Legend

Paramedic training

"I'll be there as soon as I can," I said, and turned off the phone. I didn't expect to get back before going to work, so I quickly dressed in my clothes for work and quickly stuffed another change of clothing into my messenger bag, then grabbed my phone and took off running. I ran to the tower, where I picked up an emergency kit that I had in case I needed to call on my paramedic training and the portable tissue accelerator, then hit the street. This being New York and the tower where it was, it wasn't hard to get a cab and we made good time to the hotel. By now the hotel personnel knew that I was seeing a resident and I didn't get any questions. I knocked on his door and it opened slowly. I eased through it as Damian started to slide to the floor.

I was able to catch him before he got too far down and helped him into his bedroom, which was fortunately the closest room. I stripped the bed quickly and helped him to lay down on the sheet. He tried to suppress it but he whimpered in pain. I hit the lights and started to dig through my kit. I took his blood pressure, checked his pulse, pupil dilation, skin, and respiration, slipping a pulse oximeter on his finger. His respiratory rate was higher than normal, but his pulse oximeter reading was 96%, so the respiratory rate was likely due to the pain he was in. Pupils dilated normally, pulse rapid and a little weak. His skin was slightly cool and sweaty and his blood pressure was down. He was wearing his Robin costume, and it was going to be hard to cut through; it was layered tac fabrics, maybe with Kevlar in there somewhere. I found the zippers and started to ease him out. There wasn't significant blood aside from a bloody nose; his nose was very definitely broken. The girlfriend in me cringed at the livid bruising coming up all over his torso and arms, but I hung onto the paramedic part of me that noted it and moved on.  I eased his... pants? leggings? down and saw that there was bruising on his thighs and shins, but these weren't quite as bad as the ones on his upper body. There was also an integrated protective cup, I was thrilled to see. I administered oxygen, caught up the notes on his condition, gently eased a firm cushion from the chair under his legs to raise them, flipped a light blanket over him to help with the symptoms of shock and ran an IV of fluids.

I saw his phone on the nightstand and called Alfred as I began an abdominal examination. "Master Damian?" he asked alertly. Who the hell is that awake at this hour of the morning?

"Sorry, Alfred, this is Alex. Damian called me earlier, saying he'd been in a hell of a fight, excuse the language. So I came over as quickly as I could and found him in distress." I relayed the information on the vitals. He asked questions and once much of the IV had been discharged, I repeated the vitals. Damian was more alert, his blood pressure rising, pulse stronger and slower. His skin was warming and drying as well, and Damian was able to give a summary of events; he'd been investigating some suspicious activity and been surprised by a gang; he thought they were Penguin's men. He'd managed to get free, get back to the hotel, and call me. I had Damian be quiet so I could listen to his lungs and bowel sounds, then used percussion to check for irritation. There was pain, tenderness, and slight rigidity over the upper right quadrant, indicating possible rib fracture. But there was good news, too; there wasn't a full or doughy feeling anywhere, suggesting that there wasn't internal bleeding, the combination of rigidity and guarding that presents with intestinal leakage wasn't present, and his pelvis was stable.

Alfred had me go to the extensive closet; in the corner, obscured by a couple of suits of formal wear, was an ultrasound machine on its cart. I smiled. I knew how to conduct the FAST exam. It wasn't part of the paramedic training, but I'd had a very slow shift during training and a technician showed me in detail. It took a little time to get the instrument up and calibrated, then I checked the pericardial, periphepatic, perispleenic, and peripelvic spaces, explaining to Damian what I was doing as I went. There was no sign of fluid. I breathed a sigh of relief. I turned on a laptop on the cart and sent the images to Alfred to confirm, then cleaned Damian's face while we waited.Damian said he had to go to the bathroom, which was good.