I took a long deep breath and willed my hands to steady. I reached for the open tray Anne held out for me. Setting it on the bedside, I scoured through it until I found the syringe with the long ominous attached needle. I slid an index finger along Lara’s soft damp neck until I felt it dip into the groove of her cricothyroid membrane.

The alarm throbbed in my ears.

With a slight tremor, I aimed the needle, directing it slightly upward for the skin over the cricothyroid membrane. I held my own breath as the needle pierced the skin. I felt a pop, as I penetrated Lara’s windpipe. Suddenly the tension on the syringe’s plunger gave way, and air whooshed into its hub. I steadied the syringe and uncoupled it from the needle.

“Ben, her oxygen saturation is critical,” Anne said calmly over the shrieking alarm.

“Noted,” I grunted, as I reached for the soft metal guide-wire that looked like a loose coil of silver string. Steadying my hand, I threaded the guide-wire through the needle. “Stop bagging her,” I said, needing a clearer view of her mouth.

Hesitantly, the respiratory tech pulled the mask off Lara’s blue face.

I kept advancing the guide-wire through the needle until a glint of metal appeared through the froth of Lara’s mouth. Then more wire poked out. My hand shot out to grab it. I nodded to Anne, and she handed me the clear endotracheal tube. I snaked the wire through the length of the tube. Then, using the wire as a guide, I threaded the tube into Lara’s windpipe. Sighing with relief, I felt the welcome resistance of the cartilaginous tracheal rings as the tube bumped down the rest of her windpipe. The moment its tip reached her lungs, frothy white sputum erupted out of its end.

I grabbed the Ambu-bag, attached it to the tube, and squeezed the balloon-like pump, meeting fierce resistance. My forearms ached as I fought to squeeze breath after breath of oxygen into Lara’s waterlogged lungs. For a while, the abysmal oxygen reading held constant on the monitor, but slowly, almost reluctantly, it began to climb as pinkness crept back into her blue complexion. I passed the bag over to the respiratory tech who pumped it feverishly. Lara’s color steadily improved. Even the monitor took a much-needed break from its relentless screaming

Tasting the sweat drip into my mouth, I wiped my brow and turned to Anne. “What’s a child doing with this crap in her blood?” Though, of course, I knew as well as anybody.

“She were my daughter? I’d kill her soon as she gets out of the ICU.” Anne’s lips cracked slightly at the comers in what passed for her version of a smile. She nodded once at me. High praise indeed, coming from Anne.