The Spanish Consultant (Westerling)

But it soon became clear to her that she couldn’t possibly do anything wrong because Jago was directing the entire operation with an air of cool command which left no doubt in anyone’s mind who was in charge.

Having secured the man’s airway and satisfied himself that there was no damage to the cervical spine, he turned his attention to the work of the rest of the team.

‘Get another line in. I want vital signs recorded every five minutes and get his clothes off fast—I want every inch of him examined.’

Using sharp scissors, they cut off his clothes and Katy reached for the man’s wrist to insert another line. One of the nurses handed her a swab and venflon and she searched frantically for a vein.

‘Everything’s shutting down,’ she murmured, her fingers slipping on the man’s skin as she nervously tried to find a vein.

‘Let Harry try,’ Jago said sharply, and she gritted her teeth and felt around again for a vein.

‘Give me one more go—I think I felt something then.’

Please—please…

Something moved under her fingers. Was that it?

She slid the needle through the skin and breathed a sigh of relief as blood came back into the venflon.

‘I’ve done it. I’m in.’

‘Well done.’ Harry gave her an encouraging smile but Jago merely barked out more instructions.

‘Take blood for group and cross-match, full blood count, urea and electrolytes, and get a catheter in so that we can assess his fluid output. What’s his blood pressure doing?’

‘It’s falling.’ Annie checked the reading and recorded it on the chart.

‘Remember that there is a consistent fall in the systolic blood pressure only after 30 per cent of blood volume is lost,’ Jago said, his tone cool. ‘Get him attached to an ECG monitor and let’s give him a bolus of fluid. Start with a litre of warm colloid and then we’ll reassess.’

There were so many questions that Katy wanted to ask but she knew they were going to have to wait until the patient was stable.

She watched while Jago examined the patient’s abdomen, his hands moving skilfully as he looked for signs of tenderness.

‘There’s bruising and tenderness under the ribs,’ he murmured, and then glanced at Annie. ‘Phone down and see if they’ve confirmed the blood group yet. It’s been ten minutes so they should have. Once they have, get some blood up here,’ he ordered sharply, and Annie hurried to the phone just as another nurse popped her head round the door.

‘His wife is in the relatives’ room. Is there someone who can see her?’

Jago glanced at Charlotte. ‘Can one of your team go to her until we’ve stabilised him? Tell her we’ll be with her as soon as we have some news.’

Charlotte moved towards the door. ‘And if she wants to come and see him?’

Jago didn’t hesitate. ‘Then let her.’

Katy frowned and Jago raised an eyebrow in her direction.

‘Something wrong, Katy?’

At least he was calling her by her first name now, instead of referring to her as ‘Dr Westerling’. ‘I just thought it might be distressing for her to see him like this.’

‘It is distressing…’ Jago glanced across to check the ECG and the blood-pressure reading ‘…but studies have shown that on balance it’s probably better for the relatives to see the patient in Resus than not to see them.’

Annie looked up. ‘His blood pressure is falling, Jago.’

‘He needs blood and we need to call the surgeons and warn them that he’s likely to need a laparotomy.’

Jago looked impatiently towards the door and at that moment one of the nurses came hurrying in, carrying the blood bags.

‘At last.’ Jago reached out a hand and took one of the blood bags, attaching it quickly to the giving set. ‘Open the tap and let’s see if that helps.’