Meghan had been back on rotation with the ambulance for a little over 2 months. Everyone was confident that she was healthy enough to be back at work, and she herself was finally resting easy that, with due diligence in regards to her health, she was still able to do the job she loved.

Meghan’s life had fallen into a pretty steady routine: ambulance rotation on Mondays, EMT-Basic classes on Tuesdays and Thursdays, another ambulance rotation on Friday, and usually one more rotation on either Saturday or Sunday. She occasionally helped Fred on Wednesday afternoons with the skills labs for the paramedic class. She stayed busy, but she felt she was living her best life.

She and Rick hung out as much as they could, considering their schedules. Things were slowly becoming more serious between the two, and they were eager to share their lives with one another. It was a very rare day that they didn’t call or text each other.

Meghan arrived at work Friday morning anticipating both a good shift that day as well as a breakfast date with Rick the following day. She popped her head into Brandi’s office, said hello, and went to check out her truck for the day. Jerry was already there and starting the checks of the physical truck itself.

“Morning, squirt. Ready for another day in paradise?” He pulled out the oil dipstick to check the fluid level.

She chuckled. “Sure thing. How far have you gotten on the checklist so far?”

“Just the engine stuff so far. I got this, if you’ll start working on the back.” He reinserted the dipstick and moved on to the next item on the list.

Meghan opened the side door to the patient compartment and climbed aboard. Jerry had set the checklist on the captain’s chair; she picked it up and started going through compartments, jotting restock notes on the form. She was running the daily tests on the Lifepack monitor when Jerry joined her.

“Did you do the glucometer yet?” he asked. Meghan shook her head. “I got it.” He opened the glucometer kit and started checking it, utilizing the high- and low-test fluids.

Finished with the checklist, Meghan took it and headed for the supply closet. She picked up a handy basket and started filling it with items. Basket full, she headed back to her rig and started putting supplies away.

“Who was on before us?” Meghan asked, as Jerry handed her a pager and keys for the day. “I don’t think they restocked once!”

Jerry scowled. “Two of the newbies. I’ve talked to Brandi about them regarding this before. Guess I need to go complain again.”

Meghan agreed. “We were down to our last 2 IV bags. And several other items were really low. Heaven forbid they caught a mass trauma with this level of supplies restocked.” She stood and stretched. “Any idea who else is on today?”

“I think Cherie and Dave are on today, as well,” he said. “And I think it’s B rotation with the fire department today. Whatcha thinking? Breakfast?”

Meghan chuckled. “You know me too well.” She started heading for the common area. Sure enough, Cherie was coming in from the parking lot with an armload of personal effects.

“Chika! Are you working today?” Cherie lit up as she saw Meghan.

“Absolutely! Jerry and I are on Truck 6; I think you are on Truck 4 today.” The phone rang, and Dave popped out of a call room and picked it up. “EMS station 2, Dave speaking.”

Meghan and Cherie eavesdropped on his end of the conversation. “Sounds like a breakfast invite to me,” Cherie remarked. Meghan smiled. Dave, overhearing the comment, nodded. “Okay, see you there.” He hung up and approached the two women. “Yep, breakfast in an hour. C’mon, we need to go check the rig.” He headed for the bay as Cherie quickly dropped stuff off in an open call room.

Jerry soon reappeared from the office. “Did I hear something about breakfast?”

Meghan nodded. “In an hour. I’m hungry and jonesing for coffee!”

Jerry chuckled. “When are you not wanting coffee? I need to run an errand sometime today, as well. And Brandi is sending us to the store today to get some supplies for the station whenever we can work it in.”

“Sounds like a busy day, and that’s just the housekeeping stuff,” Meghan commented.

Breakfast had been its usual rowdy event, full of friendly conversation and good food. Tones had gone off as things were winding down, sending an engine crew and Dave and Cheri off to a call.

After saying their goodbyes, Jerry drove them first to the superstore to pick up printer ink, a couple cases of paper, and some paper goods for the station. They took these back and dropped them off with Brandi so they could go back into service. Jerry then took them to the bookstore.

Meghan clipped a radio to her belt. She hopped out of the cab and made sure her wallet was securely in her pocket before shutting the door. She followed Jerry into the store. “So, what are you looking for?” she asked.

“I need to get an updated field guide,” he said, holding up one that was water-damaged. “I forgot to take it out of my work pants, and it got washed,” he added ruefully.

Meghan laughed. “I’ve done that once – the price they charge for those things, I learned to double-check my work pants before doing laundry!”

They found the guides and Jerry picked the one he wanted. “I’m gonna pay for this, and then browse a bit, if you don’t mind.”

“Works for me. Got a radio on you?”

Jerry nodded and headed for the checkout stand. Meghan looked at the titles in the area she stood in before heading for the magazines. Jerry found her about 10 minutes later, flipping through the knitting magazines. “Finding new patterns?”

She laughed. “Please remind me that I don’t need to buy 2 magazines full of patterns I don’t have time to knit!”

Jerry smirked. He looked at the cover of the magazine she held. “Are you sure? The Christmas ornaments on the cover don’t look like they’d take too much time to make.”

She playfully hit him with the magazine. “You’re supposed to be talking me out of this, Jerry.” She looked again at the cover, and sighed. “Okay, I’m headed to check out.” She heard Jerry chuckling as he followed along behind her as she made her way to the register.

They caught a couple of transfers and a chest pain call. Jerry had just cleared them from the hospital when the tones went off again.

EMS 21, respond to 2056 North Ridgeline Road for EMS standby for a structure fire. 2056 North Ridgeline Road. Time out: 1656.

Meghan scampered to the truck and hopped in. Jerry turned on the engine and pulled out, flipping on lights and sirens to aid them through traffic to the scene. As he drove, Meghan reached back behind her seat and found her turnout coat and her medic helmet: a blue hard hat with a big star of life sticker on each side. She shrugged into the coat, neglecting to fasten the closures, and plopped the helmet on her head. She adjusted her ponytail to ride lower so it wouldn’t interfere with the hat’s tightening webbing inside.

They saw the smoke before they saw the house. Jerry shook his head and rounded the corner onto North Ridgeline Road. Several fire trucks were staged strategically on the street, and hoses were everywhere. The house itself was small, but 2 stories tall. It looked to be of older construction, with a small front and back yard, surrounded by older trees.

Meghan looked at the scene with an experienced eye – she’d volunteered with a fire department during her 2 years of paramedic training. “Looks like the fire’s extended towards the attic,” she guessed. “They’ll have to be careful with interior attacks. Don’t want the ceiling caving in on them.”

Jerry, who had also had some time as a firefighter, concurred. “I’m more concerned about that giant propane tank in the back. It’s pretty close to the house.” He parked down the block and turned off the siren, but left the lights going and the truck running.

Meghan agreed. “Let’s go report in to Incident Command.” She grabbed her radio, hooked it to her belt, and climbed out of the truck. She and Jerry made their way through the maze of hoses over to the Incident Commander, designated as such by his bright orange safety vest worn over turnouts.

“Afternoon, Jerry, Meghan. We’ve got a pretty hot fire,” he said by way of greeting.

“Afternoon, Captain. How many alarms is this? How many men?” Jerry asked.

“Second alarm, 16 men. If this progresses much further, though, I’ll be calling for additional units.” He stopped, listened to a radio message, responded, and shifted his focus back to the EMS personnel. “The occupants aren’t home, and no pets to worry about. Hopefully your standby will be uneventful.”

Meghan nodded. “What channel are you using for operations?”

“Operations are Channel 4. We’ll call if we need you.” With that, the Captain turned back his attention to the fire scene in front of him.

Meghan and Jerry headed back towards their truck. They leaned against the vehicle, watching the scene. It was a hot fire. Men hurried to and fro, carrying axes and other various pieces of equipment. Engineers stood near the instrument panels of their respective engines, adjusting water flow to the various hoses their crews manned inside.

A sudden explosion startled people outside, and the radio sprang to life with various firefighters reporting in. Meghan’s vision suddenly saw a body roll and land dangerously close to the propane tank that now had pieces of fiery debris lying around it. The man wasn’t moving, and the flames were starting to catch the grass around the tank on fire.

Without hesitating, Meghan ran for the man. She reached him, grabbed his turnout coat at the neck, and started dragging. With the small size of the backyard, Meghan had no choice but to go up close to the burning structure to avoid the worst of the flames now licking around the propane tank… just in time to hear men yelling that the structure was about to flash.

She threw herself on top of the patient, covering his exposed face with her body. The propane tank exploded, and the house flashed. Meghan, who had sucked in a quick breath, started screaming as embers and debris started falling on her from the eaves of the house, landing on her legs, her back, hitting her helmet.

She was suddenly doused in water; strong hands picked her up and threw her over a shoulder and started jogging towards the ambulance. The firefighter she had been helping was also lifted and carried towards the ambulance.

Jerry directed the downed firefighter onto the cot and Meghan was eased down and set on the Captain’s chair. She was no longer screaming, but coughing and crying. Jerry assessed the firefighter while another hooked up an oxygen mask to high-flow oxygen and shoved it onto Meghan’s face. Jerry radioed for Brandi to come to the scene, and requested another ambulance to take their place.

Xavier Gomez, one of the firefighter-paramedics, took charge of Meghan. He soon had her on telemetry, hooking her to the cardiac monitor. He helped her out of the turnout coat but left it around her shoulders. He got her blood pressure and put a pulse ox on her finger. He had to keep nudging the oxygen mask onto her face before he finally just put the elastic strap over the back of head, having removed her helmet… only to discover that a lot of her hair had burned and she had bad burns to the back of her neck.

He continued his assessment down her body. Most of the lower pants leg had burned away on her left leg, leaving an area about as big as his hand blackened and surrounded by big, ugly blisters that covered most of her calf. Her right leg was in better condition, with only a few small spots having burned through from falling embers.

Meghan was extremely quiet, save for all of the coughing – she spoke not a word. Both Jerry and Xavier were relieved to see Brandi arriving on scene. The fallen firefighter was conscious but in pain from a broken leg; Jerry had that splinted and his patient ready to go. Meghan was starting to look a bit gray under the grime, and a quiet Meghan was never a good sign.

Brandi climbed aboard the ambulance, took one look at Meghan, and started barking orders. Jerry’s patient was loaded into the ambulance, two IVs were started on Meghan, and Brandi and Xavier opted to ride in.

Jerry drove as quickly as he could to the hospital. As he pulled into the ambulance bay, he could see several people waiting with a gurney. “Brandi! A team’s waiting on you! Get Meghan in, and I’ll follow with Roger.”

Xavier unhooked Meghan’s oxygen just long enough to transfer it to a bottle he could carry. “Carry the monitor, and I’ve got her, the IVs, and the O2.” He unhooked the IVs from their hooks and laid the bags in Meghan’s lap. He slung the oxygen bottle’s carrying strap over his shoulder, and picked Meghan up. Jerry opened the side door, and Xavier and Brandi carefully carried Meghan out of the ambulance and placed her on the waiting gurney. “Sit her up!” Xavier directed, and the gurney’s head was raised up so Meghan was sitting up. Brandi set the monitor down on the gurney, being mindful of Meghan’s legs, and they rushed her into a trauma bay.

Mitch Branston gulped at his first sight of his sister-in-law. Her hair was disheveled and obviously much shorter than her usual long ponytail. Her face was grime-covered, with a tell-tale dark smudge of soot right below her nose. Her neck was beet-red, and her pants were burned. Mitch directed the nurses to cut clothes, not take them off, and stepped out of their way. He listened carefully to what Xavier told him regarding the rescue and the fire scene and Meghan’s condition, before starting to give orders to his staff. “Someone page the Burn Team and get them up here! I also want Respiratory, STAT.”

Mitch stepped next to Meghan and touched her shoulder gently. “Meghan, it’s Mitch. How are you feeling?”

She looked over at him and coughed. “Hurts. To breathe. Hurts. Everywhere.” Her voice came out gravelly and raspy, and she had to breathe in between each word. Mitch winced.

“Bob, get her started on breathing treatments, albuterol and alupent. Susan, insert a Foley – we need to track urine output.” Mitch heard Meghan cough and gag, and spit up a good amount of spit that was stained black into an emesis bucket that was thrust under her mouth.

“Meghan, we’re going to have to do a bronchoscopy soon. And you know that I can’t guarantee that intubation won’t be necessary.”

She nodded, but he didn’t mistake the pleading look in her eyes.

“I know, but we may have to, to protect your airway.” He put his stethoscope in his ears and listened to her lungs. She was wheezing heavily, which meant that her airways were inflamed and constricted. “You’ve got a lot of wheezes. I’m going to see how you do on the bronchodilators.”

Bob brought over a nebulizer and squirted medications into the chamber. He assembled it, hooked it up to high-flow oxygen, and replaced her oxygen mask with the nebulizer mask.

“Knock, knock.” A doctor and two nurses in surgical scrubs entered the room. “Hi. I’m Dr. Toby from the Burn Unit, and this is Nancy and Reba. We’re going to take a look at those burns. What’s your name?”

Meghan nodded and rasped, “Meghan.”

Dr. Toby looked at Mitch. “Has she had any pain meds yet?”

“No, not yet.”

Dr. Toby ordered some medications for Meghan, and soon they were bringing her relief, and, with that, a more aware and stable Meghan. He leaned her forward and looked at the back of her neck. “You’ve got some second-degree burns here, and a lot of burned hair. Your ponytail holder has melted into the hair. Want us to just cut it out?” Meghan nodded.

While one of the nurses did that, Dr. Toby moved down to Meghan’s legs. He evaluated the right leg first. “Small patches of first and second degree. Looks like you caught some falling embers there. Let’s look at your left leg… ooh. A small patch of third degree surrounded by a lot of second degree. Reba, call down to the unit and get us scheduled for a debridement. Right leg, fist-sized area of third degree with second degree to most of the calf. Also second degree to the back of her neck. Estimated 8% of body surfaced burned, total.”

Dr. Toby put his stethoscope in his ears and listened to Meghan breathe. “Lots of wheezing. We’ll need to do a bronchoscopy.” He turned to Mitch again. “What meds has she received so far?”

“She’s on her first albuterol and alupent. About to end her first 2 liters of normal saline,” he replied.

Dr. Toby nodded. “Good. Go ahead and change the IV fluids when they’re done and drop them to a TKO rate. I see you’ve already got a Foley in, good. Go ahead and do another round of albuterol once that one is done. Is she allergic to anything?”

“Anaphylactic reaction to penicillin,” Mitch confirmed.

“I see. Let’s start her on a round of Rocephin, 1 gram, IV drip.” He nodded decisively.

Meghan coughed again, and he frowned. “Meghan, as soon as we have a procedure room set up, we’re going to take you there. You have second degree burns on your neck that we’ll treat, and second and third degree burns over most of your left calf. We will need to remove dead skin from the area so the tissue underneath can heal properly. We will give you pain meds and sedate you, as we also need to put a scope down your windpipe to see how badly damaged your lungs are and to suction out as much gunk as we can. Depending on how badly your lungs look, we may wind up intubating you and putting you on a ventilator to help you breathe and help your lungs recover. Have you ever been intubated before?”

Meghan nodded. “When. I had. The reaction to. Penicillin. Had. A trach tube. Put in.”

Dr. Toby nodded thoughtfully. “Well, I won’t know if we’ll need to intubate you or not until I see your bronchi, but we’ll have you sign the consent forms now, just in case, okay?”

Meghan nodded as Nancy handed her a clipboard. “I’ve got 3 forms for you to sign. One is consent to be intubated if necessary. One is consent for wound care. And this last one is a general consent to treat. I just need a signature at the bottom of each form, next to the X.” She handed Meghan a pen, and Meghan signed the forms before handing the clipboard back.

Dr. Toby left to make a phone call. Mitch walked over to Meghan. “I’m going to call Kelsey in a few minutes, after they take you to the Burn Unit. Anyone else you want me to call? Rick?” Meghan nodded.

Bob popped his head into the room. “Meghan, I’ve got a couple of people who want to see you before they take you out of here. Mind if I bring them in?” Meghan nodded her consent, and Bob stepped out for a minute.

Soon, Brandi and a man in a firefighter’s uniform entered the trauma room. “Meghan, how are you feeling?” Brandi’s eyes ran over her employee, assessing all the tubes and wires now connected to her.

Meghan pulled off her mask. “Hard. To breathe. But I’m. Making it.”

Brandi pushed the mask back onto Meghan’s face. “You keep that on! Listen, we won’t be but a moment. This is Chief Renolds from the Fire Department.” Meghan looked at the Chief and nodded, held out a hand.

Renolds shook her hand firmly. “Listen, I don’t want to tax your strength. I just wanted to say thank you for what you did, on behalf of the department. If you need anything, PLEASE let the department know. I hope you won’t mind us bugging your supervisor for updates?” Meghan gave him a thumbs-up. “You’ve got a lot of people pulling for you. I’ll get out of your hair, and go corral the boys who have set up shop in the waiting room. Get to feeling better.” He shook her hand again and left the two women alone.

Brandi looked again at Meghan and all of her tubes and wires. “You went above and beyond, Meghan. I’m so proud of you I could burst. And you scared me when I saw you in the ambulance. But you’re a fighter. I want you to focus on that. Fight though this and get well and get back on your ambulance and do it all again.” She saw the doctor and nurses approaching the room. “We’ve got your back, Meghan. If you need something, let me know. I’ll bring you yarn and coloring books and anything else you need.” Brandi squeezed her friend’s hand tight, and Meghan responded in kind.

Dr. Troy came into the room. “Meghan? We’re ready for you downstairs.” He turned to Brandi. “Are you a friend?”

“Yes, but I’m also her boss,” Brandi answered.

Dr. Troy smiled. “I heard about the rescue. Listen, I’ll be updating Dr. Branston, as he’s a family member. He’d probably keep you updated if you asked him.”

Brandi nodded. She gave Meghan’s hand one last squeeze, and left the room. The nurses unhooked Meghan from the monitors, transferred IVs to a pole on her gurney, and wheeled her down the corridor to the elevators to the burn ward.