It Started At Christmas...

She glanced down at the table, found the sharpest-appearing knife, and frowned at the serrated edges. She’d have made do if that had been her only option, but in her purse, on her key chain, she had a small Swiss army knife that had been a gift many years before from her grandfather. The blade was razor sharp and much more suitable for making a neat cut into someone’s neck to create an artificial airway than this steak knife. She dumped the contents of her purse onto the table, grabbed her key chain and a ballpoint pen.

As the man lost consciousness, Lance continued to try to dislodge the stuck food. McKenzie disassembled the pen, removed the ink cartridge, and blew into the now empty plastic tube to clear anything that might be in the casing.

Lance eased the man down onto the floor.

“Does he still have a heartbeat?” she asked, kneeling next to where the man now lay.

“Regardless of whether or not he does, I’m going to see if CPR will dislodge the food before we cut.”

Sometimes once a choking victim lost consciousness, their throat muscles relaxed enough that whatever was stuck would loosen and pop out during the force exerted to the chest during CPR. It was worth a try.

Unfortunately, chest compressions didn’t work either. Time was of the essence. Typically, there was a small window of about four minutes to get oxygen inside the man’s body or there would likely be permanent brain damage. If they could revive him at all.

McKenzie tilted the man’s head back. When several seconds of CPR didn’t give the reassuring gasp of air to let them know the food had dislodged, she flashed her crude cricothyroidotomy instruments at Lance.

“Let me do it,” he suggested.

She didn’t waste time responding, just felt for the indentation between the unconscious man’s Adam’s apple and the cricoid cartilage. She made a horizontal half-inch incision that was about the same depth into the dip. Several horrified cries and all out sobbing were going on around her, but she drowned everything out except what she was doing to attempt to save the man’s life.

Once she had her incision, she pinched the flesh, trying to get the tissue to gape open. Unfortunately, the gentleman was a fleshy fellow and she wasn’t satisfied with what she saw. She stuck her finger into the cut she’d made to open the area.

Once she had the opening patent, she stuck the ballpoint-pen tube into the cut to maintain the airway and gave two quick breaths.

“Good job,” Lance praised when the man’s chest rose and fell. “He still has a heartbeat.”

That was good news and meant their odds of reviving him were greatly improved now that he was getting oxygen again. She waited five seconds, then gave another breath, then another until their patient slowly began coming to.

“It’s okay,” Lance reassured him, trying to keep the man calm, while McKenzie gave one last breath before straightening from her patient.

“Dr. Sanders opened your airway,” Lance continued. “Paramedics are on their way. You’re going to be okay.”

Having regained consciousness, the man should resume breathing on his own through the airway she’d created for him. She watched for the reassuring rise and fall of his chest. Relief washed over her at his body’s movement.

Looking panicky, he sat up. Lance held on to him to help steady him and grabbed the man’s hands when he reached for the pen barrel stuck in his throat.

“I wouldn’t do that,” Lance warned. “That’s what’s letting air into your body. Pull it out, and we’ll have to put it back in to keep that airway open.”

“Is he going to be okay?” a well-dressed, well-made-up woman in her mid-to-late fifties asked, kneeling next to McKenzie a little shakily.

“He should be.” She met the scared man’s gaze. “But whatever is stuck in your throat is still there. An ambulance is on the way. They’ll take you to the hospital where a general surgeon will figure out the best way to remove whatever is trapped there.”

The man looked dazed. He touched a steady trickle of blood that was running down his neck.

“Once the surgeon reestablishes your airway, he’ll close you up and that will only leave a tiny scar,” she assured him.

Seeming to calm somewhat the longer he was conscious, the man’s gaze dropped to her bloody finger. Yeah, she should probably wash that off now that the immediate danger had passed.

“Go wash up,” Lance ordered, having apparently read her mind. “I’ll stay with him until the ambulance arrives.”

With one last glance at her patient she nodded, stood, and went in search of a ladies’ room so she could wash the blood off her hands and her Swiss army knife.

Carrying McKenzie’s purse and the contents she’d apparently gathered up, Cecilia fell into step beside her. “Omigosh. I can’t believe that just happened. You were amazing.”

McKenzie glanced at her gushing friend. “Not exactly the festive cheer you want spread at a charity Christmas show.”

“You and Dr. Spencer were wonderful,” Cecilia sighed.

She shrugged. “We just did our job.”

“Y’all weren’t at work.” Cecilia held the bathroom door open for McKenzie.

“Doesn’t mean we’d let someone choke to death right in front of us.”

“I know that, I just meant...” Cecilia paused as they went into the bathroom. She flipped the water faucet on full blast so McKenzie wouldn’t have to touch the knobs with her bloodstained hands.

“It was no big deal. Really.” McKenzie scrubbed the blood from her finger and from where it had smeared onto her hands. Over and over with a generous amount of antibacterial soap she scrubbed her skin and then cleaned her knife. She’d rub alcohol on it later that evening, too. Maybe even run it through the autoclave machine at work for good measure.

Cecilia talked a mile a minute, going on and on about how she’d thought she was going to pass out when McKenzie had cut the man’s throat. “I could never do your job,” she added.

“Yeah, and no one would want me to do yours. They’d look like a two-year-old got hold of them with kitchen shears.”

When she finally felt clean, she and Cecilia returned to the dinner theater to see the paramedics talking to the man who’d choked. Although he couldn’t verbalize, the man nodded or shook his head in response.

As he was doing well since his oxygenation had returned to normal, they had him climb onto the stretcher and they rolled him out of the large room. Lance followed, giving one of the guys a full report of what had happened. McKenzie fell into step with them.

“Dr. Sanders saved his life,” Lance told them.

He would have established an airway just as easily as she had. It wasn’t that big a deal.

The paramedic praised her efforts.

She shook off the compliment. It’s what she’d trained for.

“You’re going to need to go to the hospital, too,” Lance reminded her.

Her gaze cut to his, then she frowned. Yeah, she’d thought of that as she’d been scrubbing the blood from the finger she’d used to open the cut she’d made. Blood exposure was a big deal. A scary big deal.

“I know. I rode here with Cecilia. I’ll have her take me, unless I can hitch a ride with you guys.” She gave the paramedic a hopeful look.

“I’ll take you,” Lance piped up, which was exactly what she hadn’t wanted to happen. The less she was alone with him the better.

She arched a brow at him. “You got blood on you, too?”

He didn’t answer, just turned his attention to the paramedic. “I’ll bring her to the hospital and we’ll draw necessary labs.”

In the heat of the moment she’d have done exactly the same thing and saved the man’s life. After the fact was when one started thinking about possible consequences of blood exposure. In an emergency situation one did what one had to do to preserve another’s life.

She didn’t regret a thing, because she’d done the right thing, but her own life could have just drastically changed forever, pending on the man’s health history.