"I can't breathe!"

The patient looks like crap. Pale, cold sweat and her lips are blue. She looks about 80 but her worried daughter says she's 55. I look up at my partner. She looks just as worried as the daughter. The patient is in the tripod position and working hard to breathe. She's wincing.

"Does your chest hurt?" I ask.

She nods

"Have you had heart trouble before?"

Her eyes are screwed shut and she's nodding.

"Mom had a heart attack last year!" Says the daughter, her voice rising with anxiety.

"I'll...uh, i'll go get the cot." says my partner and she's gone.

Next I'm in the back of the ambulance with the patient. My partner has closed the doors on us with a finality that gives me a chill. Through the window I see the anxious face of the daughter.

I grab and IV bag and a needle but it's huge. Somehow I can't figure out how to put the two together. Isn't there a tube that goes between?

The patient codes. Falls right out. Dead as a doornail.

Shit!

The ambulance is rocking as we head out the winding streets of the suburban enclave.

Shit!

I grab my Lifepack 12 and a set of electrodes. The wires are a mess and the electrodes won't stick. The patient slides off the cot on a hard curve and I fight to get her back on. Where the hell are the straps???

Shit!

Somehow she's got an IV in her arm. A good one too. Thank god.

I ventilate and do chest compressions for 1 minute and then grab the drug box.

I open it and all the vials are black, red and green. No labels. Nothing. Just rows of bottles filled with red, green and black fluid.

Shit!

I don't even know what I'm supposed to give her! Or how!

We take another corner and the side door flies open. The lifepack bounces down the steps, pulls the leads off the patient and I see it skittering across the pavement of the shoulder before it's gone behind us.

Now it's raining and we're sliding all over the place.

Shit!

Drugs!

Shit!

Do I have an AED in this rig?

SHIT!

My patient has the dead stare. She's looking right at the overhead lights and lolling around the cot with each bump and swerve.

Did we just hit something?

Shit!

Is that hail????

Shit!

She's been pulseless for how long?

Shit!

What the hell am I doing?

SHIT!

I wake up with a start. Herself is quietly breathing beside me. My heart is pounding. Despite the over powered air conditioning in the house, I'm soaked with sweat.

I get up to get a glass of water.

What the hell am I doing? Am I going to make it? There's so much to learn, so much to know. Gear to learn, drugs to memorize, signs and symptoms to learn. The sheer volume of information to absorb is staggering.

Is there any way possible I can do this? Logically, I know I can.

Focus and Discipline.

But late at night, I wonder...

--maddog