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A Nurse's Search and Rescue. Alison Roberts
Читать онлайн.Название A Nurse's Search and Rescue
Год выпуска 0
isbn 9781474034210
Автор произведения Alison Roberts
Жанр Контркультура
Серия Mills & Boon Medical
Издательство HarperCollins
‘So you haven’t found anyone to help run the orphanage yet?’
Matt laughed. ‘As if! Any sensible woman is going to run screaming into the middle distance at the mention of four kids.’
‘True,’ Tori grinned. ‘You’ll just have to find someone who isn’t sensible, then.’
‘Totally mad, you mean?’
‘It might help.’ The humour was a thinner veneer than Tori felt comfortable with, however, because she knew better than most the implications of the undercurrents here.
Changing the subject was fortunately effortless enough to be perfectly acceptable. ‘Oh, look! They’ve got the cab of the logging truck onto that crane. It’s moving!’
‘That’s my cue, then.’ Matt straightened and watched for a short time as the cab containing the unfortunate driver of the truck swung slowly towards solid ground where it hovered before starting a gentle descent. Matt moved towards the ambulance. ‘I’ll grab my kit.’
‘Can I help?’ Tori’s exhaustion had mysteriously evaporated. There was, after all, the smallest chance that the truck driver was still alive.
‘Joe?’ Matt got the attention of his partner. ‘Tori’s offered to third crew for us for a bit longer. Give her the heavy stuff, eh?’
Joe was grinning as he held out the lifepack. ‘If you carry the oxygen cylinder in your other hand, it kind of balances you.’
‘Cheers.’
‘Just kidding!’ Joe put the lifepack on top of the stretcher and then added the oxygen cylinder and suction kit. ‘We’ll just take the whole bed. Pull out those handles at the end and help me lift it out.’
They had to wait as the cab was very slowly lowered to the ground. Then Matt swung himself up on the step and opened the door. Tori saw him reach to feel for a carotid pulse on the driver’s neck.
The shout, seconds later, was astonished.
‘Hey…I’ve got a pulse here. He’s alive!’
CHAPTER TWO
THIS was a life none of them had expected to save.
For the next fifteen minutes Tori found herself part of a small team working hard to stabilise a critically injured patient who had major chest and head injuries. A body splint and backboard were used, along with a team of firemen, to lift him from the cab of the truck. Matt intubated him to protect his airway and provide adequate oxygenation, and a chest decompression was necessary to deal with the pneumothorax that had caused a lung to collapse and affect his ability to breathe.
It was Tori who helped gain IV access and start fluids running to combat the shocked condition the man was now in. She kept up the monitoring of vital signs, like blood pressure, heart rate and rhythm and the level of respiratory distress, and it was Tori that found the driver’s wallet in the back pocket of his jeans.
‘His name’s Wayne,’ she told the others. ‘Wayne Judd. He’s fifty-three.’
And his driver’s licence indicated that he was listed as a potential organ donor. The wallet also included photographs of a woman and children that had to be Wayne’s immediate family. Suddenly this patient had a real identity and his willingness to help others if he could no longer be helped himself strengthened the desire Tori felt to see this man survive.
She helped load the stretcher into the ambulance and switched the tubing from the portable oxygen cylinder over to the wall connection for the main tanks.
Matt had his stethoscope on Mr Judd’s chest again. Then he glanced at the oxygen saturation reading on the lifepack.
‘He needs IPPV to get those sats up,’ he said. ‘He’s not breathing well enough on his own.’
‘I can do that.’ Tori moved to the head end of the stretcher. She picked up the bag mask and swiftly changed the connection to the oxygen supply. Swapping the mask on their patient’s face, she held the new one securely in place and waited for the chest to rise, indicating an indrawn breath. Squeezing the bag attached to the mask pushed in more air with a high concentration of oxygen that Wayne’s lungs, too damaged to inflate deeply enough, were incapable of delivering.
Joe was frowning. It was obvious that close monitoring and possibly further interventions would be necessary en route to the hospital. Providing intermittent positive pressure ventilation was all that one person could do.
‘We’ll have to try and meet some back-up if I’m driving,’ he told Matt. ‘You’ll need some help in the back.’
‘I could come,’ Tori suggested eagerly. ‘My car’s still stuck and I should be trying to get into work anyway.’
‘Cool.’ Matt wasn’t going to waste any more time. ‘Let’s roll.’
* * *
Watching pre-hospital emergency care of a critically injured patient on board a rapidly moving ambulance was a totally new experience for Tori, and she was amazed at how Matt made it look so easy. Even trying to get an accurate blood-pressure reading with the interference of engine noise would be a challenge, let alone inserting a second IV line.
Matt’s face was serious as he concentrated on his tasks, but he seemed unflappable. Swinging bags of IV fluids smacking the side of his head or keeping his footing during cornering or braking were clearly so much part of his normal working environment he barely missed a beat. He also managed to record a series of vital sign measurements and keep an eye on what Tori was doing.
‘Fantastic,’ he told her at one point. ‘You’ve got the sats well over 90 per cent now.’
Her glow of pride was out of all proportion to the task, but this was so new for Tori—an extension of the front-line medical management that was so different to her everyday job. The lack of a stable environment, limited resources and total reliance on personal skills made trying to stabilise and transport this patient a challenge that felt almost raw compared to what went on in the emergency department of a large hospital.
What would have been a terrifying responsibility if she had been on her own had become something else entirely. Matt was so confident and obviously skilled that being a part of this drama was exciting. Exhilarating, in fact. It was almost a disappointment to arrive at the Royal’s ambulance bay.
Matt had contacted the ED en route, relaying all the necessary information about the patient they had on board. They wheeled the stretcher directly into the trauma room, which had been cleared, and a medical team was waiting to take over care of the patient.
‘His name is Wayne Judd,’ Matt informed the receiving doctor. ‘Fifty-three-year-old driver of a logging truck who was trapped in his vehicle for approximately ninety minutes. When we got to him, he was status one, with chest and head injuries. He had a GCS of three, he was tachypnoeic with absent breath sounds on the left side and an oxygen saturation of 83 per cent, BP of 85 over 50 and a heart rate of 130.’
The doctor nodded. ‘Let’s get him on the bed. I’ll take his head.’ Staff positioned themselves, leaning over the bed to take a firm grip on the edge of the sheet beneath the patient. Tori lined up with Joe and Matt to lift the sheet on their side of the stretcher.
‘On the count of three,’ the doctor in charge of the airway instructed. ‘One, two…three!’
Maureen, one of the trauma team nurses, moved in to start cutting away the remains of the truck driver’s clothing. She caught Tori’s gaze.
‘You’re in trouble,’ she whispered. ‘Out playing, instead of getting to work on time.’
‘I