Extreme Measures Read Online Free PDF Page B

EKG-guided needle through the upper abdomen, just past the liver, then through the diaphragm, and finally through the pericardium—a tricky, potentially dangerous maneuver.
    Eric had other plans. He glanced toward the doorway, wondering what was taking Dave Subarsky so damn long.
    “Films first, films first,” he said, forcing calm into his voice. “I need a good lateral of his neck right away. Have them shoot a chest and pelvis as well. June, I don’t think he needs a tube yet, but he might. He looks like hell. What’s his pressure?”
    June Feldman tried to find out with a cuff and Doppler electronic stethoscope, then shook her head.
    “As soon as bloods are off to the lab, get an arterial line in him. Then a catheter,” Eric ordered.
    Feldman set to work cannulating the man’s radial artery, while a second resident numbed a spot near his navel and thrust a tube into the abdominal cavity. A flush of saline through the tube showed no evidence of internal bleeding.
    Eric nodded. The test had ruled out a ruptured spleen or liver, and had made an aortic tear less likely. The possibility of pericardial tamponade as the cause of Russell Cowley’s shock had just increased several-fold.
    Terri Dillard rushed into the room.
    “How’s he doing?” she asked breathlessly.
    “No better, no worse,” Eric said. “He’s tamponading.”
    “You sure?”
    “Not yet, but almost. And if it’s true, hold on to your hat. You’re going to get to see something no one has ever seen—not even me. That is, providing goddam Subarsky gets down here in time.”
    “Well, I hope whatever it is happens quickly,” Terri said, “because we just got a call on the Batphone. Boston Rescue is on the way in with another Priority One—a man found in an alley in the North End. No pulse, no respiration. They’re doing CPR.”
    “A drift diver?” Eric asked, his concentration still focused on the residents and technicians.
    The term referred to the derelicts pulled from snowdrifts throughout the Boston winter. Most of the time they were well beyond salvation.
    “I think so,” Terri said. “The rescue people refuse to incriminate themselves over the radio, but they did say there was a nearly empty bottle of Thunderbird in the man’s coat pocket.”
    “Is he warm?”
    “I have my doubts. Rescue made it sound like they were only working on him because their protocol demands it.”
    “EKG?”
    “Essentially straight-line, with an occasional agonal beat.”
    “Pupils?”
    “Dilated and fixed.”
    “Lord, Terri, isn’t there someone else around to work on him? This is big stuff going on here. This guy’s the president of a company, a trustee of this hospital, and he’s got treatable injuries. I don’t want him shortchanged while I go through the motions with a wino who probably died hours ago.”
    Terri’s eyes narrowed.
    “You’re the only senior person around,” she saidcoolly. “If you need help, Dr. Kaiser is next door doing walk-ins.”
    “Well, tell him to take charge of the diver. If this guy needs his pericardium drained, I’m going to do it.”
    “Eric, come on,” she said. “Gary Kaiser’s been here a year and a half, and he still gets flustered taking care of strep throats. We all think his father must have endowed a building or something. There’s no other explanation for his getting an internship here.”
    “Well, just tell him it’s time to be a goddam doctor. That’s what he came here to be. Anyhow, it sounds like this diver’s going to be just another DOA. Terri, for chrissakes, don’t make that face. Okay, look, I’ll be over to help him as soon as—Wait, there’s Subarsky. If things go the way I hope, we may be done before the diver arrives.”
    Dave Subarsky lumbered into the room, hauling a cart laden with complex machinery. Subarsky had a Ph.D. in biochemistry from M.I.T., but at six foot two or three, with a full beard and massive gut, he looked more like a professional wrestler. He and