Extreme Medical Services: Medical Care On The Fringes Of Humanity (24 page)

“I’m a big boy, Brynne. I can handle it.” Dean said with a smile. “I really did want to get a head start on the inventory.”

“Are you almost done?” Brynne asked. “What can I help with?”

“I’ve only got the trauma bag to go through and I’m finished. Maybe you could check out the Med Dispenser and see if we need to order anything from the hospital.”

“Sounds like a plan,” Brynne said. “I’ll get right on it. Then we can make a pick up later when we’re out of the station.”

The beginning of shift chores went quickly, and they were soon back in the squad room. Brynne was checking through the shift email that went out to each crew alerting them of news, training opportunities and medication changes, and Dean was reading a book on Egyptian mythology. He heard her sigh as she stared at the screen.
 

“What’s up?” Dean asked, looking up from his book.

“Have you checked your email from headquarters?” Brynne asked.

“No,” Dean said, “Is there something important?”

“There’s a warning from headquarters to us from the police investigation division that there have been unprovoked attacks on members of the Unusual population. They’re urging us to be very careful approaching scenes where an assault might have occurred because of reprisals against us for rendering aid.”

“Why would someone do something like that?” Dean asked.

“There are groups out there who are afraid of the unknown, Dean,” Brynne said. “While most normal people live blissfully unaware that the Unusuals live among us, there are a few who know the truth. Among them are some who think that we’re letting monsters live among us who will eventually do us harm.”

“Have you ever met someone like that?” Dean asked. “Are we in danger just because we provide emergency aid to them?” How we are to protect ourselves?”

“Your predecessor, Zach, had doubts about what we do, Dean,” Brynne said. “He was never comfortable caring for our group of patients. Eventually he decided he wouldn’t do it anymore. One day he refused to care for a vampire patient who had a drug problem. He would feed on junkies until he overdosed. Zach said that we should let him die because he was a danger to the human addicts he fed on. It didn’t matter if the relationship was consensual, Zach thought it was unnatural. Let’s face it, Unusuals behaviors are unnatural by human standards. That was the final straw from headquarters’ standpoint. You can’t just refuse to treat a patient you don’t like whether they’re a different breed, race, or because they smell bad. That’s abandonment, and it violated his license.”

Dean was suddenly uncomfortable. His earlier conversation with Zach sent a chill down his spine. He agreed with some of the points that Zach had made. Did that put him at risk for losing his job? He liked the work, but he had some reservations about the way the Unusuals lived and the powers they wielded. Was having that conversation with Zach justification for firing him?

“You alright, Dean?” Brynne asked. “You zoned out.”

“It’s just that I’d never thought about it that way.” Dean responded. “It seems a stupid reason to lose your job.” He paused as a thought occurred to him. “Um, do you think Zach’s mixed up in these attacks on the Unusuals?”

“No,” Brynne said. “I just don’t think he was up for this kind of work. Some people aren’t. I don’t think he’d actually hurt anyone. But, there are people out there who do horrible things based on misguided beliefs. We should make sure we’re prepared for something unusual on our calls.”

“Isn’t that the very nature of what we do here at Station U?” Dean said with a smile.

Brynne laughed. “Yeah, I guess it is. Still it doesn’t hurt to be cautious. Remember to keep your eyes open.”

They both jumped up as the tones sounded over the squad room speakers. “Medical Box 231, burn victim, 3521 Martin Highway.” Dean grabbed the dispatch paper as it came off the printer and headed out to the ambulance bay. Brynne jumped up into the driver’s seat and started up the diesel engine as Dean headed around to the passenger side.
 

He climbed in and put them responding, and then switched the radio channel over to the appropriate med channel to get the additional information. The dispatcher came on almost instantly. “U-191, respond for a thirty-four-year-old female victim of an assault. Severe burns reported by bystanders. Fire and police also en route. Use caution as you approach.”

“Received, respond with caution.” Dean hung up the mic on the dash. “What do you think we’re getting into here?”

“I don’t know,” Brynne said. “You know where the fire extinguisher is in case the assailant is still around and decides to set fire to anything else, right?” Dean nodded. “Hopefully the police get there before we do and can lock down the scene.”

It took them 10 minutes to get to the location of the call. The fire engine and police cars lit up the scene with their lights. Brynne pulled up near the fire engine but parked in such a way that she could still pull out without backing up when they had to leave. There were two firefighter EMTs next to the engine’s cab and one of them stood up as they arrived to wave them over. Dean grabbed the med bag and oxygen airway bag from the compartment on his side while Brynne walked around and climbed in the back to get the heart monitor and the trauma bag.

Dean headed over to where the two firefighters were and saw a what he thought was a pile of black rags on the ground. Then it moved, and he saw cracked red and raw skin underneath the charred clothing. Damn, this was bad. He caught a whiff of the sickly sweet smell of burned flesh, and his stomach churned. They already had a non-rebreather mask on her hooked up to their portable oxygen tank from the fire engine’s first responder kit.

“What happened?” Dean asked as he swallowed hard and knelt down next to the moaning patient.

“Bystanders said that someone just walked up to this woman and doused her with some kind of fluid from a can then flicked a match at her.” The first firefighter said. “Could have been lighter fluid or gasoline. An arson investigator will be able to tell us when he’s done with his investigation. Her clothes caught fire quickly, and she started screaming and trying to pat out the flames. Another bystander knocked her to the ground and had her roll around to smother the flames and someone else grabbed a fire extinguisher from that coffee shop and used it on her. The fire was out when we arrived. We were just starting patient care when you guys got here.”

Dean was staring at the patient, unsure where to start first when Brynne came up to stand next to him. Her gasp told Dean that she had just seen the extent of the patient’s burns. He looked up at her. He was out of his element here. He shouldn’t have been but this was more than he could handle on his own.
 

Brynne looked down at him and must have seen the look in his eyes. “One step at a time, Dean. Just take it one step at a time.” She knelt down on the other side of the patient and started talking to her. “Hello, my name is Brynne, I’m here to help you. Can you tell me your name?”

The woman turned her charred face toward the soothing voice next to her. Her mouth opened and she croaked out “Vanessa.”

“Okay, Vanessa,” Brynne said, “my partner, Dean and I are going to do some things to make you feel a little better. Then we’re going to take you to the hospital, all right?”

“All right,” Vanessa rasped. “It hurts so bad.”

Dean looked at her right arm and saw that the burns were less severe there. “Brynne, I think I can get IV access on this side.”

“Okay go for it, but if you can’t get it, we’re better off going straight to an intraosseous infusion route,” Brynne said.

“Understood.” Dean began gathering his supplies to start an IV. The firefighters were well trained. As soon as they heard what the paramedics intended to do, one of them came over and started prepping a bag of normal saline for the infusion, attaching the IV tubing and flushing out the air. Dean looked at the arm and knew he wasn’t going to be able to clean the skin very well around the IV site but he made a few passes with the alcohol preps he had pulled out. He selected an 18 gauge needle which was the largest he thought he could get in the vein he’d identified. He removed the safety cover and started to insert it gently into the area. He was rewarded almost instantly with a flash of blood in the chamber at the top of the IV catheter assembly.
 

Dean looked up at the firefighter standing next to him holding the IV fluid bag and took the end of the IV tubing. He carefully attached the IV tubing in its place. He opened the rolling valve wide open and saw the fluid flowing through the drip chamber, then taped down the tubing and catheter so it wouldn’t dislodge.
 

He left the fluid flowing wide. Extensive burns caused a fluid shift within the body and Vanessa was going to need a lot of fluids over the next twenty-four hours. He judged that she had second and third degree burns over sixty to seventy percent of her body.
 

Brynne had hooked up the blood pressure cuff and had gotten a set of vitals. She was in the process of hooking up the heart monitor leads so Dean thought about what he could do next. Vanessa’s groans reminded him that pain management was next on the list. He got out the morphine. He wasn’t going to have enough morphine on hand to deal with this patient’s pain adequately, but he could at least get started. “Brynne, I’ve got IV access and I’m going to start pushing some morphine, okay?”

“You do that,” Brynne confirmed. “I need to get ready to secure her airway. She sounds like she has some airway burns.” She looked up at the firefighters and said, “Could one of you call dispatch and tell them that we’ll need a paramedic supervisor with supplemental pain meds to this location. Also, have them notify ECMC burn unit that we have a patient with approximate 70 percent burn surface area coming in.”

The engine’s lieutenant nodded and turned away, speaking into the microphone attached to his shoulder. Dean double-checked the dose of morphine in the syringe. He attached the syringe hub to the IV tubing and slowly started pushing the drug into the patient. “Vanessa, this is Dean, Brynne’s partner. I’m giving you some pain medication now. Hopefully it will take the edge off the pain you’re feeling.”
 

As he slowly depressed the plunger, he looked down at the patient’s charred face, watching for a reaction. He saw a flash of silver around her neck and a pendant of a pentagram on a chain. It looked like it was partially seared into her neck. He got Brynne’s attention and she looked down to where he was gesturing. He thought it was a holy symbol for a Wiccan. He mouthed the word “Wicca” to Brynne. She nodded in agreement. It didn’t change anything from a treatment perspective, but it would be pertinent information based on the warning email they had received from headquarters earlier. He glanced around to see if he could spot the police he knew were nearby. Maybe they should know. Then he froze as he saw Zach standing there. He made eye contact with Dean, shook his head no and then backed away into the crowd. Brynne’s voice shook him back.

“Dean, what are you doing? We’ve got work to do, stay with me.” She said. “We need to get ready to RSI her. I’m afraid that airway is going to close up.” Brynne referred to the practice of rapid sequence intubation where a series of drugs were administered to a patient, sedating them so they could have a breathing tube inserted even though they were conscious. Dean helped Brynne draw up the meds and got the bag valve mask ready to breathe for Vanessa when the paralytics started working.
 

They had the tube successfully in place when the shift supervisor pulled up in his chase car. Brynne motioned for one of the firefighters to take over compressing the breathing bag every eight seconds and stood up to talk to the assistant chief walking towards them.
 

“Hi, Ari,” Brynne said. “I just RSI’d her. She’s burned pretty severely. I’d estimate the burn area to be around seventy percent. Dean got the IV and has already pushed ten milligrams of morphine. We’ll probably need more at some point.”

“That’s all right Brynne,” Ari said. “I heard the call and was heading over anyway. What happened?”

“Someone apparently doused her in lighter fluid or gasoline or something like that and set her on fire while she was walking down the street,” Brynne said. “Police and fire were on scene when we arrived. Do you think that it has something to do with the alert we got this evening about attacks on Unusuals? She’s wearing a Wiccan holy symbol. It could be nothing, but I’d rather be safe than sorry.”

“I’ll tell the police watch commander about your suspicions,” Ari said. “If this is the beginning of some sort of trend, we need to have a coordinated response between the agencies, especially since it might be Unusual related.”
 

Dean called out to Brynne, “I think we’re ready to get her packaged and loaded into the ambulance.”

“Be right there,” Brynne said. “One last thing, Chief. I think I saw my ex-partner Zach in the crowd but when I looked up again, he was gone. I don’t think he noticed that I saw him, but I thought you should know that he was here.”

“Let’s hope that was just a coincidence or that you were mistaken,” Ari said. “The last thing we need is to have one of our own doing this sort of thing. We’ve worked too hard to gain their trust to have it all blown by a whack job who should never have been assigned to Station U to begin with.”
 

“Let’s get the patient squared away at the hospital and I’ll take care of coordinating the investigation with the police. I’ll also call the local coven and tell them that one of their own may have been injured. They might be able to supplement the medical care in some way.”

Brynne nodded, and the two of them separated as the chief headed over to the police sergeant on the scene and she turned back to help Dean get Vanessa ready to transport. He and the firefighters had the situation pretty well in hand. She checked the vitals on the monitor and re-evaluated how Vanessa was doing with the intubation and meds.
 

“Dean,” Brynne said. “Since I had to RSI her, you’re going to have to drive the rig. Are you up for it?”