As the two paramedics approached the front door a man in his twenties met them on the front porch. “She’s in here, she can’t breathe!” He told them as they approached. He pulled the screen door open and held it for them as they walked through into the house. On entering the living room at the front of the home, they saw an attractive young woman in her twenties with red hair, seated on the edge of the sofa, her hands on her knees, slightly leaning forward as she struggled to lift her torso up to allow complete filling of her lower airways. This was called the tripod position and it was not a good sign. She was clearly struggling to breath and was pale with a slightly blue tinge to her lips. The could hear the wheezing noises from her labored respirations from across the room. On the coffee table in front of her were several medication inhalers and a portable home nebulizer with tubing that led to a mask, now laying on the floor.
Dean put the bags down on the floor next to her and started to pull out a non-rebreather mask and tubing from the oxygen bag. “Hi, my name is Dean,” he said as he worked. “We’re going to do what we can to help out, ok?”
“She’s Lydia,” the man said. “Her asthma is acting up. This is the worst I’ve ever seen it.”
Lydia gasped out some words, one word at a time. “I. Tried. My. Nebu. Lyzer. Treatment. But. It. Did. Not. Work.” There was a gasping breath between each word she said.
“Here,” Dean said, holding the non-rebreather mask up to her face with oxygen set to fifteen liters per minute. He stretched the elastic band around her head to hold it in place. “That should help a little bit while we get some other things set up.”
Brynne set the heart monitor down on the coffee table in front of Lydia and turned it on. She connected the blood pressure cuff tubing to the machine, wrapped it around Lydia’s arm and pressed the button to start inflating the cuff for a reading. She placed the earpieces of her stethoscope in her ears and held up the bell end in one hand. “I’m going to listen to your lungs, ok?”
Lydia nodded and Brynne reached around the woman’s back, lifting her shirt up and sliding her hand under. She started at the top listening on the left and right side and then moving down and repeating twice left and right for a total of six lung fields. “Wheezes at the top, diminished breath sounds in the middle and nothing at the bottom.” Brynne looked up at Dean. “So, Dean, what’s next?”
“Nebulized combination meds,” Dean said confidently. “Albuterol and Ipratropium, two point five milligrams of Albuterol and five hundred micrograms of Ipratropium via nebulizer mask.” He turned to the oxygen bag pulling out the neb mask and tubing. Taking the non-rebreather mask off Lydia, he replaced it with the nebulizer mask and attached that tubing to the oxygen cylinder, setting the flow to ten liters per minute. The chamber began bubbling, sending a cool mist of medication up into the mask for the woman to breath in.
“I need you to try to calm your breathing down,” Brynne said. “I know it is hard but try. We need to get that medication in as deep as we can into your lungs. Listen to my voice and try to breathe in as I count to five, hold it for a second, then breathe out.” Her calm voice started counting slowly holding Lydia’s eyes as she worked with the struggling woman to slow her breathing down. Dean watched as the technique actually started to work. While she was still having trouble breathing, the combination of Brynne’s tone and the medicine seemed to start having the desired effect.
“Lydia,” Brynne said, anticipating Jerry’s thoughts about treatment. “You are looking better but I think you still need to go to the hospital” She looked at Dean, “Let’s switch her to a nasal canula for now and discontinue the neb treatments.”
Dean nodded and took the spent nebulizer mask off Lydia, and reached in to pull out a nasal canula. He was in the process of removing the cannula from the plastic bag wrapper when Lydia spoke in a non-distressed voice for the first time. Her tone was captivating, literally and he just sat staring at his hands as she spoke.
“You all are so helpful,” Lydia said, her breathing easier. “I want to thank you but I’m not sure I need to go in to the hospital. You could just stay here and help me out. Right, Dean?”
Dean looked up from his hands at Lydia. Jeeze! She was beautiful. Why hadn’t he noticed that before. Her voice was so convincing and melodious, how could he even consider telling her no. “I would be happy to stay here and attend to you, Lydia.” Dean said, his eyes glazing over. “You only have to say the word.”
Lydia’s husband was staring at her aghast, “Lydia, I can’t believe you’re doing this again.” He held up a hand. “I want nothing to do with it.” He turned and stormed out. Brynne looked at the man’s back as he left the room and then looked at Jerry’s face.
“Aw, hell no!” She shouted and started digging around in the med bag on the floor, “Crap, crap, crap!” The senior paramedic obviously didn’t find what she was looking for because she stood up and bolted out the front door for the ambulance. Dean couldn’t understand why she was being so rude to their hostess. After all, Lydia was generously offering an opportunity to stay here with her which was obviously a better idea than taking her to hospital. And anyway, if he stayed here he could keep listening to her lovely voice. She was humming a tune now, nothing he recognized but a lovely melody with a steady up and down cadence that —.
Suddenly a loud clanging broke through the melodious humming and Lydia shrieked, covering her ears. Dean looked up at Brynne startled as she stood in the center of the room. How had she gotten there? She was just sitting on the couch a second ago. And what was that she was banging on with a drumstick? She stopped for a second and then held out her hand.
“Dean, twist these up and put them in your ears,” Brynne ordered. He reached out for what she was handing him, confused but obeying. He stopped though as soon as Lydia started talking again.
“You come in my home and make that infernal noise when I’m talking?” Lydia said. She shut up and covered her ears again when Brynne started beating on the metal box again. Dean shook his head to clear his thoughts. It wasn’t a metal box. It was a cowbell, like from a drum kit. Where had she gotten that?
“Dean,” Brynne shouted over the din of her banging. “Come over here. Pick up the two pieces of beeswax, twist them up and stick them in your ears.” Dean stood up, took a few steps and picked the two orange lumps off the floor. They were sticky and soft and he rolled them, one in each hand between his thumb and forefinger and then inserted the column of wax in his ear canals. The din of the cowbell taps were not as sharp as soon as the two earplugs were in place and as soon as Brynne saw that he had done as she asked she stopped the banging.
She looked at Lydia, “Lady, you’ve got a lot of nerve trying to charm my partner! We came here to help you!”