#vfib

She had crashed through the double doors into the main foyer of the trauma centre, barking at the nurse’s station to call the code red and alert the blood bank. She was still running to the front entrance, for the grab bag that was positioned there. Sarah intercepted her. "Trish, Dr Stelling already put a blood order in?" The younger nurse said, the question in her voice.

Trish stumbled to a halt. "It's not for..." She couldn't bring herself to say his name, "him. He...He stabbed Anna!" She cried aloud.

Everyone paused for an eternal moment, staff gasping in shock, patients confused and concerned. Trish took a shuddering breath, on the edge of breaking down completely, when a steady, authoritative voice joined a hand on her shoulder.

"Where?" Jones' single calm word grounded her.

"The top of the stairwell, by the helipad." Trish said. Jones looked to Sarah, who nodded, knowing where she meant.

"Lucy!" He shouted in the direction of the front door. Trish looked over seeing the paramedic already grabbing the kit from its alcove.

"Jessica, get a gurney!" Sarah shouted in another direction. "Mark, call that Code Red to Trauma 3 then get there yourself!" He was senior to her, but he didn't argue, reaching for the phone.

Trish was barely following their actions, trying to process everything. Jones pushed her through into the trauma wing, to the elevators, hammering the call button. "Focus." His solid tone got through to her. "She needs you." Trish blinked a few times, then nodded. The others had caught up just as the elevator arrived and they piled in, Trish claiming the grab bag from Lucy.

The elevator took an agonising eternity to lift them to the top floor. As the door opened and they stepped out, Trish could tell it was as bad as she had seen from the stairs. Worse even. But the limited time she'd had to process the situation was enough for her to act while the others froze behind her. She stepped forward and threw the bag down to cause a loud thump. It had its desired effect.

Hearing Carl describe Anna's situation and seeing her friend's pale blood-stained chest shook her, but she clung onto Jones' words as best she could, even when she pressed the gauze against Anna's abdomen and got no response to what would have been agonising pain.

While the others got ready to lift Anna onto the waiting gurney, Trish kept her hands pressed tightly to the wounds. On Carl's order they lifted their colleague, her sheared scrubs still hooked around her arms, onto the gurney, raising it up a moment later. They gathered the equipment and began to move towards the elevator. Trish glanced back.

She wished she hadn't. The pool of blood was big. Mortally big.

* * *

As they pushed the gurney towards the elevator Carl was keeping one eye on the monitor, and one hand on hers, but his gaze shot to Anna's face when he heard a tiny whimper. For a moment he thought he had imagined it, but then he saw the mildest flutter of her eyelids.

"It's ok Anna, I'm just helping you breath." Sarah told her, leaning close over her head as she closely followed the gurney, squeezing the ambu bag smoothly.

Carl felt a flutter of relief. She was still responsive. Once they got the rapid infuser connected they could stabilise her and get the surgeons to fix the damage. It was wishful thinking. As the elevator doors closed, the monitor let out a warning tone, that switched to a full-on alarm before Carl could even read the screen. The ecg was still flickering away with a rapid rhythm, but the pulse reading had flattened.

"Pulse check!" He shouted, as he grabbed her hand, reseating the finger sensor in the vain hope that he had accidently dislodged it. The screen didn't change. He looked at the others, the pained expressions on their faces telling him before they could even shake their heads. Anna's heart was no longer pumping blood.

"PEA arrest! Get on her chest!" He commanded Jessica, trying not to scream as he reached for the shears in the bag.

Lucy steadied the tall nurse as she climbed up to kneel beside Anna, weaving her hands together, waiting just a moment for Carl to snip the centre of Anna's bra the bottom edge lined with wet red. The cups popped apart, clearing her sternum, replaced an instant later by Jessica's hands, which immediately thrusted down, bending Anna's ribs inwards and compressing her heart.

Carl was again reminded of their play session the prior weekend. His half compressions making Anna's belly pop in a counter rhythm. These compressions were real. Each 2-inch pump forced Anna's entire slim abdomen to bulge. They came at such a rapid rate that it produced an effect akin to rolling waves across her ghostly flesh, with enough force to pop Trish's hands as they held the bandage tight to Anna's wounds. Carl tore his gaze away from his love's distending stomach, looking instead to the monitor.

The ecg waveforms were becoming unstable, the lack of a true pulse and the savagery of Jessica's compressions turning the electrical rhythm into a chaotic storm of spikes. The reading from the pulse ox was marginally more encouraging, the compressions producing waves on the line. They were small, but at least they were there.

"Tell me the rapid infuser is waiting for her." Carl said, looking at Trish.

Before she could respond, Sarah spoke from Anna's head. "Mark is on it, Trauma 3. It'll be fully loaded with O-neg." She said. The detached medical professional inside Carl was impressed by her confidence. The emotional part merely prayed that she was right, concerned only for the beautiful woman that was in cardiac arrest before them all. He lowered his head, gripping the rail of the gurney, the alarming noise of the monitor that filled the compartment cutting through his soul. He took a breath, unintentionally synchronising with the woosh of the ambu bag as Sarah squeezed it firmly, grasping for the professional side that Anna needed right now.

"As soon as the door opens we move. Jessica get a more stable position." He said as he looked at the display above the elevators control panel. Jessica finished 30 compressions, using the brief interruption of another bagged breath to loop a knee over Anna's hips, straddling the dying nurse.

The display ticked over. The elevator rumbled to a stop, letting out a ding as the doors started to slide open.

* * *

Geoff, a member of the facilities team at Riverside hospital, kept himself to himself. He was good at cleaning. Meticulous even. He should take pride in it, others would say. It seemed a strange response to him. Everything had a proper state. He just got things back to how they should be. He had just finished cleaning up Trauma 1 and was moving down the corridor. Apparently there was an incident in the stairwell that needed cleaning. It didn't bother him. Better to be doing something than sitting around. A lot of the others, especially his boss, complained when the medics called for something. Geoff didn't. It gave Geoff a good reason to not sit around with the complainers. He was playing a tune in his head, his fingers tapping the handle of his cart, he didn't know what it was called, he'd only caught a snippet on the radio in the office, but it was catchy. He turned, about to push the stairwell door open with his hip, dragging the cart behind him, when there was a ding from the elevator just a few yards away.

"Move! Move! Move!" Geoff heard the shouting first. Then the screeching alarm. It was a lot of noise. He didn't like noise but working here he was used to it. He did what he was always did. Get out of the way, and let the noise move away from him. He pulled the cleaning cart parallel to the wall, giving them as much space as possible. A gurney was pulled out of the elevator, making an impressively quick turn to head down the hall. Someone was riding on top of it.

That was odd. Not unknown, but odd. It made Geoff pay extra attention. The gurney was big, hard to accelerate. Geoff rarely paid attention to patients, their problems were their own, not his. But that gurney spent so long in his view, that he couldn't help but see the person on it. He would have just let it slide beyond him, gazing past it, except he saw a particular shade of blue. A very familiar shade of blue. He was surrounded by it every day, nurses coming and going. Asking him to do x, y or z. They were usually beside a gurney though. Not on it.

It piqued his attention even more, in that brief time. He noticed the blue giving way to black. Again, that black was common enough, as spots and splashes. That much though. That wasn't normal. Especially next to bright vibrant red. Something was very wrong. The gurney built up speed as it passed him, and he got a momentary look at the face of the person on it. Even with the rubbery mask over her mouth and nose, he knew those eyebrows. That hairline. It was one of the nurses. One he liked. One of the kind ones. She didn't treat him as something less. She never shouted or snapped her fingers, but she also didn't assume he was stupid. He was different. He knew that. But she treated him like he was at least close to normal. She told him what she wanted him to do, clearly, but without being condescending. He enjoyed doing those jobs for her. It would be nice if she was his boss instead.

And yet now she was on a gurney, with another nurse on top of her, hands pressing on her chest. The annoying alarm coming from a machine that had a group of wires connected to her. It was a bad sound. He knew that much. Something bad had happened. To her. Geoff hesitated. He wasn't sure what to do. He froze, watching the gurney as it rushed down the corridor toward the other trauma rooms.

Geoff didn't know what to do. Obviously he couldn't go and help. He'd just be in the way. He should be doing as asked but couldn't seem to open the door. Someone stepped up close to him, dressed in a lot of black. Or was it dark blue? He said something, a stony expression on his face, like a gargoyle, but everything had happened so quickly, Geoff was still confused. The man in black looked at him for a moment, then his face became human.

"Can you stop anyone from using the stairs, until I get some tape?" The man in black asked him.

"I was meant to clean something." Geoff stated. That was what he'd been asked to do.

"I know." The man in black nodded. "Can you stop anyone going in until I tell you though? It's important."

Geoff considered it for just a moment. The man in black seemed distracted. Geoff felt distracted too. He wondered if they were distracted by the same thing. "I can do that." Geoff told him, nodding in reply to the nod of the man in black. It seemed weird to him, bobbing your head to say yes, but he'd learnt what it meant, and it seemed to help when talking to other people.

"Is er...Is she going to be ok?" Geoff was surprised at himself. He didn't usually ask questions, but she was nice. He liked her. She should be ok, right? Being nice was a good thing and more good things happened if you were good. Right?

"I don't know. I really don't know." Officer Stone replied, his voice strained and weary, watching the gurney pivot and crash through the doors into trauma 3.

* * *

The double doors clattered open as the gurney slammed against them, swinging back easily as hands reached out to push them further. The team lined the gurney up next to the trauma bed, dropping the rail.

"Get ready to move her over." Carl ordered, watching the team take up position around the beds. Sarah dropped the bag, uncovering Anna's slack, pale lips. Trish maintained pressure on the bandage and Jessica continued compressions from on top of Anna's lifeless body. Everyone else reached under her, supporting her shoulders, waist and legs.  "Ready Jess." Carl said, the young nurse nodding.

"27...28...29...30!" Jessica counted out, before un-straddling Anna, getting out of the way of the others.

The team half lifted, half slid Anna across to the wider trauma bed, her blood-stained clothes dragging along with her. Trish was leaning across the gurney, keeping her hands on Anna's belly until Lucy, stood on the other side, reached over and replaced her. Jessica shuffled across to kneel beside Anna, resuming compressions just a few seconds after she had stopped. Carl disconnected the monitor, grabbing the wires and leads to plug them into the bigger monitor that hung over the trauma bed as Jones removed the unneeded gurney.

"Cut the rest of her clothes off!" Carl commanded. "I want full peripheral IV's, both arms, both legs. Is that infuser ready?" He asked, looking at Mark. The nurse shut the last container and nodded. 4 bags of O-negative blood ready to be forced into Anna's body, to replenish what she had lost. "Rush a sample for cross matching." Carl told him.

Trish ran some shears down Anna's black pants, reducing them to ribbons. Her shoes were pulled off along with her socks, baring Anna's feet. A couple of snips took care of her underwear. Carl fought his own shears through the looped fabric over Anna's shoulders. Within a minute of giving the order, Carl was looking down at Anna, the love of his life, lying totally naked before the team. She'd always been pale, long hours and night shifts precluding any sort of decent tan, especially at the tail end of the winter months. Now she was beyond pale, her body effectively drained of colour. Because it was drained of blood the bright crimson trails on her skin the only thing that wasn't a ghostly grey.

"Use the IO gun." Carl told Trish, as he grabbed Anna's limp arm and an IV kit, poking the needle in quickly. He grabbed the lines from the infuser, hooking up the first two, looking down at Anna's legs as the IO gun punched a wide bore access into her thigh bone. Trish reloaded the device as Mark secured the cannula taking another line from Carl to connect it. The second IO port was done in 30 seconds, the rapid infuser switched on to pump blood down all four lines into Anna's body.

"Pulse check after this cycle." Carl said, as he stepped back to grab a pair of purple gloves, sliding his hands into them.

Jessica beat down her hands, crushing Anna's sternum five more times before pulling back slightly. Hand pressed into pulse points at Anna's neck, wrist and inner leg, as every head looked up at the large monitor. The waves of the compressions disappeared from the pulse line, the chaos of the ecg trace also reducing. It still squiggled randomly.

"V-fib on the monitor. Charge to 200 and hand me the gel pads! Continue compressions and get a round of epi ready!" Carl said, taking a slim packet from Trish as she turned a dial on the defibrillator that sat upon the crash cart. Carl ripped the sterile packaging, peeling a shiny orange gel pad from the backing, placing it next to the electrode on Anna's right shoulder. The other he nestled on her side, just beneath her left breast. Pads in place, he turned and grabbed the large black paddles from the machine that was letting out a rising tone as its capacitors charged.

"Charged at 200!" Trish announced as the defib let out a double beep.

"Everyone clear!" Carl looked across Anna's body. Jessica had slid off the bed, Sarah held the ambu bag in the air, and Lucy raised her hands.