The Nurse's Rescue

The vocal reassurance seemed to be working. His paramedic skills were proving pretty useful, in fact. The kid wasn’t trying to escape and his gentle rocking movement was actually a help in making a visual assessment of the child’s condition. Ricky was pale. Because of the contrast of the thatch of black hair and the big, brown eyes, his face looked as white as the proverbial ghost’s. Or was that at least partly due to the layer of concrete and plaster dust? He was leaning to one side, possibly to protect painful ribs, and he clutched one elbow, cradling what was clearly a badly broken arm. He was still coughing but his breathing sounded generally OK. Joe was coughing quite frequently himself now, thanks to the plaster dust.

Ricky’s knees had grazes nasty enough to need quite a bit of attention and there were myriad other cuts and bruises on the small body, but it was the arm that bothered Joe the most.

‘You’ve hurt your arm, Ricky. That’s a shame, buddy. Is it really sore?’

The question received no more response than any of his questions so far. Joe was a little unsure of how to deal with this. Problems he had encountered were usually at the other end of the spectrum where kids were shrieking too much to talk or allow an easy assessment.

‘Can you talk, Ricky?’ If the kid hadn’t been watching him so intently, Joe would have been easily persuaded that he was severely intellectually disabled, but there was no way anyone could have eyes that that and not be intelligent. They were like Jessica’s eyes. The colour of dairy milk chocolate. Maybe he was just as shy as his mother. ‘You don’t have to talk,’ he said casually. ‘But it might help if you nod or something. Can you nod?’ Joe found he was demonstrating the action as he raised his eyebrows encouragingly at Ricky.

The movement of the boy’s head was hesitant and very slight but it was definitely there and the suggestion of a response felt like a major breakthrough. Ricky could understand what he was saying. He wasn’t just talking to himself.

‘Good man,’ Joe congratulated Ricky. He kept his gaze on the child’s head. ‘Is your arm sore?’

This time the nod was a fraction more definite.

‘Can you wiggle your fingers? Like this?’ Joe demonstrated a wiggle.

He could see the flinch of pain on Ricky’s face that accompanied the weak attempt to copy the movement, but the child made no sound of distress. Either he was incapable of producing sound or he was one brave kid.

‘What I’m going to do, Ricky, is make a little bed for that sore arm to help it feel better.’ Joe glanced into the shadows skirting the circle of light his headlamp was providing. ‘See that cardboard over there? I’m going to cut a piece of that for the bottom of the bed and some of that blanket to make a cushion. Is that OK with you, buddy?’

Joe took the silence as acquiescence and pulled his shears and a crêpe bandage from the limited supplies left in his bum bag. He could only hope that the circulation and nerve supply to Ricky’s hand wouldn’t prove to be compromised. This would be a hell of a lot easier on both of them if he could just splint the limb without having to straighten it. The impression that young Ricky McPhail was no wimp was strengthened considerably over the next twenty minutes or so. Joe was as gentle as it was possible to be but it still had to hurt and Joe wished more than once that he hadn’t used all the supplies of analgesics from his pouch on the patient with the crushed foot. The break in Ricky’s arm was nasty, involving both the ulna and radius, and had come very close to being a compound fracture. It gave another important reason for splinting the small arm other than pain relief. Any untoward pressure and one of the sharp ends of the fractured bones could pierce the skin and present a huge risk of infection and delayed healing.