"All motor functions are stopped," he informed the workers, "let's get him on a board and get those lines started. Now! We'll worry about updating vitals if we've got time after he's packaged. Get an initial report to command ASAP. Do we have any ID?"
Working with the precision born of practice and years together, all six people surrounded the victim, preparing him for a helicopter ride. They were grim and had little hope but they worked diligently. One slipped a laytex tube down his nose so they could get oxygen to him past his pulverized jaw and teeth. As they stripped away his shirt he could see the deep red welt across the chest from the steering wheel. No wonder the steering column was broken. In the flashlight beams he could see something else. "We've got a flail chest here," he informed them, "with paradoxical breathing. Get one of those full D5 bags on the left side for weight!" Man, he thought, it's going to take a gallon or two of barge cement just to hold this guy together.
She cut through his blood soaked jeans and silk bikini shorts to assess abdominal and extremity injuries. The printing across the front of his shorts read "Mr. Big Stuff." Mom was right all those years, she thought, you really do need clean underwear every day in case you're in a wreck or something. The deep wound in the left side of his groin missed the femoral artery but he was bleeding profusely. "I'll hold this one together, but get me some 4 by 4s, a trauma pad and some roller gauze," she said, wondering just how much tape and glue and staples and stitches it would take to patch all of him back together or if it could even be done. Another medic was holding direct pressure on a gaping laceration on his left arm.
"OK, give these stats to Command for Life Flight: we've got a 23 year old male, unrestrained driver ejected through the windshield upon impact with a tree; ETOH on board; extensive head injuries, blunt chest trauma with flail chest, B/P 80 over 50 and falling; no radial pulse; patient was initially combative and we had to paralyze him to get two lines established, large bore; ringers; patient is now unconscious and we've got him hooked up to a monitor," the paramedic looked at one of the first responders. "You got all that?" He nodded and headed toward Command.
MAST pants were contra-indicated because of his head injuries and all she could do once the bleeding was under control was cover him up and strap him down. She put the monitor and O2 tank between his legs and hefted her end of the board. They'd have to carry him up the narrow road and then across an uneven, plowed field in the dark to reach the landing zone. It was close to 1/2 mile. Maybe more.
The Life Flight nurse met them before they reached the helicopter. She asked short, direct questions while she checked the monitor and pupillary reactions. They answered with a minimum of words thinking of their patient as just that . . . a combination of injuries and numbers. He was crapping out and everyone knew it.
They loaded him in the bird then backed off, turning away from the debris thrown up by the rotors. Debris they couldn't even see in the night except where it looked like a swarm of bugs as it caught the light from the flares that marked the 60' X 60' touch-down point. They headed back to their rigs and the station to clean up equipment. Other than flagging the area and giving what information they could to the deputy, they were done here. Tomorrow they would pick up newspapers to see if he had lived or died.
The nurse stowed the O2 tank and lashed the monitor in its overhead cubby where she could see it. She wore a headset in order to stay in communication with the pilot and couldn't hear the beep, beep, beep of the monitor over the airborne noises. Amazingly, he opened his eyes. They slowly focused and watched her, questioningly.
"Darryl?" she said to him, "don't try to move. You cant. They had to paralyze you to start some IV's. It stops all your motor movements temporarily but it doesn't hurt you. You crashed your car into a tree and we're doing everything we can for you. We've got you in the helicopter. There's a trauma team waiting at the hospital and we'll be there in," she looked at her watch, "eleven minutes. You've got to hang in there for me, Buddy and hold yourself together. I'm depending on you to stick with me here like glue."
She smiled down at him in the nicest way. She had dark brown eyes and a pretty face surrounded with curly black hair and she meant what she said. For her, he'd try anything. Besides, he'd always wanted a helicopter ride and he was getting one with a fox. From a haze of pain and noise, he looked up at the monitor just above him. Its little green light peaked with each beat of his heart. No, that wasn't right. It blipped just after the flutter in his chest. Like a small, green, flashing echo. A green light echoing in the dark. Since he couldn't move, he'd have to use will power to hold himself together and just imagine all his parts were there. He really didn't know if they were or not. Until he could sort it out, he'd concentrate on that green blip. My echo, he thought. I will MAKE that echo. But what had happened? He didn't have THAT much to drink, he thought. He drank that much all the time and didn't have any trouble. It confused him and for a moment he forgot about holding things together. He forgot about making the echo for just one instant.
When he refocused on the monitor, he saw the little green light extend from one side of the screen to the other. A horizontal landscape without mountains or valleys. Flat like a desert floor. Flat as a pancake came to mind. No, flat like something else but he couldn't decide what. Where did the echo go? And while he puzzled over it, the throbbing in his head stopped and his world became wonderfully, peacefully quiet.
