LITMIR.BIZ

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Jack ordered, and Lizzie fished it out awkwardly and struggled to find the end.

      ‘How much do you want?’

      ‘I’ll do it, Lizzie.’ Bryony took it from her, worried about her daughter seeing her friend so badly injured. ‘You can go into the house with the other children.’

      ‘I want to help.’

      They heard the sound of an ambulance approaching and Jack looked at Lizzie. ‘Go and meet them. Tell them I want oxygen, two large-bore cannulae, IV fluids and morphine. Have you got that?’

      Lizzie nodded and Bryony glanced at him.

      ‘She won’t remember that, Jack, she’s only seven.’

      ‘She’ll remember,’ Jack said firmly, his eyes fixed on Lizzie. ‘Oxygen, two large-bore cannulae, IV fluids and morphine. Go, angel.’

      Lizzie sped back down the garden to meet the ambulance, leaving Jack and Bryony to wrap the exposed burns.

      ‘Can you get us clean sheets?’ Bryony addressed one of the fathers who was hovering by helplessly.

      ‘And someone put that bonfire out,’ Jack added, checking Annie’s pulse and breathing.

      She’d stopped screaming and was lying shivering, sobbing quietly, her father by her side.

      Annie’s mother was still hysterical at the far side of the garden.

      Seconds later the paramedics arrived with Lizzie, complete with all the equipment that Jack had asked for.

      As Bryony grabbed the oxygen and fitted the mask gently to Annie’s face, Jack smiled at Lizzie, his blue eyes showering her with approval and warmth.

      ‘Good girl.’

      Despite the stress of the situation Lizzie returned the smile bravely and Jack gave a nod.

      ‘All right, I’m going to need your help here, Lizzie. Annie needs some fluid and we’re going to put a line in and give her fluid through her arm. Then we’re going to take her to hospital. I want you to hold this for me.’

      Bryony looked at him uncertainly, still not sure that her young daughter should be exposed to the harsh realities of immediate care, but Jack seemed determined to involve her and Lizzie was frowning with concentration as she listened carefully to Jack’s instructions and did as he asked.

      Too worried about little Annie to argue, Bryony turned her attention back to the little girl, following Jack’s instructions to the letter.

      ‘Shall I give her morphine?’

      ‘We’re going to give it IV.’ Jack murmured, picking up a cannula and searching for a vein. ‘Can you squeeze for me?’

      Bryony took Annie’s little arm and squeezed, praying that Jack would find a vein first time.

      He did, of course, and she breathed a sigh of relief.

      ‘Give her the morphine and cyclizine in there and then we’ll put a line in the other arm, too,’ Jack said, holding out a hand for the syringe that the paramedic was holding ready. ‘OK, sweetheart.’ He looked down at Annie, his eyes gentle. ‘This is going to make you feel better, I promise. And then we’re going to take you to hospital. You’re doing fine. You’re brilliant.’

      He gave the morphine and then put a cannula into the other arm and looked at Bryony. ‘OK, let’s get some fluid into her and get her covered or she’ll get hypothermia from the cold water.’

      He and Bryony worked together, each anticipating the other’s needs, until finally the little girl was stabilised and in the ambulance.

      ‘I’ll go with her,’ Jack said. ‘Meet me at the hospital when you’ve dropped Lizzie at your mother’s.’

      ‘I want to come, too,’ Lizzie said firmly, and Bryony shook her head.

      ‘Sweetheart, no.’

      ‘Bring her,’ Jack said firmly. ‘I’ll run her home later. She can wait in the staffroom.’

      He dug in his pocket and produced his car keys, a wry smile playing around his firm mouth. ‘If you prang my car, Blondie, you’re history.’ Handing the keys to Lizzie, he jerked his head towards the front of the house. ‘Go and wait for your mother by the car, sweetheart.’

      Lizzie did as she was told and Jack took Bryony by the shoulders, forcing her to look at him. ‘She’s just seen her best friend horribly burned,’ he said quietly. ‘That is going to stay with her a long time and will be easier to bear if she knows she did something to help. Trust me on this one. She’s tough, our Lizzie. She’ll be fine. But do it my way.’

      Bryony swallowed and nodded, knowing that whatever they did now the trauma had already happened for Lizzie. Maybe it was best for her to be involved.

      Anne’s parents came over, her mother clinging to her husband, her face streaked with tears.

      ‘Can we go in the ambulance with her?’

      Jack exchanged glances with one of the paramedics and then nodded. ‘Of course. But try and be calm. I know it’s a terrible shock but she needs you to be strong. If she sees you panicking, then she’ll panic, and I don’t want her any more scared than she is already.’

      Bryony waited while they loaded Annie into the ambulance and then she joined Lizzie by Jack’s car.

      She pressed the remote to unlock the door and gave a short laugh. Now she knew it was an emergency. There was no other reason that Jack would have let her near his precious sports car—he never let anyone drive it.

      She strapped Lizzie in the front seat and slid into the driver’s seat, telling herself that it was only a car. Exactly like her car really, except that it was capable of ridiculous speed and cost about fifteen times as much.

      She started the engine and flinched as the car gave a throaty growl. ‘Boys with toys,’ she muttered disparagingly, finding first gear and carefully pulling out of the driveway onto the road. She just hoped she didn’t meet any other traffic on the way to hospital.

      When she arrived she settled Lizzie in the staffroom, promising to come back and update her as soon as possible.

      Jack was already in Resus, along with Sean Nicholson and a full team of staff. Jack was barking out instructions as he worked to stabilise Annie.

      ‘Can someone check her weight with her parents?’

      ‘I’ve just done it.’ Bryony hurried into the room and reached in her pocket for a calculator. ‘I’ve worked out 4 mils of fluid per kilogram multiplied by the percentage of the burn. Do you have that yet?’

      ‘Just doing it. My estimate is twenty-two per cent,’ Jack said, glancing up at her. ‘Are you OK?’

      Bryony nodded and studied the Lund and Browder charts that helped them to assess the area of the burn according to age. ‘You’re about right, Jack,’ she said lightly, feeding the numbers into her calculator. ‘I make it twenty-two per cent.’

      She worked out the volume of fluid and showed her calculation to Jack.

      ‘Right.’ He gave a nod. ‘So she needs that in twenty-four hours, but we need to give her half in the first eight hours and monitor her urine output. I want her to have a combination of crystalloid and colloid.’

      ‘Catheter is in,’ Nicky said quickly, ‘and I’ve started a chart.’

      ‘Great. Can you test her urine? And, Bryony, we need to take some bloods before she’s transferred. Cross-matching, FBC, COHb, U and Es, glucose and coagulation.’

      Bryony reached for the appropriate bottles. ‘You’re sending her to the burns unit?’

      Jack nodded. ‘The helicopter is waiting to take her as soon as we give the word. I’ve spoken to the consultant, he’s waiting for her.’

      Bryony

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