friendship, as long as you don’t try to convince me that having a home birth is a responsible choice for a parent.’
He smiled at her but she could see he really meant what he’d said. She wondered what he’d think about her complementary therapies in the birthing unit. She shrugged. He’d find out.
He added, ‘I have asked you to call me Jake, please.’
‘To friendship, then, Jake.’ She reached out and placed her hand in his, and the difference in hand size made her feel suddenly very feminine. ‘But don’t expect me not to try and change your mind.’ Sensation tingled up her arm. She bit her lip. Friendship with this man would be...difficult!
* * *
By nine o’clock that night everything was quiet on the ward. Poppy was sitting with Sandy, writing patient reports, when the internal paging system suddenly erupted with noise. The medical emergency buzzer. This drew at least one staff member from each ward to assist in the area illuminated on the board.
‘I’ll go, Sandy.’ Poppy jogged quickly down the corridor and her stomach tightened as she saw the initials of the ward involved. Children’s Ward. Maternity was the closest unit and Poppy skidded around the corner and through the door. Like Maternity, Children’s Ward was staffed by only two nurses a shift. They’d need help. She scanned the indicators for the room with the light on and drew a quick breath as she entered.
She could see the child’s eyes were huge and terrified in her pale face. The sister in charge of the ward was supporting the girl and speaking gently, trying to reassure her. The hiss of the oxygen blowing the Ventolin mist into the girl’s lungs dominated the room as the child tried to force her narrowed bronchial tubes to open enough to let the air in.
‘Poppy! Thank God.’ The sister in charge looked up briefly. ‘Amelia was admitted this evening with her asthma, and she’s not responding to the Ventolin this time.’
The junior nurse wheeled the emergency trolley into the room and looked as frightened as the patient.
‘Have you rung Dr Sheppard?’ Poppy could see the little girl becoming more and more sleepy as she tried to lean forward droopily on her thin arms. She felt her nerves tighten as she remembered the words of her intensive care tutor. A sleepy asthmatic is an asthmatic in trouble.
‘Haven’t had time, but Nurse can ring now that you’re here to stay with me.’ The junior hurried to the door. ‘Tell him urgently, please.’
‘I’ll do the trolley part. She knows you. You keep her as calm as possible. Where are her parents?’
‘Her father’s gone home to feed the animals. You’ve got her mother over in Maternity.’ Poppy checked the girl’s armband and realised that this was Sheila’s older child. Heck!
‘She hasn’t an intravenous line in situ?’
‘It leaked into the tissues an hour ago and I paged the resident to resite it, but he’s stuck in Casualty with a chest-pain case. Dr Sheppard’s going to kill me because I didn’t ring him to come back.’
Poppy winced. He probably would, but that was the least of their problems at the moment. ‘I’ll have to cannulate if Jake doesn’t get here soon. How old is she? I need to work out the dosage for the drug.’ She hoped she wouldn’t mess up any veins but it was no use worrying—she had to do it. They’d need adrenalin if the child became much worse. Amelia started to cough, with the bronchospasm in her air passages making the air entry even more difficult.
‘She’s six.’
Poppy drew up the adrenalin and taped the ampoule to the syringe. It was situations like these that the wrong drugs could be accidentally given if they weren’t easily identified. She laid it in an injection tray and assembled the equipment to set up the IV.
Come on, Jake. She knew she was being unreasonable to expect him to appear as soon as he was called. It had probably been only a couple of minutes since the buzzer had gone off. Staff from other wards were arriving and the room seemed crowded with people. Unfortunately, most of them didn’t know what to do.
Poppy could see that the little girl was getting very little air in now and her chest was barely moving. A moment of panic welled up at the thought of her dying, but Poppy squashed it down.
‘She needs IPPV with the mask.’
‘I’ve got it here.’ One of the sisters from Intensive Care arrived and moved to commence intermittent positive pressure to force the lungs to open for the Ventolin and oxygen.
‘Someone grab the automatic blood-pressure machine and we need to know her oxygen saturation, too. Someone else get a clipboard and write down the times and any drugs given.’ Poppy’s voice was controlled and quiet but the response was immediate.
She placed a tourniquet on the child’s arm. She couldn’t even see any veins to aim for as the lack of oxygen had shut down the peripheral circulation to keep as much blood flow to the brain as possible. If she gave the injection into the muscle it could take several vital minutes for it to be picked up and dispersed by the blood to take effect and allow the bronchioles to dilate.
It would have to be intravenous! The thought of Jake’s ability to find the baby’s vein earlier that day strengthened her, and she slid the needle into the largest vein in the bend of Amelia’s arm. The immediate back-flow of blood made her heave a quick sigh of relief as she taped it into position.
‘Not the best place for one but good in an emergency.’ Jake’s voice behind her left shoulder made Poppy sigh in relief. ‘What happened to the other one?’
‘It tissued!’ Poppy turned and moved aside for Jake to get to the little girl.
Jake’s voice was quietly reassuring. ‘Amelia, it’s Dr Sheppard. You’ll be OK. Sweetheart, just try and relax.’ He held his hand out behind him and Poppy placed the tray in his hand. ‘Adrenalin?’ He checked the ampoule and fitted the syringe onto the intravenous port then slowly squeezed in the drug. ‘How much would you have given, Poppy?’
‘Age times two plus eight. About two mils over three minutes, but I haven’t checked it with anyone yet.’
Jake glanced up at her briefly and nodded. ‘Pretty good for a woman who deals with babies.’
He turned back to the little girl. ‘This should ease your breathing in a minute or so, Amelia. Hang in there.’
The girl was barely conscious and the sound of the rhythmic squeezing of air into Amelia’s lungs punctuated the rapid beeping of the monitors connected to the child. She looked worse, if anything, and Poppy was starting to feel cold with dread.
Jake’s face was stone-like, as if he was willing the child to improve, but they both knew that children responded better than adults did to the treatment—if it was received in time.
The next minute dragged. Jake said, ‘Come on, Amelia. Try and cough, sweetheart.’ The girl’s eyelids fluttered and then opened wide in fear. She gave a tiny huff of expelled air and then started to cough. Over the next few minutes her colour improved as she rid herself of some of the extra secretions blocking her lungs.
Poppy sagged against the wall. The crisis was over. Amelia was still a sick little girl and would be transferred
