A Nurse's Search and Rescue

‘ETA of about three minutes.’

A fire officer was approaching now. Roger had pushed the window of the van right down and Chloe was calling.

‘I want to get out! Please, get me out now.’

‘Shall I lift her out?’ Roger directed the question at Tori but she looked towards the fire officer. Control of any scene had to be handed on to the most qualified person available.

‘Is she injured?’ the fire officer asked.

‘As far as I can tell, her only injury is a broken arm. We need to get her out to have any chance of reaching Chloe’s mother quickly—and the other children in the back.’

‘I’ll get her, then.’ The fire officer was both taller and broader than Roger. He was remarkably gentle as he eased Chloe through the gap.

‘Roger, can you look after Chloe?’ Tori asked. ‘Take her over to the side of the road and take care of her until an ambulance gets here.’ She turned to the fire officer. ‘Can you help me get to the driver? She needs help urgently.’

More fire officers were approaching. A tarpaulin was being laid on the ground and cutting equipment being set up. The police officer was using his radio, relaying the information Tori had given him and requesting further back-up, like heavy machinery to deal with the logging truck and traffic control for the approaches to both sides of the bridge.

The first ambulance pulled up and an officer got out, took a look around at the scene and then approached Tori’s group.

‘This woman’s a nurse,’ the fire officer informed the paramedic. ‘She’ll fill you in.’

The paramedic turned towards Tori and his eyebrows rose sharply.

‘Tori!’

‘Hi, Matt.’ Tori’s smile was a mixture of relief and surprise. ‘I haven’t seen you for ages.’

‘I’ve been on the south side of town.’ This was no time to renew an acquaintance, however. ‘Have you triaged the scene?’

‘As far as I can. We’re just trying to get access to the back of this van. There’s three children I haven’t seen yet.’ Tori took a deep breath. ‘The driver of the logging truck hasn’t moved since I arrived. Possibly status zero. The car over there…’ Tori pointed across the road ‘…has a passenger who’s status two, unconscious. His airway was occluded and I’ve got someone holding his head and keeping the airway patent now. Driver is possibly status three. She was conscious and breathing well but her GCS is down. She wasn’t responsive enough to question.’

Tori could see Matt’s partner spreading a blanket on the ground nearby and setting up equipment. ‘The driver of this van is a priority. She was moving when I first saw her but she’s not now. She’s still breathing but she’s losing blood pretty fast from a head wound.’

Matt had been watching Tori intently as he’d listened. Now he turned to his partner.

‘Joe, get a collar and some oxygen over to the other car and check the status of those patients. I’ll stay here and get Tori to help me.’ He turned to the fire officer. ‘How soon can we get access to the back of the van?’

‘We’re just checking the stability of that log. We don’t want it shifting when we start cutting.’

‘Is it stable right now?’ Receiving an affirmative nod, Matt turned to Tori. ‘Could you grab a dressing and bandage, a C-collar and an oxygen cylinder and mask from that blanket? I’m going to see if I can get far enough through the window to reach the driver.’

Following instructions from someone who knew what he was doing on the front line was a relief. Matthew Buchanan was more than just a paramedic. His training and involvement with the Urban Search and Rescue task force meant that he was an expert in handling a major incident.

Feeling like she was part of a team that was going to deal with whatever trauma this disaster had left in its wake was suddenly exciting. The adrenaline buzz was still increasing as Tori lugged the requested equipment closer, stepping over the hoses from the hydraulic cutting gear. Another child, a boy this time, was being lifted by Matt from the window of the van.

A glance towards the side of the road showed Roger, holding Chloe in his arms. It also showed the arrival of a second ambulance, whose crew went straight to the second vehicle on Joe’s signal. Flashing lights from police cars were on both sides of the bridge now and another fire engine was crawling past the traffic buildup. Spectators were being herded further away from the scene, but even with the burgeoning number of emergency service personnel Tori was not asked to step aside.

Instead, she found herself drawn even deeper into the rescue effort.

‘I’m too big to get far enough through this window to be in a position to do anything useful,’ Matt told her. ‘And the fire boys want to try cutting the back of the van first to get in to the other children. There’s a baby in a car seat and a toddler who appears to be unconscious. Are you OK to stay and help?’

‘I’m not going anywhere in a hurry.’ Tori’s smile was rueful as she waved at her VW Beetle, now completely hemmed in by a fire engine and two police cars. ‘What can I do to help?’

‘How would you feel about hanging upside down for a while?’

Tori’s level of circulating adrenaline went up another notch. ‘What do you want me to do?’

‘Get a collar on if possible. Assess her breathing and put some oxygen on. Get a dressing and some pressure on that head wound before she loses any more blood. Maybe start an IV.’

‘Sure.’

Tori used one end of the log to gain enough height to get through the open window. Matt passed her the pieces of gear she needed. She was perfectly capable of doing any of the requested procedures more than competently in the emergency department. She had done them hundreds of times.

She had never tried to do any of them whilst hanging virtually upside down over a crumpled door, with her head pounding from the build-up of blood and at an angle that was only secure thanks to the fireman hanging on to her legs.

The woman’s airway was patent, the movement of her chest appeared normal and Tori could feel a radial pulse that indicated her blood pressure was not dangerously low, but she was unresponsive. Tori eased the moulded collar into place and secured the Velcro straps. She inserted a plastic OP airway into their patient’s mouth and then she took the oxygen mask dangling by its tubing in mid-air beside her and positioned it over the woman’s nose and mouth, pulling the elastic strap over the back of her head. She covered the laceration with a thick dressing and wound the bandage to hold it tightly in place.

The van rocked slightly as she was securing the bandage and Tori felt the grip on her legs tighten.

‘It’s OK,’ the fire officer called. ‘They’re just cutting into the back.’

Matt’s voice was also close. ‘I’ve got the IV gear ready, Tori. Sam here is going to pass it in to you. I’m going to check on the other children.’

‘OK.’ Tori reached a hand up behind her. ‘Can I have a tourniquet, please, Sam?’

Her head was more than pounding by the time she had tied the tourniquet around the woman’s arm and used an alcohol swab to clean the area above the vein showing in the crook of her elbow. Black spots were appearing in her vision, which didn’t help as she slid a cannula into the vein and screwed a luer plug onto the end.

‘I need the tubing for the IV fluids now, Sam,’ she called. ‘You’ll need to poke the blue spike into the bag and then hold it up.’

Even her fingers were feeling clumsy by the time Tori got the IV fluids running. If she didn’t change her position soon, she would probably faint.

‘Pull me out, Sam,’ she called. ‘I need to stand up for a bit.’

She caught a glimpse of Matt bent over a baby’s car seat—his stethoscope in his ears—through the gap between the front seats, but standing up was a mistake. The sudden change in posture after being upside down for so long made her feel extremely unwell. Her vision went completely black and she could feel her legs crumpling. An ungainly collapse to the ground was prevented only by the strong grip on her arms.

‘Are you all right?’

‘Bit…dizzy…’ Tori managed.

‘Sit down. Put your head between your knees and take a few deep breaths.’

The buzzing sound receded and Tori blinked to find it was Matt’s hand circling her wrist as he took her pulse.

‘I’m OK,’ she told him. ‘I’m just not used to working upside down.’

‘You’ve done brilliantly,’ Matt told her. He smiled. ‘Thanks.’

‘How are the other children?’