The radio buzzed to life, a tone resonating through the bedroom and announcing a new emergency.

"Please respond to an MVA on highway seven. . ." The message continued, the transmission from dispatch somewhat garbled. Kat rolled over in her slumber, then jerked herself awake. By the third time that dispatch had radioed out for an EMT ro respond to the car accident, she was awake and held the radio to her mouth.

"This is EMT 03-17 to respond to the MVA on highway seven."

"10-4, 03-17. Ambulance TC-80 is en route to your location. Should I advise pick up?"

"Affirmative dispatch. Have them stop for me." Kat replied, pulling on her uniform pants and jacket.

Within three minutes she sat in the front of the ambulance she most often rode in-TC-80. Driving beside her was Gary Elson, a senior paramedic going on ten years with the fire department. In the back was Roger Connerson-another skilled paramedic and former rescue fire fighter, and Natasha Albarn, an EMT-B like herself.

"Brief me," Kat said to Gary as she buckled her seat belt. It wouldn't do any good to get hurt if Gary had to slam on the brakes while they were racing lights and sirens across town. The cold fall night left many lawns and windows frosted.

"Slept through the dispatch details again Kat?" Gary asked with a slight smirk. Although she had only been an EMT for three days, this was her first real call that promised to be serious. Dispatch crackled through the radio in the ambulance, which hung on a peg near the steering wheel;

"All units be advised: You are responding to a comfirmed MCI."

"Put the chopper on stand-by," Gary ordered her, nodded almost invisibly to the radio. Kat responded immediately. Terena county, like many other counties in Washington state, had a life flight helicopter that they could call in at need. Now sounded like one of those times.

"Dispatch, this is unti TC-80 responding to an MCI."

"Roger, TC-80."

Kat continued with her transmission as they pulled onto the highway. "Please radio county control and advise them to put the helicopter on stand-by."

"10-4, TC-80. Dispatch out."

"10-4." Kat hung the radio back on its peg just as they arrived on scene. A state trooper had redirected traffic around the accident, lining the area with red flares. Gary switched off the lights and sirens, and the crew of EMTs jumped out of the rigs. Natasha and Roger grabbed the megaduffel and the stretcher out of the back while Gary and Kat ran over to the center of the scene to observe the damage.

"Do a rapid trauma assesment on each victim." Gary told her, even though she had already begun. He had been an EMT instructor and taught her class, so he still treated her like a student even though she did have her certification.

Kat immediately tried the door of the car closest to her. It came open after she tugged on it violently. The first step to managing a multi casualty incident, she remembered, was to assess all victims before giving any advanced treatment.

Her stomach turned as she found no one in the front seat. She glanced up at the windshield, at the bloody mound covered with a tarp on the street. DOA, she guessed. Checking the back of the car, she was thankful for no children.

"Kat! Natasha!" Roger yelled, and Kat jumped out of the now occupantless car. The two newest EMTs in Terena Fire Department jogged over to him. "Kat, get me a medium cervical collar. Natasha, roll the stretcher over here."

Glancing up as another ambulance arrived on-scene, Kat dug a cervical collar out of the megaduffel and handed it to Roger. "Here," she said. He took it from her and quickly snapped it onto the driver's neck. Kat felt her stomach drop as she realized that the occupants of the car were all bore horrific injuries-the barely conscious driver had flail chest and blood coated her body, there was a teenager in the passenger who was conscious but just barely there with a noticeable head injury, and then in the back were two young children, laying limp in their own pooling blood on the floor of the car.

Kat was frozen. What could she do? Rage boiled up inside her at the sight of the unbelted children, but more intensively came the urge to run-from the metallic smell of blood, from the death that faced her. She was shaken out of her stupor that seemed to last for hours even though it was really mere seconds by Roger's stern voice.

"Kat, give the passenger what first aid you can and assure C-spine stabilization." He ordered. Kat grabbed a small kit of supplies and ran around to the passenger side of the car. She opened the door and smiled down at the boy, probably only a few years younger than her.

"Hi, I'm Kathreen Rainfield, and I'm an EMT." She introduced herself, hoping her voice did not shake as much as she felt it was. She knelt beside him, "Can I take care of you?"

"Yeah," The skinny teen said weakly, full of fear.

"Okay," Kat replied, and got down to business, taking the teen's vitals. The assesment had told them that out of the two car, five casualty incident, only these two victims were alive. Carefully, she ran her hand down the boys spine, feeling for swelling or disfigurement to point at sure spinal injury. SHe found none, and she quickly fastened the cervical collar around the boy's neck.

The crew of the second ambulance came around with the stretcher. "Can we load him up?" A woman in paramedic's uniform asked.

"Yeah," Kat nodded and moved out of the way, giving them all the info she'd gathered on the boy in the short time she'd had him.

"Kat, we're outta here!" Gary yelled as Natasha and Roger loaded the other victim into their ambulance. Instantly, Kat abandoned the wreckage, sprinting towards her ambulance. She climbed into the back through the side door, and took the crew seat at the end of the stretcher, the woman's head between her knees.

And that's when the real fight for life began.

~~##~~

The woman's chest was injured terribly. Her ribs moved opposite of the way they should when breathing, broken as they were from her sternum as it had been crushed against her steering wheel.

Defective airbags in that car, Kat thought, recalling that none of them had deployed as they should have. She placed her fingers onto the woman's carotid pulse as Roger began to splint her broken and bleeding feet. Natasha placed an oxygen mask on the woman's face, putting it on high flow. She was semiconscious, eyes half open and dull.

"Pulse is 50, weak and thready." Kat reported.

"BP's dropped too," Natasha reported. Kat cursed inwardly. She didn't want to lose this woman, her first real emergency. Her chest was bruised and her breathing ragged. Roger placed a stethoscope to her chest as Gary sped them towards the hospital.

"Confirmed hemothorax," He reported, causing Kat's stomach to drop. A lung collapsed by the broken ribs, with blood pooling in the chest cavity. "Let's roll her onto her side. Maintain spine stabilization." He instructed. Kat moved to the woman's neck and upper back, while Natasha and Roger handled her lower body. Carefully, and while keeping her spine straight, they rolled her onto the side of the collapsed lung. This would help her uninjured lung operate to its full capacity.

Kat grabbed the handle above her head to steady herself as Gary pulled to a stop in the ambulance bay at the emergency section of the hospital. Natasha and Roger rolled the stretcher out, Kat leapt out of the side door of the ambulance. The three of them moved into the hospital, Natasha pressing on the woman's open wounds in a futile attempt to ease the ceaseless flow of blood.

As the three EMTs passed their victim on to the ER staff, Kat couldn't help but wonder if she would make it.

The woman did not. And her son was orphaned.