Chapter One

Jace Parker and his work partner Alex Weatherspoon, are working together as the newest Emergency Medical Technicians in Baltimore Maryland. A medical practitioner who offers emergency medical services is known as an Emergency Medical Technician. As EMT's, Jace and Alex are required to wear uniforms. Typically, these uniforms consist of a long-sleeved or short-sleeved shirt, durable footwear, and cargo pants with reinforced stitching for storage. Depending on the particular work. EMTs like Jace and Alex frequently carry necessary medical equipment, wear standard uniforms, and wear personal protective equipment (PPE).

A light-colored blouse, dark slacks with several pockets, and strong, protective shoes are usually part of standard uniforms. To avoid exposure to bodily fluids and airborne particles, personal protective equipment (PPE) consists of gloves, masks, and eye protection. Additionally, EMTs like Jace are equipped with a range of medical instruments, such as blood pressure cuffs, stethoscopes, and trauma shears.
Therefore, they are required to wear a portable radio strap under their uniform or vest.

In order to keep the radio firmly in position, an EMT like Jace radio strap usually consists of an anti-sway strap, a radio holder, and a main strap. Additionally, a lot of straps have reflective materials, a microphone clip, and occasionally additional room for auxiliary equipment like a pen or scissors.
As an EMT, Jace and Alex, were at the fire station along with other firefighters, as Emergency Medical Services, were called to an emergency after the alarm is played over the intercom, which is a loud alarm or a sequence of tones played over the intercom is the main emergency sound that notifies firemen and EMTs at a fire station to attend to another incident.

Usually, these tones are pre-programmed to identify the precise emergency category and the necessary response. A fire station siren may also sound, particularly to warn oncoming traffic and the general public. Jace and Alex as EMTs immediately rush to the ambulance, including paramedics and the firefighters immediately rush to the firetrucks. Jace and Alex head in the front of the ambulance and two other paramedics sit in the back of the ambulance. Once Jace, Alex and other paramedics and firefighters left the station, they immediately headed to the scene. Jace speaks into a two way radio saying "EMS 5, en route to Charles Street We have a 13-year old female, who is unconscious, possibly from an overdose," says Jace, while on their way to the scene.
An EMT like Jace, will usually identify their unit and level of provider before providing their expected time of arrival (ETA) and pertinent patient information when speaking with dispatch over a two-way radio.

Age, sex, primary complaint, and a synopsis of the current sickness are all included. Baseline vital signs, relevant results, and the emergency medical care given—including the patient's reaction to treatment—are also reported. Jace and Alex are on their way to treat their patient named Jenny Migesi, a thirteen-year-old girl who had overdosed on a narcotic drug. Jace and Alex were on their way to save Jenny. 

Even firefighters where they also work with EMTs came to the scene. Jace is a first responder. So is Alex. After Jace and Alex had arrived at the scene of Jenny Migesi's house, the door was locked and one firefighter named Justin Miguel immediately came to the door and knocked down the door that was locked. Jace and Alex immediately rush into Jenny's home and after running into their home, Jace and Alex went into Jenny's bedroom and they saw her lying on her side, on the floor unconscious. Jenny was the one who called nine one before she lost consciousness.

Jace is dispatched to the location of the overdose call. Upon arrival, they quickly assess the scene for any potential hazards or threats. Jace assesses Jenny's level of consciousness, breathing, and vital signs. They look for signs of opioid overdose, such as pinpoint pupils, shallow breathing, and unresponsiveness.

If Jenny is not breathing or has a compromised airway, Jace will open the airway and help with breathing, which may include administering supplemental oxygen. Jace kneeled down on their knees and so did Alex and they grabbed their equipment to treat Jenny." She's overdosing," says Jace. Alex uses a penlight to check Jenny's eyes. "She has pinpoint pupils," says Alex.

As Jace was trying to help Jenny, Jace will first call Jenny's name to get her to wake up and give the chest plate a firm sternum rub in order to get Jenny moving. Jenny does not wake up. Jenny is then given naloxone  by Jace, who takes it from the equipment bag and squeezes it inside Jenny's nose once every two to three minutes. Jenny doesn't respond to the first dose. Jace uses Narcan for the second time. Jenny doesn't wake up on the second dose.

After placing Jenny on her back, Jace performs rescue breathing, which consists of one breath every five seconds, pinching their nose, tipping their head back to straighten their airway, and sealing their mouth. Jace does mouth to mouth on Jenny, by 2 rescue breaths before he does 30 chest compressions.  But Jenny doesn't wake up. Jace does 2 more rescued breaths. Then he does 30 more chest compressions.

Jenny doesn't wake up once again. Jace starts doing CPR. Jace then presses down 5 to 6 cm (2 to 2.5 inches) at a constant rate of 100 to 120 compressions per minute by placing the heel of his hand on the middle of Jenny's chest and then placing the palm of his other hand on top. Every 30 chest compressions, Jace administers two additional rescue breaths. Jenny did not wake up. She was still unconscious.

Alex opens Jenny's airways. Alex uses either the jaw-thrust maneuver or the head-tilt/chin-lift maneuver to open an airway, depending on whether a cervical spine damage is suspected. In order to prevent further harm, the jaw thrust is recommended for trauma patients, whereas the head tilt/chin lift is employed for non-trauma patients like Jenny. Then Alex uses  a bag-valve mask ventilation on top of Jenny's mouth to insert air in Jenny's lungs while Jace was doing CPR on Jenny.

Jenny is in cardiac arrest. After 30 chest compression, and 2 more shallow breaths, Jace immediately takes the LIFEPAK 15 defibrillator and he takes the pads and puts one pad on top of  the upper right side of the chest, directly below the collarbone. On the lower left side of the chest, below and parallel to the armpit, should have the second pad. "CLEAR!," says Jace. The defibrillator automatically shocks Jenny the first time.

After Jenny is shocked the first time, Jace follows the on-screen instructions before the defibrillator recharges itself. Jace begins to do 30 chest compressions once again on Jenny and after that Jace says, "CLEAR," for the second time before the defibrillator automatically shocks Jenny for the second time. Jace was worried about Jenny and after being shocked the second time. Jenny didn't wake up. Jace Parker's gloved hands moved with practiced efficiency as he worked the defibrillator.

The machine, a Zoll X Series, beeped steadily, an artificial heartbeat in Jenny's quiet living room. Jenny, a woman in her late twenties, lay on the floor after collapsing. "Heart rate is elevated," Jace called to his partner, Alex, who was at Jenny's head. "The respiratory rate is also high. SpO2 is ninety-eight percent."
"Copy that,"  Alex replied, preparing to administer oxygen via a non-rebreather mask if needed.

He observed Jenny's breathing, noting it was rapid but appeared unlabored. The machine's blood pressure cuff inflated on Jenny's arm with a soft whirr. Jace glanced at the screen, then back at Jenny. Her skin was pale and clammy. "Her pressure is a bit low," Jace said, his voice even despite the rising tension. "One hundred over sixty-four."Alex  nodded, focusing on his own work. He checked Jenny's airway and confirmed it was clear. "Airway is patent," he confirmed.

"Let's get her on the stretcher." Jace helped carefully move Jenny onto the stretcher, securing her in place. They worked in a rhythm born of countless calls—Alex preparing for transport, Jace continuing to monitor vital signs and preparing for the next step. The seconds stretched on, measured only by the beep of the machine and the sounds of their focused work.

They prepared to move Jenny to the ambulance for transport to the hospital. "We'll get you checked out at the hospital, Jen," Jace muttered under his breath, watching the numbers on the screen. "Just hang in there." Jace and Alex put Jenny on the stretcher and Jace shined a light into Jenny's eyes and asked Jenny if she knows where she is and is she feeling confused about what happened. Jace was nervous about saving Jenny.

His heart was racing and was afraid that he would mess up. Until then, after entering the ambulance, Jace and Alex continued to check on Jenny. Jace was understanding about the fact that Jenny had tried to commit suicide and that she needed to be looked at.  The interior of the ambulance was a confined, sterile world of its own, lit by a soft, clinical glow. Jace knelt beside the gurney, his focus a tunnel vision on the patient, Jenny. 

A heart monitor beeped rhythmically beside her, its high-pitched tone the only competition for the siren's distant wail. "Sats are dropping," Jace said, his voice level and calm, a stark contrast to his mind's rapid calculations. He adjusted the oxygen mask over Jenny's face. Her skin, pale and cool to the touch, was a map of blue, broken veins. In the front seat, Alex navigated through traffic, but his attention was tethered to the back, to Jace's updates.

"Copy that. Pushing fluids?" he asked over the ambulance's intercom, his voice a steady lifeline. "Doing it now," Jace confirmed, his gloved fingers swiftly managing the IV line. He glanced at Jenny's face. The effects of the naloxone were already wearing off; she was starting to slip back. He knew it was a race against the clock, one they were barely winning.

"We need another dose of Narcan," Jace said, his voice losing a touch of its practiced calm. "She's not holding."Alex, without missing a beat, called into the radio.

"Dispatch, we need a unit to meet us at the hospital with Narcan. The patient is relapsing."

The response was a staticky confirmation. Jace administered the second dose, his gaze fixed on Jenny's face, searching for any sign of recovery. The beeping of the monitor quickened, her heart rate spiking, then settling into a more stable pattern. 

"That's better," Jace murmured, a small measure of relief washing over him. He wiped a stray lock of hair off Jenny's forehead.

"Come on, Jen. Stay with us."

They continued their work, a silent, focused ballet of medical procedures in a small, moving room. The ambulance sped on, its siren a promise of help, the two EMTs inside a small island of order in the chaos of a life hanging in the balance. Until then, Jace decided to perform CPR once again.

Then this time, Jenny's heart rate was going back to a normal heart rhythm as shown on the defibrillator. Jace sighed in relief and said, "she's back." Jenny opened her eyes and she looked around the ambulance.

"What happened?" Jenny asked.

"Hi Jenny, I'm Jace, I am an EMT. You're on your way to the hospital." Jace said.

"No, I want to go home," says Jenny. Jace sighed.

"I'm sorry, Jenny, but you have to understand you almost died," says Jace, furiously.

"I want to go home!" says Jenny, shouting, then beginning to cry. Jace was worried about Jenny that she will probably try to hurt herself again.

Jace sighed, "Jenny, do you know why you tried to kill yourself,"Jace asked.

Jenny sighed and she looked at Jace with teary eyes. "I don't know." Jenny answered.

Jace nods his head.

Then in an ambulance, Jace always completed a written or electronic patient care record (PCR) speaking to dispatch using a black APX™ P25 Two-Way Radios and sends a brief radio report to the hospital with details. A more thorough description of the patient's condition is provided by the PCR, whereas the radio report gives a brief summary.

"Medic 1, I'm bringing a 5-6, 13-year-old female patient, chief complaint is suspected opioid overdose. The patient was found unresponsive. Bystanders report patients may have used heroin. Witnesses report the  patient was seen taking opioids before becoming unresponsive. The patient is completely alert and has regained consciousness. Respiratory rate is 2 breaths per minute. So far we have given Naloxone administered intravenously, the patient's breathing improved slightly, we also performed CPR. The patient's blood pressure is 90/60. Heart rate is 75. The patient is transported to the hospital for further evaluation and treatment, right now we are about 3 to 5 minutes out to your facility, we will see you in about 5 minutes," explained Jace.

Then, the dispatcher  asked for Jenni's age, level of consciousness and breathing status, to get a clearer understanding of the situation. In order to assess the issue and decide on the best course of action, the dispatcher usually requests further information after an EMT, such as Jace, has stated the patient's primary complaint. Inquiries concerning the patient's age, level of consciousness, respiration, and other pertinent information may be necessary to guarantee the best possible reaction.

When a patient calls emergency medical services (EMS) or is being evacuated, the primary cause for the call is known as the chief complaint. In essence, the patient's main worry, frequently expressed in their own words. The patient's major complaint is a succinct statement that explains why they sought medical assistance in their own words. EMTs such as Jace use it to determine the patient's current issue and to direct their evaluation and treatment; it is documented in the patient care report (PCR).

Jenny was crying and after arriving at the hospital, Jace and Alex took Jenny out of the ambulance, while Jenny was sitting on a gurney Jace (as he is pulling the gurney) and Alex pushing the gurney, walked into the hospital and the emergency bay doors swung open with a screech, and Jace pushed the gurney into the flurry of organized chaos. 

Jace started talking to an ER doctor, Lang Wong, about Jenny's condition and other medical information. EMTs like Jace usually provide the receiving physician with a brief verbal report when a patient is admitted to the hospital. The metallic tang of antiseptic and the low hum of machinery filled the air. Dr. Wong met him halfway, a masked figure of calm precision.

"Dr. Wong, I have Jenny, female, 13, opioid overdose, suspected suicide attempt." He laid out the sequence of events without emotion, knowing that in this room, only the facts mattered. "Arrived on scene to find her cyanotic, non-responsive, and with shallow, absent breathing. She also lost consciousness. Witnesses stating she'd taken 'a lot' of pills." He continued as he helped transfer Jenny from the gurney to the bed. "Administered one dose of Narcan intranasally at 15:01. No change in condition. Initiated CPR—rescue breaths and chest compressions." His voice lowered slightly, a hint of the adrenaline still pumping through him. "After about two minutes of compressions, she began to gasp. Breathing returned, though it's still shallow. We held off on the second dose of Narcan once we had a positive response to CPR."

Dr. Wong nodded, her hands already moving with a practiced urgency. "Consciousness?"

"Regained it fully en route," Jace confirmed. "She was lucid, alert, and stated that she didn't want to die, but that she didn't know why she did what she did." He quickly relayed her most recent vitals.
"Blood pressure stable at 90/60, pulse 110, respirations 14. Pupils are starting to constrict, but she's still exhibiting signs of central nervous system depression."

"Good work, Parker," Dr. Wong said, her voice clear and firm. She turned her attention to Jenny. "Let's get her hooked up to a monitor. Draw labs and start a line. We'll need to watch for redosing and get a psych consult down here immediately."

Jenny was administered to the trauma room and was put on a bed. Jace finished his handoff with the nursing staff, feeling the tension finally begin to recede. He took a long, quiet breath, watching as the

ER team surrounded Jenny, their movements a blur of controlled efficiency. His part of the job was done. After Jenny was brought to the hospital, Dr. Wong had no choice but to put Jenny was on a 24-hour suicide watch and was taken to a psychiatric ward. EMTs like Jace, they live their lives according to a clock, yet that clock never stops running.

Their line of work necessitates a special and frequently difficult scheduling strategy. EMTs usually work different lengths of shifts. As is typical for volunteer or part-time EMTs, these shifts might last as little as eight hours. Twelve-hour shifts are more typical for full-time professionals since they provide longer coverage and need fewer shift changes.

EMTs like Jace Parker occasionally choose to work 24-hour shifts, which are more taxing but less common and require them to work both day and night in succession. After Jace had driven home, he had called his mother Eliza Parker who answered her phone call while sitting on her living room couch at home. Jace lives in an apartment.

"Hey sweetheart," says Mrs. Parker.

"Hey mom," answered Jace, as he walked into his apartment after opening the door. 

"How are you doing? How are you enjoying your new life as an EMT?" wondered Mrs. Parker.

Jace shuts the door. "Well uh, let's just say this morning was a bit rough. I treated a young girl who had overdosed on opioids and I just. I almost thought I was gonna lose her," says Jace.

"Oh gosh, sweetheart. I'm so sorry. Is she okay?" wondered Mrs. Parker.

"Yeah, thankfully," answered Jace.

Jace walked up to his bedroom and he sat down on his bed. "Mom. I'd really thought I was going to lose her," says Jace. Mrs. Parker sighed. She felt bad for her son. "Just hang in there, okay. I know being an EMT isn't an easy job," says Mrs. Parker, in a gentle voice.  Jace (as he continues to sit on his bed) went silent for a moment. He had a flashback of Jenny, who was Jace's first patient of the day he treated and had a flashback of Jenny lying on the floor. 

"Honey?"says Mrs. Parker.

Jace clears his throat. "Yeah, sorry. Um. I'm gonna go ahead and let you go. I had a long day. I need some sleep," says Jace.

"Yeah of course. Just remember if you need anything or need someone to talk to, I'm here," says Mrs. Parker. 

Jace went silent for a moment once again and eventually spoke. "Yeah, okay. Thanks mom," says Jace. "Okay honey, you get to sleep. I love you. I'm sorry about what happened to your first patient," says Mrs. Parker. Jace nods his head and he sighs.

"I love you too, mom," says Jace.

Eventually Jace hung up the phone. He puts down his iPhone onto his nightstand. Jace stood from his bed and started taking his shirt off before heading to the bathroom outside of his bedroom across the hall from outside of his bedroom and went ahead to take his shower. Jace clearly couldn't take his mind off of Jenny.

He really cared about her and he was hoping that Jenny is being treated well at the psychiatric ward. Jace, after heading to bed to sleep, had dreamt about Jenny.

Until he woke up the very next morning, Jace had to treat another patient named Lauren Vegas. Lauren was a victim of domestic violence.

Jace had to treat her with care after her boyfriend had punched her in the face and Lauren had fallen on the floor and hit her head really hard. Jace thinks Lauren is suffering a concussion. Lauren's boyfriend was being questioned by the police.

So Jace and Alex took her to the hospital and then to the emergency room, and Lauren had to get stitches due to her head being slightly cut open on the side of her forehead.