LITMIR.BIZ

       CHAPTER ONE

      RED and blue lights flashed their signal of an emergency.

      The ambulance siren had been turned off on the final approach to the hospital but the beacons were still going as the vehicle turned swiftly and backed up to the doors of Christchurch’s Queen Mary Hospital’s Emergency Department. The day-shift resuscitation team stood waiting. The medical staff hadn’t needed the warning lights of the ambulance to notify them that a critically ill patient was incoming. That information had been transmitted en route ten minutes ago, and the team had rapidly assembled and prepared one of the highly equipped resuscitation areas in the emergency department.

      Senior Nurse Amy Brooks cast a swift glance into Resus 1 as the stretcher was being unloaded. IV fluid bags were hanging, their giving sets already primed. Trolleys stood ready. The staff knew their patient was in severe respiratory distress. Equipment for intubation and ventilation was available. A chest-drain tray was prepared and draped.

      As the circulation nurse on the resus team, it was Amy’s responsibility to have all the equipment prepared and to assist the doctors in using it. She needed to have the IV fluids ready and to assist with or insert IV lines herself, if necessary. She needed to help other nurses to remove the patient’s clothing and to record baseline observations of temperature, pulse, respiration, blood pressure and cardiac monitoring. It was the most demanding role in the nursing team, but Amy Brooks revelled in the different challenges every critically ill or injured patient provided.

      Amy even welcomed the apparent initial chaos of receiving and transferring such a patient. Ambulance crew, consultants, registrars, nurses and technical staff all tackling their own tasks within the set protocols. So much happening and so much information being gathered and passed. It took a special ability to be able to assimilate the details, to focus on each task and to switch focus with speed should the situation dictate a new urgency.

      ‘This is Daniel Lever. He’s nineteen years old.’ The ambulance officer was reinforcing information they had previously radioed through to the department. Transmission was often patchy. ‘Car versus truck. Daniel was the single occupant of the car.’

      The stretcher was positioned alongside the bed.

      ‘High-speed impact with vehicle rollover.’

      Amy noted the cervical collar around the young man’s neck and the backboard he was strapped onto. Spinal injuries had to be high on the index of suspicion after the description of the accident.

      ‘Daniel was trapped in the car for approximately forty-five minutes.’ The ambulance officer shifted the portable cardiac monitor out of the way. ‘Are we ready? One, two…three!’

      Amy moved to help lift the backboard. Entrapment time had already eaten well into the ‘golden hour’.

      ‘Systolic BP of 90, heart rate 125, respiration rate of 30. Daniel has remained conscious but confused with a GCS of 13. He has chest injuries, including a flail segment with possible pneumothorax, abdominal tenderness and a compound fracture of the left femur.’

      Jennifer Bowman was the airway nurse on the team. She was first into action as their patient was transferred to the bed.

      ‘Hello, Daniel. Can you open your eyes for me?’ Jennifer disconnected the portable oxygen cylinder and reattached

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