Page 8 of Halo

Without hesitation, Eugene administers the anesthetic, then promptly checks the inflated reservoir bag, hoping he can squeeze the mixed gases into her lungs. “Still tight. And … she’s hovering at 94.”

C’mon, Ainsley. “Sux. Now.”

Eugene nods, quickly drawing up and pushing the paralytic. “Succinylcholine in—”

An alarm trills, a red light beckoning for our attention.

The OR falls deathly silent as we all watch—no, we all beg for Ainsley’s airway to open.

91 …

90 …

Fuck, don’t do this, sweetheart.

“Cric kit,” I bark at Eugene. “Now. From the cart.”

The circulating nurse steps forward. “Want me to get—”

“Yes, please.” I nudge my head toward the scrub room, not letting her finish. “Get the surgeons in here.” I can manage a difficult airway on my own, but I’m not too proud not to call for help if it’s available. Not when a life is on the line.

Not when her life is on the line.

The room swirls into choreographed chaos. Quick, hushed steps, the opening of packages, the clank of surgical steel against steel. Eugene hands me a cricothyroidotomy tray as I take a brief look at Ainsley’s vocal cords with a scope.

85 …

83 …

78 …

Shit, she’s clamped down.

“I can’t intubate, and—” I try to ventilate her myself—“fuck, I can’t oxygenate. Let’s move, people.” I snap on a new pair of gloves, retrieving my supplies from my CRNA.

And a scalpel.

Steady, Nick.

Stabilizing her larynx, I slice through the skin before making an incision through the delicate membrane of the cricothyroid. Blood oozes from the shallow cut, the warm crimson impairing the visualization of the field.

Following her anatomical structures, I slip my finger through the cut and in between the cartilage, creating a pathway into her trachea. With the help of the bougie in my freehand, I guide the endotracheal tube into the windpipe, then hastily connect it to an ambu bag and compress.

After a few seconds, I squeeze again.

Ainsley’s lungs fill with each rhythmic squeeze, and after a few cycles, her chest begins to rise and fall.

I glance at the vitals monitor, at the low steady number of her pulse ox and wait for her body to catch up.

71 …

72 …

C’mon, Ainsley girl. Rebound. You can do it.

The stillness of the room is heavy; the anticipation, stifling. The moment stretches uncomfortably around us as we all forget to breathe with Ainsley.

Suddenly, the monitor chirps, her oximetry jumping rapidly to 84%. Then to 94. Her clammy skin pinks to a more lively hue. The entire OR sighs with cautious relief as we relish in the quiet wooshes of air.