face. ‘Why are you worried?’
‘Because when she left the house this morning she couldn’t wake her kids or her husband. She thought they were just tired, but—’
‘Are you telling me you think it might be carbon monoxide poisoning?’
‘I hope not. I—I’m sure it isn’t,’ Stella stammered, suddenly feeling foolish. ‘If it was just her husband who was tired, I wouldn’t have been worried, but it’s a bit odd not being able to wake a child who is normally bouncing around thinking of Christmas, don’t you think?’
‘How hard did she try?’
‘I don’t know.’ Stella waved her hand. ‘Will you take a look at her? See what you think? If there’s a chance I might be right, we should call the police and the paramedics.’ It occurred to her that she trusted his judgement implicitly. Whatever their differences, she’d never doubted his abilities as a doctor.
Daniel stared at her for a moment, his expression inscrutable. Then he turned and strode into the cubicle. ‘Diane? I’m Daniel Buchannan, one of the consultants here. Tell me about your headache.’ He questioned the woman as he examined her, his eyes sharp and attentive as he listened to the history and took some blood samples. ‘And the other members of you family had nausea, vomiting and headache?’
‘Yes,’ she groaned, closing her eyes. ‘I did wonder if it was something we’d eaten, but the GP said there is a gastric bug going around.’
‘Her sats are fine,’ Stella murmured, looking at the monitor.
‘The saturation level equals the sum of oxyhaemaglobin and carboxyhaemoglobin, so it’s unreliable. It isn’t going to tell us what we want to know,’ Daniel murmured. ‘I want to give her the highest concentration of oxygen possible—use a rebreathing mask. I want to check her COHb levels. And let’s do an ECG. Diane …’ Daniel turned back to the patient ‘… I don’t think this is a virus. I agree with Stella—I think you might have carbon monoxide poisoning.’
The woman looked at him blankly. ‘What?’
‘There’s been quite a lot about it in the papers. It’s a tasteless, odourless gas—it basically lowers the oxygen-carrying capacity of your blood. What sort of heating do you have at home?’
‘We’re in a rented flat,’ Diane gasped. ‘We have a gas fire in the living room. We tend to congregate there to save on heating bills. Do you think—?’
‘I suspect that the fire might be a problem.’
‘Oh, my God—the kids are in the house.’ Panic flaring in her eyes, Diane struggled to sit up. ‘My husband—’
‘We’re going to deal with it, Diane. Right now. Lie down and think about yourself for a moment.’ Her tone soothing, Stella put the oxygen mask on the anxious woman, adjusted the flow to maximum and then looked at Daniel. ‘Do you want me to call the house?’
‘I’ll do it. You do that ECG.’
Stella attached the leads to Diane’s chest and had just switched the machine on when Daniel strode back into the room.
‘Diane, there was no reply from your house,’ he said gently, ‘so I’ve called the fire brigade and the paramedics. It’s just a precaution, but if we’re right, we need to get the rest of your family in here as soon as possible.’
Diane’s eyes were bright with tears. ‘I had no idea! I just left them. I thought they were asleep!’
‘We’re getting someone round there now, Diane,’ Stella said soothingly, but Diane just shook her head.
‘What if it’s too late?’
Daniel’s mobile rang and he answered it swiftly, giving instructions to the paramedics.
‘They’re at the door now and there’s no answer—is there a key anywhere?’
‘Flower pot,’ Diane murmured weakly, and Daniel relayed that message to the emergency services on the scene. Moments later he was nodding and smiling.
‘You’re sure? OK. Yes, I’ll tell her that.’ He dropped the phone into his pocket and smiled at Diane. ‘Your husband is awake, Diane. They’re getting the children out of the house now and they’ll assess them in the ambulance.’
Diane closed her eyes briefly. ‘Are they OK? Please tell me they’re OK.’
‘They’re going to give them oxygen and transfer them straight to us.’
‘Dan? Do you want to look at this ECG?’ Stella stood to one side and Daniel scanned the strip of paper.
‘That looks all right. Nothing there that worries me.’
‘Why did that GP tell me it was a virus?’ Diane fretted, and Daniel slipped the ECG reading into the notes.
‘Unfortunately, it’s all too easy to miss.’
‘You didn’t miss it.’
‘We’re a busy emergency department—we’re more alert to the possibility of carbon monoxide poisoning than the average family doctor.’
‘But if you hadn’t thought of it—’
‘You can thank this nurse.’ Daniel’s gaze slid to Stella. ‘She was the one who was suspicious. And rightly so.’ His eyes rested on her face for a moment and she smiled and then turned away, part of her wishing that they didn’t work together so well. Maybe if she didn’t admire him as much as a doctor …
A siren sounded outside the department and Daniel moved towards the door. ‘That will be the rest of your family. I’ll go and see to them and then I’ll come back. Stella, if you need me, shout.’ He strode out of the room, leaving Stella with a very worried Diane.
‘Can I go and see them?’
‘You’re not well enough.’ Stella encouraged her to stay on the trolley. ‘Give Daniel time to assess them, and then I’ll go and find out what is going on.’
But she didn’t need to because Daniel walked into the room less than ten minutes later. ‘I’ve done a preliminary examination and it does seem to be carbon monoxide poisoning, but they’re going to be fine,’ he assured Diane. ‘Your husband is conscious and talking and the boys woke up once they were removed from the house. Your husband has contacted your landlord and the fire department will be dealing with him.’ He checked the blood results. ‘Her COHb levels are high,’ he murmured to Stella. ‘I’m going to talk to the infirmary—I’m wondering whether she would benefit from hyperbaric oxygen therapy.’
‘I thought that was controversial?’
‘I think it might be appropriate in Diane’s case. I’ll call them.’ He strode out of the room again just as Ellie walked in.
‘Diane? I’ve been looking after your lovely boys,’ she said, ‘and I wanted to let you know that they’re doing fine. We’ve given them oxygen and they’re sitting up and chatting. They’ve told me everything that’s on their Christmas lists and all
