Chapter Two

As an EMT, Jace evaluates the circumstances, and makes sure that the scene is safe. They could set up IVs, give drugs, conduct CPR, or clear someone's airway. Jace tries to stabilize the patient and transfer them to the hospital. Occasionally, they are required to help a patient who may have fallen and is unable to stand by themselves. Additionally, they offer welfare checks to elderly people who don't have relatives nearby to check on them in case they can't be reached. They are ready for anything from vehicle accidents to heart attacks to childbirth.

Jace starts his day as an EMT at five in the morning. Jace, who works at a fire station as a non-firefighter, is headed to another emergency. This time Jace and his partner Alex including the ambulance driver headed to a scene of a car accident that also included firefighters and police officers. After arriving at the car accident scene, Jace and Alex got out of the ambulance and Jace and Alex walk up to the ambulance and they unload the gurney from the back of the ambulance. Before unloading the gurney, Jace will perform a quick inspection to ensure the stretcher is in proper working condition.

Jace checks that the locking mechanisms are engaged, the wheels are clear of obstructions, and the stretcher is securely fastened to the ambulance's fastening device. Unlocking the stretcher: Then Alex gently release the stretcher from the ambulance's locking mechanism by using the designated release handle or switch, typically found at the foot end of the stretcher.

With controlled movements, Alex reduces the wheeled end of the stretcher to the ground, using the stretcher's mechanical assistance features if available. Once then, Jace and Alex roll the stretcher to the patient who's in need of assistance. EMTs like Jace are frequently the first to arrive at an accident scene and start administering emergency medical care. The firefighters had come to the scene as well because there were two cars that were caught  on fire.

Two seperate drivers, from each vehicle, were trapped in each car. Both cars were upside down. The cars were also totaled. Firefighter Kason Killman was bent on his knees and leaning down on the road to calm the driver in the first vehicle and a different firefighter was checking on the other driver in the second vehicle. After Kason and his team, including paramedics, including Jace and Alex helped get the drivers out of the car, from being trapped, other firefighters were extinguishing the fire by using water, and Jace and Alex before one of the victims is being taken out of the vehicle, it is essential that Jace manually stabilize the patient's head and neck before removing them, particularly if there is a possibility of spinal damage.

It is then fitted with a lengthy backboard and a cervical collar. Jace will quickly perform a basic evaluation, prioritizing a clear airway and maybe administering oxygen while searching for significant injuries such as bleeding, deformities, or swelling. In order to achieve rigorous spinal immobilization during patient movement and transport—especially in cases of suspected spinal injuries—EMS personnel like Jace and Alex must employ a backboard, sometimes referred to as a long spinal board.

When moving a patient from the incident to the hospital or ambulance stretcher, this gear helps keep their spine in alignment and reduce movement. Therefore, once the patient had been entered iIn the ambulance, Veronica Woodman had a ruptured lung. She became unresponsive. In order to assist a patient suffering from a pneumothorax, or punctured lung, Jace had to keep an eye on and assist with breathing. 

In the event of a tension pneumothorax, Jace had to perform a needle thoracostomy to release pressure and also supply additional oxygen to the patient. To remove air from the side of the pneumothorax, Jace inserted a needle between the ribs. Alex was using a BVM mask once again, to insert air in Veronica's lungs. While EMTs can use a BVM mask, especially for patients with respiratory distress, it's generally advised to avoid positive pressure ventilation (BVM) in cases of suspected pneumothorax, especially if it's a tension pneumothorax.

The reason is that positive pressure can worsen or even create a tension pneumothorax, a life-threatening condition where trapped air builds up in the chest, putting pressure on the lungs and heart. A pneumothorax is a condition in which air enters a person's chest cavity and presses against their lung, either completely or partially collapsing it. It may be brought on by underlying medical disorders, trauma, or medical procedures. Jace's gloved hands moved with the practiced urgency of a man who dealt in fractions of seconds. He knelt over the patient, Veronica, who was trapped in the wreckage of a mangled sedan.

Her body was pale and clammy, her chest still but for the ragged, ineffective gasps that seemed to demand more air than she could take in. The driver's-side door was a concave mess of jagged metal, and the steering column was crushed against her ribs.

"Can't get a decent breath sound on the right side," Jace said to his partner over the din of the fire department's hydraulic cutters. "Barely a whisper."

Veronica's neck veins were distended, bulging like thick cords against her pale skin. It was the last sign Jace needed. The pressure building in her chest was squeezing her heart and collapsing her lung, cutting off her ability to circulate oxygen. A tension pneumothorax.
"She's crashing," Jace shouted, his voice tight. "BP's falling, pulse is thready. We've gotta decompress."
He ripped open a sterile kit with his teeth. The foil crinkled loudly. A 14-gauge catheter-over-needle assembly, long and wide, was waiting inside.

His eyes went to the top of her right clavicle, then dropped to the second intercostal space. His fingers probed, finding the hard ridge of the rib, and then walking up just above it, searching for the perfect soft spot. He had to be just right, to avoid the nerve bundle and blood vessel that ran below the rib.
His partner pressed a stethoscope to Veronica's chest, listening. "Jace, hurry."

"I am." He wiped the area with an alcohol pad. The scent, clean and clinical, was a stark contrast to the smell of burnt rubber and leaking gasoline surrounding them.
He pressed the tip of the needle to her skin. Veronica, who had been fading, let out a sharp cry, her eyes fluttering open with a panicked, helpless fear.

"Veronica, I need you to be still," he said, his voice a low, authoritative command. "Stay with me. Just for a second."

The words were a lifeline, a focused anchor in her swirling terror. She squeezed her eyes shut, a tear leaking from the corner. Jace pushed, firm and fast. He felt the resistance of skin, then the tissue, then a final, definitive pop as the needle plunged through the tough pleural membrane. The air hissed out, a small, triumphant escape of pressure that was almost musical to Jace's ears.

Veronica's desperate gasps began to even out almost instantly. Her breathing became less frantic, more controlled. A faint blush of color returned to her cheeks. The bulging veins in her neck subsided. Jace held the catheter, listening to the rush of air. He taped it down securely, a temporary fix to buy them enough time to get her to the hospital.

"Got it," he said, his voice tinged with the relief of a battle won.

"Let's get her the heck out of here."

Jace cleaned and covered a communicating pneumothorax with a three-sided occlusive bandage. Jace would have to take the patient to a hospital for additional assessment, therapy, and other needs. Sirens continued to be heard and people during traffic had to pull to the side of the road to give room for the ambulance to rush to the hospital.

After another shift, Jace was headed to the grocery store and he needed to buy groceries for dinner. He wasn't in the mood to cook, so he grabbed something really quick and he decided to buy a few packs of crackers and some cheese. Jace was not much of an eater. He's skinny, and weighs over one hundred and twenty pounds.

After he checked out of the grocery store, Jace was walking back to his car. As Jace was walking back to his car, he opened the trunk and put his groceries in his trunk. After closing the trunk, Jace walks to the driver's side of the car, unlocks his car with his keys, opens the door and gets in the car. After sitting in the driver's seat, and then putting his safety belt over him, he takes the keys and cranks up the car. He pulls the gear in reverse, looks at the back of the windshield of his car, pushes on the gas pedal before pulling out of the parking spot and he faces the front windshield. After putting the gear in drive, Jace pushes on the gas pedal once again. Jace has left the grocery store and he is going back to the fire station.

The next morning, Jace and Alex were called to an emergency about a young ten year old girl named Aleix Boysfti who was in cardiac arrest. Her mother, who is a nurse, was already performing CPR. Until Jace and his partner Alex had arrived at a park, they immediately got out of the ambulance. After getting out of the ambulance, Jace helped Alex to take out the gurney from the back of the ambulance. Jace had all the equipment with him. After rushing up to Aleix and her mother, "help, help me!" shouted Mrs. Boysfti.

Jace and Alex saw Aleix lying on the ground unconscious and also saw Mrs. Boysfti perform CPR on her daughter. "Okay, Mrs. Boysfti, I got it from here," says Jace, bending down on his knees. Jace once again started doing CPR on Aleix. "She has a heart condition, she's very ill," says Mrs. Boysfti. "What kind of heart condition?" Jace asked while continuing to perform CPR.  "Uh, a cardiomyopathy. She was diagnosed last year," says Mrs. Boysfti, while continuing to panic.

Jace and Alex took Aleix and put her on the stretcher. After placing Aleix on the stretcher, they immediately put her into the ambulance. The driver of the ambulance began to drive away from the park and Aleix was rushed to the hospital. Mrs. Boysfeti had immediately gone to her car before Jace and Alex got into the ambulance and left the park.  Mrs. Boysfti had already gone to the hospital and was waiting for the ambulance to arrive. While still on their way to the hospital, Jace was still performing CPR on Aleix.

He did 30 chest compressions like he did with Jenny while Alex was using a bag valve mask ventilation due to Aleix being unconscious. "CLEAR!" says Jace after doing 30 chest compressions and the defibrillator automatically shocks Aleix. "She's in v-fib," says Jace. Jace then continued to do 30 chest compressions once more. "CLEAR!"  The shrill cry of the siren cut through the night, a desperate plea for speed as Jace Parker and Alex, his partner, fought for Aleix's life. The ambulance interior, typically a space of controlled chaos, was now a battleground against a heart failing from cardiomyopathy.

Aleix lay fragile and still as Jace performed compressions, each pressed a fragile hope against the encroaching silence.

"Still nothing," Alex stated, voice strained, eyes fixed on the flatline monitor.

Jace wiped sweat from his brow. "One more round of epi," he ordered, the words feeling heavy and hollow even as they left his lips.

The parents, silent and pale, watched from the back of the ambulance, their hope dwindling with each passing second. He resumed compressions, the steady rhythm a counterpoint to the chaotic thrumming of his own fear and frustration. He poured every ounce of his training and experience into those compressions, pleading with Aleix's small body to respond.

After another tense minute of compressions, Alex conducted the rhythm check. The monitor remained stubbornly flat. Alex slowly looked up, his gaze meeting Jace's, a shared understanding passing between them without words. It was over. But Jace continues to do CPR. Aleix had died. A flatline was showing on the defibrillator. "Jace," says Alex. 

Jace ignored Alex and Jace continued performing CPR. "Jace, she's gone," says Alex, gently touching Jace. Jace had stopped performing CPR. Until they'd got to the hospital, Mrs. Boysftti was informed that her daughter Aleix had passed away.

Jace ceased compressions. He stepped back, the silence that followed the cessation of the compressions echoing loudly in the enclosed space. The weight of their failure pressed down, heavy and suffocating. He turned to face Aleix's parents, the words catching in his throat. There were no words, really, to ease such profound pain. He simply shook his head, the gesture communicating the finality of their valiant, yet unsuccessful, fight.

Jace had immediately rushed into the bathroom after arriving back at the fire station and after Jace walked into the bathroom, Alex followed him from behind and noticed Jace was leaning over the sink. Jace had immediately rushed into the bathroom after arriving back at the fire station and after Jace walked into the bathroom, as he was panting, and Alex followed him from behind and noticed Jace was leaning over the sink.

Jace continued panting. He was trying to calm himself down. Alex walks into the men's bathroom. He noticed Jace leaning over a sink. "Are you all right," wondered Alex. "This was my first time ever losing a patient," says Jace. Jace sighed and nodded his head. "I'd just hope I don't ever have to go through something like that ever again," says Jace.

Jace looks at Alex. Alex didn't say a word to Jace. Jace closed his eyes and he opened them shortly afterwards. Jace turned around and walked past Alex before leaving the bathroom. Alex just stood where he was feeling confused about what Jace had told him about Aleix.