A Nurse's Search and Rescue
Alison Roberts
She was searching for adventure–and found a family!Tori Preston grew up in a large family–and now that she has only herself to think of she's reshaping her life just the way she wants it. She's left ER to retrain in Urban Search and Rescue, she loves the intensity of her new career–and she's enjoying the company of her mentor, Matt Buchanan.Matt is raising four unruly nieces and nephews on his own, and Tori's not looking for any added responsibilities. But as their mutual attraction develops into love, Tori realizes it's not just Matt she can't live without–she wants nothing more than to make his family her own.
Matt’s voice was very soft. ‘Are we more than good friends?’
‘If we were just good friends, it wouldn’t matter that our lives were so complicated or that we only got to see each other when there were other people around, would it?’
‘I did warn you.’ Matt’s voice tickled Tori’s ear. ‘I knew it was quite likely I’d fall in love with you.’
‘But I didn’t think I’d fall in love with you.’ Tori twisted in Matt’s arms so she could see his face properly. Could touch it again. ‘This is a disaster, Matt.’
But Matt’s expression looked anything but dismayed. ‘Are you saying you’re in love with me?’ He seemed to get the answer he wanted from her touch, and turned his head to press a kiss into her palm.
Dear Reader
Teenagers seem to be experts in creating conflict, don’t they? And sometimes it is for no reason other than trying to assert their own independence. I am well aware that even living with one’s own dearly loved teen can be a fraught business, and I’ve done my research on a daily basis for some time now! How much more difficult would it be to live with someone else’s teen? Especially for someone who has good reason to vow never to contemplate trying?
Tori grew up with the repercussions of extending a family to include unrelated children. Some were happy—such as the relationship with her foster sister, Sarah (A MOTHER FOR HIS FAMILY)—but others were much less happy and contribute to the issues facing Tori and Matt in this story. I enjoyed exploring those issues. I enjoyed the resolution even more. Hope you do, too.
Happy reading!
Alison
A Nurse’s Search and Rescue
Alison Roberts
www.millsandboon.co.uk (http://www.millsandboon.co.uk)
CONTENTS
Chapter One (#u2f0fdd22-691a-57e4-8dcf-07afbb57fb78)
Chapter Two (#u2ab6db76-98b3-5f57-b0d1-f04f50c1661f)
Chapter Three (#u3b2feb92-60a5-5c36-b55d-2f8e72028953)
Chapter Four (#litres_trial_promo)
Chapter Five (#litres_trial_promo)
Chapter Six (#litres_trial_promo)
Chapter Seven (#litres_trial_promo)
Chapter Eight (#litres_trial_promo)
Chapter Nine (#litres_trial_promo)
Chapter Ten (#litres_trial_promo)
CHAPTER ONE
‘OH…MY God!’
Victoria Preston had, as usual, timed her journey carefully to avoid the kind of traffic hassles commuters around Auckland, New Zealand were having to face these days.
This scene of total chaos was the last thing she had expected to see on her way to work.
This was no traffic hassle.
This was a disaster!
It must have happened only seconds ago, while Tori had been singing—no, shouting happily—along with the song rattling the windows of her ancient VW Beetle, just before she’d rounded the bend onto the downhill stretch that led to the bridge across the river.
Another car was pulling to a halt on the other side of the bridge, but Tori was officially the first on the scene as she killed the engine on her car and leapt out.
And what a scene!
A logging truck lay twisted across the road, blocking the narrow bridge. The driver’s cab had smashed through the concrete side of the bridge and now hung sideways in mid-air, one giant wheel still spinning slowly. Tori could see the bloodstained, starburst pattern of cracks in the windscreen and a figure slumped over the oversized steering-wheel. The only thing holding the cab above the water, a good twenty metres below, was the twisted coupling holding the cab to a platform now only half-full of huge logs of wood.
The spilt logs had done serious damage to the car the truck must have been trying to avoid hitting as it had come off the one-lane bridge. One had also taken out a minibus, which had presumably been travelling behind the car. The van-style bus lay tipped on an angle to one side, with the weight of a massive tree trunk crushing its side doors.
Tori could see a face in the driver’s compartment of the van. It was the face of a young child and the sound of screaming suddenly cut through the stunned silence that had been the ominous background during the few seconds it had taken Tori to size up the situation and realise the magnitude of this disaster.
‘I’ve called an ambulance.’ The shout from the bridge on the other side of the logging truck was barely audible. ‘How does it look from your side?’
‘Not good.’ Tori was moving towards the minibus. ‘Call the emergency services again. Tell them it’s a multi-casualty incident.’
‘How many people?’
‘Don’t know yet,’ Tori shouted back. ‘I’m about to find out.’
The child in the van was screaming too loudly to hear Tori. She could see a woman in the driver’s seat, her face covered in blood, moving her arms feebly. At least she was moving, which was more than the driver of the logging truck appeared to be. Another child could be seen, huddled in the gap between the two front seats. He or she was crying, adding to the muted sounds of distress coming from within the vehicle, but that child, too, was clearly breathing adequately.
Tori couldn’t see any further into the rear of the minibus. So far she had counted four patients, two of whom were seriously injured. How many more people were trapped in the back of the van? And there was yet another vehicle involved in this crash.
‘I’ll be back in a minute!’ Tori tapped on the intact windscreen of the van and the child in the front stared in wide-eyed terror. ‘You’ll be all right, sweetheart. Just hang on for a bit. I’ll be back.’
This was so hard, leaving the child with such inadequate reassurance and then disappearing from view. This never happened when she was on duty as a triage nurse in the emergency department of the Royal North Shore hospital where she worked. Patients came in neatly packaged on stretchers, with an ambulance officer who could tell her how seriously injured they were. Details of the worst cases would have been radioed through en route, in fact, and the trauma room would have been set up with a whole medical team ready to receive the injured.
This was the front line. A place Tori had never been. Thank goodness she had attended that introductory Urban Search and Rescue course last year. Even the most basic procedures for dealing with a multi-casualty incident were helpful and still fresh enough to be pulled from her brain despite the horror of the situation.
She had to see as many of the people involved as she could. A thirty-second evaluation to determine priority of treatment. Airway, breathing and circulation. Disruption to any of those three were the immediately life-threatening scenarios.
For the purposes of triage, she could take the few seconds needed to open an airway and determine whether someone was breathing, and if they were bleeding badly she could apply a pressure bandage of some sort, but that was about it. She had to find out how many victims there were and what condition they were all in.
If there was any immediate and obvious danger to the victims, she would have to try and move them regardless of their injuries, but Tori couldn’t see anything too alarming. There were no power lines down, the remaining logs on the back of the truck didn’t look like they were going to roll off and she thought the puddle of fluid on the road was water from a crushed radiator rather than fuel with its inherent fire risk.
The children she had seen in the van were breathing well enough to be able to cry. The woman had been conscious enough to be moving. Another glance towards the cab of the logging truck showed the driver to be in exactly the same position as the last time Tori had looked, but even if he was slumped enough to be occluding his airway, there was no way Tori could get into the cab to help.
She could get to the final vehicle involved. A middle-aged man was unconscious in the passenger seat, still held by his safety belt, his head slumped forward. The passenger door was too damaged to open and the driver’s side airbag had deployed and now lay dangling from the steering-wheel like a pricked balloon. A woman sat violently shaking in front of it—a horrible, keening moan issuing from her lips.
Tori was trying to open the back door of this car when another vehicle screeched to a halt. And then another.
‘Has someone called for an ambulance?’
‘They’re on their way.’ Tori eyed the solidly built young man with relief. ‘Could you help me get this door open, please?’
The first attempt failed. Then the man put his foot against the back of the car as he wrenched at the handle. The door opened slowly to the halfway point with a groan and rasp of uncooperative metal.
‘What can I do?’ A woman rushed up to the car.
Tori had to think fast. She had been about to climb into the back seat of this car and position the man’s head to open his airway and protect his cervical spine, but that would immobilise her and there could be others that needed the expertise she had until the ambulance crew arrived.
‘Climb into the back seat,’ she told the woman. ‘I want you to put a hand on each side of this man’s head and tilt it backwards until it’s upright against the headrest.’
‘You can’t do that!’ The young man who had opened the door sounded horrified. ‘I’ve done a first-aid course. You can’t move his neck.. he might have broken it.’
‘At the moment, he’s blocking off his airway,’ Tori explained. ‘He’ll die within minutes if it’s not opened.’
The woman had squeezed into the back seat. She reached for the victim’s head. ‘Like this?’ she asked anxiously.
‘That’s great,’ Tori confirmed. She could see the man’s chest through the window and it was expanding. ‘He’s breathing properly now. You’ll need to stay like that and hold his head in that neutral position until the ambulance gets here and he can get a collar put on to protect his neck. OK? Can you do that?’
The woman nodded but cast a nervous look towards the driver of the car, who was still moaning incoherently. She seemed unaware of the activity around her and was fumbling with the catch of her safety belt but seemed unable to open it. Tori couldn’t see any sign of major bleeding.
‘Talk to her,’ she instructed the head-holder. ‘Try and reassure her as much as you can and encourage her to stay as still as possible. Help should arrive very soon. And I’ll be back as quickly as I can.’
She straightened to meet the challenging gaze of the young man.
‘Where are you going?’ he demanded.
‘There are people in that van. I need to triage them— check how badly injured they are.’
The man frowned. ‘What, are you a doctor or something?’
‘I’m an emergency department nurse.’ Tori could see a look of relief washing over his face and hoped it was justified. She had just put herself in charge of this situation. Taken control of the scene. This person was ready to help rather than argue. ‘My name’s Tori,’ she continued. ‘What’s yours?’
‘Roger.’
‘Come with me, Roger,’ Tori said. ‘We might be able to break a window or something and get the children out of that bus.’
More vehicles were stopping now. In fact, blocked traffic was starting to build up and Tori shouted to a new arrival to watch that people didn’t block access for emergency service vehicles. To her surprise, the man turned immediately to do as she’d requested and her confidence, as she and Roger approached the van, increased steadily.
There was no easy way to gain access to the interior of this vehicle. The log lay over both the bottom of the front passenger door and across the side opening door in the back section. The rear of the van had been crushed by the weight of the log.
Tori caught the gaze of the white-faced child as she approached the minibus again. She had been away for only a matter of minutes and the girl, who looked to be about eight or nine years old, had clearly calmed down enough to watch for her return. Maybe the reassurance Tori had given hadn’t been so inadequate after all.
‘We could break the windscreen,’ Roger suggested. ‘And lift the kid out that way.’
Tori peered through the glass, shaking her head. ‘The glass would go all over the driver and she looks injured enough as it is.’
The woman lying half-crumpled under the steering-wheel appeared to be unconscious but Tori could see some chest-wall movement so she was still breathing. Rapidly. A nasty laceration on the side of her face was still bleeding heavily so urgent medical attention was needed here. The wail of a siren, possibly two, could be heard in the distance now, but Tori wasn’t going to wait for further assistance if there was something she could do to save a life now.
‘What’s your name?’ she called to the girl, still strapped into the front passenger seat despite the 45-degree angle the vehicle was in.
‘Chloe.’ The response was surprisingly audible and it was then that Tori noticed the gap at the top of the side passenger window.
She moved to the side of the van and stood on tiptoe to get her mouth closer to the gap.
‘Are you hurt, Chloe?’
‘My arm hurts.’
Tori could see the distorted shape of the child’s left arm, obviously fractured midway between her wrist and elbow.
‘Does it hurt to breathe?’
‘No.’
‘Is your neck sore?’
‘No.’
‘Does anything else hurt, darling?’
‘I don’t know.’ Chloe started sobbing. ‘I want to get out. Mummy’s hurt, too. Her face is bleeding.’
‘We’re going to help you all get out,’ Tori promised. ‘Who else is in there with you and Mummy?’
‘There’s Jack. He’s hurt his leg. And Toby’s asleep and Holly was crying but she’s stopped now.’
‘Are you the oldest, Chloe?’
‘Ye—es.’
The response was a frightened whimper and Tori’s heart sank. There were three more children in the back of this van and ‘asleep’ or ‘quiet’ could well mean unconscious—or worse.
‘I need you to help me if you can, sweetheart.’ Tori kept her tone as encouraging as she could. ‘I want you to use your arm that isn’t sore and see if you can turn the handle to wind this window down.’ She turned to Roger, who was staring in horrified fascination at the injured driver. ‘Can you try and push the window down to help Chloe open it?’
He seemed relieved to have the distraction of something to do. ‘Sure.’
Sirens could still be heard in the distance but they had been switched off in the two emergency vehicles now arriving on scene. The first was a police car and the second a fire engine. Tori saw some of the gathering crowd of onlookers pointing in her direction and then a police officer moved swiftly towards her.
‘I’m told you’re a nurse and you’ve got a handle on how many injured here.’
Tori nodded. ‘There’s a total of eight victims as far as I can make out. At least two are seriously injured— status two. The driver in the van here and the passenger in that car there.’ She glanced towards the cab of the logging truck again. ‘Possibly a status zero in the truck and there are several children in the back of this van that I haven’t been able to assess yet. How far away is an ambulance?’
‘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?’
‘The toddler seems to be OK. He was conscious— just too frightened to move. The baby’s had a bump on her head, which may be more serious. They’re both being transported, priority one. We’re going to break the windscreen and do a dash roll to get the mother out now.’
‘And the others?’
‘They’re being loaded now. The driver’s OK—badly shaken but no more than a few bumps and bruises, thanks to the airbag. Her husband regained consciousness but had to be sedated. He was very combative due to his head injury.’
Matt glanced up as a fire officer stepped over Tori’s legs. ‘I need you to move a bit so we can get on with this extrication. You feel OK to stand up?’
‘Sure.’ But Tori was grateful for the assistance Matt gave her and she staggered slightly before stopping to lean against the side of the closest fire engine from where she could watch as they cut open the front of the van and used a backboard to secure and move the unconscious woman.
A new ambulance crew was ready to transport the patient and Tori wondered just how many vehicles had been deployed to this scene. The closest emergency department would be that of the Royal, where Tori worked, and that thought made her glance at her watch and groan. They would be hard-pressed to deal with the influx of casualties and she should have been at work over an hour ago.
‘Excuse me,’ she called to the ambulance officer on the end of the woman’s stretcher. ‘Are you going to the Royal?’
‘It’s the closest hospital.’ The female paramedic nodded. ‘They’re working under a disaster management code for this.’
‘I’m Victoria Preston,’ Tori told her. ‘I’m supposed to be on duty in the ED. If you get a chance, can you let someone know why I’m held up?’
‘Sure.’
‘Do you want to go with them?’ Matt had overheard the interchange. ‘The police can arrange for your car to be sorted later.’
‘Are you leaving now?’
Matt shook his head. ‘We’re on standby for the moment in case anyone gets injured, trying to clear this scene. The crane’s arriving now, too, so we’ll wait until we can check the truck driver. Not that I hold out much hope for him.’
‘No.’ Tori looked at the slumped figure in the truck’s cab, still dangling over the side of the bridge. The carnage of the other vehicles, now even more deformed by the extrication efforts of the fire service, were a reminder of how many people had been seriously injured here, and the enormity of it all really hit home. Tori suddenly felt exhausted. ‘I’ll stay for a while, too,’ she said. ‘I’m not sure I’m up to starting a shift in ED just yet.’ Taking a deep breath, she exhaled slowly. ‘I don’t know how you cope with this sort of thing on a daily basis.’
‘Big incidents like this are few and far between,’ Matt responded. He grinned. ‘And you know what we’re like in the ambulance service. Being able to do what we’re trained for on a scale like this is a highlight of the job.’
That adrenaline buzz might only be a memory now but it was strong enough to make Tori nod slowly.
‘It’s a very different ball game compared to hospital work, isn’t it? You have to be far more self-reliant. Yelling for help isn’t necessarily going to get someone who’s going to be any more able to deal with the situation.’
‘And every challenge is that little bit different. It never gets boring, that’s for sure.’
Matt’s partner, Joe, was packing away their gear but Matt seemed content to take a break. He leaned against the side of the fire engine beside Tori. ‘So, how are you?’ he queried. ‘It must be nearly six months since I’ve seen you.’
‘That’d be right. You talked me into coming to that USAR introduction course you ran last year, remember?’
‘Of course I do. You were hopping around on crutches. How’s the leg now?’
‘Good as new.’
‘Did you find the course at all useful?’
‘Absolutely.’ Tori smiled at Matt. ‘That session on triage started flashing like a neon sign in my head as soon as I found I was the first on the scene here.’
‘Really?’ Matt looked so delighted that Tori found her smile widening.
‘Really,’ she confirmed. ‘It was a great course.’
‘You should come and do some more advanced USAR training, then. We could do with some more medically qualified people on the teams.’
‘Hmm.’ Tori was enjoying the look of genuine interest on Matt’s face. His encouraging smile seemed to reach all the way to a pair of equally warm hazel eyes. ‘I might just do that.’
For a fraction of a second Matt held her gaze and Tori was reminded of a connection that had been completely buried over the last six months. A base for a friendship that had just been strengthened by what had happened this morning. A friendship she would be more than happy to build on.
Not that she’d want Matt to think she’d changed her mind about anything else, though. Tori broke the eye contact hurriedly.
‘How are all the kids?’ The reminder of just what had put Matthew Buchanan firmly off any agenda other than friendship was definitely timely.
‘Settling in finally, I think. That’s why I kind of disappeared for a while. I took a desk job, thinking that the more regular hours would help.’
‘And did it?’
Matt shrugged. ‘Maybe. Trouble was I missed being on the road too much. In the end I decided that making myself miserable wasn’t going to help any of us in the long run. It was rubbing off on the family, no matter how much I tried to hide it.’
Tori found her gaze caught again. He would have tried to hide it, wouldn’t he? Anyone who’d been prepared to turn his life upside down and even sacrifice a long-term relationship for the sake of four orphaned nieces and nephews had to be some kind of saint. Or, at the very least, an awfully nice guy.
‘So you haven’t found anyone to help run the orphanage yet?’
Matt laughed. ‘As if! Any sensible woman is going to run screaming into the middle distance at the mention of four kids.’
‘True,’ Tori grinned. ‘You’ll just have to find someone who isn’t sensible, then.’
‘Totally mad, you mean?’
‘It might help.’ The humour was a thinner veneer than Tori felt comfortable with, however, because she knew better than most the implications of the undercurrents here.
Changing the subject was fortunately effortless enough to be perfectly acceptable. ‘Oh, look! They’ve got the cab of the logging truck onto that crane. It’s moving!’
‘That’s my cue, then.’ Matt straightened and watched for a short time as the cab containing the unfortunate driver of the truck swung slowly towards solid ground where it hovered before starting a gentle descent. Matt moved towards the ambulance. ‘I’ll grab my kit.’
‘Can I help?’ Tori’s exhaustion had mysteriously evaporated. There was, after all, the smallest chance that the truck driver was still alive.
‘Joe?’ Matt got the attention of his partner. ‘Tori’s offered to third crew for us for a bit longer. Give her the heavy stuff, eh?’
Joe was grinning as he held out the lifepack. ‘If you carry the oxygen cylinder in your other hand, it kind of balances you.’
‘Cheers.’
‘Just kidding!’ Joe put the lifepack on top of the stretcher and then added the oxygen cylinder and suction kit. ‘We’ll just take the whole bed. Pull out those handles at the end and help me lift it out.’
They had to wait as the cab was very slowly lowered to the ground. Then Matt swung himself up on the step and opened the door. Tori saw him reach to feel for a carotid pulse on the driver’s neck.
The shout, seconds later, was astonished.
‘Hey…I’ve got a pulse here. He’s alive!’
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.’
The charge nurse nodded then sighed. ‘We’re short-staffed as it is, and with everyone possible shoved back into the waiting room when we went on code, it’s going to be hours before we get back to normal. Get yourself changed and I’ll assign your patients. Are you able to stay on a bit later tonight?’
‘Sure.’ Tori glanced through the doors to the ambulance bay on her way to the locker room and saw the beacons being activated on the ambulance now out on the main road. The sound of the siren kicked in a second later and Tori smiled. There was a bright side to be found here.
The longer she was on duty in the ED, the more chance she had of seeing Matt. And the more she saw of Matt, the more likely it was that they would become friends.
Matthew Buchanan had a lot of responsibilities. He probably had very little time to have fun these days but he seemed like someone who would be very good at it, given the opportunity.
Tori was good at finding opportunities. If they didn’t come along by themselves, she was quite capable of engineering them, given an incentive. And the thought of seeing that smile on Matt’s face at frequent intervals was an excellent incentive.
* * *
But it proved frustratingly difficult to get anything more than brief snatches of conversation with Matt, however hard Tori tried.
The turn-around time for an ambulance crew delivering patients to the emergency department was generally rapid, and Matt and Joe seemed slicker than most. The times they were held up for some reason— by a queue waiting for triage or a bigger than usual clean-up operation before being available for a new job—were invariably the times that Tori was tied up with patient care and could do no more than smile or wave across a busy department.
Happily, Matt seemed as determined as she was to renew their acquaintance. Over the first few days after the incident with the logging truck, both Matt and Joe were keen to get updates on the progress of the accident victims. Tori made sure she kept in touch with what was going on.
Chloe had been the first to go home.
‘She got a bright pink cast on her arm,’ Tori told Matt the next day. ‘She was delighted with it.’
A day later her siblings were allowed to go home with their father.
‘Mum’s still in ICU but she should go through to a ward later today or tomorrow. She’s doing well.’
The male passenger of the car had been transferred to a spinal unit.
‘He had a fracture at C6-7,’ Tori relayed. ‘I’m so pleased I got someone to sit there and hold his head. He’s had surgery to stabilise the fracture and he’s not showing any neurological deficit.’
The truck driver wasn’t doing so well, still in a coma a week after the accident.
‘I went up to see him.’ Tori shook her head. ‘He looks awful! His eyes are completely black and his face is so swollen it’s unrecognisable. His wife is in there with him most of the time and she’s so grateful for what was done on scene. She tried to thank me but I told her it was you guys who deserved the praise. I’m sure she’d love to say hello to you.’
‘We’ll try and pop in later maybe.’
‘Why don’t you go up now?’ Joe suggested. ‘Control wants us to wait for a patient coming down from plastic Outpatients for a rural transfer. I can go and get her by myself.’
Tori wasn’t going to lose this opportunity. ‘I’m due for a break,’ she informed Matt. ‘I’ll come with you.’
It was a satisfyingly long trip up to the intensive care unit after they bypassed the lifts and took the stairs.
‘This is good,’ Tori announced, pushing open the fire stop door. ‘I really needed to get out of the department for a few minutes.’
‘It didn’t look overly busy.’
‘More like boring today. I’ve had two abdo pains, a ninety-three-year-old with a rectal bleed and a sprained ankle so far. I’m on the trauma team but nothing’s come in yet.’
‘My apologies,’ Matt grinned. ‘I’ll see if I can arrange a good crash or a nice medical emergency for you.’
‘Awful thing to wish for,’ Tori admitted. She gave Matt a stern look over her shoulder as she led the way up the stairs. ‘I’m blaming you for how tame work seems to be lately.’
‘Hey, it’s not my fault if people are staying healthy and happy.’
‘No, but if I hadn’t enjoyed helping at that crash scene so much, I wouldn’t have started to notice how ordinary my job is most of the time.’
‘So join the ambulance service,’ Matt suggested calmly. ‘We get our share of boring, though, believe me.’
‘Yeah, but when it’s not boring, it’s really not boring.’
‘True.’
The easy conversation was interrupted for the short time they spent in the ICU. Mrs Judd was delighted to have the opportunity to thank Matt. She was also a lot happier than the last time Tori had seen her because Wayne was showing signs of regaining consciousness.
‘They’re keeping him sedated because he still needs the machine to breathe properly, but he opened his eyes this morning and I know he recognised me. He even squeezed my hand.’
‘That’s great to hear.’ Matt smiled.
Colleen Judd had a lot of questions she wanted to ask Matt about the accident and Wayne’s rescue, but Tori found her attention wandering. Her nursing career had led very directly to the area she had most wanted to work in and her position in the emergency department represented the goal she had been aiming for.
A career change that might take her in a completely new direction—onto the front line even—had never occurred to her. Until now.
‘I might think about what you said,’ she told Matt as they made their way back downstairs. ‘I could do with a new life.’
‘Really? You not happy with the old one?’
Tori could have sworn she read real concern in Matt’s eyes and she bit back the denial leaping to her lips.
‘It’s been a weird few months,’ she admitted. ‘I’m not enjoying anything right now as much as I used to.’
‘What happened to change things?’ Matt not only slowed down on the stairs, he paused on the landing. Tori stopped as well.
‘It’s your fault again,’ she said with a grin. ‘It was that USAR course that did it.’
Matt raised his eyebrows in both a silent protest and question.
‘You remember that cyclone that was happening in the Pacific then?’
Matt nodded but then frowned. ‘But USAR didn’t get activated for that.’
‘They sent a medical relief team, though, and thanks to doing that course, Sarah got called. I couldn’t go because my leg wasn’t up to it, but she went.’
‘Sarah’s your sister, yes?’
‘Foster-sister really, but we’re very close. We were both still living at home and we looked after Mum for ages before she died last year.’
‘I’m not quite following how this is my fault yet.’ Matt’s attention was fully focused on Tori and the sensation was far from unpleasant.
‘I went to that course and dragged Sarah along purely for your benefit, you know.’
‘Really?’
Tori nodded firmly. ‘I’d decided you two were perfect for each other.’
‘We were?’
Tori nodded again. ‘She loves kids and you’re running a private orphanage.’
Matt laughed. ‘Hardly. They are family.’
‘Yeah. And you were just too nice a guy to say no.’
‘That’s me.’
‘Modest as well.’ Tori grinned. ‘I’m actually quite disappointed you’re not going to be my brother-in-law.’
‘I haven’t had a chance to try,’ Matt protested. ‘Where’s Sarah? Not that I’ve proposed to anyone for a while, but I’m prepared to give it a shot.’
‘I’ve been trying to tell you,’ Tori growled. ‘Sas went off to help with that cyclone relief team and she never came back.’
‘What?’
‘She got kind of involved with someone there. She’s living in London now but they’re going back to Fiji to get married in a couple of months.’
‘I guess she won’t want another proposal, then.’ Matt shook his head philosophically. ‘Story of my life.’
‘Well, it’s changed my life, too, you know.’ Tori sighed. ‘I’m living alone for the first time in my life, rattling around in a house that’s far too big. Nobody wants to come and live with me because it’s too far out of town, and I can’t sell up because it’s half Sarah’s house and, anyway, it’s where I grew up so I don’t really want to sell up.’ Tori smiled a little sadly. ‘So, here I am with the freedom to be out having a wild old time but instead I’m working all hours and missing having Sas around. My job was what was holding it all together and now—thanks to you—I’m starting to feel like it might not be exactly what I want to be doing.’
Matt’s pager sounded and he read the message. ‘Joe’s waiting for me. I’d better head back. Nice long drive out to the country. Hardly an exciting end to the day.’
‘Beats being stuck inside, waiting for another sprained ankle or a sore tummy that’s going to be around for hours demanding to know why something isn’t being done to fix them.’
Matt held the fire stop door open for Tori this time. ‘Seeing as it’s all my fault that life is less than perfect for you right now, why don’t I make amends?’
Despite herself, Tori’s heart gave an unusually vigorous thump. There was no disputing Matt’s attractiveness, and even being the object of conversational attention was enjoyable. How far would he go to make life a bit more interesting?
‘Keep talking,’ Tori instructed.
‘Come out on the road properly some time. I can arrange for you to be on board as an observer—especially if you are at all interested in changing careers.’
‘Who would I go out with?’
Matt grinned. ‘I don’t think Joe would protest at having you as third crew, and seeing as I’ve mucked up your life I feel obliged to help you find a bit of excitement again.’
Tori’s nod was satisfied. ‘Sounds fair to me. I’ll talk to my people and get back to you.’
* * *
‘We’re just good friends.’
Tori’s airy statement earned her a black look from Maureen, who dropped the magazine she’d been leafing through and stalked out of the emergency department’s staffroom.
Erin, the nurse who had brought up the subject of Tori’s relationship with Matt, eyed the abandoned seat at the table and gave Tori a meaningful glance.
‘Someone’s not happy.’
Tori shrugged. ‘She’s on the hunt for a new boyfriend. She liked the look of Matt.’
‘Can’t say I blame her.’ Erin took another bite of her sandwich. ‘So how long have you been seeing him now?’
‘I’m not seeing him, Erin. When I said we’re just good friends, I meant it. I’ve been out on the road with him a couple of times. I’m seriously thinking of becoming an AO.’
‘You’re kidding!’
‘Nope. I love it. Every job is different and you never know where you’re going to be next. We went from this mansion, which actually had a maid to let us in, the other night to an incident at a gang headquarters, where the police had to escort us inside for safety.’
Erin shuddered visibly. ‘And what happens when the police aren’t there?’
Tori ignored the warning. ‘It was a gunshot wound,’ she said. ‘With a hole in his chest sucking in air. I had to seal it with my hand until we could get an occlusive dressing on it, and then we had to load and go with the armed offenders squad outside dealing with the rival gang.’ She sighed happily. ‘It was really exciting!’
‘I’d rather be in here with a few security guards sitting on the troublemakers,’ Erin said firmly. ‘In fact, I think I’ve had about enough of Emergency. I’m thinking of transferring back to Orthopaedics.’
‘I love it,’ Tori repeated. ‘Especially being out with Matt and Joe. They’re great fun.’
‘Hmm.’ Erin’s expression was supremely tolerant. ‘Just good friends, huh?’
* * *
‘We’re just good friends,’ Tori said again later that night when Sarah rang from London. ‘He’s such a nice guy, Sas. Maybe you should reconsider.’
‘When I’ve got Ben? Not in this lifetime, kid!’
Tori suppressed the pang of totally unreasonable envy that Sarah had found ‘the real thing’. It wasn’t even on her own agenda, was it? Not for years and years, anyway. Good grief, she was only twenty-five and she intended to have as much fun as possible before she settled down to the kind of bliss Sarah was experiencing.
‘How’s Phoebe?’ she asked hurriedly. ‘Is she still doing well after the surgery?’
‘It’s amazing,’ Sarah said. ‘The tissue expansion created all this perfectly normal skin and they’ve managed to get rid of all the scar tissue on her face. She’s going to look absolutely gorgeous once the swelling’s gone down a bit more.’
‘That’s wonderful.’ Tori knew she wasn’t sounding as enthusiastic as the news warranted. ‘I miss you, Sas.’
‘It’s not long till the wedding and our plans to emigrate to New Zealand are really taking shape. I’ve persuaded Ben that living north of Auckland will be perfect. He can commute into the city to work. You’d better start keeping an eye out for properties near you.’
‘Maybe you should have this house. It’s too big and spooky for just me.’
‘Yeah…’ Sarah was laughing. ‘You could fit Matthew and all his kids in there.’
‘Don’t joke! The thought of taking on someone else’s family is a recurring nightmare. You know I had quite enough of foster-children when I was growing up.’
‘Hey—I was one of those foster-kids.’
‘You were different.’ Tori had to swallow a lump in her throat. ‘It’s so good to talk to you, Sas.’
‘Are you all right, Tori? You sound…I don’t know…lonely.’
‘Who, me? The ‘‘out on the town’’ party girl flitting from one romantic adventure to the next? Lonely? Hello-o-o!’
‘So what romantic adventures have you not been telling me about, then? The last one I knew about was Robert, and that was a disaster!’
‘He was the last one,’ Tori admitted. ‘How sad is that?’
‘So get out there and find someone new,’ Sarah ordered. ‘You obviously like Matt.’
‘Matt’s out of the question.’
‘Why?’
‘You know why. He’s got four children and no life!’
‘You don’t have to marry him.’
‘He doesn’t seem the type to do anything less than serious. And he’s too nice for me to want to make his life any more complicated. Besides, I don’t want to spend my time off with a bunch of kids.’
‘He must escape occasionally.’
‘Only to work, from what I can make out.’
‘So maybe he needs a chance to have some fun.’
Tori was silent. That thought wasn’t totally original, was it?
‘And at least he’s been upfront about the kids, which is more than Robert was. And he doesn’t have a wife tucked away either.’
‘Hmm. He’s too ugly.’
‘I’ve seen him, remember?’
‘Oh…so you have.’
‘When are you seeing him again?’
‘I’m not seeing him. We’re—’
‘Just good friends,’ Sarah interrupted. ‘You already said that. So when are you going out on the road with him again?’
‘Tomorrow, actually.’
‘A night shift?’
‘Yeah.’
‘Have fun.’
‘I’ll do my best.’ Tori was still smiling well after the phone call had ended. She wouldn’t have to try hard. The easy conversation, the humour and the growing friendship made her look forward to his company to the extent that Sarah’s suggestion appeared to have some merit.
Later, turning yet again on her pillow as she tried to settle into sleep, Tori decided against offering anything more than friendship, however. There was just something too inherently decent about Matt to contemplate an affair with no strings. Or maybe she just liked him too much.
She had never had a really close male friend without a physical relationship or the desire for one interfering with the friendship on one or both sides. Adding sex to their relationship would be the fastest way to ruin what was promising to be the best friendship Tori had ever had with a man. No matter how attractive Matthew Buchanan was, it wasn’t worth the risk.
‘And that,’ Tori whispered aloud to herself, ‘is that. End of story.’
CHAPTER THREE
IT DIDN’T turn out to be much fun after all.
The prospect of another night on the road as an observer with Matt and Joe had been the highlight of Tori’s week. The shift started with great promise and the priority-one callout to a car v. pedestrian resulted in an adrenaline-pumping, high-speed obstacle course through rush-hour traffic with Matt’s impressive driving skills tested to the limit.
The job was a fizzer, though, and it was almost embarrassing to turn off first the siren and then the beacons, having been informed by the owner of a secondhand furniture shop that the ‘victim’ had dusted himself off and walked home. Matt and Joe seemed quite philosophical about it, smiling and waving at the group of wide-eyed children who had gathered to watch. Matt blipped the siren in farewell as they pulled away and a small boy could be heard crowing with delight as the noise from the vehicle faded.
The second call, over an hour later, was to a ‘sick person’ who was apparently unwell enough to also require a priority-one response.
‘I’m dying,’ he told the crew as he lay on his bed with a damp cloth covering his eyes.
‘Don’t think so,’ Joe said cheerfully. Matt pulled a blood-pressure cuff from the kit and winked at Tori.
‘What’s been happening?’ he queried.
‘My head hurts. My eyes hurt. I’ve got a sore throat. I ache all over and I feel dizzy when I try and stand up.’
‘Anyone else in the family been unwell recently?’
‘My wife had the flu last week but she wasn’t this sick.’
Tori glanced at the woman standing in the doorway of the bedroom with a toddler balanced on one hip and an older child holding her free hand. She probably hadn’t had time to be that sick.
‘Have you seen your GP?’
‘No-o-o.’ The man groaned rather dramatically. ‘I’ve been too sick to try and get out of bed.’
His wife sighed wearily. ‘They don’t do house calls any more.’
They listened to their patient’s chest, which was clear, took an ECG, which was normal, and pricked his finger to test his blood-sugar levels—also normal. They recorded a normal blood pressure and a slightly elevated temperature. They noted a clean medical history and absence of any prescribed medications.
‘You’ve got the flu, mate,’ Joe told him finally. ‘You need to rest and keep your fluid intake up. If you take some aspirin or a cold and flu preparation, it’ll help the aches and pains. A day or two in bed and you’ll be as right as rain.’
‘But…you’re supposed to take me into hospital, aren’t you?’
‘We can take you if that’s what you really want,’ Matt said, ‘but you’ll be in a very bright, busy, noisy emergency department. You’ll be well down any priority list and it could take hours to see a doctor, who will probably send you straight home again with the same advice we’ve just given you. By then it’ll be about 2 a.m. and you will have missed a good few hours’ sleep.’ Matt’s tone became much less forbidding. ‘Why don’t you try and get some rest at home and see how it goes? You can always call us back if things get worse.’
‘Can I?’
‘Of course.’ Joe was latching the kit. ‘That’s what we’re here for.’
The patient’s wife saw them to the door. ‘I’m so sorry,’ she said. ‘I wanted to take him to the after-hours clinic but he really did seem very sick and I couldn’t carry him to the car.’
‘Man flu,’ Tori pronounced as they headed back to station. ‘It’s a terrible thing.’
‘Careful,’ Matt warned. ‘You’re outnumbered right now.’
Tori was unimpressed. ‘Let’s hope the next one is a female patient,’ she said. ‘We might actually get a genuine case.’
They had to wait nearly two hours for the next call and the patient was, indeed, a female.
It was also very genuine.
* * *
The address was central city, one of a run-down group of old houses that backed onto a commercial and industrial street. Tori eyed the unkempt garden cluttered with rusting car bodies with some misgivings. The house looked equally uninviting. Window-panes were cracked or broken, curtains hung in ragged shreds. The front door stood ajar and revealed a dimly lit hallway strewn with rubbish. A strong smell of cannabis drifted out as they waited for a response to Matt’s knock.
‘Hello!’ Matt moved into the hallway. ‘Ambulance here.’
Tori hoisted the weight of the oxygen cylinder to hold it in her arms. While grateful for the solid presence of Matt and Joe in front of her, knowing she had a potential weapon of her own for self-defence was reassuring.
‘Hello!’ Matt called more loudly. ‘Anyone here?’
A man appeared at a doorway near the end of the hall. Naked to the waist, jeans undone, his body was covered with tattoos. Metal spikes protruded from piercings beneath his bottom lip and added considerably to the belligerent expression on his face. He took the joint of cannabis from where it appeared to be stuck to his lower lip.
‘Whaddyawant?’
‘Someone called an ambulance to this address.’ Matt had stopped and now he moved back in a subtle fashion, which Joe mirrored. Tori found herself surrounded and knew that both these men were poised to protect her if necessary.
‘Wasn’t me,’ the man said.
‘She’s out the back.’ A female voice came from someone still in the room behind the male occupant of the house. ‘In the garage.’
Matt turned and touched Tori’s shoulder. ‘Let’s go,’ he murmured.
They went out the way they had come in, found a gap between the hulks of wrecked cars and discovered a double garage with its side door hanging open.
Two teenage girls, devotees of Gothic styling, sat on a bare mattress just inside the door. They stared at the newcomers with matching blank faces.
‘Hi, there. I’m Matt from the ambulance. This is Joe and Tori. Did you guys call for us?’
‘Yeah.’ One of the girls pointed to the other side of the garage. ‘It’s Charlene. She won’t wake up.’
Another young girl lay on her side between two mattresses piled with some old blankets and pillows that were losing their stuffing. Matt rolled her over onto her back.
‘Charlene, can you hear me? Open your eyes, love.’
There was no response. Even in the dim light provided by the single bare bulb dangling in the centre of the garage Tori could see the blue tinge of cyanosis on the girl’s lips.
Joe was uncurling the leads from the life pack to attach electrodes. He cut through a thin sweatshirt to expose what looked like the underdeveloped chest of a child. Having determined that Charlene was not breathing, Matt flipped open the kit and pulled out the bag mask. Tori grabbed the end of the tubing and pushed it onto the oxygen cylinder’s connection. She fitted the key to the valve, twisted it open and turned the flow up to fifteen litres a minute—the highest available.
Matt tipped the girl’s head back and lifted her chin to open her airway, having checked that there was no obstruction in her mouth. He fitted the mask and inflated the bag twice to deliver two full breaths. Then his fingers went to the side of Charlene’s neck.
‘No pulse,’ he reported grimly.
Joe simply nodded. The display on the screen of the life pack was just settling into a readable rhythm.
‘Fine VF,’ he announced, equally grim. Tori could understand why. When first in cardiac arrest, a rhythm of ventricular fibrillation was coarse, with the wiggles much further away from a flat base line. There was far more chance of converting a coarse VF into a perfusing rhythm. The longer the ‘downtime’, the finer the wiggles…and the less hope there was that a life could be saved.
‘What’s happened here?’ Matt directed the question to the girls still sitting near the door. ‘How long has she been like this?’
One of the girls shrugged. ‘Dunno.’
‘Stand clear,’ Joe directed. ‘Shocking at 200 joules.’
Matt moved backwards so that he wasn’t touching the patient. He put the bag mask down and reached for his radio. After a rapid request for back-up to a cardiac arrest, he turned to his kit.
‘Could you hold the torch to give me some decent light, please, Tori? I’ll intubate in a minute.’
‘Sure.’ Tori clutched the torch and held it high enough to cast a useful circle of light. She watched in dismay as Joe delivered a second and then a third shock, with no change to the fatal cardiac rhythm displayed on the life pack screen.
Matt unrolled the intubation kit. ‘Put the torch down for a sec and hyperventilate her for me, Tori.’
She did as requested, giving the girl as much oxygen as possible before the procedure of securing her airway with the tough, plastic tube. Then she held the torch again, holding her own breath in sympathy with the look of intense focus on Matt’s face as he lifted the tongue with the laryngoscope and angled the light on the instrument to visualise the vocal cords.
Tori was ready with the bag mask when Matt had inflated the balloon on the ET tube to help secure its position. He listened for the sound of moving air as Tori squeezed the bag, to ensure it was going into the lungs and not the stomach which would indicate incorrect placement of the tube.
‘We’re in,’ he announced. ‘Start CPR, Joe, and I’ll get IV access.’
Tori inflated the girl’s lungs twice after every fifteen of Joe’s chest compressions. They kept it up for a full minute, by which time Matt had an IV cannula inserted and a bag of saline attached. Then Tori sat back to allow Joe to start the next series of three shocks. Matt was drawing adrenaline into a syringe. He looked up as he twisted the top off the second ampoule.
‘Somebody needs to tell us what’s been going on here,’ he told their silent audience. ‘It could make a difference to whether we can help Charlene or not.’
His words had an effect. One of the girls burst into tears and the other one put her arms around her.
‘Leave her alone,’ she shouted at Matt. ‘It’s not Jamie’s fault.’
Tori felt, rather than heard, Matt sigh. ‘How old is Charlene?’ he asked.
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