Chapter Three

Back at the station, Jace was at the station in the ambulance checking for expired prescriptions or anything else while he's not on call.  Jace has to stay up to date on medical regulations and procedures because he works as an EMT. To improve their knowledge and abilities, this frequently entails going to training sessions, workshops, or courses. In addition, Jace makes sure that all supplies, including bandages, prescription drugs, and medical gadgets, are supplied and in good operating order by routinely inspecting and maintaining the equipment.

Jace has to fill out thorough notes on the situations, including patient assessments, treatments given, and results, after answering calls. For the purpose of legal documentation and care continuity, this documentation is essential. Jace and the other EMTs may be at the station doing standard duties like organizing and cleaning the ambulance and its equipment, getting ready for the next shift, and doing safety inspections. A  lot of paramedics and EMTs like Jace himself take part in community outreach initiatives to inform the general population and many other responsibilities.

Jace had a flashback of Aleix. He imagined her death. Jace while still sitting in the ambulance, he decided to take out his wallet from his pocket and he took out a photo of this girl who was smiling in the picture. That girl is Jace's little sister. Her name is Brianna Parker. Jace took his thumb and gently rubbed the picture and he sighed. Jace was missing his little sister Brianna. Jace puts the picture of Brianna back into his wallet and then puts his wallet back into his pocket. Jace then was on call again to another emergency. He immediately gets out of the ambulance, closes the ambulance doors and he and other EMTs and paramedics immediately rushed into the ambulance and Jace after getting into the passenger side of the ambulance and Alex being the driver, had gotten into the drivers side of the ambulance.

Jace (after heading home) is asleep in his bedroom on his bed. Jace was sound asleep. Until a noise was being made and it woke Jace up. Jace heard footsteps. It sounded like it was coming from downstairs. Then the footsteps got closer and closer. Jace thought he was in another dream.

Maybe he didn't really get out of his first dream. Until Jace heard a little girl laugh. Jace frowned and he pulled his blankets and sheets to the side and got out of his bed. After Jace stood out of his bed, he slowly walked up to the door in his bedroom of his apartment and he slowly grabbed the doorknob and he turned the doorknob before opening the door. Jace slowly opened the door. Jace heard another laugh from the little girl. Jace said," hello?" before he stood out of his bedroom and he looked both ways as he stood out of his bedroom and for the third time in a row the little girl laughed. Jace said, "hello?"

Nobody said a word. It eventually got quiet. Jace sighed. Jace then turned around and went back inside his bedroom. After closing the door, he walked back to his bed. Jace lied back down in his bed. He pulled the sheets and cover back on top of him and he went back to sleep. Jace (while back at the fire and rescue station) wished a good morning to his friends at work as he walked into the gym. He wanted to work out and exercise. Alex was doing push ups. Working out was part of their job as EMTs.

It's a daily routine for Jace and other workers at the station. Jace decided to do push ups as well. After Jace began to do push ups, he spoke to Alex at the same time he was doing push ups. "How are you feeling from the other day?" wondered Alex. Jace answered and said, "oh, I'm okay. I was just a bit shaken up after experiencing someone die on me for the first time."

"Yeah. I can understand that," says Alex, continuing to do push ups.

Jace says, "I heard something weird last night," says Jace.

"What do you mean?" wondering Alex.

"I might just be dreaming, but I heard this little girl laughing," says Jace.

"little girl?" says Alex, chuckling.

"Yeah," answered Jace.

"Well, I mean, you could have been dreaming. Or, it's just paranoia," says Alex.

"I'm not kidding," says Jace.

"Okay. I didn't say you were," answered Alex.

Jace took a break for a minute after doing twenty push ups. Alex stopped doing push ups as well. "What if?" says Jace, looking at Alex. "What if what?" says Alex, looking at Jace. Jace nods his head no. "Nothing," answered Jace. Jace cleared his throat. Until another emergency was declared at the station. Jace and Alex immediately stood up from the floor and went to the ambulance immediately after leaving the gym. After Jace and Alex and other first responders, including law enforcement officials went to a scene of a school shooting as well.

Jace noticed a lot of people were severely injured and he went to help this one girl named Jamie Joan who is a victim of the shooting. She was shot! Jamie was lying on the floor injured inside the school and Jace and Alex immediately went up to Jamie. "Hi, Jamie. I'm Jace Parker, I'm an EMT, I'm here to help you," says Jace. Jace and Alex kneeled down and Alex grabbed the equipment.

"Jamie, can you hear me?" Jamie was barely awake. 

Jace and Alex noticed Jamie was losing a lot of blood. Jamie was losing consciousness and her lips were turning blue. Jace also noticed Jamie's fingernails were turning blue. "She's going into hemorrhagic shock," says Jace. Jace's mind had already compartmentalized the scene by the time he and Alex knelt beside the small body. The flashing red-and-white lights painted the street in strobing, violent colors. A woman wailed, held back by a uniform. But all Jace saw was the girl. A girl crumpled on the school floor. The red stain on her t-shirt was impossibly dark, spreading like a shadow.

"Alex, get the trauma kit. Now," Jace ordered, his voice a low, steady rumble that cut through the chaos.

He didn't look at his partner, his eyes locked on the girl's face. Her skin was a pale, clammy white. Her breath, what little there was, hitched in her chest. Alex was already at his side, tearing open the kit. The crisp, clean rip of the plastic bag sounded obscene in the noise. "Got it," she said, her voice tight but controlled. "Jace..." he began, his gaze fixed on the girl's abdomen, where a small, dark hole was the epicenter of the destruction. He knew what she was going to say. Don't pack the wound.

Abdominal and chest wounds couldn't be packed; the source of the bleeding was too deep. But the rules were for adults. This was a child. The sight of it was a punch to the gut, a cold dread that Jace fought to suppress.

"I know," he said, and his own words were a bitter taste on his tongue.

"No packing. Just pressure. Gentle, steady pressure." He stripped off her t-shirt, revealing the extent of the bruising around the entry wound.

"On three. One... two... three," Alex counted, and they rolled the girl onto her side to check for an exit wound. A collective gasp went up from the small crowd of onlookers. Jace saw it: a corresponding, jagged tear in the small of her back. The bullet had passed through her body, leaving a trail of devastation in its wake.

"No exit wound. Alex, start an IV. I'll focus on the bleeding," Jace said, pressing the dressing to the entry wound, his fingers steady despite the tremor in his hands. He could feel the warmth of the blood seeping through the bandage, a terrible warmth that spoke of life draining away.

The girl's eyes fluttered open. A deep brown, wide and terrified. "It hurts," she whispered, her voice a thin, reedy sound.

Jace's composure wavered. He'd seen so many of these scenes. Gunshot wounds were an everyday tragedy, but a child... that was different. He pushed the thought away, focusing on the moment, on the task at hand.

"I know. We're going to make it better. Just breathe for me, can you do that?" Jace said softly, his voice full of a desperate tenderness. He watched her breath catch, the slightest tremor going through her small frame.

Alex, meanwhile, had found a vein in the girl's arm and was expertly inserting the needle. Her hands moved with a practiced, fluid motion. She squeezed the girl's other hand, a silent promise, an unspoken solidarity.

"We're almost there," she murmured to the girl. "Almost there."

The ambulance pulled away from the scene, its siren a mournful cry in the night. The street was left to silence, punctuated by the lingering sobs of a grief-stricken mother. In the back of the ambulance, Jace and Alex continued their frantic work. A child's life hung in the balance, and in the tense silence of the ambulance, they worked with grim determination, a shared purpose in the face of an incomprehensible tragedy.

After a gunshot, an EMT like Jace tackles hemorrhagic shock by first managing the bleeding and then attending to the physiological consequences of blood loss. Direct pressure is applied to the wound, and in cases of significant limb bleeding, a tourniquet may be used.

The circulatory system is subsequently supported by fluid resuscitation (IV fluids). Blood transfusions and blood pressure-raising drugs may also be required in some situations. EMTs like Jace also treat hemorrhagic shock in prehospital care by restoring blood volume and lowering blood pressure with intravenous fluids.

They usually use a peripheral IV catheter to deliver isotonic crystalloid solutions, such as Lactated Ringer's or 0.9% saline. Although two-liter first boluses are typical, the patient's response and condition might determine the appropriate rate and volume. Small, water-soluble molecules that easily flow through blood vessel membranes that are semipermeable make up crystalloid intravenous (IV) fluids.

They are frequently employed for fluid resuscitation, especially when bleeding, dehydration, or hypovolemia are present. Alex put the electrodes stickers on Jamie's chest. After grabbing the LIFEPAK 15 defibrillator and placing the electrodes stickers on Jamie's chest, Jace looks directly at the defibrillator.

"She barely has a heart rhythm," says Jace. Jamie completely lost consciousness.

"She's in cardiac arrest, v-fib," says Alex.

Ventricular fibrillation (V-fib) can result from hemorrhagic shock. Ventricular quivering rather than coordinated contraction is a potentially fatal cardiac rhythm abnormality known as V-fib. Numerous factors can cause it to develop as a consequence of hemorrhagic shock, such as the structural alterations in the heart muscle caused by severe hemorrhagic shock, which increases the risk of electrical instability and the emergence of arrhythmias like V-fib.

Alex had to open the airway on Jamie, and to make sure Jamie's  face was well sealed, and then squeeze the bag to administer breaths. Squeezing the bag with one hand while holding the mask is the best two-person method. A common technique for sealing and opening the airway is the C-E grip. Jace started doing chest compressions on Jamie.

After doing chest compressions, Jace takes the paddles and says "CLEAR," before he shocks Jamie using the LIFEPAK 15 defibrillator. Jace looked at the vital signs on the defibrillator and Jamie was still unresponsive. Jace begins to do chest compressions for the second time and he says, "CLEAR," for the second time before taking the defibrillator paddles to shock Jamie for the second time.

In between chest compressions, Alex can do rescue breaths during chest compressions by stopping the compressions to give two mouth-to-mouth breaths, usually at a ratio of 30 compressions to 2. Jace looks at the defibrillator and he doesn't see a normal heart rhythm on the defibrillator. "Let's shock her again," says Jace. Jace takes the paddles for the third time and places it on Jamie's chest, and he says "CLEAR," and he shocks Jamie using the paddles.

Eventually, Jamie gained back consciousness. Jace sighs in relief. "She's going to be fine," says Jace. Alex removes the mask from Jamie's mouth and Jace notices Jamie opening her eyes slowly. "What happened?" wondered Jamie.

"You're okay, Jamie. You lost consciousness, due to a gunshot, but we're gonna take you to the hospital now," says Jace.

"Okay." says Jamie.

Jamie looks at Jace. Jace leaned back in his seat. He started to get dizzy. Jace softly moaned and closed his eyes. He heard a little girl laugh. "Hey," says Alex, gently touching Jace's arm. Jace opened his eyes and looked at Alex. "Are you okay?" Alex wondered.

Jace nodded his head and said, "yeah, I'm fine. I'd just got a little lightheaded for some reason," says Jace. Alex sighed and Jace as he just sat in his seat looked around the ambulance. Jace then noticed a little girl who was covered in blood and had pale skin and evil eyes, was standing in the corner of the ambulance.

Jace looked away and then looked back at the corner inside of the ambulance. Jace just sat there staring at the corner inside the ambulance. He swallows nervously before looking back at Alex and softly smiles at Alex.