Theresa was in the back of the unit, audibly snoring, and Jim, while driving, smacked the partition that separated the back of the ambulance from the cab and yelled, "Alright, wake up. It looks like we will probably have a call. Taylor, go ahead and check the nearby vehicles, then switch on code 3."
I had already fired up the ambulance's scanner, checking the registry of any nearby vehicles, and I turned to him, "Should we wait until Dispatch calls us?" Although I asked him, I immediately clicked on the lights and sirens as soon as I determined nobody of import was driving nearby.
"Nah... we're so close it's almost impossible we don't get toned out for this," he said with the drawl of someone who had seen and done it all.
Sure enough, barely ten seconds later, an impossible-to-ignore klaxon briefly played in each of our heads before the voice of our Dispatch came on the line, "Unit 88, MVC on loop 210 in Santo Domino, northbound. Bus, 37 occupants, other possible involved vehicles, unknown injuries. NCPD on scene. Respond."
Jim glanced at me as he easily wove around traffic, half of which didn't even bother to pull over for our lights and sirens, and asked, "You wanna?"
I blushed but nodded and grabbed the radio handset on the dash, and pressed the push-to-talk. I could have done this in my implant, but it was cooler to use the handset, "Dispatch, Unit 88, responding. ETA zero three minutes. We're almost already there."
I placed the handset back on the dash and said, "Hopefully, this isn't a mass casualty incident." That caused Jim to snort.
"You heard the police scanner; it was a MaiMai. I bet the bus crunched it like a Nicola can. Probably then got rear-ended by the cars behind it. I bet only a few of the people on the bus are injured," said the more experienced paramedic. But then he paused, "But if it is, I will take one patient, and you and Theresa can stabilise another."
I nodded and then looked up ahead to see a huge traffic backlog, but a few NCPD patrol cars had already opened up a small path so that we could drive right up to the scene of the accident. I got on the radio to report that we were on scene, but right before I was going to get out of the ambulance, another different klaxon played in my head, and we received the following radio alert, "Unit 88, Dispatch, be advised Trauma Team is responding to collect their client, NC 17728192 Anders Weber. They are zero six minutes out, redirect and stabilise their patient, then proceed to the bus after patient hand-over."
Jim held a hand up, and he responded himself, "Dispatch, Unit 88, roger. Deets on the TT client's vehicle or condition?" But I had already zeroed in on a sports car that had rear-ended the bus and elbowed Jim and nodded in that direction. He chuckled and nodded, "Nice catch, newbie. Let's hurry. I always love when we get there before TT, plus the company loves it because TT pays us triple rates when we respond to their clients, even if it is only for a few minutes."
I grabbed the cardiac monitor and the bag with most of our commonly used equipment while Jim was carrying the bag with our drugs, and Theresa had the ventilator unit, just in case. I scanned the man that was sitting next to the crunched-up sports car; he was bleeding freely from a few lacerations on his head and neck, and his arm, an obviously cybernetic limb, seemed to be seriously damaged.
Jim took a look at his minor injuries and shrugged, and said, "You can take care of him. We can leave the field bag here for now, and Theresa and I will check the bus. Be real chill with TT when they get here; they're good chooms but take their jobs pretty serious-like." I nodded at him and handed over the vital monitor/defibrillator to him.
I scanned his face real quick to verify it was actually Anders Weber before kneeling down and saying in my best professional healthcare worker voice, "Mr Weber? How are you doing? Let me take a look at you if you don't mind. I'm a paramedic."
He glanced at me, seeming a little out of it, "Oh.. huh.. isn't Trauma Team...?"
I nodded at him and said, "They should be here in a few minutes, but we were just down the road and actually got here first, for once."
That caused him to chuckle, "Well... my tax dollars at work, I guess. Go ahead." I wanted to tell him that emergency medical services were privatised in Night City, although a lot of people didn't realise it since all the medics dressed the same, all the ambulances had a similar paint job, et cetera.
I plugged my personal link through the firewall, which was actually legal for me to own now that I was a first responder, into his interface socket as I diagnosed both his injuries, got a readout of his installed cyberware, and a report from his medical biomonitor. I went through a neurological assessment with him while simultaneously perusing his internal biomonitor. He had an older version that didn't include a direct link to a medical provider, so that meant that Trauma Team didn't have his vitals.
Almost on cue, a beep in my mind preceded another radio transmission, "NC Med 88, this Trauma Team Flight 4, we are two minutes out. Do you have a patient report?"
I fiddled with my internal controls, not used to the particulars of this company-provided software, before I figured out how to respond to them, then mentally held down the radio talk button, "Trauma Team 4, 88, your subscriber has two minor scalp lacs, one minor lac to the neck, scoring B on the SACE, vitals from his biom are pulse of 144, bp of 165 over 94, nothing interesting on the tox report, his left superior has severe damage, its a DK-MT-201 by Arasaka. I was going to disconnect it from its power cell, as it keeps trying to deploy the blade, and I don't want it to poke me, but I can wait if you want."
I had already started to clean and apply bandages to his neck and scalp, carefully avoiding the malfunctioning arm that contained a mantis blade and keeping it inside its reach in case it malfunctioned and deployed the blade on me. The SACE was the Standard Acute Concussion Evaluation, and although a B sounded like a good score, it meant that there was definitely a concussion and, therefore, at least a minor brain injury going on here. He couldn't remember precisely what day it was; he thought it was yesterday. But it didn't seem too severe; he was mostly alert, aware and had a non-altered mental state other than that.
He also said he was only a five out of ten for pain, which impressed Taylor because, to her, it looked like it hurt a lot more than that.
Trauma Team got back to me rapidly, "Roger that. Yeah, go ahead and disable that arm if you don't mind. We appreciate not getting geeked by our own patients, too. Also, if you could start an IV and administer 1mg of lorazepam, and a standard dose of whatever opiate you have, see if we can get that blood pressure down a bit. We'll have to land on the other side of the highway, but we should be there soon."
"Mr Anders, Trauma Team is almost here. I'm going to start an IV, and they've directed me to administer something for the pain; they should be here soon," I told the man. It was always best practice to tell a patient that was more or less alert what you were going to do to them, then do it, then tell them again what you just did to them.
I grabbed a small IV kit from the field bag, not bothering to move at the unnatural slow motion I usually did, which startled the man for a moment before I reassured him and started the IV, then pushed the benzo and opiate, followed by a flush of saline down the line. "Mr Anders, please, if you can, hold out your left arm. Your DK-MT has been significantly damaged, and I need to disable it briefly for the safety of everyone involved." He obeyed, and I let my medical sense and what I had researched about arm cybernetics guide me to an access panel, which I flipped open before carefully wiggling a power connector out of its position, managing to yank it free, which caused the whole limb to power down, and stop making those terrible grinding and sparking noises.
I heard the AV overhead, and it landed on the other side of the highway, briefly shutting down traffic going the other direction before four armoured people hopped out and double-timed it, hopping over the median and jogging over to me. The Security Specialists were scanning everyone and everything, and while they didn't have their small carbines pointed in my direction, they did have them held at a sort of ready port arms position, cradled in their arms where they could be deployed in an instant.
I took a step back, disconnecting from his interface socket, "Here's your guy. One milligram of Ativan was administered, and fifty mikes of fent. His pulse is down to 124, and his blood pressure has dropped thirty, both systolic and diastolic. Pulled the main power bus on his mantis blades, so they're in safe mode."
The two Trauma Team medics were easily spotted as they carried quite a bit of gear and only had a pistol in a holster on their thighs. One of them said, "Nice. Thanks. We got it from here; I'm sure they diverted you; go ahead and check the bus now," while the other deployed a portable gurney.
I nodded and waved before turning around and grabbing the field bag, and heading over to my two colleagues. I could hear another siren in the distance, which I assumed was at least one more ambulance responding to this crash.
Jim saw me coming over and said, "Awesome, I was just about to come over and steal the narcs. Get fifty of fentanyl and twenty of ketamine ready for Theresa's patient. Then come help me with this one; I think we might have to RSI."
I frowned and drew up the requested medication. I was a little upset now. These two from the bus were obviously much more injured, yet I had to waste time with someone that barely had a concussion. I sighed, I realised things like that would happen, and there wasn't really anything I could do about it. Perhaps when I took over the world, I could make it more egalitarian, but now I would just save those who I could.
I walked over to Jim's patient, and he reported that the man had a moderate to severe head injury and, through the mechanism of injury, was going to be directly transferred to the trauma centre in Watson. They were actually breaking regs by splitting themselves up and treating two patients at a time when one was seriously injured, but I assumed it was our second ambulance en route, and if so, it would save a little time if both of the package work was done ahead of time. It wasn't something she would have decided to do. Still, she could see how a very experienced paramedic would make that decision, especially if they expected me to return imminently, so she felt it was fine.
RSI was an acronym for "rapid sequence intubation," and it was one of the foundational "special skills" of a paramedic. If you stopped breathing or looked like you were about to stop breathing, well, we had ventilators to breathe for you.
Jim glanced at me and said, "Alright, we'll do this..."
While we didn't get back-to-back calls all day, thankfully, that first call took quite a bit of time. It wasn't even the most seriously injured patient we got that day, as that went for the last call of the day, where we responded back to Arroyo.
*bzzt* "Unit 88, Dispatch, respond to the 2000 block of Jefferson street, Arroyo, the Fat Burger restaurant. Reportedly a man, who was pistol-whipping his friend..."-
Jim interrupted the radio transmission with, "As one does," to which I nodded ruefully.
"-apparently shot himself in the chest. He's unresponsive. NCPD on scene. Respond."
That caused Jim to tsk tsk with his finger while driving and shake his head, "Poor trigger discipline, choom. Alright, newb, hit it. Time for the rockstars of medicine to roll out."
Personally, I felt that was a case of instant karma, but I suppose we still had to save the lives of assholes, too.
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Proper fucked
NC Med Ambulance had a "traditional" EMS schedule of twenty-four hours on, twenty-four off, twenty-four on and then four or five days off. You ended up working about fifty hours a week unless you worked an extra half or complete shift on your days off. The burden was below average for normal Night City workers, who usually worked between fifty-five to sixty hours a week, with some working much more than that.
I kind of liked the schedule since it gave me a lot of time off. However, it was kind of rough on the days when we had a lot of calls. Typically, there was time for napping, and we weren't running back-to-back calls the entire shift, but that situation wasn't actually rare, either. EMTs were very superstitious, but I didn't know if I noticed anything crazier during the shift I had worked on the full moon, but both Theresa and Jim had assured me it was a factor, if only for the Animals gang.
In the case of situations where there was no time to take naps at all, the company provided free stimulants, although they were little better than various mixed amphetamine salts, so I wasn't really interested in using them. A few of the employees offered to sell me better, as in better for me, stimulants on the side, and I was shocked when one offered me the same neuro-stimulant that I had made my first day here. It was a proprietary stimulant made by Biotechnica, and it was definitely not in its trademarked tablet form.
At first, I accused him of trying to rip me off, but he gave me a small sample to take home. I didn't have a mass spectrometer, but in some ways, my internal biomonitor did in its toxicology processor, so I ended up just diluting some highly with water and then tasting a small portion like I was a Dark Ages alchemist until I got a report that it was indeed the same chemical formulation that I was expecting.
The next shift I was working, I asked him about it, and he told me that most sales of that substance on the street were in its powdered form. Apparently, Biotechnica were kind of assholes and included a formulation in their tablet coatings that would ruin the active ingredient in their stimulant about thirty days after the product was exposed to air. The entire tablet would turn black, then, so you would know it wasn't effective anymore.
So, it was very common for organised groups to buy second-hand pills a few days before they were no good and unencapsulate the active ingredient as a powder from the tablet, then sell either the straight powder or make your own tablets for them.
As such, I was currently making my own pill press at home. I didn't intend to get involved in the drug trade, really, but I felt that even if I brought my sleep-inducer to work and slept for thirty minutes or so when we were on lunch, there would be times when I would actually be legitimately fatigued, to the point where I would be a hazard to caring for my patients. If this was America I remembered and not Night City, I would guess that we would have the option to call for a few hours of sleep and go out-of-service, but even though NC Med Ambulance had a pretty good reputation for treating their workers well, all we got was free speed.
