Laura Iding – Marrying the Playboy Doctor (страница 2)
The female paramedic’s tone was defensive. He didn’t have time to tell her not to take it personally. He would have verified anyone’s ET tube placement, even his own.
“I’ve listened. There are breath sounds bilaterally,” Cynthia, another trauma nurse, spoke up.
Alyssa returned. “Dr. Hendricks is on the way.”
He nodded, somewhat relieved his colleague and friend Michael Hendricks happened to be the cardiologist on call today. He trusted Michael’s judgment and didn’t mind the extra help.
A radiology tech wheeled in a portable X-ray machine. As they shot a quick chest X-ray, another nurse spoke up. “Lab results are back. Electrolytes are a little abnormal, her potassium is low, but her hemoglobin is within normal range so she’s probably not bleeding.”
Seth took a deep breath. Okay. So far they’d ruled out two of the six possible causes of PEA. “What about her troponin and cardiac enzymes?”
“They’re still being processed.”
He pinned the radiology tech with a fierce gaze. “I want to see that film
The young tech nodded and scurried off, downloading the image onto the designated radiology computer terminal. Seth waited, and was forced to admit technology was amazing when the chest film image was available on the screen in less than a minute.
“No tension pneumothorax. There might be some blood around the heart, though.” Finally a potential diagnosis. Cardiac tamponade was a potential cause of PEA. He spun back toward the patient. “I’m going to do a pericardial tap, to see if that helps.”
He drew on a pair of sterile gloves as the nurse on the right side of the patient pulled out a sterile cardiac needle and syringe, carefully opening the packages so he could grab the items. The nurse on the other side of the patient doused her chest with an antibiotic solution while he connected the needle and syringe and picked out his landmarks. He took a quick, steady breath and slid the needle into the V beneath her sternum, hoping and praying he didn’t cause more harm than good. When he saw the flash of blood, though, he knew he’d hit the right spot. Pulling back on the syringe, he drew out a good fifty milliliters of blood.
“Nice job,” Michael drawled from behind him. “Why did you bother calling me?”
Seth spared his friend a quick, exasperated glance before putting another syringe on the needle to see if there was more blood to be removed. He withdrew another eighteen cc and then glanced up at the heart monitor. “Hold off on CPR. Let’s see if she finally has a blood pressure and pulse to go with her rhythm.”
There was a moment of complete silence as several staff members, including Michael, felt for a return of the patient’s pulse.
“I feel a pulse, but it’s weak.” Michael spoke up.
Alyssa nodded, confirming she felt it, too.
“She has a blood pressure, but it’s only sixty-five systolic,” Cynthia added.
“Start a dopamine drip, and find out what that troponin level is.” Seth stepped back and stripped off his sterile gloves. “Michael, our working diagnosis so far is an acute myocardial infarction with a pericardial effusion. I called you so you can take her to the cath lab if needed.”
“It would be nice to see the troponin first,” Michael said.
“I have it—her troponin is 0.51, which has been reported as critical,” Alyssa informed them.
The number didn’t sound high, but anything over 0.03 was considered indicative of an MI, so 0.51 was way above the accepted range.
Seth glanced at his friend. Michael nodded, understanding his unspoken question. “Okay, she’s mine now. Let’s prepare to get her transferred immediately to the cath lab.”
The nurses sprang into action, placing the patient on a portable heart monitor and then gathering all their paperwork together. Seth noticed the female paramedic stood off to the side, watching as the events unfolded. Once the cardiology team had taken over Seth could sign off on the case, although he knew the odds weren’t in this poor woman’s favor. She wasn’t out of the woods yet. It was a sad fact that women who suffered from acute myocardial infarctions had a much lower survival rate than men, mostly because of their atypical presenting symptoms. At least in this case the paramedics had realized the potential and had treated the patient accordingly.
“Excuse me? Dr. Seth Taylor?”
He turned when he realized the female paramedic was speaking to him. “Yes?”
She held out her hand. “I’m Kylie Germaine, the new paramedic education coordinator here in Cedar Bluff.”
“Nice to meet you.” He took her hand in his, feeling a slight jolt at the brief contact. He let go and took a step back, wondering if she’d felt the brief sizzle, too. “Nice call on the MI—helped steer us in the right direction.”
“Thanks.” A small smile tugged the corner of her mouth. “I’ll confess, my partner thought I was nuts.”
He raised a brow. “I guess you proved him wrong, didn’t you?” Her ringless fingers made him smile. He liked her. She might be young, but Kylie was gorgeous, and he hadn’t gone out on a date in what seemed like forever. He was on the verge of asking if she’d like to get together for a drink when she continued speaking.
“As part of my job I have started setting up meetings with each of the ED physicians, to get insight into potential training needs. I believe you and I are scheduled to meet in a couple of hours?”
They were? Seth wasn’t always very good at keeping up with his calendar. “Uh—yeah. A couple of hours.” He glanced at his watch and rubbed the back of his neck. “Actually, I’m free now, if you have time.”
“Now?” Kylie didn’t look happy at the abrupt change in plans.
“We could wait until later. But you need to know patient care comes first. If I’m needed in the trauma room then we’ll have to reschedule anyway.”
Cedar Bluff only had one hospital, and they provided the only level two trauma services within a seventy-five mile radius. They stayed busy—especially in the height of the tourist season.
Seth swept a pointed glance around the momentarily empty trauma bay. “Your choice.”
She narrowed her gaze, but nodded. “Give me a minute to talk to my partner, then.”
He could wait, and he watched as she went back to talk briefly to the short guy who’d brought the patient in with her. Actually, now that the resuscitation was over he couldn’t even remember noticing the other paramedic at all, only Kylie. Perky ponytail and youthful face aside, Kylie had certainly taken the lead in the situation.
He was glad she’d stopped by to talk with him.
She returned a few minutes later. “Okay, I’m ready.”
“Great.” He tried to soften her up with a smile. “My office is just down the hall.” He waved to a short hallway off to the right.
She preceded him down the hall, and he had a hard time pulling his gaze from her swinging ponytail. He found himself thinking how to best approach her—because he was interested in getting to know young-miss-paramedic-liaison better.
And, as he knew only too well, life was too short not to go after what you wanted.
Kylie was far too conscious of Dr. Seth Taylor following behind her as she made her way to his office.
Maybe he
Of course if he knew she was the single mother of a six-year-old Kylie had no doubt Seth Taylor would back off in a hurry. Most men did. Which suited her just fine.
She found his office and walked in through the open door, taking a seat as he made his way around to the other side of his desk.
“So, Kylie.” His smile lit up his whole face. “How can I help you?”
His smile was lethal, and she was shocked to feel the impact all the way down to her toes. She licked her lips and struggled to remember why she was here. Seth Taylor had the uncanny knack of making her feel like she was in high school again, garnering the attention of the quarterback of the football team.
“Deficiencies, huh?” Seth drummed his fingers on the desk. “One area we can all stand to review is how women suffering an acute MI present differently than men. Today was a prime example.”
She nodded. “Yes, I’ve already made a note of that—considering how Jim thought I was crazy to think along those lines.”
Truthfully, she hadn’t been too impressed with Jim’s performance today, and hoped he wasn’t an indication of how all the paramedics in Cedar Bluff worked. If so, she was in for a long haul to bring their skills up to what she considered an acceptable level.