temptation to take you up on your offer strains my limits, but it just wouldn't be right, not this soon after your ordeal. If you baked cookies for me, I'd gladly accept them and share them with my partner and the pumper crew who were also there to help pull you out of a disaster."
After thinking about it for a few seconds, Millie sighed and then smiled. "My dad's a lawyer, Kevin, so I've been taught all about 'the perception of impropriety'. I can see now how my invitation might put you in a tight spot. I just want you to know that I'll never forget what you did. Thanks again for giving me back my life." She leaned forward and kissed my cheek, then turned and ran back across the street to her car.
A week later I walked into the office to check my mailbox before my shift. The Chief saw me come in and waved me into his office. "Kevin, that box there on the chair is for you. A real knockout of a woman brought it in yesterday afternoon and asked me to make sure you got it, so, there you are."
"Thanks, Chief. Did she leave a message or say who she was?"
.... There is more of this story ...