Love Islands: Summer Kisses. Joanna Neil
the patient. His brain was spinning furiously, trying to remember where all the emergency equipment was in the medical centre.
Medical centre. It could barely even be called that. It had the basics, but was better designed for general consultations than emergency medicine. He’d expected to treat a few bites and stomach aches. Not a full scale head injury.
The crew members carried Jack inside and helped Nathan slide him across onto one of the trolleys. He did the basics and hooked Jack up to the cardiac monitor and BP cuff; at least they had one of those.
Rachel seemed to have gathered herself and was pulling Jack’s notes from the filing cabinet. ‘No significant medical history,’ she shouted as Nathan pulled an oxygen mask over Jack’s face and quickly inserted an IV cannula.
‘Do we have any Glasgow Coma Scales?’ It was unlikely. The Glasgow Coma Scale was used the world over to monitor unconscious patients. Rachel pulled open a few admin drawers and shook her head, passing him a recording sheet for pulse and BP, then taking a blank sheet of paper and making some quick scribbles.
She walked over and handed it to him as she slid the pen torch from his back pocket as though she did it every day, lifting Jack’s eyelids and checking his pupils.
Nathan glanced at the paper. It was Rachel’s attempt at an impromptu Glasgow Coma Scale. It had captured the basics—eye response, verbal response and motor response. Both of their heads snapped up as the monitor started alarming.
He ran his fingers down Jack’s obviously broken arm. The colour of his fingertips was changing. They were beginning to look a little dusky, meaning that the blood supply was compromised. He swapped the oxygen saturation probe over to the other hand and watched as it came back up to ninety-eight per cent.
He looked up and his gaze meshed with Rachel’s. He didn’t even need to speak; she could see the same things he could.
‘Nathan, do you have keys to the medicine fridge?’ He nodded and tossed them in her direction. For a doctor who didn’t routinely work in emergency medicine, she’d certainly remembered the basics. He finished his assessment of Jack, recording all the responses while she drew up some basic pain medication.
Even though Jack wasn’t awake they were going to have to straighten and splint his broken arm to try and re-establish the blood supply. No doctor could assume an unconscious patient couldn’t feel pain. It didn’t matter that Jack hadn’t responded to the painful stimuli that Nathan had tried as part of the assessment. His breathing wasn’t compromised so they had to administer some general pain relief before they started.
His arm fracture was obvious, with the bones displaced. Thankfully, they hadn’t broken the skin so the risk of infection would be small.
Rachel spun the ampoule she’d just drawn into the syringe around towards Nathan so he could double-check the medicine and the dose. He gave a little nod of his head while she administered it.
He couldn’t help but give a little smile as she positioned herself at Jack’s shoulder. ‘Do you remember how to do this?’
She shook her head. ‘Of course not. Why do you think I’m in the anchor position? The responsibility for the displaced bones and blood supply is yours.’
Of course she was right. It would have been years since she’d been involved in repositioning bones. He’d done it three times in the last month.
It only took a few minutes to reposition the bones and put a splint underneath the arm. The most promising thing was the grunt that came from Jack.
‘Can you patch that head wound?’ he asked. ‘I’m going to arrange to medevac Jack back to the mainland.’
Rachel opened the nearest cupboard and found some antiseptic to clean the wound, some paper stitches and a non-adhesive dressing. She worked quickly while he made the call. She waited until he replaced the receiver and gave him a nervous smile. ‘I haven’t sutured in a while so I’ve left it for the professionals.’
He nodded. It was good she wasn’t trying to do things she wasn’t confident with. She’d just been thrown in at the deep end and coped better than he’d expected. If the shoe was on the other foot and he’d found himself in the middle of a medical unit, how well would he do?
He might be able to diagnose and treat chest infections, some basic cardiac conditions and diagnose a new diabetic but would he really know how to treat any blood disorders or oncology conditions off the top of his head? Absolutely not.
Nathan picked up the phone and dialled through to the emergency number. Thank goodness he’d checked all these yesterday when he arrived. It didn’t matter that Lewis had told him nothing would happen. Working for Doctors Without Borders had taught him to be prepared.
The call was answered straight away and arrangements made for the dispatch of the medevac. ‘It’s coming from Proserpine Airport. We’re in luck; they were already there.’
Her sigh of relief was audible and he joined her back at the trolley. Jack still hadn’t regained consciousness. Nathan took a few more minutes to redo the neuro obs and stimuli.
‘Do you know where the medevac will land?’
He gave a nod of his head. ‘Can you go outside and find Ron? We’ll need some help transporting Jack down to the beach. They’ve probably cleared the landing spot already.’
She disappeared quickly and he sucked in a breath. This was a whole new experience for him. They’d trained together at university and spent their first year working as junior doctors in the same general hospital. But they’d never actually done a shift together. She’d done her six months medical rotation first while he’d done his surgical placement. They’d swapped over six months later.
He’d already known he wanted to specialise in surgery at that point, whereas Rachel had expressed a preference for medicine. They’d applied to the same hospital in Melbourne and been accepted to work there. But he’d been unable to take up his job and had a frantic scramble to find another in England. He’d always assumed that Rachel had just carried on without him. Now he wasn’t so sure.
Ron’s sweaty face appeared at the door. He’d really need to check him over at some point. ‘‘Copter should be here in a few minutes. Once it’s down, there are four guys outside to help you carry the stretcher.’ His brow creased as he glanced at Jack. ‘How is he?’
Nathan gave a little nod. ‘We’ve patched him up as best we could but he’s still unconscious. Hopefully, he’ll wake up soon.’
Ron disappeared and ten minutes later the thwump-thwump of the helicopter could be heard overhead. A wave of familiarity swept over him. For a few seconds he was back in the sand, war all around, his stomach twisting at the thought of what throwing back the medevac door would reveal. But then Rachel rushed back in and the moment vanished. He finished another blood pressure reading and pupil check, then disconnected the monitor.
He pulled the blanket over Jack’s face to protect him from the downdraught and any flying sand but it actually wasn’t quite as bad as he’d expected. Helicopters didn’t faze him at all. He’d spent the best part of five years travelling in them and pulling patients from them. But Rachel looked terrified.
She ducked as they approached the helicopter even though the spinning blades were high above her head. Several of the crew members did the same. The paramedic flung open the door and jumped down.
The handover only took a few seconds. ‘Jack Baker, twenty-four. A few tons of sand-filled barrels landed on him. Suspected broken ulna and radius, blood supply looked compromised so it’s been realigned. Unconscious since the accident. GCS six with recent response to pain. His right pupil has been sluggish. No problems with airway. Breath sounds equal and abdomen soft.’ He handed over the charts he’d made, along with a prescription chart and Jack’s notes. ‘He’s had five of diamorphine.’
The paramedic nodded as he anchored the stretcher inside and started connecting Jack to his equipment. His eyes met Nathan’s.