pulled back the warming blankets to get a better look at her small body. Lily was right on the edge, hovering between severe and moderate hypothermia. It was a wonder she hadn’t gone into cardiac arrest.
‘How’s her respiratory effort?’
Harry was sounding her chest. ‘For a child who was submerged I’m not hearing any fluid in her lungs. Just a few crackles. She is breathing, but not enough to keep me happy.’
‘Wait a minute, folks.’ Jess held her hand up as the monitor flickered, going from a stable but slow heart rate to a run of ectopic beats. She shook her head.
Time was of the essence here. She needed to make a decision.
Lily was deathly pale. All her surface blood vessels had contracted as her little body was focusing its resources on keeping her vital organs warm.
Her lips and ears were tinged with blue, showing lack of oxygen perfusing through her body.
Her eyes fell on Lily’s fingers and toes. Their colour was poor.
No. Their colour was worse than poor.
The blueness was worse.
The tinkle of the monitor indicated Lily had gone into cardiac arrest. Jessica leaned across the bed and automatically started cardiac massage with the heel of one hand.
It clarified things and made the decision easier.
‘Harry, we’re not going to wait. Call the team. Let’s get her to Theatre and begin extracorporeal rewarming. Can you phone ahead? Let them know we are resuscitating.’
One of the nurses nodded and picked up the phone in the resus room. ‘Paediatric ECMO in Theatre ASAP. Yes, it’s one of the minibus victims. Four-year-old female, submerged, with a core temperature of twenty-eight degrees. She’s arrested and currently being resuscitated. Dr Shaw has her intubated and they’ll be bringing her along now.’ She replaced the receiver. ‘Theatre one will be waiting for you.’
A wave of relief washed over Jessica. There was no drama. No struggling to find theatre time. It sounded as though the theatre staff was already prepared for the possibility of one of the hypothermic kids needing ECMO.
Extracorporeal membrane oxygenation worked with cardiopulmonary bypass to take over the function of the heart and provide extracorporeal circulation of the blood where it could be rewarmed and oxygenated. It had only been used in a few cases of hypothermia with cardiac arrest in the last few years, but had had extremely positive results with good outcomes for patients.
Lily was going to be one of those patients.
Jessica was absolutely determined.
Two porters appeared at either side of the trolley, ready for the move.
As they swept down the corridor towards the lifts she caught sight of Callum again, taking notes and talking to one of the nurses. He was still here?
She hadn’t had a chance to think about him. She had been too busy concentrating her energies on keeping this little girl alive. She could feel the cold flesh under her hand as she pumped methodically, trying to push blood around Lily’s body. Trying to get some oxygen circulating to her body and brain.
This was somebody’s child. Somebody’s pride and joy.
Their reason to get up in the morning and their reason to go home at night.
Any minute now some poor, frantic man and woman would turn up in A and E anxious to get news of their daughter.
Praying and pleading to hear the best possible news. Trying not to think about the pictures their brains had been conjuring up ever since they’d heard about the minibus crash. Struggling to remember to breathe as they made the journey to the hospital.
A journey that probably seemed to take twice as long as it normally did.
Their ‘normal’ day had changed beyond all recognition. Had they kissed their daughter goodbye that morning before they’d dropped her at nursery? At the place they’d assumed she would be safe?
Had they spent a few brief seconds taking her in their arms and feeling the warmth and joy of cuddling a child before they’d left her that morning? Or had they given her the briefest kiss on the top of her head because they had been in a rush to get to work? Because they hadn’t realised it could be the last time they kissed their child.
Would they spend the rest of their lives regretting signing a consent form to say their daughter could go on the nursery trip? The one that could have cost her life?
All these thoughts were crowding her brain. Any time she had to resuscitate a child she was invaded with what-ifs?
But the what-ifs were about her own life. She’d spent the last three years thinking about the what-ifs.
What if she’d been driving the car that night?
What if she hadn’t been on call?
What if her husband hadn’t stopped to buy her favourite chocolate on the way home?
The lift doors pinged and they swept the trolley out. She lifted her head. The theatre doors were open and waiting for them.
One of the perfusionists was standing by, already scrubbing at the sinks, preparing to insert the catheter lines that could save Lily’s life.
This was why she did this job.
This was why after a year of darkness she hadn’t walked away. She might not have been able to save her own child but she would do her damnedest to save this one.
Callum stared at his watch. It had been six hours since he’d last seen Jessica sweeping down the corridor, her thin scrub trousers clinging to her wet backside, her hand pumping the little girl’s chest.
He’d felt physically sick at that sight.
Not because he wasn’t used to dealing with casualties. Casualties of all ages and all descriptions were part and parcel of the job.
But seeing the expression on Jessica’s face wasn’t.
Everything about this situation was having the strangest effect on him. The sight of Jessica hadn’t just been unexpected—it had been like a bolt out of the blue.
They’d been childhood sweethearts who’d broken up when life had moved on and they’d never moved in the same circles again. He hadn’t even heard anything about Jessica over the last few years.
Her words on the steep embankment had intrigued him.
Things just didn’t work out for me.
It made his brain buzz. There was a whole world of possibilities in those words. But he didn’t feel as if he could come right out and ask.
Particularly when the sick kids were the priority.
And his lasting memories right now were the way her body had felt next to his. The way they’d seemed to fit together so well again—just like they
