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kk095 · 22 days ago

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Kenzie’s Cardioversion

*good evening! Since my New Year's story didn't post the way I had hoped, I figured I'd post a different story I had saved. If you're interested in the new years story, I still have the read only link posted. Anyway, enjoy!*

The automatic doors of the emergency department slid open as a paramedic team wheeled Kenzie in on a stretcher. She was propped up, her broad shoulders and thick, sturdy, 5’11 frame making her look larger than life against the narrow confines of the gurney. Her light brown hair was tied back in a ponytail, and her blue eyes darted nervously around the bustling ER. Dr Sarah, the on-call physician, approached with her clipboard, her demeanor calm. Nurse Heather trailed behind, ready for whatever was next.

“Kenzie Cole, 28 years old.” one of the paramedics began, keeping pace with the stretcher. “Fainted at home earlier today, now presenting with severe chest pain, palpitations, and a pinching sensation in the chest. BP’s stable at 118/77, but her heart rate’s been sitting around 130. EKG shows some irregularities we couldn’t immediately identify.” The medic continued, relaying the information.

Kenzie let out a shaky breath and winced as another wave of pain shot through her chest. “It feels like my heart’s tryin’ to jump right outta me!” she said, her southern accent soft yet evident. Dr Sarah placed a hand on Kenzie’s arm to ground her. “We’re going to take good care of you, Kenzie. I just need you to stay calm for me, ok?” Sarah told her patient. “Mhmm…” Kenzie nodded, a hand on her chest. “Let’s get her into Trauma Room two.” Sarah instructed the paramedics, continuing to wheel Kenzie further into the hospital.

Inside the room, the team moved quickly, transferring Kenzie onto the trauma room table as the medics made their way out. “Hey, I need a CBC, BMP, tox screen, d-dimer, cardiac enzyme, and HCG.” Sarah called out to Heather, who sprung into action, getting the necessary equipment for the battery of blood tests just ordered. Sarah then approached the table. “Kenzie, I need you to describe the pain to me again.” Dr. Sarah said, her tone steady. “It’s sharp, like somethin’s pinchin’ me real hard right in here…” Kenzie replied, pressing a hand against her sternum. “And my heart just won’t calm down…” added Kenzie, looking down at her chest. “Alright, let’s start her on a beta-blocker to bring that heart rate down.” Dr. Sarah said to Nurse Heather. Turning back to Kenzie, she added, “Kenzie? We’re running a few blood tests to try and figure out exactly what’s going on. In the meantime, I want you to take slow, deep breaths.” Kenzie nodded, though her eyes remained wide with worry. As the heart monitor beeped steadily in the background, Dr Sarah glanced at the slightly irregular EKG readout, her gut telling her there was more to this case than met the eye.

“How’re you holding up, Kenzie?” Dr. Sarah asked, glancing at the EKG monitor again. Kenzie gave a small, nervous smile. “I’m alright... Just wish my chest would stop feelin’ like this...” The patient answered. “We’re going to figure everything out.” Dr. Sarah reassured her. “First, let’s get a chest X-ray to see if there’s anything structural going on. Nurse Heather, will make it quick.” The cute, nerdy redheaded doctor continued. While Heather stepped aside to arrange the portable X-ray, Dr Sarah continued her examination, carefully pressing along Kenzie’s chest and ribcage. “Any pain when I press here?” inquired Sarah. Kenzie shook her head. “No, ma’am. The pain’s deeper, like… it’s on the inside.” Kenzie answered. Just then, Nurse Heather returned, wheeling the portable X-ray machine closer to the table. “Alright, Kenzie, I’m going to need you to sit up straight for me and hold your breath for a second.” Heather said as she positioned the X-ray plate behind Kenzie. As Heather worked, Kenzie tried to distract herself from the discomfort. “Y’all don’t sound like you’re from Tennessee, huh?” she remarked, her soft drawl making Heather smile. “Nope, born and raised in Virginia, but moved here after I got out of nursing school. “What about you?” Heather continued. “Tennessee through and through.” Kenzie said with a small laugh. “I grew up in Chattanooga. Moved here for work a couple years back. Still ain’t used to the winters, though!” The patient continued. Dr. Sarah chuckled. “Can’t blame you there. I’ve lived here my whole life, and I still complain about the snow every year.”

Heather stepped back and nodded. “All done here. It’ll take a second to get the x ray processed.”

Kenzie leaned back with a relieved sigh. “Thanks, y’all. I appreciate it.” Sarah smiled for a second “of course Kenzie, that’s what we’re here for!”

As they waited for the results, Nurse Heather took a seat beside Kenzie on a stool. “So, Chattanooga, huh? What brought you here again?” asked the young nurse. “Oh, a job offer I couldn’t turn down.” Kenzie explained. “It’s a big change, but I figured it was worth a shot. Didn’t think I’d end up in an ER like this, though.” Kenzie went on, looking down at her chest again, eyeing the wires and EKG electrodes stuck onto her. “Most people don’t, but I promise, we’ll get this sorted out.” Dr. Sarah said, pulling a chair over to review her notes.

Minutes later, the X-ray results popped up on the screen. Dr. Sarah leaned in, her brow furrowing as she examined them. “Well, it’s clear…” she said, a mix of relief and confusion in her voice. “No structural issues, no signs of fluid or anything else abnormal.” Sarah shook her head. Kenzie looked between Dr. Sarah and Nurse Heather, her expression turning more worried. “So… what now? Is that good or bad?” the patient asked. “Now, we have to dig deeper.” Dr. Sarah said with a reassuring smile. “We’ll probably order an echocardiogram. It just means we have to keep investigating. Don’t worry- we’ll get to the bottom of this, we always do sooner or later.” Sarah reassured. Kenzie nodded, though the uncertainty lingered in her blue eyes. She leaned back against the table, her accent softening as she murmured, “I sure hope so, Doc. I don’t like this one bit…” Dr. Sarah gave her arm a comforting squeeze before stepping out to confer with the team about the next steps.

A short time later, the portable echocardiogram machine was rolled into the room, and Dr. Sarah and Nurse Heather began preparing Kenzie for the next round of testing. Kenzie lay back on the table, her wavy, light brown hair cascading over the bed, and her blue eyes fixated on the machine. “We’re going to take a closer look at your heart, ok Kenzie?” Dr. Sarah explained, snapping on a pair of gloves. “This ultrasound will help us see how it’s functioning and if there are any structural abnormalities we couldn’t pick up on the X-ray.” Dr Sarah continued explaining. Kenzie nodded, her tan complexion slightly flushed, whether from nervousness or her condition was unclear. “I ain’t ever seen my heart before… Kinda strange to think I’m about to.” she said, her southern accent softening her words. “Most people haven’t. It’s pretty amazing, though- watching the heart work in real time.” Dr Sarah smiled. Heather applied a cool gel to Kenzie’s chest, and she flinched slightly. “Sorry, I know it’s a bit chilly.” Heather said with a grin, adjusting the probe as Kenzie relaxed. As Dr. Sarah began moving the probe across Kenzie’s chest, an image of her heart flickered onto the monitor. Kenzie’s eyes widened in curiosity. “That’s my heart?!” she asked, her voice tinged with awe. “Yep, that’s your heart, Kenzie.” Dr. Sarah confirmed, her attention divided between Kenzie and the screen. “Right now, we’re looking at the left ventricle- the part that pumps oxygenated blood to the rest of your body.” Explained the doctor, pointing to the screen with one hand. Kenzie’s gaze didn’t waver from the monitor. The rhythmic contraction of her heart was oddly mesmerizing to her- a tiny engine working tirelessly to keep her alive. “It’s kinda beautiful, ain’t it?” she murmured, a smirk on her face. “Never thought about it like that before.” Heather chuckled. “Most people don’t until they see it. It’s pretty remarkable.” Chimed in Dr Sarah, eyeing the ultrasound monitor. Dr. Sarah adjusted the probe, capturing different angles of Kenzie’s heart. The sound of the doppler flow filled the room, a rapid whooshing noise that matched the quick rhythm of her pulse. “Looks like it’s workin kinda hard.” Kenzie commented, her tone a mix of fascination and concern. “It definitely is.” Dr. Sarah said, her eyes narrowing slightly as she examined the images on the screen. “Your heart’s pumping well, but it’s moving faster than it should be. No obvious structural issues so far, which is good, but we’ll have to keep looking.” Sarah explained to the her patient. Kenzie’s curiosity didn’t waver. “Can y’all keep that thang over my chest for a another second? I just wanna look at my heart a little longer!” asked Kenzie, her tone oddly excited. Sarah shrugged, “why not.” Kenzie’s blue eyes lingered on the screen a moment longer, watching the steady rhythm of her heart. “It’s wild, y’all…” she said quietly. “That thing’s been beatin’ inside me since before I was even born. Never really gave it much thought ‘til now…” Kenzie thought out loud. Dr. Sarah gave Kenzie an encouraging nod. “You’re right- it is amazing. And it’s going to keep going while we figure this out! One step at a time.”

A little while later, there were still no answers. Sarah glanced at the monitor- Kenzie’s heart rate was climbing, and her EKG was shifting into a more worrisome rhythm. “Still no labs?” Dr. Sarah asked Nurse Heather, her tone sharp with urgency. “They’re backed up in the lab. I’ve called twice, but they’re swamped.” Heather shook her head, frustration etched across her face. “Alright, let’s focus on what we can do. For now, we’ll manage her symptoms and keep her stable until we get some answers.” Dr. Sarah shook her head. Kenzie, who had been lying quietly on the table, suddenly grimaced and pressed her hand to her chest. “It’s getting’ worse, Doc!” she said, her voice strained. “Feels like my heart’s ‘bout to burst…” Her eyes pinched shut for a second. Dr. Sarah sprung into action and stepped to her side immediately. “Dizzy? Short of breath?” asked the doctor. Kenzie nodded weakly. “Both! It’s like my chest is getting squeezed, and my head’s floatin’ away.” Explained Kenzie.

The monitor let out a louder beep, catching everyone’s attention. Dr. Sarah’s eyes snapped to the screen, where the EKG now showed a concerning pattern: stable ventricular tachycardia. Kenzie’s heart was beating dangerously fast, and the rhythm had taken on an ominously irregular look. “She’s in stable v-tach.” Dr. Sarah observed, her tone calm but urgent. “We need to start chemical cardioversion now. Heather, get me an IV push of amiodarone.” The doctor called out. Heather nodded and hurried to prepare the medication while Dr Sarah leaned over Kenzie. “Kenzie, your heart’s beating too fast, and we need to slow it down. We’re going to give you a medication that should help. You might feel a little strange when we do this, but we’re keeping a close eye on you.” Dr Sarah explained. Kenzie’s blue eyes were wide with fear, but she nodded. “Okay… just… just don’t let me die, alright?” Kenzie answered. Dr. Sarah squeezed her hand. “You’re in good hands. I promise.”

Heather returned with the syringe and began administering the amiodarone through Kenzie’s IV. Dr. Sarah kept a close eye on the monitor, watching for any sign of improvement. “Take slow, deep breaths, Kenzie.” Dr. Sarah instructed. “In through your nose, out through your mouth. That’s it. Stay with me.” Continued Dr Sarah. Kenzie closed her eyes briefly, her tan complexion now pale. The chest pain was unbearable, but she focused on her breathing, trusting the team around her.

Dr. Sarah kept her eyes glued to the monitor as the amiodarone infusion ran through Kenzie’s IV. The jagged peaks of the EKG line showed no signs of calming, the ventricular tachycardia holding steady. She glanced down at Kenzie, who was visibly struggling. Kenzie’s breaths came quicker now, shallow and labored, her hand gripping the thin blanket tightly. She moaned softly, her face contorted in pain, tears brimming in her wide blue eyes. “Doc… it’s not workin’..,” she uttered, her voice trembling. “It’s getting’ worse. Somethin’ ain’t just ain’t right…” Kenzie shook her head. Dr. Sarah placed a reassuring hand on Kenzie’s arm, though her own heart sank at the sight of the monitor. “I know, Kenzie. We see it. We’re not giving up- just hang in there a little longer for me, okay? We’ll get this under control.” Soothed Dr Sarah. Kenzie turned her head slightly, tears slipping down her cheeks as she winced again. “It hurts so bad…” she moaned, pressing a hand to her chest. “It feels like somethin’ inside’s about to explode!” her voice wobbled. Nurse Heather returned to the bedside, her expression a mix of calm professionalism and urgency. “Vitals are holding, but her heart rate is still climbing-160 and rising. BP’s 124 over 78, but I don’t like how pale she’s getting.” Heather called out. Dr. Sarah nodded, her mind racing. “We need to stabilize her before this escalates. Prepare for synchronized cardioversion. Let’s get the defibrillator ready and explain the process to Kenzie.” Sarah told Heather.

Heather moved swiftly to grab the defibrillator pads while Dr. Sarah knelt by Kenzie’s bedside. “Kenzie, we’re going to try another method to get your heart back to a normal rhythm.” she said, her tone calm but firm. “It’s called synchronized cardioversion. It’s a quick electrical shock, but we’ll give you something to make you comfortable beforehand. This is the next step we need to take.” Explained Dr Sarah. Kenzie’s eyes widened with fear, her chest rising and falling rapidly. “Shock me?!” she asked, her voice breaking. “You’re gonna shock me?! But my heart’s still beatin!” Kenzie asked, trying to make sense of what was about to happen. Dr. Sarah nodded, her expression softening. “I know it sounds scary, but it’s controlled, and it’s necessary. Right now, your heart’s working too hard, and we need to help it reset. We’ll give you medication to relax you first- you won’t feel a thing.” Sarah tried to reassure. Dr. Sarah took a deep breath, bracing herself as she crouched next to Kenzie. The young woman’s fear was palpable, her tear-streaked face turned toward the ceiling as her chest heaved with rapid, shallow breaths. “No, no, no!” Kenzie sobbed, shaking her head. “You can’t shock me while my heart’s still beatin’! That ain’t right! Please don’t do this to me!” resisted Kenzie. “Kenzie, I know this is scary.” Sarah began, her voice calm but firm. “I need you to listen to me, okay? Your heart’s in a dangerous rhythm. If we don’t intervene now, it could get way worse- this procedure will help your heart reset before that happens.” Sarah went on. Kenzie’s sobs grew louder, her hands clutching at the thin blanket draped underneath her. “But it’s beatin’! My heart’s still beatin’! Y’all don’t need to shock me! Please don’t do this!” Kenzie continued to resist. Nurse Heather moved closer, her voice gentle but steady. “Kenzie, I know this sounds terrifying, but synchronized cardioversion is different. It’s not like the shocks you see on TV during a code. We’re going to time it carefully with your heartbeat to reset your rhythm. You’ll be relaxed, and it’ll be over in seconds.” Heather chimed in. Kenzie turned her tearful gaze to Heather, her body trembling. “You promise I won’t feel it?” asked Kenzie nervously. “You won’t feel a thing, and we’ll be right here the whole time, keeping you safe. Heather assured her. Kenzie sniffled, her sobs beginning to subside as she processed their words. She wiped at her face with the back of her hand, her breathing still uneven. “Alright…” she whispered shakily. “Alright, I’ll let y’all do it… but please… just get it over with so I’ll be alright.” Consented Kenzie. Heather nodded and began setting up the defibrillator, moving with practiced efficiency. “We’ll take good care of you, Kenzie. You’re doing great.” Smiled Heather.

As Heather peeled the adhesive backing off the defibrillator pads, she glanced at Dr. Sarah. “I’ll place these while you give her something to calm her down.”, to which Sarah nodded. Dr. Sarah met Kenzie’s gaze, offering a reassuring smile. “The procedure will be quick, and complications from this are very rare. You’re in good hands.” Sarah told her patient. Kenzie sniffled again, her tears still flowing but her demeanor more composed. She shivered slightly as Heather placed the first pad on her upper chest, the cool adhesive making her flinch. “Almost there, Kenzie.” Heather said softly, placing the second pad below Kenzie’s left ribcage. Kenzie nodded weakly, her voice barely above a whisper. “Please… just make me better…” Sarah rested a hand gently on Kenzie’s arm, squeezing it lightly. “We’re going to take care of you, Kenzie. Just relax- we’ll handle the rest.” Reassured Sarah. Kenzie nodded again, her blue eyes fluttering shut, though a single tear slipped down her cheek. “Okay…” she murmured.

As Sarah administered the medication and synchronized the defibrillator, a quiet settled over the room. The hum of the monitor and the faint rustle of equipment were the only sounds. The defibrillator began to hum, a low, rising tone that sent a fresh wave of fear through Kenzie. She moaned softly, her body tensing in nervous anticipation. “I can hear it…” she whimpered, her voice trembling. “Oh God, I don’t wanna do this again…” Kenzie thought to herself. Dr. Sarah leaned in, keeping her tone calm but firm. “Kenzie, I know this is hard, but you’re doing great. Just stay as still as you can, okay? We’re going to try the first shock now. It’ll be quick.”

Kenzie nodded shakily, her hands gripping the edges of the table. “Alright…” she whispered, barely audible “Clear!” Sarah called, ensuring everyone had stepped back before pressing the button. Kenzie’s body jolted briefly as the shock coursed through her. “Ooooo!” she grimaced, her face contorting in discomfort. As the jolt passed, she exhaled sharply, her chest heaving. “That’s… that’s it?” she asked breathlessly, blinking back tears.

Heather leaned over the monitor, scanning the EKG. The jagged, rapid peaks of ventricular tachycardia remained stubbornly unchanged. “No change,” Heather announced, her tone clipped and professional. Sarah’s face tightened, but she quickly masked her concern. She stepped back to Kenzie’s side, crouching slightly to meet her gaze. “Kenzie, I need you to listen to me.” she said gently. “The first shock didn’t work, so we’re going to try again. This happens sometimes. It can take more than one attempt to reset your heart.” Sarah reassured. Kenzie’s blue eyes widened, and fresh tears spilled down her cheeks. “Again?!” she groaned, shaking her head. “You mean y’all have to shock me again?!” Kenzie’s voice wobbled. “I know it’s not what you wanted to hear.” Sarah replied, her voice steady but compassionate. Kenzie sniffled, her bottom lip trembling as she tried to compose herself. “Alright… just… just do it. I can’t take too much more of this...” she whispered hoarsely. Heather gave Kenzie’s hand a reassuring squeeze. “You’re strong, Kenzie. We’ll get you through this.” Promised Heather. Sarah turned back to the defibrillator, resetting it for another shock. The hum of charging electricity filled the room once more, and Kenzie squeezed her eyes shut, bracing herself. Sarah’s finger hovered over the controls. Kenzie braced for what was to come, unaware of how much her fight to survive would leave an indelible mark on everyone in the room.

The defibrillator charged again, the rising, electrical hum filling the room with a sense of tension. Sarah glanced at the monitor, the jagged peaks of Kenzie’s arrhythmia still unchanged. “Kenzie, we’re going to try another shock, okay? This one might do the trick.” Sarah eyed Kenzie for a moment. Kenzie barely nodded, her lips trembling as fresh tears streamed down her face. “Please… just make it stop…” she begged, her voice cracking. “Clear!” Sarah called. “AHHH!” Kenzie cried out in pain as the second shock hit her. Her body arched slightly off the table, her large frame twitching involuntarily before falling back against the table. Her breathing was heavy, and she clutched at the sides of the stretcher, her knuckles white.

Heather scanned the monitor. “Still in v-tach…” she reported grimly. Sarah sighed and crouched down next to Kenzie again. “Kenzie, I know this is hard, but we need to try again. I’m going to deliver a third shock. You’re doing so well- just one more try.” Sarah held Kenzie’s hand for a second. Kenzie moaned, shaking her head as her sobs grew louder. “No… no… I can’t do this anymore! Please, y’all, stop! I can’t take it!” she cried, her voice breaking. Heather leaned closer, her tone soft but insistent. “Kenzie, I know it hurts, but we’re trying to save your life. Just hold on a little longer and we’ll get through this together.” Reassured Heather. Kenzie couldn’t speak, her cries turning into gasping sobs. Sarah nodded at Heather, her expression resolute. “Charging…” Sarah said, her voice steady despite the tension in the room. “Clear!”

Kenzie let out a piercing scream as the third shock dashed through her. Her 5’11 frame twitched violently on the table, her legs briefly lifting off the bed. She collapsed back with a loud yelp, clutching her chest as tears streamed down her face. Heather’s eyes remained on the monitor, her expression tight. “Still no conversion, Sarah.” she said quietly. Sarah hesitated for only a moment before addressing Kenzie again. “Kenzie, I’m so sorry, but we need to deliver one more shock. This could be the one that works.” Sarah gently strokes Kenzie’s hair for a second. Kenzie’s head snapped up, her tear-streaked face a mask of anguish. “NO!” she screamed, her voice raw and trembling. “Y’all better not shock me again! I can’t! No more!” she resisted. She clutched at her chest, sobbing uncontrollably as the sound of the defibrillator charging filled the air once more. The hum grew louder, relentless, as Sarah and Heather exchanged a quick glance, each understanding the weight of the moment. Sarah crouched down again, her voice as soothing as she could make it despite the chaos. “Kenzie, I know you’re scared. I know this is hard. But we have to keep trying. You’re stronger than this- you can do it.” Kenzie shook her head frantically, her sobs wracking her entire frame. “No… no more… please…” she whimpered, but the charge was ready, and time was running out.

“Clear!” Sarah called as the defibrillator delivered its next shock. Kenzie’s body jolted violently again, her toes curling involuntarily at the end of the stretcher. Her large, size 13 feet tensed up hard, exposing the soft, thick wrinkles in her soles, and the faint sheen of her white toenail polish glinted under the fluorescent lights. She let out a sharp cry as the electrical current coursed through her, her frame trembling before collapsing back onto the table. Heather’s eyes remained glued to the monitor, her heart sinking as the v-tach persisted. “Kenzie?” Heather leaned over, her tone calm, trying to mask her growing concern. “We’re going to shock again, okay? We’re not giving up.” Heather explained. “NO!” Kenzie sobbed, her voice trembling with terror. Tears streamed down her face as she gripped Heather’s hand tightly, her fingers digging in. “No more, please… I don’t wanna die. I don’t wanna die!” Her voice cracked, raw with desperation. “I’m so scared!” Sobbed Kenzie.

Heather gave Kenzie’s hand a reassuring squeeze, locking eyes with her. “Kenzie, listen to me.” she said, her voice steady and soothing despite the chaos. “You’re not going to die. We’re going to fix this. You’ve been so strong- we’re not giving up on you.” Heather told her patient. Kenzie sniffled, her sobs growing quieter but no less heart-wrenching. She nodded faintly, her chest heaving with uneven breaths. “Okay… Just… just help me…” she uttered, her voice barely audible. Heather brushed a strand of light brown hair from Kenzie’s forehead. “We will.” she promised softly, even though deep down, she couldn’t shake the growing ominous feeling in her chest. The sound of the defib pads charging up filled the air again, rising in pitch. Time was running out, and the unrelenting rhythm on the monitor told a story none of them wanted to face.

“Clear!” Sarah’s voice rang out as she pressed the button to deliver another shock. Kenzie’s body tensed violently, her busty chest thrusting forwards as the current surged through her. “AHHH!” she yelped loudly, the sound echoing through the trauma room. Her hand shot to her chest, clutching it tightly as if trying to shield herself from the pain. Her tear-filled blue eyes darted between Sarah and Heather, no longer seeing the compassionate caregivers who had reassured her moments ago. Instead, her gaze was filled with fear and betrayal, as if she were staring at two torturers. Kenzie gasped heavily, her breaths labored and erratic. “I… I can’t… I…” Her words broke into a series of hyperventilated sobs. Her eyes dropped to her chest, her face growing increasingly pale. She started taking deep, dramatic gasps, her whole body shaking. “Kenzie, stay with us!” Heather urged, moving closer and resting a hand on her shoulder. “You’re okay. Just breathe with me- slow breaths in and out.” Heather continued. Sarah leaned over the monitor, watching her vitals closely. “Kenzie, we need you to stay strong for us, ok?” she added, her voice steady with subtle worry. But Kenzie didn’t respond. Her gasps grew shallower and slower until her eyes glazed over, staring blankly at the ceiling. Her body slumped back onto the table as her muscles went limp. “She’s unresponsive!” Heather called out, moving quickly to check for a pulse. “Crap. Start bagging her!” Sarah instructed, her own heart racing as she glanced at the monitor. Kenzie’s heart rhythm had degraded further. “Get the crash cart back over here! We need to act now!” Yelled Sarah.

“Heather, let’s move!” Sarah commanded, her voice sharp as the team sprang into action. Heather immediately lowered the bed and positioned herself beside Kenzie. Grabbing a pair of trauma shears, she snipped through the fabric of Kenzie’s bra in one swift motion, exposing her chest and large, natural breasts. She interlaced her fingers and placed her hands in the center of Kenzie’s chest, beginning firm, rhythmic compressions. Heather’s compressions, steady and precise, caused Kenzie’s body to shift slightly with each push. The sound of her effort filled the room, accompanied by the steady beeping of the monitor. “Come on, Kenzie, don’t do this…” Heather muttered under her breath as she worked tirelessly on Kenzie.

At the head of the bed, Sarah was laser focused on securing Kenzie’s airway. With practiced efficiency, she opened the intubation kit and inserted the laryngoscope into Kenzie’s mouth, maneuvering it carefully to visualize her vocal cords. Her own breath hitched for a moment as she caught sight of Kenzie’s wide, lifeless blue eyes staring blankly up at her. It was an eerie sight, as though Kenzie was silently witnessing the scene around her. “Tube ready.” Sarah said, sliding the 8.0 endotracheal tube smoothly into place. She secured it with one hand while quickly inflating the cuff with the other. “I’ll start bagging.” Sarah called out, attaching the ambu bag after taping the tube in place. The rise and fall of Kenzie’s chest with each squeeze provided a slight glimmer of hope amid the urgency. “Pulse check!” Heather called after completing her cycle of compressions, her face flushed. Sarah leaned over, her fingers pressing against Kenzie’s carotid artery. She shook her head. “Still no pulse. Resume compressions.” She instructed. Heather nodded and immediately began another round, her hands pressing deeply into Kenzie’s sternum. Each compression caused a ripple through Kenzie’s body, her large frame shifting around. Kenzie’s chest caved in hard, her large breasts juggling around in sync with each individual compression. Kenzie’s belly rippled out as Heather continued pumping away at her chest. “Epinephrine, one milligram, IV push.” Sarah ordered, not taking her eyes off the monitor. Sarah got the medication ready, and administered it into Kenzie’s IV line. “Let’s prep for another shock, she’s not converting.” she added, the tension in her voice rising. “Charging to 200 joules. Everyone clear!” shouted Sarah. Heather momentarily stepped back, lifting her hands off Kenzie’s chest as Sarah delivered the shock. Kenzie’s body jerked sharply on the table, her arms and legs twitching before falling limp once again. “Resume compressions.” Sarah ordered, her tone resolute. Heather immediately leaned back over Kenzie, resuming the relentless compressions, her hands pressing into Kenzie’s sternum with tremendous force.

Heather positioned her gloved hands firmly on Kenzie’s chest, her fingers interlocked and arms locked straight. With each forceful compression, Kenzie’s body shifted on the table, her chest visibly caving under the violent pressure. “five, six, seven…” Heather silently counted in her head as she delivered deep, rhythmic compressions. The monitor beeped steadily with no signs of improvement, the jagged waves of ventricular fibrillation mocking the duo’s efforts. After two minutes of relentless CPR, Sarah glanced up. “Okay, everyone, . Charging to 300 joules.” Sarah called out as Heather backed away from the patient. Heather stepped back, wiping her forehead with the back of her hand as the defibrillator charged. The hum of the machine filled the room, a sound that made everyone hold their breath. “CLEAR!” Sarah pressed the button, releasing the shock. Kenzie’s body flopped violently on the trauma room table, her head rolling slightly to one side as the electricity coursed through her. A sharp, guttural gasp escaped her lips- a reflexive response to the shock rather than a sign of life. Heather’s eyes flicked to the monitor. No change. The unrelenting v-fib pattern still dominated the screen. Sarah sighed heavily, her voice steady but tinged with frustration. “Still in v-fib. Resume compressions.” Sarah shook her head. Heather immediately moved back into position, pressing her hands against Kenzie’s chest once more. The force of each compression sent ripples through Kenzie’s sturdy, motionless frame, her pale skin glistening under the harsh overhead lights. “Come on, Kenzie…” Heather murmured under her breath, her voice almost pleading.

Heather’s hands moved mechanically as she continued chest compressions, but her mind was a whirlwind of emotions. Just a short while ago, Kenzie had been laughing nervously, chatting about her home in Tennessee, her southern accent adding a charming warmth to the conversation. Now, that same vibrant young woman lay motionless beneath her hands, her life slipping further away with each compression. “She was fine… she was fine…” Heather muttered under her breath, her voice barely audible over the whoosh of the ambu bag and the occasional beeps of the monitor. Her jaw clenched as she fought back a wave of frustration and helplessness, tears threatening to blur the young nurse’s vision.

At the head of the bed, Sarah worked diligently, her gloved hands adjusting the ambu bag between compressions to ensure Kenzie’s lungs were properly inflated. But her focus was fractured, her thoughts gnawing at her composure. “Did I miss something?” Sarah’s mind replayed the entire case like a film on fast-forward. Kenzie’s EKG abnormalities, the unsuccessful cardioversion attempts, the worsening symptoms. Had there been a sign- something subtle, that she’d overlooked? “She trusted us…” Sarah whispered, the weight of responsibility settling heavily on her chest. Her voice was so low that no one else heard it. She swallowed hard, pushing the guilt aside as best she could. There was no time for self-incrimination. Heather’s voice broke through the tense silence. “Another two minutes of compressions done.” she announced hoarsely, stepping back as Sarah moved to check the rhythm. The monitor still displayed the chaotic, disorganized waves of v-fib. Sarah closed her eyes briefly, forcing herself to take a deep breath. She had to stay strong for both Heather and Kenzie. “We’ll go another round,” Sarah said, her tone firm but betraying the faintest tremor of weariness. Heather nodded, stepping back into position, but she couldn’t shake the haunting image of Kenzie’s wide, terrified eyes as she begged them not to shock her again. Heather’s heart ached as she resumed compressions, the repetitive motion a grim reminder of how fragile life truly was. During this cycle of compressions, the air in the room grew heavier, the emotional strain palpable. Despite their best efforts, the team felt the creeping despair of a battle they feared they might lose.

Heather’s hands returned to Kenzie’s chest without hesitation, delivering powerful, forceful compressions. Each downward thrust sent subtle ripples through Kenzie’s thick, sturdy frame, a stark contrast between her strong build and her fragile condition unnerving to the team. “Charging to 360.” Sarah announced, her voice steady despite the hectic battle ensuing in the room. The defibrillator’s high pitched whine filled the air as it prepared for the next shock. “Clear!” Sarah called, stepping back as Heather moved aside. The shock was delivered, and Kenzie’s body arched slightly, her feet kicking up reflexively at the end of the table. Less than a second later, her feet plopped back down unceremoniously, her large feet landing with a soft thud, the deep, wide, prominent wrinkles in her soles on full display. Despite the dramatic response, the monitor’s display remained unchanged, with v-fib continuing to display. Heather let out a shaky breath, immediately resuming compressions. “Come on, Kenzie…” she murmured, her voice a mixture of determination and desperation as she continued to press into Kenzie’s bare chest. “Pushing another dose of epi.” Dr Sarah called out, her focus unwavering.

“Let’s prepare for another round.” Sarah instructed, glancing briefly at the clock. The code had been ongoing for several minutes, but she refused to give up just yet. Heather maintained the cycle of compressions, sweat beginning to bead on her forehead as she worked tirelessly to sustain circulation. The team worked in near-perfect synchronization, their actions precise and deliberate. “Hold compressions, Heather.” Sarah said, reaching for the defibrillator controls. The pads were once again recharged to 360 joules as Heather stepped back from the table. “CLEAR!”

The next shock was delivered, the current visibly jolting Kenzie’s body once more. Her arms shifted slightly, and her chest rose briefly before settling back down, but the monitor’s erratic waves refused to stabilize. “No change.” the nurse confirmed solemnly. Sarah clenched her jaw, her mind racing through the remaining options. “Resume compressions.” she ordered. Heather obliged without hesitation, her hands returning to their task as Sarah began to strategize the next steps.

The atmosphere in the trauma room grew heavier with each passing minute. The monotony of the code-compressions, medications, shocks- was relentless, each cycle blurring into the next. The monitor stubbornly displayed the chaotic, disorganized rhythm of ventricular fibrillation, its jagged peaks a grim reminder of Kenzie’s condition. Heather’s movements remained methodical, but her exhaustion was evident in the faint tremble of her arms as she pushed down on Kenzie’s chest. “Come on… come on Kenzie…” she whispered, more to herself than anyone else. She fought the mounting dread gnawing at her, unwilling to accept the thought that their efforts might be in vain. “Another dose of amiodarone in.” Sarah informed Nurse Heather, her voice sharp despite the weight in her chest. She wiped her brow with the back of her glove, glancing at the clock on the wall. The minutes ticked by with an almost mocking speed, the relentless pace of time a cruel contrast to the stagnant rhythm on the monitor. “We need to shock. Charging to 360 again.” Sarah said, her voice steady but her stomach twisting. Heather stepped back as the defibrillator charged, the familiar high pitched whine filling the room like a warning bell of sorts. “CLEAR!” Sarah called, pressing the button. Kenzie’s thick body twitched slightly, her head tilting back as the shock coursed through her, but the monitor remained unchanged. “No response.” the nurse said quietly, avoiding eye contact with anyone in the room. Heather stepped back into position, her hands returning to Kenzie’s chest. Her compressions were just as strong as the first cycle, but the emotional toll was starting to show. Heather avoided looking at Kenzie’s face at all costs, the sight of her lifeless eyes too much to bear. “We’re going to shock again, pushing another dose of epi and atropine first.” Sarah decided, almost her voice almost mechanical, as if detaching herself emotionally could shield her from the growing sense of failure. She caught herself glancing at Kenzie’s face, the memory of her vibrant personality from earlier flashing in her mind. The dread in Sarah’s gut turned into a cold knot. The duo continued, but the energy in the room was shifting. The once vivid determination had given way to a quiet desperation, each team member acutely aware that they were likely fighting a losing battle.

Trauma room two was filled with the incessant beeping of the monitor and the rhythmic thumping of Heather’s compressions. Kenzie’s body shuddered under Heather’s strong hands, her chest rising and falling with the brute force. “Charging to 360.” Sarah said again, her voice strained but composed as she prepared for yet another shock. The defibs whined as it powered up. “CLEAR.” Sarah called. Heather stepped back, her hands hovering as the shock was delivered. Kenzie’s body tensed, her head tilting slightly, and a faint, involuntary moan escaped her lips- a reflex, nothing more. Heather immediately resumed compressions, but the monitor showed no change. V-fib stubbornly persisted, as deadly and unrelenting as it had been since the start of the code.

Minutes blurred together, each one a cruel thief of hope. Heather kept going, her hands now aching with fatigue, her breaths short and heavy. At the head of the bed, Sarah leaned over Kenzie’s face, shining a pen light into her wide, unblinking eyes. Kenzie’s head bobbed slightly with each compression, her lifeless gaze fixed on nothing. Sarah straightened up, exhaling sharply as she slid the pen light back into her scrub pocket. “Pupils fixed and dilated.” she announced quietly, her tone edged with defeat. She checked the clock on the wall. “Kenzie’s been down for 35 minutes, still in v-fib.” Continued Sarah. Heather hesitated, her movements faltering for the first time. She stopped compressions, her hands lingering on Kenzie’s chest before she finally stepped back, her lips pressed into a thin line. The room fell silent except for the relentless alarm of the heart monitor, the jagged peaks of v-fib still mocking the duo’s efforts. Sarah scanned the room for a moment, before looking at Heather, her own face a mask of exhaustion and guilt. Finally, she drew a deep breath and made the dreaded announcement, “Time of death… 14:47…”

The words hung In the air, heavy and final. Heather swallowed hard, her hands clenched at her sides as she stared at Kenzie’s lifeless form. For a moment, no one moved. “Let’s clean her up…” Sarah said softly, breaking the silence. The room was somber as the team began the grim process of postmortem care. Dr. Sarah remained at the head of the bed, her movements mechanical as she detached the ambu bag from the ET tube, setting it aside. Her fingers lingered briefly on the monitor before she reached for the power. button, silencing the alarm that had marked every failed moment of the code. Heather worked delicately at Kenzie’s side, removing the IV lines from her arms and disconnecting the EKG wires. She peeled off the defib pads from Kenzie’s chest, each movement feeling heavier than the last. Her eyes darted to Kenzie’s face- a face frozen in its final, terrified expression. Kenzie’s wide, unblinking blue eyes stared blankly at the ceiling, a hauntingly beautiful stillness overtaking her features. The ET tube remained in place, its end hanging awkwardly out of her mouth, brushing lightly against her pale lips. Heather’s throat tightened at the sight of the death stare, a memory she knew would be impossible to erase.

Sarah filled out a toe tag, her pen scratching softly against the paper. She paused for a moment, as if the simple act of writing Kenzie’s name made the loss feel all too real. With a steadying breath, she knelt by Kenzie’s left foot and slipped the tag onto her big toe. It dangled there, brushing against the deep, thick wrinkles in the soles of Kenzie’s feet- a stark, unyielding symbol of the young woman’s untimely fate. Heather stepped back as Sarah got a cover from a nearby drawer. Together, they pulled the cover up and over Kenzie’s still form, concealing the lifeless gaze that had captivated and haunted them in equal measure. The trauma room grew quiet, except for the shuffle of their feet as they moved around the bed. The finality of it all settled over them, heavy and suffocating. Dr. Sarah placed a hand gently on Heather’s shoulder. “Let’s take a minute, Heather.” she murmured, her voice heavy with emotion. Nurse Heather nodded, but her eyes remained fixed on the covered body before them. No matter how many times she went through this process, the weight of loss never grew lighter. Just like that, Kenzie became the latest beauty to find herself toe tagged and under a sheet in our emergency department.

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