Career Girl in the Country. Fiona Lowe
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me get him onto this trolley.’
They half hauled and half dropped the injured man onto the mattress and as soon as the sides had been pulled up, Matt asked, ‘Do either of you have any injuries or is that your mate’s blood?’
‘We’re OK.’
Matt wasn’t convinced. ‘Sit over there and wait. As soon as we’ve checked out your mate, someone will examine you both. No one is to leave until you’ve been examined, do you understand?’
Both men looked sheepish. ‘Yeah, Doc.’
He pushed the trolley into the resus room. ‘What’s his pulse ox?’
Poppy slid the peg-like device onto the end of the patient’s finger. ‘Eight-five.’ She unravelled green plastic tubing and turned on the oxygen. ‘Mr …?’
‘Daryl Jameson.’ Jen supplied the information.
‘Mr Jameson. I’m Poppy Stanfield, this is Jen Smithers, and on your left is Dr Matt Albright. You’re in good hands. We’re just going to give you some oxygen and help you to sit up.’
Matt tried not to show his surprise that Poppy had failed to mention her qualifications and that unlike many surgeons she was actually quite personable with an awake patient. ‘Daryl, how’s the breathing, mate?’
‘Hurts.’
‘Where does it hurt?’ Poppy adjusted the elastic to hold the nasal prongs in place.
‘It’s me chest and arm that’s killing me.’
‘Do you know what day it is?’ Matt flicked on his penlight.
‘Sunday. I remember everything up to the moment the idiot hit me.’
Matt flashed the light into his patient’s eyes. ‘Pupils equal and reacting.’
Jen tried to ease Daryl’s shirt off but resorted to scissors when Daryl couldn’t move his arm without flinching. The soft material separated, revealing purple bruising all over the thin man’s chest. The nurse gasped.
Matt looked up from the IV he was inserting, hating that he knew exactly what would have caused such trauma. ‘Steel-capped boots. Welcome to the seedier side of Bundallagong, Poppy.’
She attached electrodes to Daryl’s chest, and at the same time Matt knew she was examining the rise and fall of his chest given the complaint about pain on breathing. ‘Sinus tachycardia. Jen, organise for a chest and arm X-ray.’
‘On it.’ The nurse started to manoeuvre the portable X-ray machine into position.
While Poppy wrapped a blood-pressure cuff around their patient’s uninjured arm to enable automatic readings, Matt swung his stethoscope into his ears and listened to Daryl’s breathing. He could hear creps and he palpated a paradoxical movement of the chest wall. ‘Flail chest. I’ll insert prophylactic chest tubes.’
A frown furrowed her smooth, white brow. ‘Good idea but it’s the damage under the fractured ribs that worries me.’
Matt nodded. ‘We’re in agreement, then.’
‘There’s a first time for everything.’
The words sounded precise and clipped, but her plump, berry-red lips twitched. Like the siren’s call, he felt his gaze tugged towards them again and wondered what they’d feel like to kiss.
The blood-pressure machine beeped loudly, ripping into his traitorous thoughts and grounding him instantly. He pulled his shame-ridden gaze away, reminding himself that he loved Lisa and he had a patient who needed his total concentration. ‘Pressure’s dropping.’
‘He’s bleeding somewhere.’ Poppy’s hands went direct to Daryl’s abdomen, her alabaster fingers, with their neatly trimmed nails devoid of polish, palpating expertly. ‘Any pain here?’
Daryl barely managed a negative movement of his head.
‘No guarding. It’s not his abdomen.’ Poppy’s frown deepened, making a sharp V between her expressive black brows. ‘His O2 sats aren’t improving. What about a haemothorax?’
‘If he does have that, it’s not massive because there’s no mediastinal shift or tracheal deviation.’
But the blood-pressure machine kept beeping out its worrying sound as Daryl’s heart rate soared and his conscious state started to fade. Matt stared at the green lines racing across the screen. PQRST waves scrawled the heartbeat but he thought he saw something unusual. He hit the printout button and studied the paper strips, detecting a change in the ST segment. Combining it with Poppy’s musings, he had a sudden idea. ‘Check his jugular vein.’
Matt shoved his stethoscope back in his ears and listened carefully to Daryl’s heart beat. Instead of a loud and clear lub-dub, the sound was muffled.
‘Cardiac tamponade.’
They spoke in unison, their thoughts and words meshing together for the very first time. ‘He’s bleeding into the pericardial sac.’
Poppy ran the ultrasound doppler over his chest, locating the heart. ‘There you go.’ She pointed to the dark shadow around the heart that squeezed the vital muscle.
Matt snapped on gloves and primed a syringe, knowing exactly what he had to do. Under ultrasound guidance, he withdrew the fluid from around the heart. ‘Hopefully that will stabilise him until you work your magic.’
Her teeth scraped quickly over her bottom lip; the slightest of hesitations. ‘A pericardial sac repair without the back-up of bypass isn’t quite what I’d expected.’
He understood her concerns and he had some of his own. ‘The anaesthetic will stretch me too.’
‘It’s going to be touch and go.’
‘I know.’ He met her direct and steady gaze, one devoid of any grandstanding or combative qualities, and wondered not for the first time about the many facets of Ms Poppy Stanfield.
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