That’s why we have triage. Non-emergency cases go to the bottom of the pile and they stay there until someone has time to see them.’ She smiled sympathetically at Katy’s drawn expression. ‘Don’t worry, you get used to people yelling at you after a while.’
‘I don’t mind people yelling,’ Katy lied quickly, not wanting to risk Charlotte telling Jago that she couldn’t cope. ‘I just wish we didn’t have to keep people waiting.’
‘At least you’re working with Jago. He can be a pretty hard taskmaster, I know, but he’s a brilliant doctor. You’re lucky.’
Katy kept her mouth clamped shut. Lucky? She certainly didn’t feel lucky to be working with Jago. She felt as though she must have done something seriously wrong in a previous life to have deserved such punishment.
Realising that Charlotte was looking at her oddly, she managed a smile.
‘I’m sure you’re right,’ she replied smoothly. ‘I’m looking forward to learning from him.’
‘As a doctor he’s staggeringly gifted,’ Charlotte went on. ‘He has this uncanny ability to spot things that other people miss, but sometimes he forgets that the rest of us are human. Don’t let him get to you.’
He was getting to her.
He made it perfectly obvious that he didn’t think she had what it took to work in A and E and he was watching her every move, waiting for her to make a mistake. Why did he hate her so much?
All she’d ever done had been to fall in love with him, and surely that was her problem, not his.
They hadn’t really talked about what had happened in the past. Maybe she should bring it up. Clear the air.
Feeling totally miserable, Katy sighed and reached for the X-rays but at that moment Annie, one of the staff nurses, rushed up.
‘Ambulance Control just rang. They’re bringing in a forty-year-old man who’s had an accident in a warehouse. He got caught by a forklift truck. Apparently he’s in a bad way. Very weak pulse and virtually no blood pressure. They should be here in less than five minutes.’
‘Find Jago,’ Charlotte said immediately, but his voice came from behind them.
‘I heard. Annie, get the trauma team together in Resus and make sure we have a radiographer. I don’t want to be hanging around for X-rays.’ His gaze flickered to Katy. ‘You can join us in Resus and act as one of the circulation doctors. You saw us in action yesterday—do you think you can cope?’
Katy’s stomach lurched and her pulse rate quickened, but she met his gaze without flinching.
‘Of course.’
She’d cope or die in the attempt.
‘Good.’ His dark eyes locked on hers moodily and then he strode off towards Resus, leaving her to follow.
Charlotte alerted the nursing team and one of them was given the task of informing people in the waiting room that the waiting time was likely to be increased because a major injury was coming in.
‘There’ll be a riot,’ Annie predicted gloomily, and Harry, one of the other consultants, nodded.
‘Very probably, but there isn’t much we can do about it except mop up the blood afterwards.’
Jago was prowling around Resus, checking that the right equipment was ready and everything was where he wanted it.
Moments later the doors crashed open and the paramedics hurried in with the stretcher.
‘This is Dan Walker. He’s a warehouse supervisor. He was caught under the ribs by a forklift truck. No obvious injury but he’s shocked and his pulse is thready. We’ve given him high-flow oxygen and we managed to get a line in at the scene …’
The paramedic outlined the care they’d given and Jago moved to the head of the trolley.
‘OK, let’s move him across, on my count—one two three.’
They lifted the man carefully and he groaned slightly, his skin pale and clammy.
Katy’s blood was pounding in her veins. This was her first real trauma case. What if she did something wrong?
But it soon became clear to her that she couldn’t possibly do anything wrong because Jago was directing the entire operation with an air of cool command which left no doubt in anyone’s mind who was in charge.
Having secured the man’s airway and satisfied himself that there was no damage to the cervical spine, he turned his attention to the work of the rest of the team.
‘Get another line in. I want vital signs recorded every five minutes and get his clothes off fast—I want every inch of him examined.’
Using sharp scissors, they cut off his clothes and Katy reached for the man’s wrist to insert another line. One of the nurses handed her a swab and venflon and she searched frantically for a vein.
‘Everything’s shutting down,’ she murmured, her fingers slipping on the man’s skin as she nervously tried to find a vein.
‘Let Harry try,’ Jago said sharply, and she gritted her teeth and felt around again for a vein.
‘Give me one more go—I think I felt something then.’
Please—please …
Something moved under her fingers. Was that it?
She slid the needle through the skin and breathed a sigh of relief as blood came back into the venflon.
‘I’ve done it. I’m in.’
‘Well done.’ Harry gave her an encouraging smile but Jago merely barked out more instructions.
‘Take blood for group and cross-match, full blood count, urea and electrolytes, and get a catheter in so that we can assess his fluid output. What’s his blood pressure doing?’
‘It’s falling.’ Annie checked the reading and recorded it on the chart.
‘Remember that there is a consistent fall in the systolic blood pressure only after 30 per cent of blood volume is lost,’ Jago said, his tone cool. ‘Get him attached to an ECG monitor and let’s give him a bolus of fluid. Start with a litre of warm colloid and then we’ll reassess.’
There were so many questions that Katy wanted to ask but she knew they were going to have to wait until the patient was stable.
She watched while Jago examined the patient’s abdomen, his hands moving skilfully as he looked for signs of tenderness.
‘There’s bruising and tenderness under the ribs,’ he murmured, and then glanced at Annie. ‘Phone down and see if they’ve confirmed the blood group yet. It’s been ten minutes so they should have. Once they have, get some blood up here,’ he ordered sharply, and Annie hurried to the phone just as another nurse popped her head round the door.
‘His wife is in the relatives’ room. Is
