LITMIR.BIZ

       CHAPTER TWO

      CIRO beat them there.

      Pulling back the curtain and assessing in a split second what had happened, Ciro knelt down and swiftly examined Alyssa who lay unconscious on the floor. He checked her vital signs as Harriet pulled an oxygen mask from the wall and placed it over the young girl’s mouth, careful not to move her until Ciro gave the OK.

      ‘She said she felt OK,’ Mrs Harrison was sobbing. ‘I thought if I got her home to her own bed—’

      ‘Did she hit her head when she fell?’ Ciro’s question was direct.

      ‘No. She was just getting off the trolley and she went dizzy.’

      ‘Did you break her fall?’

      ‘Yes!’ Mrs Harrison’s voice was a screech. ‘What the hell’s happening? Has she fainted or something?’

      That was what Harriet had been hoping when first she’d seen the young girl collapsed on the floor, but normally, with a simple faint, consciousness returned almost as soon as the patient was prone. But despite the oxygen, despite the seconds ticking past, Alyssa still lay unconscious.

      ‘Let’s get her over to Resus.’ Ciro’s expression was grim as he attempted to check her blood pressure, but as Harriet went to pull out the trolley Ciro impatiently shook his head. He swiftly removed the oxygen mask. Picking up the feather-light young girl in his arms, he carried her through the department to the better-equipped resuscitation room as Harriet moved like lightning ahead of him.

      ‘Fast-page the paediatricians,’ Ciro ordered, but thankfully Susan was already on to it. Even Charlotte was thinking ahead, pulling open a flask of IV saline to run through a drip, but though Harriet was pleased to see her acting independently, she still needed supervision.

      ‘Charlotte,’ Harriet called, as she attached Alyssa to a multitude of monitors, ‘run the saline through a paediatric burette. She’s extremely underweight so we have to be very careful of doses.’

      ‘We need to be very careful not to overload her with fluid,’ Ciro confirmed and even though he was busy, inserting an IV and connecting the drips, he still managed to find the time to explain his thought process to the eager grad nurse. ‘Her heart is beating irregularly, she may have some heart failure, so the last thing we want to do is give her more fluid than her heart can deal with. On the other hand…’ He paused as he carefully examined Alyssa’s neck, checking her jugular venous pressure. Then he whipped out his stethoscope and listened carefully to her lungs for a moment before resuming his knowledgeable lecture. ‘She is undoubtedly dehydrated. Let’s give her a stat 200 ml bolus. I want a catheter put in and her input and output strictly monitored.

      ‘Come on, Alyssa.’ His words were loud, the call to his patient sharp as he not-too-gently rubbed her sternum. It worked. Alyssa’s eyes flickered open as she attempted to push him away. ‘Good girl.’ Ciro’s voice was more soothing now, moving quickly to orientate his patient to her new surroundings. ‘You lost consciousness again, Alyssa, so we have moved you to a different area of Emergency where we can keep a closer eye on you…’ The frantic running of feet along the corridor outside heralded the arrival of the paediatric team, but instead of turning to greet them, Harriet noted with approval that he carried on talking to Alyssa, perhaps sensing that a full emergency team arriving at her bedside would be daunting for the young girl. Ciro took time to reassure her that, despite the apparent chaos, everything was very much in order. ‘We were concerned about you so there are going to be a lot of doctors arriving and a lot of talk that you don’t understand, but you are going to be OK.’

      There certainly were a lot of doctors arriving. An emergency call always merited a rapid response, but the page had been put out as a paediatric emergency and though the difference was probably negligible, Harriet was sure that everyone had run just that bit faster to get there, from the anaesthetist to the nursing supervisor.

      ‘Alyssa Harrison,’ Ciro explained, ‘presented with a head injury secondary to a fall while dancing…’

      Harriet listened as she worked on, listened to his heavily accented English barely faltering as he explained Alyssa’s complicated symptoms, and even though it was his first night, even though none of the doctors had met him before, he delivered his findings with a calm authority that demanded respect, explained without words to the rapidly gathering crowd that he was very much in control.

      ‘Can you chase up those results?’ Ciro looked over and Harriet let out a low moan.

      ‘I’ve left the pathologist hanging on the line.’

      ‘Tell him we’ll be sending some blood gases along shortly,’ Ciro called as Harriet rapidly headed back for the nurses’ station.

      It took for ever to get through, the switchboard operator telling her in a rather pained voice that ‘yet again’ she was about to be connected, but suddenly those tiny white spots that had been dancing in front of her eyes earlier seemed to have returned for an encore. The nurses’ station seemed impossibly small all of a sudden. Sweat trickled between her breasts as she choked back bile, pleading with the powers that be to just let her get through the next few minutes of her life without major problems. If she could just get the blessed results down, she could hopefully escape the department for five minutes.

      ‘Harriet, we need those results!’ Ciro’s voice was booming at her, his impatient face swimming before her eyes as she looked up. Finally Harriet conceded to herself that she had to get to the bathroom at once. Hurling the receiver somewhere in Ciro’s direction, she stumbled off the stool.

      ‘The pathologist is on the line now.’

      ‘So, what are the results?’

      ‘I don’t know,’ she mumbled, backing out, her hand over her mouth. Thankfully Susan was around, and recognised potential disaster before it hit. Susan’s reflexes were like lightning, guiding Harriet to a vacant cubicle, sitting

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