PHANTOM OF A CHANCE (Part 2/?)
By Missy
(missy@lexicon.net)

DISCLAIMER:
See Part 1

WARNING:
This story does get rather gory and explicit in terms of
injuries sustained.  If you are under 15 years or have a weak
stomach for details, I would think twice about reading this. 
But then again, if you watch ER, you can't be too bad <g>

Many thanks must go to my editors Susan Drake and Carolyn
Delaney for their tireless and marvellous editing and for
providing me with wonderful suggestions for the story.  

PART 2/?

Kerry dropped down awkwardly onto her right leg from the
open rear door of the BMW.  The car had sailed over a
crushed Toyota Camry into the front cabin of the truck.  She
angrily pushed the numbers for 911 again.  It had already
been ten minutes since she her initial call, and probably
countless others she thought as she scanned the ever
increasing crowd.   

There had been no chance for the truck driver with the flying
mechanical missile coming through his cabin.  Both the
driver and passenger were alive but with very shallow
breathing and weak pulses.   Their windshield had imploded
on impact causing multiple deep lacerations to their upper
torsos with one large jagged piece imbedded in the male
driver's chest.   Neither were conscious, which was probably
a blessing for them both.

With the Camry, there was no chance to even check on the
victims trapped beneath the BMW and tanker cabin.  Kerry
shuddered at the thought of their condition. 

"This is Dr. Weaver.  I'm at the accident scene at the corner
of S. Western & Archer Avenues.  Where the hell  are the
paramedics?"  Her tone begged no argument or excuse.  She
didn't have the time to hear it.  There was a pause as she
listened to the operator.  "Two minutes.   Make sure that's
for the fire department and the haz. mat. team. as well!"

"Dr. Weaver."  Carly came up to her as she finished the call. 
"The injuries to the victims in the other cars appear to be
minor apart from one.   There's a fifty year old man
complaining of chest pains."

"Radiating?"

"Not at this stage but he's in a considerable amount of
distress."  

"Probably shock from the accident.  Give him an aspirin and
keep an eye on him.  If the pain starts radiating, get me." 
There wasn't much more they could do for the man if he was
suffering a more serious heart condition without back-up
equipment and medications.  Carly could do just as good a
job as she would be able to.  She would have preferred to
have had him in the hospital and on cardiac monitors.

Kerry pocketed her cell phone once again.  She pulled off the
blood covered gloves, making sure they were turned inside
out since she had no hazardous waste basket to dump them
in.

Wailing sirens, their cry rising and falling, filled the air. 
Kerry was relieved that they would finally be able to do more
to help the patients than their present makeshift efforts.  Her
attention was diverted as a scream of agony came again from
the Chevrolet Suburban half crushed beneath the tanker. The
roof had been compressed to half its usual height at a forty-
five degree angle.  All the glass windows had exploded,
leaving splinters and shards in all directions.   Metal twisted
in all directions, the cabin no longer recognisable as such, the
right rear wheel from the BMW lodged in the driver's side
window.    

"Someone get me out of here!"  came the agonised cry. 
"Don't let me die in here."

Although understanding the pain the girl must be in, she
didn't need her terrifying Katie, whom she had only managed
to calm down minutes before.

"Calm down!  I'm a doctor." She spoke not in her usual soft
tone but in a direct voice meant to cut through the fear. 
"Okay, that's better."

Although the girl was still crying uncontrollably, she had
ceased her screaming.  

"I'm going to come in and have a look at you but I want you
to stay still."  Kerry had found  that the girl was on the floor
of the van.  The other two occupants in the rear of the
Suburban made no noise and Kerry didn't hold out much
hope for them, even if they were alive.  It was miraculous
that the girl on the floor had survived with the crushed state
the van was in.

Reaching in the smashed window, she dropped the first aid
kit to the floor.  Using her crutch as support, she pushed
herself up and through the tight squeeze made by the
crushing effect on the window.  She detached her crutch from
her wrist to drop outside.   Although she pulled herself
through carefully, she still landed on the ground heavily,
slivers of glass impregnating her hands.

Dusting herself off as best she could, she stretched out and
grabbed the first aid kit.   Taking a quick look towards the
front cabin as she did so, her suspicions were confirmed. 
The two young men, teenagers really, had no chance of
survival.  Their bodies had been ravaged by the trauma they
had sustained.   Vivid streaks of crimson blood and gore
coated the dashboard and large fissures of what was left of
their skulls bore testament to the irreversible damage.

The  two victims in the back also stood no chance of
survival, their bodies were crushed and dismembered in the
mass of twisted metal that had ceased to resemble any part of
the vehicle.  Blood ran in several streams meeting at the
junction near her feet and cascading through the break in the
floor to form a small red waterfall.   Even though she was
used to seeing trauma every day, she felt the bile rise in her
throat at the enormous loss of life from this one accident. 
Awkwardly she crawled up the aisle beside where the
teenage girl had been thrown onto the uneven floor.  Blood
seeped through both their clothes, staining them in dark
patches.

"Hi."  Kerry said gently as she slipped on another pair of
protective gloves..  "What's your name?"  

"Kirsty.   Kirsty Wilson."  the girl spoke with difficulty, her
breaths coming out in short gasps.  She gave a couple of half-
hearted coughs, crying out at the pain.

"Okay.  I'm just going to listen to your chest."  Kerry put the
stethoscope to the girls chest. Moving the stethoscope across
her chest and listening, Kerry noted that the girl had no
breath sounds on the right side.    Gently she felt down the
ribcage and found several broken ribs, one of which had
probably punctured the girl's lung.

"Kirsty.  I'm just going to get some paramedics to give me a
hand."

"Don't leave me."

"I'll be back." Kerry replied forcefully as she crawled back
towards the window, ignoring the sobs coming from Kirsty.

Dropping to the ground with a crunch, Kerry winced at the
pain which shot up through her leg and reverberated up her
spine.  She clenched her teeth firmly together and picked up
the crutch she had discarded earlier.   It was covered in the
chemical fluid.  Kerry consciously tightened her hand around
the handgrip as the rubber tip slipped on the fluid causing her
to struggle to maintain her balance.  

The fumes from the fluid were at least being diluted by the
misty rain but it still caught the breath in her throat.   A raspy
wheeze rattled in her chest.   Heading around the back of the
vehicles, Kerry found Elizabeth inside the passenger seat of
a four wheel drive that had skidded into the mass.  

"What've you got?" Kerry looked past Elizabeth at the
victim whose central chest area was covered in blood.

"GSW to the chest." Elizabeth answered shortly.

"What!"

"You heard correctly.  Here."  Elizabeth passed her a small
calibre handgun.  Kerry took it from her dubiously, handling
it with extra care.   Elizabeth smiled.  "Don't worry, Kerry. 
I've removed the bullets.  Plus, the safety's on.   I didn't feel
like adding myself to the list of victims."

Relief flooded through Kerry and she gripped the gun more
firmly but was unsure of what she should do with it. 
"What're his vitals?"

"BP's 90 palp.  Pulse is strong and steady.  No other obvious
signs of injury."

"How about the others?"

"Family of eight in the Futura wagon.  Both parents have
chest and lower extremity injuries, possible spinal injuries as
well.  Twelve year old girl with compound fractures to both
legs, two five year olds in the rear seats are dead, eight year
old in the front has massive head and chest trauma.  Other
two seem fine.   The Taurus has one deceased male and a
female with abdominal injuries.  She's been impaled by a
golfclub."  Elizabeth rattled off the details quickly and
concisely.

"Damn.  This accident just gets worse by the minute.   Where
the hell....... I'll just go and  get the paramedics."  Finally
giving up on what to do with the gun, she slipped it into her
pocket, glad once again that she always made sure her pants
were well endowed with pocket space.  It was one of the
disadvantages of her disability that one hand was always
permanently occupied and this was her solution to the
problem.

The police cars, fire trucks and ambulances where lining the
intersection in all directions.  The scene was now being
cordoned off from the general public and there appeared to
be some semblance of order coming into force.  Kerry was
making her way across to the closest ambulance when a
shout stopped her.

"Hey, you'll have to get back behind the tape.  This is an
accident scene."  

Kerry turned toward the owner of the authoritative voice and
recognised the distinctive epaulets of the fire chief.  She
turned and approached him with her firm and purposeful
stride.  

"I'm well aware of that.   Dr. Kerry Weaver, County General. 
I was here at the time of the accident." 

His eyes travelled over her clothing, besplattered with blood
and the chemical, giving a rough assessment of her and
paused noticeably at her crutch.

"Don't judge a person by their looks."  Her tone held a firm
warning.

He looked sheepish at having been caught.  "I'm sorry. 
Captain Donnegan."  He held out his hand in apology and
Kerry gave it a quick conciliatory shake.  "So what've we
got?'

"A mess,"  Kerry stated and continued to give him a run
down of the situation and was just finishing when they were
interrupted by one of the firemen.

"The tanker was carrying petroleum."

"Damn," Captain Donnegan swore.  It negated the use of any
of their high powered equipment to release the victims.   This
was going to require the utmost diligence from all team
members if the victims were to be brought out alive.

As one of the paramedics rushed towards the scene laden
with equipment, Kerry called out to her to stop.   "Doris! 
Come with me.   I've got a victim I need to intubate."

Doris stopped following her partner towards the scene,
surprised.   She recognised the voice of the abrasive
attending from County General although she was trying to
recall the doctor's name.  Doris was astounded that the red-
haired doctor remembered her own.  She had borne the brunt
of her sharp tongue more than once, but had never heard her
use her own name on those occasions.   Although she
disliked the doctor, she had witnessed her work in the ER
department and acknowledged how competent she was.  She
knew that if she was ever injured, she'd be happy to have this
no-nonsense doc on board.

Her partner noticed her hesitation and waved her off to
follow the efficient doctor.  As Doris caught up with Kerry,
her emergency kit banging sharply against her legs, she
noticed how the doctor was aware of her presence.

"You're not claustrophobic?"

"Not that I know of." Doris was unsure of what she meant
until they got up close to the tanker and the devastated mass
of cars.    At the edge of the scene, she had barely given
thought to the tragedy held in the grips of the twisted pile of
metal.  Now she recoiled at the blood which was freely
mixing with the chemical spill, the occasional foam bubbles
on the surface an eerie shade of red.  

"Right.  We've got a fifteen year old girl with a
pneumothorax in the rear of the Suburban.   It's a tight fit in
there."  Kerry warned as she once again balanced herself on
the edge of the window frame and slid inside.

Kerry's crutch bounced on the ground with a sharp metallic
zing.  The sound brought Doris' mind back into focus on the
accident and her priorities.   Doris was ready for Kerry when
she put her hand out for the emergency kit and knew without
a doubt that she was expected to follow Kerry into the
crushed van.

Holding her breath, she mimicked Kerry's own moves to get
in through the window and was glad for her tomboy days. 
Doris dropped to the floor gently and waited a moment for
her eyes to adjust to the dark shadows.  As her eyes absorbed
the interior of the van, her stomach recoiled at the carnage
within the twisted wreckage.

Kerry, glasses now perched on her nose, looked across at
Doris wondering why she hadn't moved and noticed the
colour drain from the experienced paramedic's face.

"Doris, get ready to bag her.  I've lost her pulse."

Kerry's firm voice broke through Doris' shock and she
crawled her way awkwardly over the sharp fissures in the
floor, wincing as one of the rough edges tore through the leg
of her trousers.

Kerry opened the teenager's mouth and carefully inserted the
laryngoscope.  Finding the vocal cords, she peeled the sterile
cover off the endotracheal tube and began working it down
Kirsty's throat and into her trachea.   Doris was ready with
the ambu-bag and as soon as Kerry pulled back from the
young girl's mouth, she connected the tube to the bag.

By this time, Kerry had moved to Kirsty's side and
commenced CPR, counting.  She heard the ominous cracking
of another rib under the pressure of her compressions.  They
worked together in syncopation, five compressions to every
squeeze of the bag, Doris regularly checking for a pulse.

"Okay Doctor........er..... I've got a pulse."  

"Kerry."  Kerry said shortly, her breath coming in short
spurts after the effort of the compressions.  She put the
stethoscope to the girl's chest and she listened. 

"What?"  Doris had automatically increased the
compressions on the bag once Kerry had ceased her
compressions on the girl's chest.

"My name's Kerry." she responded as she looped the
stethoscope once again around her neck.

Doris felt the heat rise in her cheeks and was annoyed with
herself for letting Kerry know that she wasn't aware of her
name.  She had hoped to be able to find out through her own
avenues.

Kerry ran through her routine, checking blood pressure and
murmuring the results for Doris' benefit.  Both knew this
first hour was critical to Kirsty's survival and they needed to
get her out and to a hospital if she had any chance.   She
inserted an IV into each of her arms, hung them on the
contorted remains of the seats and ran them wide open.

"Hey Doc!" 

Kerry finished checking the IV bags to make sure they were
running safely before looking across at Captain Donnegan.

"How is she?"  Captain Donnegan was sturdy and well-
muscled.  He had the look of a man who wasn't just a pen-
pusher, but a leader who could work shoulder to shoulder
with his men in the field.

"She's got a collapsed lung, multiple internal injuries and
probably spinal cord damage.  I need to get her to a hospital."

"It's going to be a while.  We need to stabilise the tanker
before we move any of these cars."  He looked at the roof of
the van and realised the precarious position it was in.   The
tanker rested heavily on the crushed roof.  

"Just get us out of here as soon as possible."  Both of them
had turned from each other as soon as Kerry's words were
out of her mouth.  They  immediately immersed themselves
in their respective jobs at hand.  Neither had time to waste on
idle conversation and their brusque manner conveyed it to all.

Captain Donnegan's prediction that they might be trapped for
a while helped Kerry made the decision that she had been
struggling with.  Searching through the emergency kit, Kerry
found some of the items she would need and improvised with
the ones that just were not in a paramedic's kit.   While she
would have preferred to be doing this in the ER with all
necessary equipment, this was what she had trained for and
in Africa, she had managed with a lot less.

"What're you lookin' for?" Doris was watching, wondering
what she was doing.  Kerry opened  an endotracheal tube and
laid it down on the top of the kit beside a pair of scissors and
scalpel.  She tore off several long pieces of tape, sticking the
ends lightly to the edge of the kit.  Finally, she lifted out the
portable suction unit, mainly used for clearing blood or
secretions from mouths, but would in this instance be put to
an entirely different use.  It appeared to Doris that Kerry was
setting up what was fast looking like a make-shift operating
tray.

"I've got all I need to put in the chest tube."

"Here?"  Doris' voice rose a notch.   She didn't know the
first thing about putting in a chest tube and wasn't sure she
wanted to know either.  But she did know that the risks of
infection in this environment were enormous.

"If I don't, she'll die."  Kerry stated matter-of-factly.

Moving the emergency kit close to her side with it's lid as a
makeshift instrument tray, Kerry cut through the teenager's
clothing spreading it wide and clear of where she was to
operate.   She swabbed the area with alcohol wipes, ready for
the incision.  Holding the scalpel steadily, she took a deep
breath before she made the incision into the upper left side of
Kirsty's chest between the fifth and sixth intercostal space. 
Through the neat cut, she inserted the endotracheal tube. 
Holding it steady with her right hand, she pulled the tape off
the kit and firmly taped the tube in place with six of the
strips.   The ET tube curved slightly upwards, not allowing
the blood to flow down the tube.   Kerry had been prepared
for this and connected the suction unit to the end of the tube,
turning it on and creating the suction needed to drain the
blood filling the girl's lung and keep it expanded.  She gave
a small smile of triumph when the blood surged up and over
the curve.  Listening to Kirsty's chest once more, she was
pleased that she could hear breath sounds on both sides.  

However, there was an ominous groaning and grinding that
filled the air around them.  Kerry and Doris' eyes met, both
realising the source of the sounds as the roof above them
began sinking under the pressure of the tanker.

End Part 2/?