LITMIR.BIZ

Скачать книгу

I belong in a Flying Doctors’ plane rather than an ambulance, although today I don’t belong in either.’

      ‘Ben’s lucky Emily was driving into town on her day off.’ Andrew’s voice wavered before he cleared his throat and spoke in his usual professional tones. ‘Ben McCreedy, age twenty-one, right arm crushed by a truck. Analgesia administered in the field, patient conscious but drowsy.’

      Linton sucked in his breath as he swung his stethoscope from around his neck and into his ears, checking his patient’s heartbeat. Ben McCreedy was Warragurra’s rugby union hero. He’d just been accepted into the national league and today was to have been his last local game.

      The young man lay pallid and still on the stretcher, his legs and torso covered in a blanket. His right arm lay at a weird angle with a large tourniquet strapped high and close to his right shoulder.

      ‘He’s tachycardic. What’s his estimated blood loss?’ Linton snapped out the words, trying for professional detachment, something he found increasingly difficult the longer he worked in Warragurra.

      ‘Too much.’ Emily’s almost whispered words held an unjust truth as she assisted Andrew with moving Ben from the stretcher onto the hospital trolley.

      Two medical students sidled into the room. ‘Um, Dr Gregory, is this where we should be?’

      Linton rolled his eyes. Give me strength. ‘Attach the patient to the cardiac monitor and start a fluid balance chart. Where’s Sister Haigh?’

      Jason, the student who’d almost fainted, looked nervously around him. ‘She said to tell you that Maternity now has, um, three labouring women.’

      ‘And?’ Linton’s hands tensed as he tried to keep his voice calm against a rising tide of apprehension.

      ‘And…’ He stared at his feet for a moment before raising his eyes. ‘And she said I wasn’t to stuff up because she had a croupy baby to deal with before she could get here.’

      Linton suppressed the urge to throttle him. How was he supposed to run an emergency with two wet-behind-the-ears students?

      He swung his head around to meet a questioning pair of grey eyes with strands of silver shimmering in their depths. Eyes that remained fixed on him while the rest of her body moved, including her hands which deftly readjusted the female student’s misapplied cardiac-monitor dots.

      He recognised that look. That ‘no nonsense, you’ve got to be kidding me’ look. Twice a year he spent a fortnight with the Flying Doctors, strengthening ties between that organisation and the Warragurra Base Hospital. Both times Emily had been his assigned flight nurse.

      ‘Emily.’ The young man on the stretcher lifted his head, his voice wobbly and anxious. ‘Can you stay?’

      Ben’s words rocked through Linton. What a brilliant idea. Emily was just who he needed in this emergency. He turned on the full wattage of his trade-mark smile—the smile that melted the resolve of even the most hard-nosed women of the world. ‘Emily, can you stay? It would help Ben and it would really help me.’

      The faintest tinge of pink started to spread across her cheeks and she quickly ducked her head until she was level with her patient. ‘I’m right here, Ben. I’m not going anywhere.’

      Then she stood up, squared her shoulders and was instantly all business. ‘Catheter to measure urine output and then set up for a central line?’

      He grinned at her, nodding his agreement as relief rolled through him. For the first time today he had someone who knew what she was doing. He swung into action and organised the medical students. ‘Patti, you take a set of base-line obs, Jason you’ll be the runner.’

      Andrew’s pager sounded. ‘I have to go.’ He gave Ben’s leg a squeeze, an unusual display of emotion from the experienced paramedic. ‘You’re in good hands, mate. Catch you later.’

      The drowsy man didn’t respond.

      Linton rolled the blanket off Ben. ‘Emily, any other injuries besides the arm?’

      ‘Amazingly enough, I don’t think so. I did a quick in-the-field check and his pelvis and chest seem to be fine.’

      ‘We’ll get him X-rayed just to confirm that. Now, let’s see what we’re dealing with here.’ He removed the gauze from Ben’s arm. Despite all his experience in trauma medicine, he involuntarily flinched and his gut recoiled. The young man’s arm hung by a thread at mid upper arm. His shoulder was completely intact as was his hand but everything in between was a crushed and mangled mess.

      ‘Exactly what happened here?’ Linton forced his voice to sound matter-of-fact.

      Ben shuddered. ‘I was driving to the game down Ferguson Street.’ His voice trailed off.

      Emily finished his sentence. ‘Ben had the window down and his elbow resting on the car door. A truck tried to squeeze between his car and a parked car.’ Her luminous eyes shone with compassion.

      ‘You have to save my arm, Linton.’ The words flowed out as a desperate plea. ‘I need two arms to play rugby.’

      I can’t save your arm. Linton caught Emily’s concerned gaze as her pearly white teeth tugged anxiously at her bottom lip. Concern for Ben—she knew it looked impossible.

      Concern for Linton—somehow she knew how tough he found it to end a young man’s dream with five small words.

      ‘BP sixty-five on forty, respirations twenty-eight and pulse one hundred and thirty.’ Patti’s voice interrupted, calling out the worrying numbers.

      ‘The blood bank’s sending up three units of packed cells and X-Ray is on its way.’ Emily spoke and immediately snapped back to the brisk, in-control nurse she was known to be. ‘Jason, go and get more ice so we can repack the arm.’

      Linton knew Ben’s body had been compensating for half an hour, pumping his limited blood supply to his vital organs. Now they were entering a real danger zone. ‘What’s his urine output like?’

      Emily checked the collection bag that she’d attached to the catheter. ‘Extremely low.’ Her words held no comfort and were code for ‘major risk of kidney failure’.

      He immediately prioritised. ‘Increase his oxygen. Emily, you take the blood gases and I’ll insert a central line.’ He flicked the Haemaccel onto full bore, the straw-coloured liquid yellow against the clear plastic tubing. ‘Patti, ring the blood bank and tell them to hurry up.’

      His pager beeped and he read the message. ‘Jeremy’s arrived in Theatre so as soon as the central line’s in place, we’ll transfer Ben upstairs.’

      Emily ripped open a syringe and quickly attached the needle. The sharp, clean odour of the alcohol swab dominated the room as she prepared to insert the needle into Ben’s groin and his femoral artery. ‘Ben, mate, I just have to—’

      Suddenly Ben’s eyes rolled back in his head and the monitor started blaring.

      ‘He’s arrested.’ Emily grabbed the bag and mask and thrust them at Patti. ‘Hold his chin up and start bagging. I’ll do compressions.’ She scrambled up onto the trolley, her small hands compressing the broad chest of a man in his athletic prime. A man whose heart quivered, desperate for blood to pump.

      ‘I’m in.’ Linton checked the position in the jugular vein with the portable ultrasound then skilfully connected the central line to another bag of plasma expander. ‘Now he’s getting some circulating volume, let’s hope his heart is happier. Stand clear.’

      Emily jumped down off the trolley.

      The moment her feet hit the floor and her hands went up in the air showing a space between her and the trolley, he pressed the button on the emergency defibrillator. A power surge discharged into Ben’s body, along with a surge of hope. It was tragic enough, Ben losing an arm. He didn’t need to lose his life as well.

      Four

Скачать книгу