what Mike may or may not be thinking.
‘The information I’ve got is that we have two burns victims coming in. Priority One. Mike, you take the first one, his injuries are more extensive and you’ve got the most experience. Anna,’ she said, nodding at the other doctor, ‘your team can take the other. We’ll triage any other patients on arrival,’ Davina finished as the first ambulance pulled in to the emergency bay.
Kitty pulled on a pair of disposable gloves and craned her neck as the ambulance doors opened, trying to see which paramedics were in attendance.
She couldn’t see Joe.
‘Young adult male. Unresponsive. Burns to his legs and arms.’ She heard the information being disseminated as the patient was wheeled past her but she was already turning away, turning back to the road, on the lookout for the next ambulance.
She waited nervously, hoping the next unit would bring Joe. When her parents had been killed in a car accident, and again when Jess had been diagnosed with cancer and throughout her treatment, Kitty had always been able to rely on him and she couldn’t imagine how she would cope if anything happened to him.
She shook her head, clearing her mind as another ambulance pulled in. Anna had her hand on the rear door and she swung it open. Kitty exhaled as Joe emerged from the back. Broad shoulders, long legs, spiky hair. Strong and solid. He reached for the stretcher, pulling it from the ambulance. He bent his head and she could see him talking to his patient. His voice would be calm, reassuring.
Kitty stepped closer as Joe’s partner slammed the driver’s door and came to help manoeuvre the stretcher.
Joe was filthy. His uniform was covered in black soot and Kitty could smell smoke, diesel fuel and burning rubber. The smell seemed to have permeated the clothes of the paramedics and the victim, but at least Joe appeared to be in one piece.
‘Hey! I thought I might find you here,’ he said as she fell into step alongside him.
‘You’re OK?’ she asked. When he nodded she glanced over his shoulder. ‘How many more are there?’
‘Only two seriously injured. The rest are smoke inhalation victims and assorted, non-life-threatening orthopaedic injuries.’
Kitty knew it could have been worse. Joe didn’t say anything in front of their patient but Kitty could hear in his voice and she’d seen the scene for herself. Two burns victims, no fatalities and some people suffering from smoke inhalation and a few fractures was a pretty good outcome. It could have been much worse. But their patient didn’t need to hear that.
‘This is Carlos, the bus driver, fifty-three years old, second-degree burns to his hands and arms. Smoke inhalation but airway not compromised.’
Kitty looked down at Carlos. He had a sheet pulled halfway up his chest covering his arms but she could see an ID badge on his shirt pocket and she could just make out the bus company logo. His shirt, like Joe’s, was blackened with soot, and he had an oxygen mask covering his nose and mouth but Kitty took that to be a precautionary measure given Joe’s summary.
As they pushed the stretcher through the hospital doors and into an exam room, Joe drew back the sheet that had been tented over Carlos’s forearms in an attempt to protect him from exposure to bacteria. His hands were bright pink, the skin blistered and hairless, and the burns extended halfway up his forearms. Someone had inserted an IV cannula into his elbow but no fluids had been connected. His transfer had been less than thirty minutes so there had been no urgency.
Kitty grabbed a slide board and prepared to transfer Carlos from the stretcher. She stood next to Joe and waited while Anna and the other paramedic carefully rolled Carlos. She and Joe slid the board under their patient.
‘On three.’ The transfer went smoothly and Joe and his partner stepped out of the way, removing their stretcher and leaving Kitty and Anna to get to work. With a wink in her direction, Joe was gone.
Kitty didn’t waste time. Anna was cutting Carlos’s shirt away as Kitty replaced his oxygen mask and attached monitors. She and Anna worked together well. She was an experienced ED doctor and Kitty liked working with her. She was methodical and didn’t miss much.
‘Carlos, I’m Dr Lewis. Kitty and I will look after you. Do you have any medical issues we need to be aware of? Any heart problems, diabetes? Anything like that?’
Carlos shook his head.
‘I’m just going to take your oxygen mask off to check your airway,’ Anna explained softly.
Kitty recorded Carlos’s heart rate, blood pressure and respiration rate while Anna did her examination. She replaced the oxygen mask with tubing once Anna was finished, looping it over his ears and sliding the pegs into his nose. She recorded his oxygen levels as Anna kept talking.
‘We need to replace your lost fluid and get these burns cleaned up. I’m going to give you something for the pain, OK?’
They worked quickly through their initial assessment, needing to get a handle on the extent of Carlos’s injuries. Some, like his burned skin, were obvious but damage to his lungs was less easy to spot and more likely to cause problems, although often not for a day or two. They had to prioritise.
Anna attached a bag of saline to the cannula in Carlos’s elbow to replace the fluids he’d lost while Kitty distracted him, asking questions about his family. ‘Is there anyone you want us to call?’
‘The paramedics called my wife. Someone is bringing her to the hospital, but can you tell me how the boy is?’ His voice was raspy and breathless. It sounded painful to talk and Kitty was sure she’d heard correctly. Boy?
She frowned. Was Carlos delirious? Her gaze flicked to the monitors. His temperature was raised but not excessively. ‘What boy?’
‘The one I pulled from the bus. Did he make it?’
Kitty realised he was talking about the other victim. Their first patient. ‘You pulled him out?’ The vision she’d watched on the television flashed back in her mind. The man dragging the other body from the bus. The standing man. The one who’d looked as if he’d been about to collapse only Joe had caught him just in time. That had been Carlos. ‘Is that when you got burnt?’
Carlos nodded and struggled to talk. To explain. ‘When the fire started it was just a bit of smoke. I stopped and told everyone to get off but the boy only got as far as me and said something about his bag. He ran back down the aisle before I could stop him. Then something exploded. The windows of the bus blew out and he got caught in the flames. I couldn’t leave him.’
Kitty glanced at Anna, communicating mutely. Carlos would be hailed a hero, which meant the hospital would be swarming with media. They would all want a piece of him.
In silent consultation they agreed to take their time treating him, giving him a chance to catch his breath, and then they’d see if he wanted to make a statement. There were lots of variables and it wasn’t Kitty’s place to comment on what he should do.
‘He was in a bad way. Do you know how he is?’ Carlos asked, oblivious to the silent exchange going on between Kitty and Anna. He appeared to be more concerned about the boy than himself.
‘He’s here,’ Kitty told him. ‘He was brought in just before you. He’s being looked after.’
‘So
