Page 2 of Tough Justice

Between herself, the two paramedics, the cop who’d come with them, four nurses, and Ashanti, the respiratory therapist, the small room was packed.

“Get him on the bed,” Tori ordered, standing back to give the paramedics room to work. “What do we have?” she asked.

The cop assisted the paramedics in transferring the patient to the ER stretcher. That’s when she noticed the embroidered words on the cop’s shirt: DEA K-9 Unit. Wonderful. It just had to be DEA agents. The bane of her family’s existence.

“Patient is thirty-five years old, found down with suspected opioid exposure during a raid. He was in respiratory arrest when we arrived on scene. This guy,” the paramedic said, nodding to the cop, “was giving him mouth to mouth. We tubed him.” Again, he nodded to the cop. “He gave him eight milligrams intranasal Narcan. We gave him another two. He went into VTAC arrest during transport. We’ve been doing compressions, gave him two epis, three hundred milligrams of amiodarone, and three shocks. The last was two minutes ago. On our monitor, he’s still in VTAC. Our last rhythm check was PEA.”

Pulseless electrical activity. Damn. He still wasn’t responding. “How long has he been in VTAC?” Tori asked.

“About eight minutes.”

“Hook him up to our monitor, start another line, and get the auto-compressor on him.” She watched the flurry of activity as Suzie quickly started another IV line, while the other nurses switched the heart leads to the ER’s cardiac monitor and moved to position the chest compression system over the patient’s chest. “Stand back,” she ordered the cop. As if the room wasn’t tight enough with all the hospital personnel, now she had to contend with this giant K-9 cop getting in her way. “Please, go to the waiting room.”

Finally, he backed away but didn’t leave the room. Right now, she didn’t have time to deal with him.

While the auto-compressor was positioned and turned on, the respiratory therapist took over for the paramedic squeezing the bag-valve mask.

“Give him another milligram of epi.” Tori moved over to give one of the nurses room to adjust the auto-compressor and bumped into something solid and unmoving. Correction, someone solid and unmoving. The damned cop. Hadn’t she told him to get lost?

Since he was still here… “What exactly was he exposed to?” she asked him. Not that it made a difference in her treatment protocol, but she wanted to confirm her suspicions.

“I don’t know exactly,” the cop bit out. “Some kind of opioid.”

“Opioids? Where are his clothes?” The patient was in his underwear, and she didn’t want hospital staff exposed to any opioid residue.

“Bagged,” the cop said.

“A bad batch of something’s going around,” one of the paramedics said. “We’ve been averaging eight ODs a day in our area alone this week. And those are just the ones we know about, let alone hung on long enough for us to get there. We’re going through naloxone like it’s water.”

Tori held back a few choice expletives. This particular opioid concoction was killing people left and right. Apparently even the DEA wasn’t immune. She suspected this agent had been exposed to the same thing. The detailed labs she’d been requesting on her OD patients would confirm it.

“His capnography just jumped,” Ashanti said.

“Stop the compressor, and check the rhythm.” Keeping her eyes fastened on the monitor, Tori checked for a pulse at the man’s carotid.

C’mon. Beat, goddammit. Her own heart seemed to slow as she waited for a telltale blip.

The green line on the cardiac monitor jumped, and she felt a weak pulse beneath her fingers. “There you go. Hang in there.”

A collective sigh came from everyone in the room, including her. “Sinus rhythm.” Now to get him breathing on his own. “How much naloxone do we have in this room?”

“One vial.” Suzie tore the wrapper off another syringe. She popped the cap and drew out the remaining naloxone.

“Push another point-five milligrams, then check Room 4 for more. Hit up the pharmacy if you have to.” Because if this agent was exposed to the same opioid cocktail she suspected he was they’d need a lot more naloxone. “And page Dr. Barnett. Tell him we have another one, and I need his help.” Her friend, Wil, had an inherent understanding of just what treatments worked best on OD patients, especially the bad ones. Like this one. With that much naloxone, he should have responded and been breathing on his own by now.

Suzie administered the next dose of naloxone then hustled from the room.

Tori touched the man’s cheek. “Cold and clammy,” she muttered then pushed up one of his eyelids. “Pinpoint pupils.” All classic symptoms of an overdose. Still examining her patient, she asked the paramedics, “How long wasn’t he breathing on his own?” When no one answered, she looked up to find them watching the K-9 cop, who was grinding his jaw so hard the muscles in his lean cheeks rippled and flexed.

“Do you have any idea how long he wasn’t breathing?” she asked.

“No,” he gritted out.

“No?” She glared at the agent—A. Decker, according to the tag on his shirt. In addition to him, there had to be a dozen other cops and DEA agents in the waiting room. “He’s one of your own. How could you not know?”

“We got separated,” he growled.

“Did he inhale it, or just touch it?” She’d read that a police officer in Pennsylvania had brushed some kind of opioid powder off his hand then passed out a few minutes later.