The door at the side of the room burst open. ‘Donovan! I need you, now!’
In any other set of circumstances he might have been grateful for the interruption, relieved even. But Grace’s face was as white as a sheet. The head of every reporter in the room turned to her and in one action the whole crowd seemed to surge towards her.
Donovan couldn’t take his eyes off her. Her previously coiffed hair was sticking out in all directions, her scrubs were rumpled, but the thing he noticed most was her unwavering focus.
He stood up and pushed his way through the crowd. ‘Out of my way!’
It was only seconds until he reached her, but it felt like for ever. The reporters were too busy chasing the story, rather than thinking of the emergency situation. Grace’s hands and legs were spread at the doorway, firmly stopping any of the reporters getting through. Her chin was set determinedly, but her eyes were scanning the crowd frantically, looking for Donovan.
He placed his hand over hers in the doorway and she grabbed it quickly and pulled him through with a force he underestimated, kicking the door closed behind her.
He felt the first flush of fresh air surround his skin.
‘Now,’ she said, her feet running a few steps down the corridor, giving him no time to think. As soon as the door had closed behind him he was instantly aware of the cardiac-arrest alarm sounding in this part of the hospital. It had been years since Donovan had heard one. It had been years since Donovan had responded to one in this kind of environment, but all his automatic medical senses kicked into place.
He was right behind her as she ran into a room, dragging an emergency trolley from the corridor behind her. There was one nurse, with a knee on the bed, counting out loud as she did chest compressions on the small boy.
Donovan did a double take. ‘Where is everyone?’ In all his years he’d never seen this. Whenever a cardiac arrest alarm sounded in a hospital setting, everyone responded. It was an unwritten rule. Only one nurse and Grace? It was unheard of.
The little body had two IVs running, one with fluids, one with bloods, and from the signs on the bed he’d already been haemorrhaging.
Donovan moved to the top of the bed, taking the most obvious position of airway support. He released the brake on the bed, pushing it forward and lifted the headrest out of place. He grabbed the Ambu bag from the top of the trolley, connected the oxygen and inserted a child-sized airway to maintain the little boy’s respiratory status. This was a temporary measure. The child should be intubated but he couldn’t see the equipment he needed right now.
Grace was connecting the monitoring equipment and defibrillator around the nurse’s hands. ‘Sorry, Donovan, I needed urgent assistance.’
‘Where on earth is the rest of the staff?’
‘There are four of them outside, transferring one of the kids onto a helicopter.’
‘You arranged the transfers?’ He was surprised she’d managed to pull it off. Grace was rising in his estimation all the time.
‘Yeah, with a few conditions.’ She waved her hand. ‘We’ll get to them later?’
As for getting him out the press conference? It wasn’t ideal. The press would be all over this like a rash. But patients always came first. And Grace had looked as if she couldn’t care less about the members of the press. She’d just known she’d needed help.
He couldn’t even begin to let himself acknowledge how panicked he’d begun to feel in that room. Right now it felt safer to recognise that Grace had interrupted the conference to get help. Safer for him at least.
She finished connecting the electrodes to the little boy’s body. ‘There’s a sick adult on the other side of the ward. Two staff are inserting a chest tube.’ She gave her head a little shake. ‘We just don’t have enough staff for the poor condition of these patients, Donovan.’ She opened up the IV nearest her, quickly moving back to the patient. ‘This blood isn’t going in quickly enough.’
Donovan nodded in agreement. Tyler Bates. Five years old. He’d reviewed him with Grace a few hours ago and recommended he be transferred as soon as possible to ICU. The little boy was deathly pale. It was clear he’d started to haemorrhage. Rapid fluid replacement, both blood and clotting factors, would be needed to help him survive.
‘Hands off.’ The nurse stopped what she was doing and immediately started running the cryoprecipitate to aid blood clotting through another IV.
Donovan turned his eyes to the monitor. His hand was routinely squeezing the Ambu bag to push air into his lungs. He identified the heart rhythm immediately. ‘VF. Shock him, Grace.’
She didn’t hesitate and set the level on the machine. ‘Stand clear.’ He’d no idea how long it had been since Grace had resuscitated someone—let alone if she’d ever resuscitated a child before—but she made it look as if she did this every day. Now she had the additional support she’d needed for his airway, she was the coolest person in the room. He lifted his hands away from the little boy’s face.
The little boy’s body shuddered and they watched the flickering blue line for a few seconds. The unruly squiggle, ventricular fibrillation, had shown them his heart wasn’t beating properly—just quivering in his chest. There was few seconds of hesitation then the squiggle changed. One little blip, slowly followed by another.
‘Give him some adrenaline.’ The child’s heart rate was still too low but at least he had one. In another minute Donovan would have needed to intubate, but now the little boy gave an involuntary cough and his temporary airway was expelled. Donovan turned the oxygen supply up full and pulled a mask over his face, keeping the Ambu bag close by in case he needed it again.
The slow heartbeat took a few minutes to gradually pick up its rate. Their biggest concern now would be helping this little boy maintain his pulse and blood pressure while they tried to replace his lost blood products.
Two other nurses appeared at the door. ‘What happened?’ one of them asked.
Grace gestured to the bed. ‘Tyler arrested.’ She looked up. ‘Did Jacob get transferred?’
They nodded. One of the nurses moved over towards the bed and started clearing away the used supplies, while the other checked Tyler’s blood pressure. ‘The medevac team did mention something about other doctor and nurses.’ She raised her eyebrows in question at Grace.
Donovan caught the glance between them. Tyler’s breathing was becoming steadier. ‘Grace?’
A little colour flushed her cheeks as she checked the rate on the IV delivering blood to Tyler. ‘I might have agreed to a few conditions for the transfer,’ she mumbled.
Donovan felt his ears prick up and cool wave wash over his skin. ‘And what might they be?’
He couldn’t even begin to imagine how Grace had managed to arrange the transfers so quickly. He had visions of the DPA budget being blown out of the window, with his name attached to it.
He straightened up, because she hadn’t answered. ‘Grace, what did you agree to?’
She was checking Tyler’s heart rate again. Her eyes glanced quickly over at him then skittered away. ‘I might have agreed to put a team into the hospital at Panama City.’
He sucked in a breath. They already had another team headed here. Three teams? Working on the same outbreak? Well, that would make DPA history.
‘You phoned the request in?’
She licked her lips. ‘Yes.’ She still wasn’t looking at him.
‘And they agreed?’ He could see how nervous she was, how edgy.
And he wasn’t mad at her. He wasn’t. Patient care came first. And if this was the only way to get the kids transferred to the facilities they needed, then so be it.
He could make the argument in the director’s office later.
She took a deep breath and finally looked him in the eye. Her words tumbled out. ‘I’m sorry, Donovan. I said you insisted. I said yo
u authorised it. I didn’t know what else to do. They didn’t have the expertise at Panama city ICU and said the only way they could accept the kids was if they had specialist help. They made the case that they had other patients to protect. I couldn’t think of a way around it. So I just said yes. And I gave your name.’
She’d moved, and was standing in front of him now. She was breathing quickly; he could see the little pulse throbbing at the base of her neck. She looked as if she might cry. The nurses looked up, both with amused expressions on their faces. Tyler heart rate was steady now. ‘I’m going to talk with Tyler’s mom,’ said one. ‘I’m going to get some sheets to change the bed,’ said the other, and they both exited the room at top speed.
Another doctor appeared at the door. He was one of the regular hospital staff. He looked at the equipment. ‘Sorry, I couldn’t respond to the arrest call. The chest drain is in now and my patient is stabilised. Can I take over in here? The second medevac phoned to say they’ll be here in ten minutes. Can you write up Tyler’s notes about what just happened?’
Grace hadn’t moved. She was still standing in front of Donovan. Looking at him with those big green, trembling eyes. ‘Of course,’ he said quickly, picking up Tyler’s case notes and grabbing her hand to pull her from the room.
The corridor was quiet. There was only him and her. But it seemed too open, too exposed. He pulled her towards the nearest on-call room and closed the door behind them.
Now it was definitely just him and her. He hadn’t even flicked the light on in the room. He could almost sense that she wouldn’t want him to.
He put his hands on her shoulders. ‘Grace, are you okay?’
It wasn’t just her eyes that were trembling, it was her whole body. Did she really think he’d be annoyed about her decision?
Then it hit him. And he didn’t hesitate. He wrapped his arms around her and pulled her close against his chest.
‘You’ve never resuscitated a child before, have you?’