Midnight Heat (Black Phoenix Book 2) by Sarah Grimm Page A

Five

     
    Sirens sliced through the early evening air, echoing off the side of the hospital and nearly deafening Rebecca as she stepped out into the ambulance bay. Normally, she waited for patients to be brought in by the EMS crew, but she was restless and had been all shift. Haunted by a desire to do more, even as she struggled against a nagging sensation emergency medicine was not where she belonged.
    Coming to that realization while facing a pediatric trauma was not a good omen, yet here she was, in step with the beep-beep-beep as the rig backed up. With a deep breath to center herself, she pulled open the rear door as soon as it stopped. “What have we got?”
    “Three-year-old male run over in his driveway. Father reports the child was in the back seat unrestrained when he opened the door and fell out while the vehicle was reversing.”
    As the medic continued feeding her pertinent information, Rebecca focused on her patient. Despite manually being fed oxygen through an endotracheal tube, his skin was pale and clammy, which made the widespread petechial hemorrhage over his upper chest impossible to miss. His abdomen was distended and marked by patterned bruising. Her stomach twisted painfully as she identified the pattern as that of a tire.
    “Patient was unresponsive and in mild respiratory distress at the scene, then stopped breathing five minutes out. Heart rate has held steady at 150, BP is—”
    “Blood pressure is dropping,” the second medic interrupted. “We’re losing him.”
    No way. Not on my watch.
    They burst through the doors at a jog, jockeying around a startled young woman standing frozen in the center of the hallway. A few more steps and they arrived in the trauma bay, where they moved the child onto the ER’s gurney and quickly attached him to the heart monitor and crash cart.
    “Get me c-spine, chest, abdomen, a trauma panel, and blood gas,” Rebecca ordered as she began her head to toe examination, gliding her hands over the child’s body. “Where is the father now? The mother?”
    Karmen stepped in and wrapped a trauma I.D. band around the tiny wrist.
    “Father hitched a ride with the uniforms on the scene. No mention of the mother,” one of the medics replied.
    Rebecca’s vision tunneled on the patient as she performed a primary survey – ABCDE: airway, breathing, circulation, disability and exposure. Her main concern was internal bleeding. And although the medic continued to manually supply oxygen via the ambu bag, she wasn’t happy with the rise and fall of the boy’s chest. A quick check with her stethoscope showed absent breath sounds on the left side.
    “Get me a chest tube.” She poured betadine over the boy’s chest as a tray was placed within reach. “Who’s on for surgery tonight?”
    “Dr. Connelly,” Karmen answered. “I haven’t seen him yet.”
    “Get him down here.” Rebecca inserted the catheter and stepped aside as bloody fluid flowed out the tube. “He’s got a hemothorax. I need O neg uncrossed blood.”
    A nurse handed her the connective tubing for attachment to the drainage system. It worked by replacing the negative pressure in the chest, which in turn reinflated the lung. What she’d wanted to happen – the patient’s breathing would ease and blood pressure would improve – didn’t.
    An alarm sounded.
    Someone swore.
    The boy’s blood pressure continued to fall.
    “Start a second line and get that O neg hung,” Rebecca ordered.
    He was just a little boy. Small for his age. Hair the color of milk chocolate. Knees scuffed in a way that told her he enjoyed roughhousing – as a lot of boys his age might.
    A cold sweat trickled down her back as she checked heart sounds. The bleeding in his chest was causing blood to pool around his heart and impede its function. Without surgery, he wasn’t going to make it.
    “Heart rate’s bradying down,” the nurse called out.
    Damn it! No way was she giving up without a fight. “Karmen, get a cardiac