if a tracheal intubation proved impossible.
With no more than a subtle nod, Tom broke the glance, scooped the child into his arms and took off.
‘Follow us,’ Laura told the mother. She had picked up the lifepack as Tom had started moving and she really was running this time to keep up with him and not break the connection between the pads and the defibrillator.
People in the emergency department stepped hurriedly out of their way. Laura saw the startled expression on Fizz’s face and the way she signalled junior doctors to take over what she was doing. She was right on their heels by the time Tom put the girl down on the bed.
‘Respiratory arrest,’ he told Fizz. ‘Anaphylaxis. Known allergy to dairy.’
‘Has she had any adrenaline?’
‘Yes...’ The girl’s mother was near the foot of the bed, her arms held tightly across her body as if she needed physical support. ‘We used her auto-injector but...but it didn’t seem to be working. When she started getting wheezy I just drove straight here.’
She was used to coping, Laura thought. Used to providing her own support. Was she a single parent, like herself?
‘Laura? Draw up some adrenaline, please.’
‘Onto it.’ The personal connection Laura was feeling to this patient and her mother had to be put firmly aside as she focused on what she needed to do.
Other staff members were arriving now, including the two medic arrest team. Laura was pleased to see a new nurse beside their patient’s mother, easing her to one side of the room, out of the way, but staying with her as she endured the terrifying sight of a medical team fighting to save the life of her daughter.
There was so much happening. Tom was intubating the girl, using a video laryngoscope so that he could actually see what he was doing amongst the swelling tissues. An anaesthetist who’d been on call for the arrest team was setting up the ventilator that would be attached as soon as the intubation had been successfully completed. He had a kit on standby for creating a surgical airway if the intubation was not possible due to the amount of swelling.
Fizz was working to gain IV access and someone else was setting up the bags of saline and the giving sets that they would need for a fluid challenge to combat anaphylactic shock. Laura administered the first dose of intramuscular adrenaline and then began sorting the other drugs that she knew would be needed. More adrenaline, to set up as an infusion if there wasn’t enough response to the first doses, along with an antihistamine and steroids. She filled syringes and taped the ampoules to the barrel of the syringes to identify them. She was keeping an eye on the screen above the bed, too, so that she could warn Tom of any changes that could be significant, like a further drop in blood pressure or heart rate. This would become even more of a challenge if the heart stopped in the wake of the lack of oxygen from the respiratory arrest.
The tension was palpable and, at one point, Laura heard the stifled sob of the girl’s mother behind her. She could feel a lump in her own throat. This was every parent’s nightmare, wasn’t it? She was going to hug Harry so hard when she went to pick him up after work today that she knew he would squeak and wriggle free, probably giggling or groaning at the same time, the way six-year-old boys did. In the meantime, she was going to do everything she could to help save this young life in front of them. The alternative was simply unimaginable.
‘We’re in...’ Tom gave a satisfied nod as he hooked his stethoscope back around his neck after checking the placement of the airway. ‘Now, let’s get this oxygen saturation looking a bit better.’
‘Heart rate’s picking up.’ Like Laura, Fizz was watching the screen above them. ‘And I’ve got wide-bore access on both sides.’
‘Let’s start the fluid challenge.’ Tom turned his head to where the child’s mother was standing. ‘How much does she weigh?’
‘Um...she was about twenty-six kilos the last time it was checked.’
‘And how old is she?’
‘Nine. Nearly ten...she’s always been small...’
Like Harry, Laura thought. He’d always been small for his age and a bit underweight, as well. It made them seem younger than they were. More vulnerable. She wanted to give this young mother a hug. To try and reassure her. She could actually sense the same empathy coming from Tom, whose face creased in an almost smile.
‘What’s her name?’
‘Elizabeth. We call her Lizzie...’
* * *
‘She’s going to be fine. The immediate danger is over.’
‘But she’s in Intensive Care...’
‘This is the best place to monitor Lizzie for a few hours. Just to make sure that everything’s under control and the medications are doing their job.’
The woman closed her eyes as she nodded slowly. ‘I can’t thank you enough, Dr Chapman.’ She pressed her fingers against her mouth. ‘I feel like it was my fault. How could I not have noticed that the auto-injector was past its expiry date?’
‘I’m sure that’s something that will never happen again. And you did exactly the right thing, bringing her straight to Emergency.’
‘I could have lost her. I... I thought I had...’ She had her hand over her eyes now.
The urge to touch this woman’s shoulder, or hug her even, to provide comfort was so strong that Tom had to curl his fingers into a fist.
He didn’t get personally involved with his patients. Or their families. If he did, he’d never be able to do his job well enough and doing his job to the very best of his ability was the most important thing in Tom Chapman’s world.
The only thing, pretty much...
‘Go and sit with her now,’ he told Lizzie’s mother. ‘Or take a break? You probably need one after all that drama.’
‘I won’t be leaving her side for a while yet. It’s you that needs a break, I reckon. You worked so hard to save my little girl.’
‘It’s my job. And my privilege.’ Tom glanced at his watch. ‘I am on a late lunch break now. That’s why I popped up to see that Lizzie was settled well.’
‘I hope you’ve already had your lunch?’
‘Not yet. That’s next.’
But he wasn’t really hungry at all, Tom decided as he walked towards the café in the Royal’s entrance foyer. It was often like that, in the aftermath of the adrenaline rush that came from treating someone so critically ill—even more so when that fight for life was on behalf of a child. All life was precious, of course, but children and especially babies were so vulnerable you couldn’t help becoming emotionally involved to some extent. For some reason, the feeling of connection was harder to shake off after this case. Maybe that was why Tom gave in to the impulse to turn into the gift shop beside the café.
Ten minutes later he was standing in front of a door in the maternity suite of the Royal.
Hesitating...
He
