LITMIR.BIZ

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case of an inconceivable emergency?

      Tyler’s lips had doubled in size, his arms and face and what was visible of his chest in the V of his shirt were covered in angry red hives. His puffed-up eyes screamed out for help as he writhed and clutched his throat. Traces of vomit graced his front. His whole body shook in panic. But he was whimpering. Which meant he could breathe. For now.

      Luke checked Tyler’s pulse. Rapid and weak. He wrapped an automatic blood-pressure cuff around the boy’s arm and waited for its verdict. Dangerously low. Slipping a pulse oxy-meter onto Tyler’s thumb, he grimaced.

      ‘Come on. Where the hell is that oxygen? The trolley?’ Sats dropping, airway almost compromised. Was he supposed to just watch the boy sink into arrest?

      This reaction was severe and headed down a perilous path. Anaphylaxis had its own timetable. And it was always too fast.

      ‘Where was he stung?’

      ‘Back of his neck. I put ice on.’

      ‘Any other allergies?’

      ‘No. I should have watched him more closely.’ The mother’s hands trembled and tears ran down her cheeks. She pulled down the back of Tyler’s collar and revealed a livid lump with a tiny black barb sticking out.

      Luke grabbed tweezers and yanked the sting out. ‘Has he any other medical problems?’

      ‘N-no. Oh, my God. Help him.’ She tore at Luke’s sleeve, barring his way.

      ‘I’m trying. Please. If you could just wait outside. We need …’

      He glanced to the door and beckoned to Maggie, the practice nurse, to take Tyler’s mother to a calmer environment. Though he knew every pore of her would strain to stay with her child, his own ghoulish experiences had taught him she would never ever forget the disturbing images that could unfold. He wouldn’t wish that on another parent.

      As Maggie shuffled the desperate mum away, Luke caught sight of Jessie, portable oxygen tank in one hand and dragging a trolley behind her with the other. Thank God.

      Another doctor. Help. That must be why the hairs on the back of his neck had stood to attention at the sight of her. Yes.

      Hopefully he wouldn’t have to bark orders.

      She threw the cylinder onto the bed and switched it on. The reassuring whoosh of pressurised oxygen filled the room. ‘Anaphylaxis?’

      ‘Yep. Bee sting. Pretty rapid onset. I need adrenalin. Now.’

      ‘I’ve got heaps, shame you can’t bottle it.’ For a millisecond her eyes met his. Her calm dark pupils glistened. Clearly she enjoyed emergency work as much as he did. A shot of heat pumped alongside the adrenalin racing through his veins. He took a steadying breath.

      Focus.

      As Jessie secured the mask over Tyler’s grossly swollen face, Luke snatched out a packet of ampoules and an injection set. He checked the label. ‘Adrenaline 1 per 1000. 0.3 mL. Right?’ He drew the clear liquid into the syringe and primed the needle. ‘Now, I need to get this into him.’

      He turned to the child. ‘Hold on there, Tyler. Let’s get those shorts up, mate. A sharp scratch. Attaboy.’

      Luke couldn’t wait for more than a nod of consent. ‘Stay still. Still.’

      If he stopped, just for a second, he could risk this child’s life. He dragged up the leg of Tyler’s shorts and plunged the life-saving fluid deep into his thigh muscle.

      ‘And I’ll secure intravenous access.’ Jessie searched the trolley but shook her head. ‘Which is the twenty-four gauge? The packaging’s different wherever you go.’

      ‘Clear packet.’ He directed her to the right-sized luer.

      ‘Got it.’ She snapped a tourniquet round Tyler’s skinny arm, tapped gently then stabbed the sharp point into his vein. ‘Damn, I think his peripherals are shutting down. No, no, wait.’

      She peered down, a concentrated frown on her face. The boy’s arm flopped to the side as she rubbed and palpated. ‘We’re good to go. I’ll get a line up and some normal saline in.’

      The look she flashed him was one of pure relief.

      The boy was in shock and needed an urgent boost. If IV access wasn’t secured now and his veins shut down completely there’d be hell to pay and a bigger mess when he got to the hospital.

      ‘Well done, Grinch.’

      This new look she threw him wasn’t so gleeful. But it still had the same effect. A direct hit to his abdomen where it pooled in a shimmering glow. Damn. Tyler might be crawling out of the woods but Luke was getting woefully lost in the details of a woman’s smile. What on earth was wrong with him today? Find a map and get out quick.

      ‘Mum?’ Tyler dragged the mask from his face, his voice wobbly and weak. His eyes were bloodshot and very, very scared. ‘Where’s Mum?’

      ‘Steady on, Tyler. I know this sucks.’ Luke gently but firmly pushed the mask back over Tyler’s face. Could someone please invent a mask that doesn’t frighten the hell out of kids?

      ‘Doesn’t matter if they’re disguised as fish, dragons or shaped like kooky lollipops, they still make a scary noise, eh, buddy?’ Jessie stroked the boy’s head.

      Luke stood open-mouthed. ‘Are you a mind reader? I was thinking the exact same thing. Weird.’

      ‘What?’ She frowned. ‘No. It’s just scary for them. Keep that there a bit longer, Ty, while the juice works its magic.’

      ‘Want Mum.’

      ‘I’ll send someone for her in a minute, mate. Hold still. You’re being real brave.’ A wriggling patient normally caused Luke a great deal of agro, but this time it meant he’d done his job and saved a life.

      Relief surged into his belly. He leaned against the trolley and allowed himself a deep exhalation.

      He always worked on autopilot, pushing back any thoughts of what-ifs and maybes, following a path of medical drugs and best practice. The high of his own fight-or-flight chemicals carried him along. But after the event he struggled with the kickback, the jittery blast of emotion and the unassailable desperate truth that one day it might just be his own daughter he was working on.

      ‘Back with us?’ Jessie stroked the boy’s hair and beamed at Luke. Her eyes lit up, revealing gold flecks in the pools of deep blue. Thick black eyelashes brushed her cheeks and a smattering of freckles crinkled over her nose. Her body relaxed into the smile as she nodded and spoke. ‘His resp rate’s much better already. Blood pressure rising. Sats at ninety-eight. I can never get over just how quickly adrenalin kicks in.’

      ‘Yeah. They don’t call it a rush for nothing.’

      That smile just about stopped Luke’s heart beating. The warmth of it reached right down to his toes, wrapping him in a haze of heat.

      But there was more to a woman than a bright smile. Lies, arguments and pain, for example. This was why he spent every day as a single dad. He may be half of an excellent doctoring team, but flying solo at home suited him just fine. It was like a comfortable sofa he’d no intention of updating.

      He forced himself to look away and fuss with the luer, finding his equilibrium again.

      Tyler’s mother’s chipped toenails and stripy jandals came into his peripheral vision. He scanned upwards, hoping she hadn’t seen the extent to which they’d had to manhandle her child. ‘Hi, there. How’re you doing?’

      ‘Is he okay? What happened?’ Her voice trembled.

      Luke wrapped an arm round her, helped her find a spot to sit next to her son. He knew how much she’d be wanting to touch Tyler, hold him, breathe him in. ‘It’s okay. He’s going to be fine. Yes, you can hold his hand. He’s a bit of a pin

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