損
“Life of the Party”
Live band cranked decibels and a few dancers induced by the rhythm bounced closely while others, jostled, swayed watching. It was happening here in this packed place. On the opposite side of a “horseshoe” bar in an adjoining area game room, balls clacked about a pool table. The player, semi seated on a bar stool next to blinking pinball game lights, waited cue in hand for the next turn. Remarkably the busy bartender was the only true witness to the collapse. The pool player seemed to suddenly turn, and “just toppled forward”. A disconnect was created between the back bar patrons, who began to notice someone had fallen, the “immersed” music rocked crowd and the seriousness of the situation. The small commotion isolated at first to the game room, slowly seeped, spreading into the remaining area.
A large cut across the forehead, an aftermath of the collapse, distracted and delayed the assessment of “out cold” but 911 was activated by said witness bartender. The band, upstaged, went to break and the sudden silence was replaced by the corner jukebox.
Arriving first responders, now 13 minutes after call, finding no pulses, finally initiate BLS CPR. The attached AED plays “NO SHOCK ADVISED”. ALS backup was requested but due to a projected “long ETA” of ground ALS, air ambulance was requested.
Landing following a 7 minute launch, a 17 minute flight, the flight crew is EMS escorted through a gateway to the game room where CPR continues behind the pool table.
The monitor, with a brief halt of this interference, green lines asystole, a flat indication of cardiac standstill. CPR resumes bringing back the erratic line dance across Lifepac LED. ALS interventions of an established IV, an amp of adrenaline, intubation, fluids followed by an empiric chaser of bicarb for the long duration of resuscitation.
Nearby the pinball machine, a menacing black knight with flashing red eyes electronically rasps “Try the Challenge”. A 500cc infusion, the fluid challenge is complete and despite another round of ALS medications, there is still the unwavering stable asystole. There is no blood, there has never been significant blood loss from the forehead laceration, a clue in the “Which came first?” game.
Wilhelm/Baynes: At the foot of the mountain, the lake: the image of Decrease.