A/N: Please see the notes at the end for where this story came from. As a writer and as a medic, getting this part of the content right is quite important to me.
Content warning: temporary character death, CPR written from personal experience of doing it multiple times.
KKRAAAAABOOOM!
“We didn’t back off far enough!”
Already running for the lee of the parked Spectrum Pursuit Vehicle, Scarlet had just enough time to process the thought before the shockwave hit, tossing him and Blue to the ground like ragdolls and making the SPV rock.
Ears ringing and dazed, the wave of heat followed next, enough to make his skin prickle with sweat as it flashed over him. The ground under his back rumbled while a mushroom cloud of smoke and ash that had once been an airfield darkened the clear blue summer sky overhead.
The Mysterons had won this one.
Cryptic as always, they’d threatened to ‘darken the skies of the betrayed and failed prince’. Spectrum had managed to deduce their target was the Brightsky radar project. It was a newly developed laser-based system being tested at the WAAF Caernarfon Airfield in Wales - the birthplace of the incompetent Edward the Second, who was deposed by his wife, Queen Isabella.
They could have found the bomb before the Mysteron agent dropped it into the base’s av-gas tanks if the base commander had simply let them do their job, but that was neither here nor there right now. With no idea if they had time to go in after it or drain the tank, Scarlet and Blue had made the call to evacuate the base and surrounding area and wait at what they thought was a safe distance.
“Looks like we got out just in time…” Ears ringing and feeling the throb of healing bruises all over his shoulders and back, Scarlet groaned and picked himself up off the ground, finding his RadioCap on the grass not too far away. He looked around, not seeing his partner. “Blue?” he called out. The light was fading as the ash clouds drifted across the sun, pushed by an offshore breeze and casting the world into a nicotine-yellow haze. “Captain Blue!” Scarlet hollered, now starting to get worried. Adam had been right behind him a moment ago. Where was he?
He rounded the front bumper of the SPV and caught sight of a blue RadioCap resting against the wheels, then saw its owner, perhaps a metre away.
Blue was sprawled gracelessly on his back on the grassy shoulder of the road, eyes half-open and unnaturally still.
“Adam!” Paul felt his heart drop into his boots as he scrambled over to his partner’s side and knelt beside him, shaking him roughly but getting no response. Desperately hoping he was simply unconscious, Scarlet tipped Blue’s head back and leaned in to listen for any breathing, looking down his chest and belly for any movement.
Nothing.
“Shockwave must have stopped his heart…”
Paul activated his RadioCap as he feverishly unzipped the armoured tunic and wrenched it open. He fitted the heel of one hand into the little divot on the sternum, seemingly placed there for the purpose, and set his other hand on top. “Captain Scarlet to Cloudbase! Spectrum is Red! Medical emergency, my location. Blue is down. Starting CPR. Send help!” he grunted out between compressions, wincing when he felt one, two, then three ribs crack under the brutal force needed to be effective, to work the heart from the outside and keep the blood moving. He barely heard Green’s staticky acknowledgement, his world narrowing down to the rote and rhythm of ‘30 to 2 no matter who, 100-120 beats per minute’, that he’d first learned as a schoolboy.
One corner of his mind mused how strange it was that such untouched skills just came flooding back like this when he needed them.
“... 17, 18, 19… C’mon Blue, don’t make me kiss you… 25, 26, 27, 28, 29, 30!” Paul tipped Adam’s head back again, pinched his nose shut with one hand, grabbed his jaw with the other, sealed his mouth over Adam’s and gave two quick puffs of air. “Wake up, damn it! Please!” he begged, as he started pushing again, hearing another rib pop in protest of the necessarily harsh treatment. “Blue, wake up! 26, 27, 28, 29, 30!” He leaned down to deliver more air.
“Taking over compressions!”
Scarlet blinked when another voice intruded on his concentration and a pair of small hands slid into place from the other side of Adam’s chest. “Hi. Susan, off duty medic. In the area and saw the boom,” the woman said by way of introduction, glancing up at him as she started compressions. Scarlet registered hazel eyes, ash blonde hair tied in a braid and a serious expression before she put her head down to focus on compressions. “Got a defib in the tank?” she asked.
“Yes, there is!” Scarlet made for the SPV, found the compartment where the first aid box waited and yanked it free.
He got back just as Susan started another cycle of compressions and dug through the box for the compact automatic external defibrillator and a pair of clothing shears.
“Move your hands!” he ordered. Susan paused, hands hovering an inch over Blue’s chest as Scarlet sliced through the black undershirt, then dropped back into compressions as soon as the clothing was out of the way. Paul ripped the cover off the book-sized AED and slapped the two sticky pads into place on the right shoulder and left side, shouting ‘Clear!’ just as he’d been taught all those years ago. The lights of the machine blinked as a robotic male voice intoned ‘Analysing, do not touch the patient. Analysing, do not touch the patient.’
They both sat back on their haunches, tense as they waited for the device to deliver its verdict.
‘Shock advised. Press the flashing orange button now,’ it told them firmly.
“I’m clear!” Scarlet held his hand over the defib, waiting for Susan’s confirmation.
“Clear!” she affirmed, holding her hands well away from Adam.
“Shocking!” Paul stabbed the button and waited as Adam’s body twitched from the high energy shock.
Nothing.
‘It is safe to touch the patient. Begin CPR. For help with CPR, press the flashing blue button,’ the voice advised.
“I’ll pump, you blow,” Susan instructed, putting her hands back into place on the sternum and starting to compress again. “Is... help... coming?” she got out between compressions. “.. 25, 26, 27, 28, 29, 30!”
Paul gave Adam the two breaths of air before answering: “I’ve alerted our base. Help is enroute.”
‘Next analysis in one minute, thirty seconds.’
“... Good... 25, 26, 27, 28, 29, 30!”
Another two breaths.
‘Next analysis in one minute, fifteen seconds.’
“... 25, 26, 27, 28, 29, 30!”
Another two.
‘Next analysis in one minute.’
“You... do... breaths... then... swap,” Susan puffed. “Getting tired. 27, 28, 29, 30!”
“Next analysis in forty-five seconds.”
Paul blew air into his partner again, slid his hands back into place, and started pumping, trying to ignore the hideous blue-grey tint to Adam’s face. “... 25, 26, 27, 28, 29, 30!”
‘Next analysis in thirty seconds.’
Susan flipped her braid out of the way and delivered the breaths. “What happened?” she asked, frowning as she glanced around but did not see any particular reason for Blue’s collapse.
Next analysis in fifteen seconds.’
“Hit by... the shockwave,” was the short reply Scarlet got out between compressions. Sweat was beading his brow and gathering under his uniform, even with adrenaline and his own augmented endurance, this was hard work.
‘Stop CPR. Analysing, do not touch the patient,’ the device beside him intoned. ‘Analysing, do not touch the patient.’
They both sat back, staring at the AED and waiting as the seconds crawled by like slugs while the machine read what the heart was doing and if it could be shocked or not. “Come on Adam, you’re not done yet,” Paul urged.
‘Shock advised. Press the flashing orange button now.’
“Clear!”
“All clear!”
“Shocking!”
Again the full body twitch…
But this time Adam moved, sucking in a shuddering gasp of air.
The half-open eyes blinked and he looked up at them blankly, dazed. Scarlet closed his own eyes for a moment and breathed a sigh of relief, silently thanking whoever was listening that it had worked.
‘Check patient for signs of life. If no signs of life, commence CPR. For help with CPR, press the flashing blue button,’ the defib blithely advised. Susan reached over to silence the device, but left the pads on Blue, just in case his heart conked out again.
“Blue, can you hear me?” Scarlet asked in the meantime, touching his shoulder gently.
“... Yeah…” Groggy but alive, Blue managed a nod, then frowned and brought a hand up to touch his chest where bruises were starting to bloom. “... Ow...” he managed to get out, not really up to communicating much more.
“Not surprising. You’ve just had CPR, so you’ve probably got a few broken ribs. Hold still and breathe shallowly,” Susan told him with a tired smile. She turned to Scarlet. “Sir, are you okay?” she asked, her gaze frank, but compassionate. “You’ve just done CPR on someone I’m guessing is a friend. Do you have pastoral care or something like that at Spectrum?”
“Yes, we do,” Scarlet found himself saying.
“Good. Use it,” was the firm instruction. “You’ll be feeling okay-ish about this right now because of the adrenaline, but go talk to someone in the next couple of days, promise? It’s going to hit you later, when you’ve had a chance to think about what just happened here,” she explained.
“I promise.” Paul nodded absently, most of his attention still on his dazed and sore friend.
“Well done, by the way, you just fixed dead.” She smiled at him, then turned her attention back to Blue, gently talking to him and checking quickly and efficiently for any other injuries. Scarlet found himself pressed into assistance, patching up a nasty gash on the back of Adam’s head that he must have picked up when the shockwave had knocked him down.
They were finishing securing the dressings when a medical helijet circled over the area and landed on the road not far from the SPV. Four Spectrum staff in medical tunics hurried out with a stretcher and equipment - local staff, not Cloudbase. Within a few minutes, they had loaded Blue onboard and were spooling up to take the injured captain to the nearest hospital for stabilisation, before he could be shifted up to Cloudbase to recover.
To the dismay of both captains, Scarlet couldn’t go with Blue - there wasn’t enough space for him as well as the flight medics who had been sent along. That, and Colonel White wanted someone there to control the scene until a ground officer could arrive for the clean up.
Not that Scarlet really felt up to actively controlling anything right now, to be quite honest. As he leaned against the SPV to watch the heli’ take off, he was more than happy to just wait for whoever it was to show up and take over. The events of today had taken a lot out of him, mentally and physically.
“With any luck, Adam will get back to base before I do,” was the absent thought Scarlet had as the helijet took off. He really did not want to be the first one back and cop an interrogation from Karen before Fawn could get a look at Adam. He didn’t have the mental energy to handle her intensity right now. Far better Fawn, who had the patience and experience for it, take the brunt of it first; then when he arrived, the inevitable interrogation from her would be far more tolerable once her fears had been assuaged. Not to mention he’d probably be getting raked over the proverbial coals by the Old Man as soon as he returned, anyway.
Perhaps not being able to get on the heli’ straight away wasn’t such a bad thing.
Off in the distance, he could see the winking lights of the arriving fire trucks. The conflagration hadn’t spread far, but it was spreading. Positioned down a side road, they were out of the way, but odds were the journalists would be arriving hot on the heels of the emergency services, and any Spectrum vehicles were a magnet to news crews. He could only hope the local officer would be here soon, so he could hand over the situation to them and avoid a line of news crews trying to question him.
“Oh, yes. Speaking of questioning...” Scarlet sighed and reluctantly put himself back into work mode. Procedure needed to be followed. He hoisted himself off the SPV and went looking for Susan.
He found her just up the road, sitting on the grass next to a blue sedan he presumed was hers, judging by her proximity to it, and contemplating the mud and grass stains on the toes of her sneakers and the knees of her jeans from kneeling in the grass for the CPR. Scarlet was very much not looking at the state of his own boots and trousers; while he’d knelt on the grass, his feet had been on the road and he’d shredded his boot toes. This would probably be it for this pair.
“Hey.” She gave him a tired smile. “You okay?”
“I am, thank you.” Scarlet sat down beside her and fished a notepad and pen from his vest pocket. “Thank you again for what you did today. From what the medics were saying, Captain Blue will be all right. They’re taking him to a nearby hospital to get him stabilised, before taking him to our base to recover,” he explained.
“Oh good.” She looked relieved. “Is there any chance someone can let me know if he pulls through? We don’t often get to find out the final outcomes of patients, once they’re in the hospital, that’s usually the last we know.”
Scarlet considered it for a moment and nodded. “I’ll have to ask our CMO and our commander, but I don’t see why not,” he replied. “Knowing Captain Blue, he’ll probably want to contact you himself, once he’s well enough.”
“Is that what that is about?” she asked, nodding to the paper and pen.
“In part.” Scarlet handed it over, his tone more serious now. “It’s standard procedure: because you’ve been in close contact with one of our senior staff, we do have to follow up on you. Someone from Spectrum Intelligence will contact you in the next few days for a debriefing, and I have to request that you forget about today, for your safety. There are people out there who wish to glean whatever information they can, however they can get it.”
“Got it.” She scribbled down her details. “So no selling my story to the tabloids?” Susan teased as she handed the notepad back.
“Absolutely not,” Scarlet affirmed with a half-smile as he tucked it away. “And I would appreciate a forgetful memory about names when Intelligence comes to visit,” he added quietly, belatedly remembering what he’d said. “We aren’t supposed to know each other’s names.” That rule had lasted all of three weeks at Koala Base, but they tried to maintain the fiction in public spaces and while in the Old Man’s earshot.
“Wow, it’s taken that seriously?” Susan blinked, eyebrows raised in surprise. “Should I look for any identifying features or something when the Intelligence people come to visit? Just in case?” she asked, looking concerned.
“That’s not a bad idea, actually.” He nodded thoughtfully. “I’ll find out who will be coming and call you with their names.”
“Thanks, I appreciate that.”
Scarlet rubbed the bridge of his nose, feeling a headache starting to build behind his eyes. Yep, his adrenaline was starting to crash. He was also starting to have some very complicated feelings about what he’d just done to Adam. A session with Juniper was definitely on the to-do list.
“I think that’s the first time I’ve done CPR outside of training,” Scarlet admitted to Susan, very carefully not dwelling on the survival statistics he’d also learned at the time. “I’d forgotten what they’d told us about breaking ribs until I felt them go.” He couldn’t help but shudder at the remembered sensation of crunch underneath his hands.
“Yeah.” Susan nodded. “It’s always hard the first time you hear or feel a rib break, but if you’re doing it right, you’ll crack ribs. It’s brutal, but it’s the help that they need.”
From down the road, he saw a flash of red - an approaching Spectrum Saloon Car. That would be his relief coming. “Time to get back to work,” he grunted as he stood, feeling the tired muscles of his legs and torso starting to protest. “You’d better get clear; I imagine the news crews will be here soon too. And once again, thank you.”
“You’re welcome.” Susan stood as well and dusted herself off. “Well, good luck out there,” she said by way of farewell, offering her hand.
Scarlet took her hand and shook it. This was why he and the others did what they did, to protect the people like her, who stood up when help was needed. “The same to you,” he told her.
Author’s notes:
This short story was born from the frustrations of a first aid tutor and volunteer ambulance officer seeing very bad CPR continually being perpetuated in literature and media.
It’s a problem because if someone’s only experience with CPR is seeing bad CPR on TV, they’re going to do bad CPR and have the wrong expectations. While it’s true any CPR is better than no CPR , perpetuating the inaccuracies actually puts first responders in danger from distraught family when we can’t work miracles and fix it like what they saw on TV the other night.
I know this personally. While I’ve been lucky and haven’t been hit yet, I’ve had to talk people down before they could wind themselves up and I know ambos who’ve been attacked over it.
The one artistic licence taken with the medical bits here is that Scarlet checked for breathing before calling for help. We teach the order as Danger, Response, Send for help, Airway, Breathing, CPR, Defib as the initial assessment in New Zealand. He was flustered, it’s understandable, but as long as the help is called for promptly that’s the main thing. Pulse isn’t usually checked for in the initial assessment because if someone is not breathing normally (as in it is insufficient for supporting life - less than two normal breaths in 10 seconds) and is unresponsive, they are dead.
Yes, you will break ribs doing proper CPR on an adult, I’ve broken ribs on everyone I’ve done CPR on.
Yes, some countries teach no breaths for CPR, but the odds are better for the patient if you do, and the odds of catching something off the patient are minimal as per the Resuscitation Council of New Zealand. If you don’t want to do the breaths, just do continuous compressions.
Yes, it’s exhausting, most people can only manage two minutes/four 30:2 cycles of high quality CPR before the quality starts to drop, swapping out with someone is a very good idea.
The odds of getting someone back without a defib are infinitesimal. CPR only moves blood and air to keep the brain and heart in good condition; the defib reboots the heart’s electrical system. Both are needed.
No, you most likely won’t be up and walking after being resuscitated. I’ve only seen one revive to be fully conscious and fully lucid afterwards, because we were literally on him the moment he died; they’re usually either groggy as anything or unconscious afterwards.
Most importantly: No, you can’t shock a flat line. Most shows have a defib being used on a flat line and bringing the patient back to life. Flat line or asystole means the electrical system of the heart has failed completely and it has stopped beating. We can only do something if the heart is in certain kinds of fibrillation - the sequence of firing nerves is out of kilter, but nerves are still firing and the heart is twitching but not beating - and the defibrillator stops it and forces the heart into attempting a reboot cycle. Look up atrial fibrillation and ventricular fibrillation, if you want to see what they should be showing on the monitors in medical dramas. Flatline = perma-kaput for everyone except Paul Metcalfe.
I hope this all helps explain a bit behind the brutal help needed to get a heart back into action.
Cheers!
Shades