seconds later, he took the cuff off and moved the earpieces of his stethoscope from inside his ears to around the back of his neck.
“Forty-six over twenty-eight,” he said. “She’s in serious trouble. I need to get her on oxygen and get her to the hospital. I don’t think she is going to make it.”
As he was reaching into his bag for the second time, the woman on the floor tensed up. Her body went rigid for a second and then completely relaxed and her head canted slightly to the right. While Lawrence was setting the oxygen flow on the regulator, I watched the woman’s pupils slowly dilate. Lawrence placed the clear mask over her nose and mouth. I noted the absence of fog adhering to the inside of the mask. The fog, normally present, resulted when warm, moist air being exhaled contacted the cool rubber mask, causing a vapor to condense on the inside.
Lawrence noticed the signs, too. He felt for a pulse again. His fingers moved around her neck, obviously not finding what he was searching for.
He quickly reached into his supply bag again and withdrew an Ambu bag which was attached to a face mask. He placed the face mask over her nose and mouth.
“You start the chest compressions and I’ll breath for her,” he said frantically.
The county couldn’t afford a second person on the ambulance. Normally ambulances have two people who work together to stabilize a patient. One person would then drive to the hospital while the other attended the patient in the back during the trip.
Since our ambulance was a one man team, I was accustomed to helping stabilize patients prior to transport. When Lawrence and I performed CPR, I always started out on compressions.
I interlaced my fingers and put the palm of my right hand over the back of my left hand. I leaned over the woman and placed the palm of my left hand over her sternum. I allowed the weight of my body to come down on her chest, causing it to collapse. Then I took my weight off my palms, allowing her chest cavity to rebound to its normal volume. The idea was to mechanically contract the chambers of her heart, causing it to move blood through her body.
By the time I had performed thirty repetitions, Lawrence had connected a line from the oxygen tank to an inlet in the Ambu bag. Our artificial respiration wasn’t nearly as efficient as her own breathing would have been. The increased oxygen levels in the Ambu bag would help offset our inefficiency. I tilted her head back to open her airway as Lawrence pressed on the face mask to make a good seal and squeezed the Ambu bag two times. With two breaths delivered, I continued chest compressions.
After four compression breath repetitions, Lawrence advised me to check for a pulse. I felt her neck for a nonexistent heart rhythm. “Nothing,” I said.
Lawrence grunted from the strain of standing and stated, “I’m going to get the defibrillator from the ambulance.”
“Use that one,” I said, pointing to the green box hanging on the wall below a white sign that read “A.E.D” in red letters.
Lawrence pulled the box from the wall while I continued chest compressions. He opened the box, revealing a device that had an LCD display above a keypad. It also had a foil packet that was connected to the device with a white, plastic-coated cord. He pushed the power button and we were greeted by an electronic voice, “Unit OK.” The voice paused for two seconds, and then continued, “Adult pads,” another pause, “Stay calm…Check responsiveness…Call for help…Attach defib pads to bare chest.”
Lawrence pulled a pair of scissors from a pocket on the thigh of his pants and quickly cut through the green, silky fabric of her shirt. The machine repeated, “Attach defib pads to bare chest.”
After he had cut the shirt from top to bottom, he pulled the severed fabric to either side, revealing the skin that covered her slight frame.
“Attach defib pads