Алисон Робертс – At His Service: Her Boss the Hero: One Night With Her Boss / Her Very Special Boss / The Surgeon's Marriage Proposal (страница 7)

‘Give us a minute,’ Tama ordered. ‘I want to get an IV in and some oxygen on before we do anything more.’ He slid the Thomas pack off his back and, magically, enough clear space opened beside him to allow the pack to be opened out. ‘Mikki? You want to get the IV in?’

‘Sure.’

She hoped she sounded sure. An eagerness to show Tama what she could do—please him, even—bubbled inside her, and he’d handed her what should be an easy way to begin. Apart from having to step around the crumpled driver’s door on the ground, access wasn’t a problem. The paramedic unhooked a pair of shears from his belt and cut through the jersey and shirt covering her patient’s arm. Mikki slid a tourniquet on and pulled it tight.

Tama leaned past to slip an oxygen mask over the man’s face, then he hooked the stethoscope hanging around his neck into his ears and leaned in to listen to the man’s chest. The paramedic was waiting his turn to get close, a stiff neck collar in his hands.

‘Chest and neck injuries,’ Tama informed Mikki succinctly. ‘I’m not happy with his airway but an OP will have to do until we get him out. BP’s well down so I want to get fluids started stat.’

Mikki just nodded, concentrating on gaining access to a forearm vein with the wide-bore cannula she held. It wasn’t easy. Their patient was a very large man and she was having to go on touch rather than a visual target. To her relief, blood flowed into the chamber instantly. She advanced the needle a little further, slid the cannula home and withdrew the mechanism.

‘Got a luer plug?’

‘Here.’ The paramedic had a dressing and tape ready to secure the line as well and then a giving set and bag of fluids appeared with commendable swiftness, but if Mikki had expected any praise for succeeding in her task, she would have been disappointed. Not that there was time to think of it because things were moving very rapidly now.

Josh joined them.

‘Truck driver’s only got minor injuries and the female passenger from the car is stable. They’re both being transported by road. Where are we here?’

They were at the point of being able to move their patient. Mikki stood back, letting the more experienced and stronger men put on an impressive display of peeling back crumpled metal and then using a body splint and backboard to turn and slide the victim free with minimal disruption to his spinal alignment.

The unconscious driver was on a stretcher within a very short period of time, moved clear of the wreckage, but securing him in the helicopter was still some way off, it appeared. The man’s breathing was deteriorating and Tama clearly wanted to try and stabilise his condition prior to transport. He opened pockets of the Thomas pack and took out a large, tightly rolled package.

Mikki was using the stethoscope as Tama untied the package and opened it up to reveal an intubation kit. She nodded her agreement.

‘He’s got some bleeding going on in his trachea,’ she said. ‘And I don’t like this swelling in his neck. If we don’t secure his airway now, we might lose it completely.’

‘Absolutely.’ Tama was holding up a pair of gloves that looked far too small for his hands. ‘Go for it, Doc.’

Mikki couldn’t help her jaw dropping in astonishment.

Technically, she had higher qualifications than either of the paramedic air rescue crew. She had intubated dozens of people in emergency departments and Theatre but these guys had the huge advantage of experience in working under precisely these conditions.

Rescue crews were still busy around them. It was noisy and dirty and … foreign. And this was an obese patient who could be difficult to intubate even under ideal circumstances. Tama was throwing her in the deep end here but she had breezed through that cannulation, hadn’t she?

She could do this, too.

Except it was harder than she had feared. With blood in the airway and bright sunlight negating the effect of the laryngoscope’s light, it was impossible.

‘I can’t see a thing,’ Mikki had to admit.

‘Here. I’ll shade you.’ Tama loomed close over Mikki and the man’s head, blocking the light from falling directly on them.

Mikki still couldn’t visualise the vocal cords. It was hard to keep a note of desperation from her voice.

‘I need suction.’

‘It’s here.’ Tama managed to slip the handle of the suction unit inside their patient’s mouth without dislodging the laryngoscope Mikki held in place. She reached for an ET tube.

‘Here goes,’ she muttered hopefully.

Her first attempt failed.

‘Oxygen saturation is dropping.’ Josh was right beside her. ‘I’ll bag mask him for a sec.’

Mikki sat back on her heels, looking for a replacement tube in the kit. She caught Tama’s steady gaze. ‘Maybe you should do this,’ she suggested. Or Josh could. Except that Josh was now responding to a signal from a fire officer. It looked as though one of the rescue workers had injured himself.

‘Have another go,’ Tama directed.

So she did and again it proved impossible.

‘The trachea’s swelling,’ she said in despair. ‘I can’t get this past the cords even with a guide wire.’

‘I’ll have a go.’

They swapped places. Tama handed her the bag-mask unit and she held the mask over the man’s face, squeezing the bag to try and get a high concentration of oxygen into the man’s lungs. She could feel it becoming more difficult as the airway closed further. Tama was pulling on gloves. As he picked up the laryngoscope, Mikki could hear the deterioration in the man’s breathing. A nasty stridor that suggested they might be about to lose this challenge.

Tama positioned himself and the patient’s head. He inserted the laryngoscope.

‘Give me some cricoid pressure,’ he instructed seconds later.

Mikki pressed on an Adam’s apple that was actually hard to locate in an already thick neck that had severe swelling going on as well. If things were this hard from the outside, what hope did Tama have of slipping a tube through the airway internally?

Very little, but he managed. Almost instantly, he slipped the tube into place and then straightened to secure it and attach the bag mask to the end of the tube. Mikki picked up the unit as Tama placed his stethoscope on the chest. She squeezed the bag as he listened for lung sounds and then placed the disc below the ribs to exclude air going into the epigastrium.

‘We’re in,’ he announced calmly. ‘Let’s get this guy on board and get moving.’

The packing up and preparation for take off were practised and smooth. Josh returned and again Mikki was left on the outskirts of the routine, simply watching.

No wonder. She had messed up, hadn’t she? Failed on the first real medical challenge that had been thrown her way.

She was a liability. Tama hadn’t wanted her on his crew in the first place and now he had good reason to resent her inclusion.

No wonder he was so focussed on his patient he didn’t spare her even a glance on the homeward journey. No surprise she wasn’t asked to assist in any medical capacity either. These guys had it sorted. Intensive monitoring, another IV line, fluids going in under pressure, a badly broken leg dressed and splinted.

She was just a passenger. An unwanted one. Present but not included, and it stirred memories Mikki had thought long buried.

They came in to land on the hospital helipad with their patient still stable and breathing well. The two paramedics were clearly satisfied with the way the job had gone. Tama seemed to have forgotten the debacle with intubation but Mikki couldn’t. She had to bite her lip and blink away a very unexpected prickle in her eyes that suggested the possibility of tears.

She was about to cry?

No way!

Mikki clenched her jaw tight as she climbed out of the helicopter to follow the stretcher. She wasn’t going to let it matter that Tama didn’t want her. That she had played into his hands by begging to go on a job and then demonstrating a very uncharacteristic lack of ability.

He’d give her another chance.

He had to.

CHAPTER FOUR

‘HAPPY?’

‘Yeah … sure,’ Tama replied.

Josh quirked an eyebrow. ‘You should be. You don’t have to carry on with the incredibly boring stocktake.’

This was true. If it remained quiet on station he could carry on with Mikki’s training. She needed to learn how to load and unload the stretchers. How to secure sliding doors and all the medical gear and what to check before telling the pilot that ‘all was secure in the rear’.

‘Do you know how many individual components we have in IV gear alone?’

‘No.’ And Tama didn’t know why he wasn’t as happy as he claimed to be either.

‘Fourteen,’ Josh said in disgust. ‘Five different gauges of cannula, wipes, luer plugs, giving sets, Tegaderm, tape …’

Tama pushed open the door of the men’s changing room, barely registering the list. Mikki wasn’t in the kitchen end of the messroom and it was well past time they had some lunch. Where was she?

‘Then there’s four sizes of syringes and six sizes of needles on top of that,’ Josh continued, ‘and I have to count every single one of them.’ He, too, looked around the room. ‘Where’s the mouse?’

‘Dunno.’

‘She was kind of quiet when we got to the hospital. If the job had been a bit much for her, I would have expected her to feel happy to be on familiar turf, even if it wasn’t an ED she’s worked in. She didn’t look happy, though, did she?’