to acknowledge it, would not let him get to her. Not again.
“Help,” a woman cried out.
Victoria jerked her head in the direction of the panicked voice. A pale, middle-aged woman with dark hair ran into the hallway. “My father. He’s choking.”
Without hesitation, she ran to help. The morbidly obese patient she recognized as Mr. Schultz sat in an extra-wide chair beside his bed. Mentally she cued the information she’d obtained during morning rounds. Age seventy-two. Status post-CVA six days ago with residual right-sided hemiplegia, speech deficit, and difficulty swallowing.
“Are you able to breathe at all, Mr. Schultz?”
He slapped at his neck with his left hand and strained to inhale, a high-pitched wheezing sound the result.
Quick assessment: Face flushed. Diaphoretic. Eyes pleading. Inefficient air exchange. Victoria pushed his over-the-bed table out of the way, noticing an open bag of colorful hard sucking candies as she did. His daughter was going to get a stern talking to when this was all over. She inserted her hand behind his back and pushed him forward, giving four rapid blows between his shoulder blades.
Nothing.
“Papa. Don’t die, Papa,” the hysterical woman cried. “You have to save him.”
Victoria moved in front of the patient. “Open your mouth, Mr. Schultz.”
She could not see the obstruction. “What can I do to help?” Kyle asked.
“I need this bed out of the way.” So she could reach the suction apparatus on the wall behind the patient. “Then please accompany Mr. Schultz’s daughter and his roommate to the lounge.” As stressful as this situation was for her, a trained practitioner, it was worse for a family member/roommate to experience, especially if things didn’t turn out well.
“I’m going to help you, Mr. Schultz,” she said, surprised at how calm her voice sounded, knowing the man was probably past listening or understanding but needing to say it just in case.
“I don’t want to go. I want to stay with him,” the daughter yelled.
Kyle spoke to her in soothing yet persuasive tones.
Victoria focused on her task. She reached for the disposable suction container and snapped it into the plastic wall receptacle, thankful her exemplary staff made sure each room was fully stocked with all necessary equipment at all times. Her hands shook. It’d been a while since she’d been in any life-or-death situations. They were not her favorite part of nursing, too many variables outside her control.
“Almost done, Mr. Schultz.”
Kyle rushed back into the room. “Should I try the Heimlich?”
“Can you get your arms around him?”
“I think so.” Unable to squeeze behind the patient since she was back there setting up suction, Kyle moved the chair like Mr. Schultz was the size of a child rather than the three-hundred-plus-pounder he was.
“I think his belly is too large for your thrusts to be effective,” Victoria said. “Position your hands over his sternum instead. Pull straight back. Hard and fast.”
Kyle did as instructed with excellent technique but no positive result.
The patient’s skin took on a purplish reddish hue. They were running out of time.
Leaving Kyle to continue his attempts on his own, Victoria returned to the suction equipment, hooking the red vacuum tube to the container. She ripped open two sets of tubing, unraveled both. One she connected between the collection container and the wall gauge. The other she attached to the nozzle labeled “Patient”, then pulled apart the ends of the wrapper on the curved oral suctioning catheter, and, attaching it to the suction cable, was finally ready to proceed.
“Any luck?” Victoria pulled on a pair of latex gloves and turned back to the patient.
“No. He looks about to pass out.”
Yes, he did. If one attempt at suction didn’t work she’d call for the code team. Victoria removed the suction catheter from its packaging, turned on the suction device and cranked the knob to high. When she reached for Mr. Schultz’s chin, preparing to open his mouth, he grabbed her wrist. Hard.
Kyle intervened, prying the patient’s fingers off her. “She’s trying to help you, sir. Let her do her thing.”
Victoria placed her finger on the patient’s lower jaw to open it. “Open up for me, Mr. Schultz. I’m going to clear your airway.” Please, please, please let this work.
He allowed her to open his mouth.
Pressing down on his tongue with her thumb, Victoria slid the catheter deep until it tapped something hard that did not feel at all like the walls of the mouth or throat. She pressed her finger over the hole in the neck of the hard plastic catheter to concentrate the suction into the tip, pressed against the hard object very carefully, and gave a little tug. Like a cork had been released, Mr. Schultz sucked in a huge, gasping breath. Then another and another. A coarse but wonderful sound.
Relief made Victoria’s legs weak.
Tears streamed from Mr. Schultz’s eyes.
Careful to maintain full suction so the obstructing object did not loosen from the tip and fall back into the patient’s throat, Victoria eased back on the catheter. A bright red ball of candy stuck to the end.
Victoria blew out a breath.
“You did good,” Kyle said.
Mr. Schultz took her hand and held it to his cheek. She patted his shoulder with her other hand. “You’re very welcome.”
Victoria hit the button for the intercom to contact the unit secretary. “Nora, is Ali back on the floor?”
“She’s heading my way right now.”
“Tell her Mr. Schultz just choked on a hard candy. He’s okay. We’re going to get him into bed. She needs to call his physician and come take a set of vitals.
“Would you help me … ?” When Victoria turned back to the patient Kyle already had him sitting on the side of the bed. She rushed over to lift his swollen feet and together they pulled him up in bed, although Kyle did most of the work. Then she raised the head of the bed.
“I’m going to talk to your daughter, Mr. Schultz.” She put up all four side rails and put the patient’s call-bell in his left hand. “Push this button …” she demonstrated “ … if you need anything before I get back.”
He nodded and gave her a small half-smile using the facial muscles not affected by his stroke.
“Thank you for your help, Kyle.” He followed her to the door.
“Still perfect in everything you do, huh?”
“Hardly.”
He took her by the arm. She turned to face him. He leaned in until his mouth grazed her ear. “For the record, my thrusts are always effective. And hard and fast suits me just fine.”
Typical. He’d taken her Heimlich instruction and turned it into something sexual. She didn’t respond, would not be provoked. She simply looked down at his hand on her arm. He released her and she walked out of the room.
After discussing the prescribed dietary restrictions with Mr. Schultz’s daughter and supervising the removal of all the remaining hard candies, Victoria left the patient in her best friend and Mr. Schultz’s nurse Ali’s capable hands, surprised to see Kyle waiting for her in the hallway.
His eyes seemed softer somehow, not as antagonistic as they’d been. But she refused to let down her guard until she found out why he’d come back to town.
“Nothing better to do with your time?” she asked.
“He okay?” Kyle tossed his chin in the