As promised, I am posting the first chapter for Resuscitation, the second book in the Racing the Reaper Trilogy. I’m very excited for the upcoming release and I wanted to give you all a sample of what to expect. Please share this with all your friends and please let me know what you think. Enjoy!
James compressed the young pregnant woman’s chest outside her car on the road. The warm asphalt and gravel dug into his knees.
The communications center sent Jacob and James to a head on collision on a two-lane highway forty-five minutes south of Boise, Idaho. The initial reports stated injuries were unknown. It wasn’t until a few minutes before they arrived that they received updated information from the volunteer fire department on scene. Jacob immediately called for a helicopter.
A farmer driving a tractor down the road discovered the accident and called 911.There was a pregnant woman trapped in a compact car for an unknown amount of time, and once she was pulled out of the wreckage, she lost pulses. The volunteer fire fighters that freed her from the car stood around watching. Jacob was thankful for them, but he was agitated they weren’t more aggressive in offering assistance. It was only a matter of minutes before the baby the woman was carrying would also die.
They were on a small, two-lane highway in the middle of the woods. The road wasn’t well-traveled. The sun peeked through the plush green trees that lined the curvy road, casting various shaped shadows on the asphalt.
Jacob glanced at the other vehicle. A man’s body was slumped over the steering wheel with the windshield caved in and the glass pierced into his skull. The steering wheel buckled from the impact of his body being flung into it; he hadn’t been wearing a seat belt.
Jacob grabbed his cell phone. He couldn’t control his trembling fingers as he tried to push the numbers on the keypad. Taking a deep breath, he tried to control his anxiety. Slowly he exhaled through pursed lips, and dialed the emergency room at Magic County Hospital. After several rings, a woman answered the phone.
“ER,” she said abruptly.
“This is Jacob on Medic-57. I need to speak to a doctor, now!”
The clock was ticking and they didn’t have long before they would lose the unborn child, too. Once a patient went into cardiac arrest from trauma, they had less than a one percent chance of survival unless they were on the operating table. If the mother wasn’t breathing, neither was the baby. Jacob’s primary concern was, what could he do to save the baby? Would CPR be sufficient until they were able to get her to the hospital? They were forty-five minutes away from the closest facility. The helicopter wouldn’t fly a patient in cardiac arrest because there wasn’t enough room for them to be able to continue resuscitation measures. The options were limited to only one and Jacob needed the doctor on the phone. Jacob paced back and forth next to his partner, James. With each compression, the woman’s head bobbed up and down.
The operator sighed. “Hold on.”
A moment later, a man picked up the phone. “This is Doctor Young.”
Jacob’s throat constricted. “This is Jacob on Medic-57. We’re on scene of a head on collision with one confirmed fatality. We have a pregnant female who is approximately eight months along. We lost pulses a moment ago, and we’re forty-five minutes from the nearest hospital. What do you want me to do?” Life or death calls brought out the best in him, but the added element of having a child’s life in his hands terrified him. There was silence on the other end of the phone. “Hello? Are you there?” Jacob felt as though a vacuum had sucked the air from his lungs.
James pumped frantically on the woman’s chest. Beads of sweat from his forehead slowly traced down his face and fell onto the lifeless woman’s body.
“Yes. I’m here. How long has she been in cardiac arrest?”
“Less than a minute. My partner is doing CPR on her now.”
Doctor Young cleared his throat. “You have two choices. I can talk you through a field C-section, or you can do nothing and the baby will die. There’s nothing you can do for the mother. She’s already dead.”
The thought of cutting into the woman’s abdomen horrified Jacob. “I’m not trained for that! I don’t know the first thing about performing a C-section.”
“Look, I know you’re scared, but that baby will die if you do nothing. That is a guarantee. At least if you try, the baby has a chance at life.”
Jacob sucked in a deep breath. He didn’t have time to think and had to get control of himself. I should’ve called in sick today!
“Do you have access to a scalpel?” Doctor Young asked.
Jacob grabbed the OB kit with shaking hands and ripped it open. The scalpel dropped to the ground. He reached down and picked it up. “Yes, right here,” he said holding it in trembling hands. He wiped the sweat off his forehead with his arm. Seconds ticked away, lessening the chance for the baby’s survival.
“Do you have any betadine on your ambulance?”
Jacob stared at James quizzically. “Does it matter if we disinfect her stomach?”
Doctor Young sighed. “Good point. Now, take your scalpel and cut a vertical incision from her xiphoid process down to her pubic region. Don’t cut too deep; you don’t want to perforate her bowel.”
Jacob put the phone on speaker and laid it on the ground next to him. He pushed the scalpel into her skin being careful not to go too deep. Adrenaline surged through his body. Afraid of doing serious damage, he was careful how far he slid the scalpel into her stomach. The urge to slice her stomach open and pull the baby out was overwhelming. As the blade pierced the skin, a small trace of blood poured from the entrance wound and down the sides of her swollen abdomen.
“How is it going? Have you made it through the first layer of tissue yet?” Doctor Young asked.
“I’m trying,” Jacob nervously answered. His hands trembled as he slid the scalpel down the woman’s abdomen. A thin line of blood traced his incision. He concentrated on not allowing the CPR that James was performing to distract him. As long as her heart was being compressed, oxygen rich blood made its way to the baby.
“You’re doing fine. There is going to be quite a bit to cut through. But Jacob…. you need to work fast.”
As if there wasn’t enough pressure, now I have to go faster?
The tone in Doctor Young’s voice renewed the urgency that he needed to work quickly. The only chance the baby had to survive rested solely on his shoulders. After making the initial pass, Jacob cut a little bit deeper. Blood pooled, making it difficult to see where he was cutting. A wave of nausea rolled through his stomach. He choked down the urge to vomit and refocused on the task.
“There’s a lot of blood.”
“Get some gauze and wipe it away,” the doctor instructed.
Jacob sat the scalpel down on the woman’s abdomen, reached into the jump bag, and retrieved several small white packages of gauze. He ripped them open and blotted the blood, clearing a visual path. The scalpel bounced on her stomach with each compression. Picking up the scalpel, Jacob continued cutting. After several passes, bowel and intestines came into view. Jacob grasped the organs, lifted them up, and pushed them to the side. Just underneath, a semi-pink mass appeared. A sigh of relief slipped through his lips.
“I think I’ve made it to the uterus.”
“Good. You’ll need to cut through that carefully. Remember, there’s a baby inside there.”
Jacob’s hands shook uncontrollably, making it difficult to hold onto the scalpel.
Calm down. You can do this.
Pushing the scalpel ever so lightly into the mass, he started to cut through. A moment later, a large gush of clear fluid flowed out of her abdomen.
Oh no! What have I done? “A lot of fluid came out of her.”
“What color is it, Jacob?”
“Okay, that’s good. That’s the amniotic fluid. Carefully continue your incision, but hurry. You’re running out of time.”
Cautiously he continued to cut through the uterus. A few moments later, dark hair from the top of the baby’s head appeared. A momentary sigh of relief pushed his fear away; he was close.
“How are we doing, Jacob? Is the incision big enough for the baby to fit through?”
Jacob grabbed more gauze to soak up the remnants of the fluid. How is Doctor Young able to stay so calm through this?
“Yeah. I think so.”
“Now you need to reach in, grab as much of the baby as you can, and pull it out.”
“Am I going to hurt it if I pull too hard?” Jacob wouldn’t be able to live with himself if he did permanent damage to the small child. This life was innocent. He’d made it this far and didn’t want to turn back now.
“Not any worse than if you do nothing and the baby dies.”
Jacob sensed the urgency in the doctor’s voice. He focused on what to do next. Reaching in, he grabbed the baby, and tugged on the small body. The baby wasn’t budging—he panicked. “The baby won’t come out!”
“Listen to me, Jacob. You have to pull that baby out and do it now!”
This baby was sliding off into certain death. With one last heave, he pulled as hard as he could. The limp and blue baby slid out of its mother’s stomach. James stopped doing CPR, grabbed the umbilical cord clamps, placed them on the cord, and cut through it once it stopped pulsating.
“The baby is out!”
“Good. I don’t hear it crying. Have you stimulated it?”
His greatest fear was lying lifeless in front of him—a baby that wasn’t breathing. Jacob retrieved the bulb syringe and suctioned out the baby’s mouth and nose—still no breathing. James grabbed the baby and with his large fingers, compressed its small chest. His hands were twice the size of the infant. It was so little and frail. He’d done the impossible and successfully performed a C-section. He couldn’t bear the thought of losing the baby now.
Dust flew from their leather boots as the two men ran toward their ambulance. Jacob got inside first, reached down, and helped James into the back of the ambulance. Jacob placed the baby on the cot and continued to compress the chest. The silence in the ambulance was deafening. His chest constricted against his thumping heart. Vertigo hit him full force and he grabbed the cot in an effort to steady himself. He forced himself to suck in a deep breath.
Grabbing a bag valve mask, he hooked it up to oxygen, and ventilated the baby. It was a boy. With each squeeze of the bag, his chest expanded filling with oxygen. While performing CPR with one hand, James placed the cardiac monitor leads onto the baby’s bare chest; a green flat line scrolled across the screen. His heart wasn’t beating. Grabbing the pediatric kit, Jacob pulled out the laryngoscope and an endotracheal tube. As he slid the straight blade of the scope into the tiny mouth, he couldn’t see anything past the baby’s large tongue. He repositioned the laryngoscope, lifted the tongue out of way, and the white vocal chords appeared. With ease, he slid the tube past them and then secured it to the baby’s ashen colored face with a tube holder.
After what seemed an eternity of performing CPR, a blip showed up on the cardiac monitor, and then another one. Jacob’s heart skipped a beat. He stared at the monitor and his breath quickened.
“Come on, little man. You can do it. Fight!” Jacob pleaded.
In rapid succession, the baby’s heart rate scrolled across the screen. Jacob reached down, squeezed his brachial artery, and felt a strong heartbeat. The corners of his mouth tugged upward and a small smile traced across his face.
James stopped compressing the baby’s chest.
The color of the baby’s trunk changed from ashen to pink. His small arms moved intermittently, but he still wasn’t breathing on his own. After a few minutes the baby’s arms and legs changed from ashen to pink.
The emotional workout almost brought Jacob to his knees. In the near distance, the familiar sound of the helicopter approached. This was music to their ears; if only they could’ve arrived sooner. James slid a needle into the baby’s small arm. He was able to establish an IV on his first attempt, a rare accomplishment on a newborn child. After the IV was secure, he leaned back against the wall of the ambulance, his breathing slowing to a normal rate.
The flight crew, once on the ground, approached Jacob and James with their flight cot and equipment. After giving them a brief report, they whisked the baby away, and ran across the asphalt toward their air ambulance. Moments later they were airborne.
James and Jacob sat down on the bumper of their ambulance. The emotional stress took a toll on their bodies. For several minutes, neither man spoke. Several of the volunteer firefighters walked over and congratulated them. Jacob couldn’t feel proud of what they’d done. They were able to save one life, but they also lost two others. The odds of the baby surviving were grim. He wasn’t sure if the CPR was effective enough to keep blood flowing to the baby’s small body.
James placed a hand on Jacob’s shoulder. “Great job, man. I couldn’t have done it.”
Jacob rested his elbows on his knees. He tried to be a macho man and not let his feelings get the best of him, but he couldn’t hold back. The floodgates of emotions opened and unleashed their unforgiving fury upon him; he wept.
After a few minutes, Jacob peeled off the blood soaked gloves, and dropped them on the ground. He dried his eyes, walked over and picked up the cell phone, pressing it against his ear.
“Hello? Can you hear me, Jacob?” asked Doctor Young.
Jacob dried his eyes and cleared his throat. “Yes. I’m here. Sorry. We handed off the baby to the flight crew.”
“Is he okay?”
“Yes. We got him back.”
“They saved the baby!” Doctor Young yelled. He could here shouts of joy and people clapping in the background. In the midst of the chaos, for a brief moment, Jacob was happy. Realizing they faced a grim situation, kept their composure, and were able to give the baby a chance, he smiled.
“You did a great job. I’m proud of you.”
“I wish I could feel good about it, doc. Thank you for your help.” Jacob hung up the cell phone and slid it back into his pants pocket.
James followed Jacob over to the mother’s body. James pulled a sheet over her up to her head while Jacob knelt down next to her body, studying her face: her face pale and lifeless, yet so peaceful and angelic. Not more than an hour ago, she was driving down the road probably thinking about what color to paint her baby’s room. Now she was dead. It saddened him to think the child would never know his mother. He reached down and pulled a few strands of dark brown curls out of her eyes.
“You have a son. A beautiful little boy. I’m sure you’d be proud of him. I’m so sorry we couldn’t do more to save you.” A tear trickled out of the corner of Jacob’s eye.
James took the sheet and pulled it over her head.
Jacob stood up while looking down at the woman. “I’m in a lot of trouble now. I just did something paramedics aren’t allowed to do and I may lose my license.”