A Nurse's Search and Rescue

CHAPTER TWO

THIS was a life none of them had expected to save.

For the next fifteen minutes Tori found herself part of a small team working hard to stabilise a critically injured patient who had major chest and head injuries. A body splint and backboard were used, along with a team of firemen, to lift him from the cab of the truck. Matt intubated him to protect his airway and provide adequate oxygenation, and a chest decompression was necessary to deal with the pneumothorax that had caused a lung to collapse and affect his ability to breathe.

It was Tori who helped gain IV access and start fluids running to combat the shocked condition the man was now in. She kept up the monitoring of vital signs, like blood pressure, heart rate and rhythm and the level of respiratory distress, and it was Tori that found the driver’s wallet in the back pocket of his jeans.

‘His name’s Wayne,’ she told the others. ‘Wayne Judd. He’s fifty-three.’

And his driver’s licence indicated that he was listed as a potential organ donor. The wallet also included photographs of a woman and children that had to be Wayne’s immediate family. Suddenly this patient had a real identity and his willingness to help others if he could no longer be helped himself strengthened the desire Tori felt to see this man survive.

She helped load the stretcher into the ambulance and switched the tubing from the portable oxygen cylinder over to the wall connection for the main tanks.

Matt had his stethoscope on Mr Judd’s chest again. Then he glanced at the oxygen saturation reading on the lifepack.

‘He needs IPPV to get those sats up,’ he said. ‘He’s not breathing well enough on his own.’

‘I can do that.’ Tori moved to the head end of the stretcher. She picked up the bag mask and swiftly changed the connection to the oxygen supply. Swapping the mask on their patient’s face, she held the new one securely in place and waited for the chest to rise, indicating an indrawn breath. Squeezing the bag attached to the mask pushed in more air with a high concentration of oxygen that Wayne’s lungs, too damaged to inflate deeply enough, were incapable of delivering.

Joe was frowning. It was obvious that close monitoring and possibly further interventions would be necessary en route to the hospital. Providing intermittent positive pressure ventilation was all that one person could do.

‘We’ll have to try and meet some back-up if I’m driving,’ he told Matt. ‘You’ll need some help in the back.’

‘I could come,’ Tori suggested eagerly. ‘My car’s still stuck and I should be trying to get into work anyway.’

‘Cool.’ Matt wasn’t going to waste any more time. ‘Let’s roll.’

* * *

Watching pre-hospital emergency care of a critically injured patient on board a rapidly moving ambulance was a totally new experience for Tori, and she was amazed at how Matt made it look so easy. Even trying to get an accurate blood-pressure reading with the interference of engine noise would be a challenge, let alone inserting a second IV line.

Matt’s face was serious as he concentrated on his tasks, but he seemed unflappable. Swinging bags of IV fluids smacking the side of his head or keeping his footing during cornering or braking were clearly so much part of his normal working environment he barely missed a beat. He also managed to record a series of vital sign measurements and keep an eye on what Tori was doing.

‘Fantastic,’ he told her at one point. ‘You’ve got the sats well over 90 per cent now.’

Her glow of pride was out of all proportion to the task, but this was so new for Tori—an extension of the front-line medical management that was so different to her everyday job. The lack of a stable environment, limited resources and total reliance on personal skills made trying to stabilise and transport this patient a challenge that felt almost raw compared to what went on in the emergency department of a large hospital.

What would have been a terrifying responsibility if she had been on her own had become something else entirely. Matt was so confident and obviously skilled that being a part of this drama was exciting. Exhilarating, in fact. It was almost a disappointment to arrive at the Royal’s ambulance bay.

Matt had contacted the ED en route, relaying all the necessary information about the patient they had on board. They wheeled the stretcher directly into the trauma room, which had been cleared, and a medical team was waiting to take over care of the patient.

‘His name is Wayne Judd,’ Matt informed the receiving doctor. ‘Fifty-three-year-old driver of a logging truck who was trapped in his vehicle for approximately ninety minutes. When we got to him, he was status one, with chest and head injuries. He had a GCS of three, he was tachypnoeic with absent breath sounds on the left side and an oxygen saturation of 83 per cent, BP of 85 over 50 and a heart rate of 130.’

The doctor nodded. ‘Let’s get him on the bed. I’ll take his head.’ Staff positioned themselves, leaning over the bed to take a firm grip on the edge of the sheet beneath the patient. Tori lined up with Joe and Matt to lift the sheet on their side of the stretcher.

‘On the count of three,’ the doctor in charge of the airway instructed. ‘One, two…three!’

Maureen, one of the trauma team nurses, moved in to start cutting away the remains of the truck driver’s clothing. She caught Tori’s gaze.

‘You’re in trouble,’ she whispered. ‘Out playing, instead of getting to work on time.’

‘I couldn’t help it,’ Tori protested. ‘Pam isn’t furious, is she?’

‘She hasn’t had time to be.’ Maureen slipped Wayne’s shoes into a paper ‘patient property’ bag. ‘It’s been chaos in here.’

Other staff were crowding around the stretcher now and orders were being given for X-rays, CT scans and a neurology consult. Matt and Joe had pushed the stretcher out of the way and were finishing their paperwork in a corner of the room. Maureen took a swift glance at the two ambulance officers as she bundled up the rest of the driver’s clothing and put it in the bag. Then she winked at Tori.

‘I think I’d stay away and play with those two as well.’

Tori followed her out of the trauma room. It was high time she apologised to the charge nurse, Pam, got herself changed and started work. She certainly didn’t want to get caught up in one of Maureen’s conversations, which always seemed to be centred on men. Her colleague’s attention was not easily diverted, however.

‘Who’s the new paramedic?’ Maureen asked.

‘Matt Buchanan. He’s not so new. He was around for a little while last year before you started here. He’s been off the road for the last six months.’

‘You know him?’

Tori nodded. ‘I went on a weekend USAR course he ran.’

‘Do you know if he’s married?’

‘Yes.’

‘Oh.’ Maureen looked crestfallen. ‘Why is it that the gorgeous men are all taken by the time I see them?’

Tori had actually meant that she possessed the information but having opened her mouth to correct Maureen’s assumption, she promptly closed it again. Matt was probably more than capable of looking after himself, even as the prey of a determined man-hunter like Maureen, but Tori felt absurdly protective. Even more strangely, she took considerable pleasure in extending Maureen’s disappointment.

‘He’s got four kids, too.’

Maureen sighed heavily. ‘Well, that’s that, then, isn’t it?’

‘Yep.’ Tori saw Pam coming out of a cubicle on the other side of the department and moved to intercept her boss and apologise for her lateness. She passed Matt and Joe coming out of the trauma room with their stretcher, and smiled in response to Matt’s grin.

‘Catch you later,’ she said. ‘Don’t work too hard.’

‘We won’t,’ Matt assured her. ‘Sure you don’t want to come and third crew with us for the rest of the shift?’

‘I’d love to…’ Tori grinned ‘…but I don’t think it would make me any more popular around here.’

They could all see the frown on Pam’s face as she watched Tori approach.

‘Want me to put in a good word for you?’ Matt asked softly.

‘Pam’s OK. She’s just stressed.’ Tori waved them through the automatic doors to the ambulance bay. She couldn’t help one last glance over her shoulder before moving to appease the charge nurse. Matt and Joe were laughing as they loaded the stretcher, and even from this distance Matt’s smile was contagious. As Maureen had said, having four kids ended any possibility of a relationship more than friendship but friends were important, weren’t they?

A friend like Matthew Buchanan could quite possibly be the best available. He was a very likable person and now that he was working on this side of town, Tori would be seeing a lot more of him. The thought was enough to buoy her spirits considerably.

‘I’m so sorry, Pam. I got caught up in the accident. There really wasn’t any way I could have got here earlier.’