She exhaled and let the ball lift out of her hand. Swoosh. Nothing but net from the three-point line.
“Nice shot!” Theo exclaimed, returning from the bathroom.
The klaxon went off with a request for Medic, and they left Kwon behind.
The call took them to the fourth floor of an apartment building. Two teenagers explained their pregnant neighbor had collapsed. “Don’t know what’s wrong with her. Her color isn’t good,” their mom said. “This is Tiffany Wickwire.”
“Tiffany, I’m Theo, a firefighter with CCFD. Can you speak?”
The young woman on the floor held her barely-there belly, hidden by a bathrobe. “Heart feels funny.”
“How many weeks along?” Erin asked, dropping to her knees with the jump bag. The delivery kit was on the gurney.
“Twenty-three.”
Erin and Theo shared a grimace. They didn’t carry specialized equipment for preemies. According to their recent re-test, they were supposed to avoid delivery at all cost. If forced to deliver, they would wrap the baby in saran wrap and use a bag-mask to breath for it while breaking the sound barrier to MetroGen.
“I’m getting over 300 on and off. You?” Erin asked Theo who had his stethoscope in his ears. Tiffany’s pulse was abnormal, and her wrist was very swollen.
“Too fast to count. Monitors,” Theo agreed. “Get the AED?”
“She’s conscious. It won’t shock her.” Erin said. The AED only shocked V-fib and V-tach, in which the patient was usually unconscious.
They helped Tiffany onto the gurney with the portable 3-lead EKG monitor inside her bathrobe.
“I have WPW… my cardiologist. Wolf-Parkinson-White. WPW,” Tiffany murmured, paling again. “Take meds.”
“Which ones? Did you take them today? How long ago?” Theo asked.
“Perkins put me on Sotaolol. Took them this morning…”
“I’m not familiar with that one,” Theo said, glancing at Erin.
“Never heard of it. Sounds like a beta blocker. Aww, no.” Erin pointed to the monitor; Tiffany’s heart jumped from 120 to 300 beats per minute. If they didn’t take action soon, Tiffany would go into cardiac arrest.
“She’s in SVT!” Theo exclaimed. “Vagal maneuvers.”
“We can do it while we roll. Tiffany, we’re going to rub your neck now to slow your heart. Then to MetroGen.”
“Save my baby,” Tiffany said faintly. Erin could see her runaway pulse sprinting. She started massaging Tiffany’s neck as they entered the elevator. Vagal maneuvers stimulated the vagal nerve which could slow the heart rate, even in supraventricular tachycardia.
“Stabilizing you saves the baby,” Erin assured her. They couldn’t monitor the baby, but it didn’t matter. If they didn’t keep a heartbeat on the mama…
No mom meant no baby.
Erin could not think about that now. They weren’t going to let her die. Not today. Not on Christmas Eve.
They rolled Tiffany to the ambulance, and Theo started hooking Tiffany onto the main monitors and a nasal oxygen cannula. Her heart rate stayed 300.
“That didn’t work.” Erin opened their book on advanced cardiac life support (ACLS) and flipped to the chapter on WPW. Tiffany had confirmed her diagnosis, so no reason to start at the basics. Erin read out loud, “WPW can lead to atrial fibrillation, atrial flutter, SVT, and…”
“What?” Theo leaned forward.
“It says ‘consult cardiology’ and that it’s very difficult to treat in pregnancy so ‘consult cardiology.’”
“Typical,” Theo snorted.
Erin whispered, “We need to get her to MetroGen. Skip the IV—scoop and run.”
