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Rescuing Dr. MacAllister

Page 21

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'Keep checking,' Ben growled. 'Nobody is ever cold and dead. Only warm and dead.'

Ellie nodded, aware that in extreme hypothermia it was sometimes impossible to find a pulse but that the patient could still be alive. As she felt for a pulse she stared down into the woman's face and frowned slightly.

'Ben, we know her.'

Ben glanced up briefly and then returned to what he was doing. 'What are you talking about?'

'Her name is Joanna Kingston.' Ellie turned to one of the junior nurses, her tone urgent 'Go to Reception and get her notes, will you, please? She was in two months ago with a suicide attempt. Swallowed paracetamol.'

Ben's mouth tightened. 'Suicide attempt? Well, this time she just might have succeeded. If we're not careful she'll go into VF with a core temperature that low.'

'I've got a pulse!' Ellie looked up, triumphant, and Ben gave a brief nod.

'OK, I want U and Es, FBC, toxicology, clotting screens, blood glucose, amylase, blood cultures and ABG.' He glanced up and his eyes narrowed as he looked at Ellie. 'Why are you smiling?'

'You sound like one of those doctors from the movies,' she told him, fishing out the right blood bottles while the' casualty officer searched for a vein. 'Just let me know when you're ready for me to mop your fevered brow and swoon at your feet.'

Ben looked at her for a moment and then a ghost of a smile touched his mouth. "That won't be necessary. Can you arrange an X-ray and an ECG?'

Ellie was already dialling as he spoke, breaking off to speak quickly to X-Ray, her free hand reaching for the ECG machine. 'It's a good job women are good at multitasking,' she muttered as she wheeled the machine over to the patient.

Will cursed under his breath. 'I can't find a vein. I think her circulation has collapsed.'

'Let me...' Ben tightened the tourniquet and took hold of the woman's arm, examining it carefully. Seconds later he stuck out a hand. 'Venflon.'

Ellie handed him one immediately and Ben deftly inserted it under the skin, grunting with satisfaction as blood oozed up the cannula.

'Tape it fast before we lose it,' he said tersely, moving back up to the patient's head. 'Give that oxygen through a humidifier,' he instructed, turning to the casualty officer. 'When you send off those blood gases, remember to tell the lab that she's hypothermic. We'll give IV fluids through a warming device and not too fast.'

With an awed expression on his face, Will set to work, following Ben's instructions to the letter, asking questions all the time. 'What happens if we give it too fast? I haven't dealt with a case of hypothermia before.'

Ben's glance rested on Ellie who'd returned to the patient's side. 'Maybe Nurse Harrison can answer that?'

'Testing me, Dr MacAllister?' Ellie smiled cheerfully at Ben but the smile faded rapidly as she turned back to Will and noticed that he was staring at her chest again. Blow the man! 'Give her too much fluid and you might precipitate pulmonary oedema.'

Her tone was flat and Ben gave her a searching gaze before leaning over her shoulder as she positioned the ECG leads.

She flicked the machine on and watched closely. 'Ouch. Look at that.'

'I'm looking. Someone bleep the medical reg,' Ben said, his mouth set in a grim line as he scanned the ECG. 'We're aiming for a core temperature rise of one degree an hour. If we do it too fast we risk causing hypotension and another fall in temperature.'

It was another hour before the team had stabilised the woman and transferred her to the intensive care unit.

'Will she make it, do you think?' Ellie tore off her apron and stuffed it into the bin, her face concerned.

Ben shrugged. 'I don't know. Maybe. If she does, they'll need to arrange a referral to the psychiatrist.'

'Poor thing.' Ellie gave a long sigh. 'I wonder what made her feel so desperate she wanted to kill herself. Terribly sad.'

Sean stuck his head round the door. 'When you've finished here, the two of you should go home. It's almost two a.m. and you must be totally knackered after the night you've had. Ellie, what's happening about your car, sweetheart? Are you going home with Jack?'

'He's already left. I didn't think to ask him.' Ellie bit her lip in dismay. She'd forgotten about her car. And she needed to get back to feed Max. 'Don't worry—I'll cadge a lift from someone or get a taxi.'

'I'll give you a lift, Ellie,' Will said immediately, and Ellie felt her heart sink. That was the last thing she wanted, but she didn't want to be rude.

'She's coming with me.' Ben's tone was abrupt and Will glanced from one to the other and gave a careless shrug!

'Fair enough. I'll see you folks tomorrow, then.'



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