okay to do this?’
Maggie wanted to bristle. She wanted to say, Listen sonny, I was helping with intubations while you were till wearing baggy pants. But she didn’t. She just nodded and asked, ‘What size?’
He sent her another slow, lazy smile. ‘Four.’
Maggie lowered her gaze, feeling uncharacteristically flustered. She’d been in hundreds of medical emergencies and had never been anything other than ruthlessly efficient. This time would be no different.
She turned to the resus trolley she knew would be behind her, reached inside the drawer and pulled out the requested endotracheal tube. She opened the packaging and squirted some lubricant on the end of the narrow curved tube.
The tone on the sats monitor started to dip and the infant’s heart rate started to drop. Instantly they were both alert, the funny zing between them forgotten.
‘Heart rate falling,’ Maggie said her gaze flicking to the green squiggle behind Nash’s head. ‘One hundred.’
They watched the infant’s chest as her respiratory rate dropped off further. ‘Sats ninety-two,’ Maggie relayed, watching the blue number on the LCD screen dip lower and lower.
‘Okay, no time to wait for the ICU reg. Let’s do it.’
Maggie couldn’t agree more. Normally working with a doctor—a registrar—she didn’t know made her nervous as hell in these fraught situations. But strangely she wasn’t. She didn’t know Nash from a bar of soap— apart from his lady-killer rep—but his supreme confidence was utterly assuring.
‘Let’s give her some vecuronium, Zoe,’ Nash said to one of the emergency nurses as he pulled down on the infant’s chin, opening her mouth for a brief inspection before placing the mask firmly back in place. ‘Have we got some atropine drawn up?’
Maggie blinked as the man with the slow, sexy smile vanished and morphed into a consummate professional. She followed suit, ignoring the fierce jolt of sexual attraction and becoming the experienced PICU nurse, calm and in control.
‘Vecuronium on board,’ Zoe said as she pushed the drug into the child’s drip. ‘Atropine ready if you need it.’
Nash nodded and started taking over the infant’s breathing altogether as the drug acted quickly, paralysing all muscle function. ‘Okay,’ he murmured giving some big breaths to pre-oxygenate. The sats came up to one hundred per cent and the heart rate rocketed into the one hundred and sixties.
‘Right,’ he said, dropping the bag. ‘Let’s go.’
Maggie passed him the laryngoscope and everyone held their breath as he expertly slipped the metal into the child’s mouth. The light at the end allowed Nash to visualise the tiny white vocal cords.
‘Tube.’
He held out his hand as the other one applied pressure through the handle of the scope to keep the patient’s jaw open. He was like a surgeon asking for an instrument, his eyes never leaving the target.
Maggie passed it to him positioned correctly so he could slip it down the blade of the laryngoscope and push it through the cords in one fluid movement.
‘Heart rate one fifty-nine. Sats ninety-eight,’ she said quietly.
Nash nodded as he angled the tube in. He’d been about to ask. His back was to the monitor so he couldn’t see the figures. All he knew for sure was that while he was performing the intubation the patient wasn’t getting any respiratory input at all. The drug she’d been given had stopped her breathing altogether and the longer he took, the more he deprived her body of vital oxygen.
‘Cricoid pressure,’ he murmured.
Maggie automatically reached for the child’s neck using her thumb and forefinger to apply gentle pressure mid-trachea to the cricoid cartilage, temporarily occluding the oesophagus to prevent aspiration of stomach contents into the lungs.
Nash was impressed with the nurse’s quick, sure location and technique. Often the pressure applied was too much, deviating the airway anatomy, but her technique was perfect.
‘Heart rate one sixty-five. Sats ninety-two.’
Nash nodded as he completed the procedure. ‘I’m in.’
He held the tube in place as Maggie attached the bag and puffed in a couple of gentle breaths. The patient’s tiny chest rose and fell. Rose and fell. Her sats climbed.
‘Do you want to listen?’ Maggie asked.
Nash nodded. He took the bag from her, keeping a firm grasp on the tube. He held very still as she carefully pulled his stethoscope from his neck, and placed it in his ears. Her gaze brushed his as she did so and then stuck. Her cheeks were a pretty pink and even though a part of his brain was listening for the whoosh of breath sounds as she moved the bell of the stethoscope around the patient’s chest, the other part was noticing her deep brown eyes, her high cheekbones, her wide, full lips.
‘What a beautiful noise,’ he murmured, not taking his eyes off her.
Maggie swallowed. This close, he was incredibly handsome. His eye colour defied belief. A clear pale blue, like tropical waters or maybe, depending on his mood, glacial ice. His skin was tanned, stretched nicely across prominent cheekbones, and he had deep crinkles on his forehead and tiny lines around his eyes like he enjoyed a good laugh as much as he enjoyed a good dose of Australian sunshine.
She became aware she was staring again and snapped herself out of it. ‘Should we get this tube taped in?’ she prompted.
‘Good idea,’ Nash murmured.
Maggie dragged her gaze away, grateful to have a job that required looking down and not up. She’d applied the first piece of tape, ignoring his long tanned fingers holding the tube firmly in place, when the ICU reg finally made his entrance.
‘Mac,’ Nash greeted him. ‘You’re a little too late.’
‘Sorry,’ Mac Caldwell panted, bending over and clutching his side. ‘I ran all the way.’
Nash laughed. ‘Have a seat, man. Crisis over.’
Maggie found concentrating on the finicky task of wrapping zinc tape around the tube even more difficult with him being so close. His chest was at her head level and his body heat combined with his intoxicating aftershave formed a potent mix.
Her downward gaze took in the rich tan of his chinos and the obvious flatness of his abdomen beneath the casual masculinity of his checked shirt. He wore it open at the neck and rolled up to his elbows revealing tanned forearms in stark contrast to the covering of blond hairs.
She listened as he filled Mac in on the case and spoke with just the right amounts of empathy, confidence and authority to the infant’s distressed mother.
‘Let’s hook her up to the portable ventilator,’ Nash requested as the last tape was secured around the tube. ‘We’ll get an X-ray to check the tube position, and can we load her with some anti-convulsants, please, Zoe?’
‘I’ll just let the consultant know we’ve got ourselves another customer,’
