The pre-arranged drill was to be a simple one. The local Fire and EMS Services would provide the actual rescue scenario reenactment and the Flight Team would land, accept hand-off of the patient, load and take off for a brief spin of the athletic field. After the fly by, the helicopter would once again land, allowing the mock patient to get back to his or her everyday life and then it was Danni’s turn to address the student body seated in the stands. All told, they should be on the ground for no more than thirty to forty minutes. It was a well-planned program.


Everything had clicked and ran smoothly as planned. The person who had been the mock patient was thrilled by his flight in the helicopter, not to mention being attended to by the likes of two beautiful women. The heart of a seventeen-year-old male was easy to win, especially in such close quarters. They had landed and now the young man was the hero of his class as he paraded triumphantly off the field and into their ranks. All three members of the crew stood watching as he was met by whooping and hollering, each one thinking how excited the young man was over something that they did every day. Oh, the pleasures of youth.


As the revelry in the stands was meeting its crescendo, the odd procession of nurse, surgeon, and pilot made their way to the small stage that had been constructed on the field. It was planned that they all would be introduced to the students in an effort to show that although not all of them were medically trained, they worked as a team to deliver the patient the best of their care. It was the dream of every Guidance Counselor to show that people in everyday walks of life could make a difference to more than just themselves. The Flight Team stood on stage and waited for their names to be called as they watched the group of cheering students in the stands.


Garrett looked around the field and the days of her youth soon flooded her mind. She’d only played soccer for one season but she could still remember how it felt to come running onto the field with her parents and brother in the open-ended stands, cheering her on. 'God, what I wouldn't give for just one more day with them?'


Her attention was grabbed by the nudge she received, and the whispered command to wave as her name had just been announced. The surgeon stepped forward and obliged, then turning her attention to Danni, she waited for the young woman to deliver her speech.


The petite blonde stepped up to the microphone; she let her eyes scan over the students and teachers who were assembled there. All eyes were on her as she began. "I’m happy to say that our services were not needed here today but that doesn’t mean that safety is something to be taken for granted. Each time that any of you slide in behind that steering wheel, you hold more than just your own life in your hands."


Garrett watched the nurse intently, letting her senses drink in all that they could. She loved the way Danni could speak to the whole-assembled group but yet make each one feel as though they were the only one she was talking to. It was as if they had suddenly all become part of her menagerie. She was concerned about them and it showed. Now, it was the surgeon who was proud to be on the nurse’s team. This she could tell by the smile stretching across her face, the likes of which she’d never felt before.


Lost in a dream world of what might have been, Garrett stood mesmerized by the young woman. It was then that Cowboy leaned in and whispered in the tall woman’s ear. "Wonder what she’s looking at?"


The surgeon’s thought pattern was broken and she now studied the face of her friend. Danni’s furrowed brow showed more concern than Garrett thought necessary and she began looking up in the direction of Danni’s gaze. It was at that precise moment the mock patient of just a few minutes ago fell from the side of the stands, landing with a thud; followed by the gasps followed by the students around him. Before Garrett could react, Danni was asking in the most calm and reassuring voice for Cowboy to step up to the microphone and tell the group a little about the helicopter.


The pilot stood there, wide-eyed and in shock. ‘Hey, that’s not part of the routine,’ he thought as he watched both of his team members step off the stage and break into a run toward the bleachers. ‘What the heck?’ Then Cowboy saw the commotion to the left of the bleachers and realized that he had been handed the most important part: to keep everyone calm and out of the way of the medical personnel. He hurriedly stepped up to the microphone and began to speak. "Well, let me tell you what this little baby can do if you really need to get somewhere in a hurry." He laughed and pulled out from his memory any story that he could think of to hold the students’ attention.


The Flight suited pair came up to the victim within seconds. The commanding tones of the surgeon parted the crowd of onlookers as they made their way to the young man who was being attended to by several of his instructors. The angle of his arm and the spattering of blood on the ground about his head were enough for the surgeon to know the severity of the fall. She determined his point of impact to be first the arm and that fractured under the stress. His head then took the remainder of the force associated with the fall.


"Okay, everybody step back. Please, give us some room to work." Garrett announced as she made the final steps to her now-real patient. "Danni, you’ve got the head until someone from EMS gets here." She glanced at his chest and watched for the rise and fall of it. "He's still breathing on his own."


The nurse slipped in behind her and steadied the patient's head with her gloved hands, protecting him from any further injury due to a traumatized spine. "Has someone called for EMS?"


One teacher stepped forward in answer to her question. "Yes, I sent one of the student's over to their vehicle. Is Richie going to be alright?"


Blue eyes met with green and the exchange of thoughts was done. Danni spoke calmly as the surgeon continued with her assessment of the patient. "We're going to do the best we can for him."


By the time that Garrett had made her initial assessment, the EMS personnel arrived with their equipment. She was quick in directing them in the patient’s care. After a fast splinting of the arm and the further protecting of his cervical spine with a collar in place, their next priority was to get him onto a backboard and packaged for transport via helicopter. Danni kept a constant vigil over the young man's vital signs, reporting any of her concerns to the Flight Surgeon.


With the patient strapped onto the board, Garrett did one last round of neurological checks. After clapping her large hands together in front of his face, she yelled out his name as she bent closer to his ear. "Richie…Richie can you hear me." She paused for a brief moment, seeing no sign of reaction to the noise or to his name, the surgeon moved on to the next evaluation of his status. Taking her thumbs, she found the small-notched bone in the supraorbital rim. Pushing on it to elicit pain, she waited for a reaction of any sort. 'Come on, blink…open up those eyes.' But again, nothing happened.


"Gar, his respirations are becoming a bit labored." The nurse cautioned.


Garrett nodded and continued on in her quest as she placed her fingers in his uninjured hand. "Richie, squeeze my fingers if you hear me." She repeated herself but again there was no response. "Damn it, Richie, move something." Her frustration was getting the better of her as she thought about the reaction of the parents once they found out the severity of their son's accident. Only a few moments ago, she had been wishing to spend one more day with her parents. How could she let him not have that and more now? Making a fist, the surgeon roughly ran her knuckles up and down his sternum in the middle of his chest much like the washboards of early twentieth century. It was a painful experience for someone who had sensation, but again, the young man was motionless to it all.


"How's his breathing, Danni?"


"It's becoming more labored as we speak." She assessed her monitor. "His heart rate is up in the 120's. He's cool and clammy to the touch."


"Neurogenic shock." Garrett looked to the EMS providers now. "Do you have intubation equipment?"


The young woman nodded eagerly, "Yeah, Doc. Right here."


"Good, then let's get him intubated before we load him into the ship." She walked to the head of the stretcher and accepted the offered equipment. "Danni, can you give me a little pressure over the cricoid, please?" She opened the laryngoscope and positioned it in her hand. Then she slid the blunt straight blade of the scope into her patient's slightly agape mouth and followed the tongue to the back of his throat using the instrument to prevent his tongue from dropping into her view. The tiny but bright fiberoptic bulb lit her way into the darkened region of his throat as she searched for his vocal cords and where to place the tube for his breathing.


"Press a little harder, Danni. That's it, I see them. Give me the tube."


The size seven and a half endotracheal tube was pushed into her hand after having been approved by the nurse who made sure the small retention cuff on the end worked. Taking it, Garrett inserted it through the cords and into the trachea, letting the blade slip out of the patient's mouth, then pulled out the stylet that was used to hold the flexible plastic tube’s shape as it was inserted. The surgeon held on firmly to the tube so as not to lose her placement of it as Danni inflated the small retention cuff once more only this time to hold it in place. "Okay, let's bag him. Danni listen for his breath sounds."