blast out the mess in the pavilion after showtime, was directed full at the dogs.
Nothing else could have separated them. The blast hit the pit bull square on the muzzle and drove him back. The hose turned to the spaniel, but he was already whimpering in retreat, badly bitten by the pit bull, while Rachel launched herself at the prone body of the girl.
‘Her leg …’ she breathed.
The girl’s leg was spurting bright arterial blood, a vast pulsating stream. Oh, God, had the dog torn the femoral artery? She’d die in minutes.
The dog had lunged at her upper leg and the girl had been wearing shorts! Dear heaven …
‘Someone, get my bag. Fast! Run!’ Hugo was shouting with urgency. ‘The car’s by the kiosk.’ Car keys were tossed into the crowd—swiftly, because Hugo’s hands were already trying to exert pressure. Rachel was hauling her T-shirt over her head. They needed something for a pressure pad—anything—and decency came a very poor second to lifesaving.
She shoved the shirt into Hugo’s hands and Hugo wasn’t asking questions. He grabbed the T-shirt and pushed.
‘Kim, don’t move,’ Hugo was saying, and with a jolt Rachel realised he was talking to the girl. He was good, this man. Even in extremis he found time to tell his patient what was happening. ‘Your leg’s been badly bitten and we need to stop the bleeding. I know it hurts like hell but someone’s gone for painkillers. Just a few short minutes before we can ease the pain for you, Kim. I promise.’
Could she hear? Rachel didn’t know and she had to concentrate on her own role. Hugo would want a more solid pad than one T-shirt could provide. She stared up into the crowd. ‘Michael,’ she yelled. Hugo was too busy applying pressure to haul off his shirt and he needed something to make a pad. And Michael could help with more than a shirt. He had the skills.
But Michael was gone.
It couldn’t matter. ‘Take mine.’ A burly farmer had seen her need and was hauling off his shirt. She accepted with gratitude, coiling it into a pad.
Out of the corner of her eye she saw her overnight bag, sprawled and open in the dust where she’d dropped it as she’d lunged for the tap. More clothes. Great. As Hugo looked up, searching for whatever she had, she handed him a pad. She made another with what was in the bag. Then she shoved the pad hard down over his and pressed. He pressed with her. Even their combined effort wasn’t enough to stop the flow.
‘I need forceps,’ he said grimly. ‘My bag …’
‘Clive’s gone to fetch it,’ the farmer told them, hovering over both doctors as they worked, his face ashen with concern. ‘He’ll be back any minute. He’s the fastest runner.’
‘Good.’ They were working together, their hands in tandem. Hugo was breathing fast, using all his strength to push tighter, and Rachel realised that she was hardly breathing at all. Live. Please. It was a prayer she’d learned early on in her medical training, and had used over and over. Skills were good but sometimes more was needed.
Luck?
Still the blood oozed. ‘Push down harder,’ Hugo told her. ‘Don’t move off the wound.’
‘I’m not moving,’ she said through gritted teeth. The bite resembled a shark bite—a huge, gaping wound that, left untended, would release all the body’s blood in minutes.
Even if tended …
She was pushing down so hard it hurt.
‘I need forceps.’ Hugo’s voice was growing more urgent as the situation became more desperate. ‘Damn, where’s my bag?’
‘Here.’ A youngster, a boy of about sixteen, was bursting through the crowd, carting a bag that was three times the size of any doctor’s bag that Rachel had ever seen. A country doctor’s bag.
‘Haul it open.’
The boy flicked the bag open and Rachel’s eyes widened. Forceps. There were several and they were sitting on the top as if prepared for just this emergency. She lifted a hand from the wound and grabbed the first pair.
‘We’re not going to stop this without clamping,’ she muttered. ‘The femoral artery has to have been torn to explain this.’
He accepted her medical knowledge without a blink. ‘I agree. Clive, take a shirt and clear as much blood as you can while we work. Let’s go.’ He grabbed forceps himself and then looked across at her. ‘Ready?’
She took a deep breath. This was a huge risk. They needed the pad to stop the spurting, but the only way to stop the bleeding altogether was to remove the pad and locate the source. They had only seconds to do it or the girl would die beneath their hands.
‘OK.’ She took two deep breaths. ‘Now.’
They lifted the pad away from the wound. The blood spurted out and they were working blind, searching in the mess that was the girl’s leg.
Where in this mess was the artery? Dear God, they had to stop it.
‘Take the swab right away, Clive. Just for the moment,’ Hugo said. ‘Be ready to replace it.’
And in the tiny millisecond before the wound refilled with blood …’There!’ Rachel pushed in and grasped, and the forceps linked to the torn artery. She clicked them shut—and the pumping died.
Not enough.
There were more. As well as the femoral artery, two or three minor vessels had been torn. They could kill all by themselves.
Hugo’s forceps clamped shut on another blood vessel and the flow abated still further. Another pair of forceps was in Rachel’s hands and Hugo had another.
She was working like lightning. Without the pads there was no pressure—the blood simply pumped out.
‘Gotcha.’ Another one was under Hugo’s forceps. He clamped.
And another.
And that was it.
The blood was still oozing, but slowly now. The pumping had stopped. It’d be flowing from the ripped veins but they’d done what they had to do. For now.
‘We need to continue with pressure,’ she said, and sat back as Hugo set to work with another shirt, forming another pad. They’d been lucky. Trying to find the blood vessels in these conditions …
Yeah, they’d been lucky—but this man was good!
Hugo was tying the pad firmly around the leg. He gave her a curious glance. There was still urgency but they were working with minutes now rather than seconds. They’d blocked off the blood supply. Now they needed to prevent shock setting in. They needed to replace fluids and they needed to save a leg that no longer had a blood supply.
‘Pete, ring the ambulance,’ Hugo snapped into the crowd. ‘Tell them I want plasma and saline on board and if they’re not here in thirty seconds I’ll have their hides. Dave, can you and a couple of the men find those damned dogs and deal with them before we have another disaster? Toby … Where’s Toby?’ He
