Letting Go With Dr Rodriguez. Fiona Lowe
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‘Loud, eh?’ The heavily made-up teenager grinned. ‘That’s Jason saying “G’day”. He always does that when he’s taking a load of sheep to Perth. He does it when he comes back too so Kylie knows he’s safe.’
‘And no one’s ever asked him not to?’ Lucy’s adrenaline surge was fading, leaving her jittery and slightly on edge.
The girl looked at her as if she had two heads. ‘No. You get used to it when you—’
The gut-wrenching sound of the long screech of rubber against asphalt deafened all other noise, followed immediately by the chilling crunch of metal against metal.
Lucy ran. As her feet hit the pavement she looked left, but could only see heat haze shimmering on the road. Then she looked right and gagged. A jack-knifed truck lay on its side along with a four-deck trailer full of sheep. Sheep were everywhere—some standing, some bloodied and bleeding, but Lucy’s eyes passed over them as she saw the driver climbing out of the cabin. She ran to her car, picked up her medical bag and kept running.
When she reached the driver, he was walking in circles, his hands pulling at his hair and blood pouring down his face. ‘Jason? You need to sit down.’ Lucy took his arm and shepherded him toward the kerb, wanting to check his pupils for a concussion.
His unfocused gaze settled on her face. ‘She came from nowhere.’
Lucy didn’t know what he meant. ‘Who’s she?’
‘The other car.’
The other car? She spun around, her eyes searching beyond the truck and the bleating sheep.
‘Lucy!’ Deb, an off-duty nurse from the hospital, ran up to her breathless. ‘Geraldine Carter’s in the other car.’
Oh, God, she couldn’t even see another car and a thousand thoughts ran through her head. ‘Get Dr Rodriguez, ring the police, find someone to stay with Jason and then come and help me.’
As she ran, she heard the scream of sirens in the distance and gave thanks, knowing the police and local volunteer fire brigade would block off the road and sort out the sheep. She rounded the truck and braced herself for what she imagined would be horrific.
She breathed in hard to keep from retching.
What had once been a small hatch-back car was now smashed almost beyond recognition. The impact of the crash had flattened the passenger side of the car before pushing it off the road into the low stone fence of the community park. A woman was slumped forward over the steering wheel, deathly still.
Checking there were no power lines touching the car, Lucy gripped the car door handle and prayed it would open without needing the cutting skill of the ‘jaws of life’. She gave an almighty pull and felt some give so tugged again. Grudgingly, the door opened just enough for her to squeeze in. She put her hand on the woman’s shoulder. ‘Can you hear me?’
The woman didn’t move. What had Deb said her name was? ‘Geraldine, can you hear me?’ She heard a moan. ‘I’m Lucy and a doctor and I’m going to help you.’
Airway, breathing, circulation. Lucy pressed her fingers against the woman’s neck, feeling for the carotid pulse. Thready. Carefully, using her hands as a brace, she brought Geraldine’s head into a neutral line. She needed to apply a cervical collar, but to do that she needed to sit her upright. Ideally, it was a two-person job.
Hurry up, Marco.
Airway comes first. She knew she didn’t have time to wait, especially when she had no clue how far away help was from arriving. ‘Geraldine, I’m going to move—’
‘What’s her condition?’
Thank you. Lucy had never been so pleased to hear a Spanish accent in her life and she swivelled her head around in relief. Intelligent, dark brown eyes filled with a host of medical questions gazed at her, backlit with care and concern.
A odd, fleeting half-thought amidst the chaos of the moment made her wonder how it might feel to be the focus of that sort of caring.
She brushed it aside as completely irrelevant. ‘She’s conscious, although only just, and given her pulse rate, probably bleeding somewhere. We need to treat her as a possible spinal injury.’
Marco nodded and tugged on the door which shifted, giving them a bit more room, but they’d need a lot more to get Geraldine out of the car. He turned and yelled to the police sergeant, ‘Graham, we need this door off.’
‘On it.’
Lucy heard Graham on his two-way radio to the fire brigade and then Marco moved in next to her, filling the cramped space with his clean, fresh citrus scent and the welcome support of professional reinforcement. ‘Geraldine, this is Marco. We’re going to carefully sit you up and protect your neck.’
The woman groaned without forming any words.
Lucy continued in triage mode. ‘Marco, you support her mid-thorax and I’ll support her neck. On my count. One, two, three.’
They sat Geraldine up and then without being asked, Marco passed Lucy the cervical collar.
‘This will support your neck, Geraldine.’ She quickly wrapped it into position.
‘Lucy, take this.’
She turned and Marco held out the equipment she needed to attach Geraldine to the Propaq so they could monitor her vital signs. ‘Thanks.’
He nodded. ‘I’ll insert the IV.’
‘Sorry, Geraldine, but I have to rip your shirt.’ The woman’s eyes flickered open and shut again. Lucy tugged at the buttons on the blouse and they came open and she applied the patches to the woman’s skin. A moment later, the machine beeped into life. ‘BP’s low. Two lines would be good.’
‘Oxygen too.’ He shoved the green mask and plastic tubing into her hands and then he returned to his task, his forehead scored deep with worry lines. He quietly reassured a barely conscious Geraldine while his fingers moved up and down her arm seeking a viable vein. He tightened the tourniquet and tried again.
Lucy wanted to watch, wanted to will a vein to appear but she knew it wouldn’t help. Her job was to check Geraldine’s pupils’ reaction to light and hopefully rule out a head injury. They each did their job, working as a team and pooling their body of knowledge as they scrambled to stabilise their patient. They spoke few words, but the ones they voiced locked together to build a synchronicity that flowed between them.
‘IV is in.’
‘Great. Push fluids.’
Marco pumped in a litre of Hartmann’s through the hard-won IV line in a furious attempt to bring up Geraldine’s blood pressure.
Blocking out the bleating of sheep and all other extraneous noises, Lucy moved her stethoscope around Geraldine’s chest. The woman was taking short, shallow breaths and her pulse-ox numbers stayed low despite the help of the oxygen. ‘I think she’s got a tension pneumothorax.’
Marco’s frown deepened. He handed the bag of Hartmann’s to a bystander saying, ‘Hold it high.’
The young man nodded and did as he was asked while Marco passed gloves, antiseptic and a large bore needle to Lucy. ‘Needle decompression.’
Lucy snapped on the gloves and sloshed the brown antiseptic onto Geraldine’s skin. ‘Second intercostal space at the level of the angle of Louis.’
‘Sí. Then gentle traction on the plunger and checking for air bubbles.’
Lucy knew it all, but saying it out loud to a colleague and hearing confirmation always helped. ‘And then an immediate relief of symptoms.’
I hope. Her fingers located the position and she pressed the needle into place, praying the needle wouldn’t block. The beeping of the monitor faded.
‘Beuno,