The Australian's Proposal. Alison Roberts
Чтение книги онлайн.
Читать онлайн книгу The Australian's Proposal - Alison Roberts страница 5
‘There’s a bullet in my leg,’ he said, and the phrasing of the answer made Hamish frown, although he didn’t question how or why, simply repeating part of Kate’s question.
‘And your name?’
The lad hesitated for another few seconds then finally said, ‘Jack. My name’s Jack.’
He was radiating tension that Kate guessed was more to do with his circumstances than his condition, although he seemed very weak. But if his tension arose from being abandoned, injured, in the middle of nowhere, surely their arrival should have brought relief.
And the name? Had he opted for Jack as a common enough name or was he really a Jack? Kate didn’t know, but she did know it didn’t matter. Jack he would be while they tended him, and part of tending him would be getting him to relax.
Hamish was doing his best, chatting as he ran his hands over Jack’s head and neck, asking him questions all the time, satisfying himself there were no other wounds and no reason to suspect internal damage. Where was the pain? Could he feel this? This? Had he come off his horse? Off a bike? Hit his head at all?
Jack’s responses were guarded, and occasionally confused, but, no, he hadn’t fallen, he’d stayed right on his bike. It was a four-wheeler.
And where was the bike?
He looked vaguely around, then shook his head, as if uncertain where a four-wheeler bike might have disappeared to.
The smell hit Kate as she fitted a mask and tube to the small oxygen bottle she’d taken from her backpack. She looked up to see Hamish unwinding the bandage from Jack’s leg. Necrotic tissue—no wonder the boy was feverish and looked so haggard.
‘How long since it happened?’
Jack shrugged.
‘Yesterday, I think. Or maybe the day before. I’ve been feeling pretty sick—went to sleep. Didn’t wake up until Digger moved me here this morning.’
‘Where’s Digger now?’ Kate asked, holding the oxygen mask away from his face so he could answer.
‘Dunno.’
Hamish raised his eyebrows at Kate, but didn’t comment, saying instead, ‘His pulse is racing. He needs fluid fast. I don’t want to do a cut-down here, so we’ll run it into both arms. If you open the smaller pack you’ll find a lamp. Set it up first then in your pack there’ll be all we need for fluid resuscitation—16g cannulae and infusers for rapid delivery. You’ll see the crystalloid solutions clearly marked.’
Kate found the battery-operated lamp and turned it on, a bright fluorescent light pushing back the shadowy evening. Now it was easy to see what they had—sterile packs of cannulas and catheters, bags of fluid, battery-operated fluid warmers, boxes of drugs.
‘Good luck,’ she said to Hamish as she handed him a venipuncture kit. ‘We’re going to get some fluid flowing into you,’ she added to Jack, as she found the fluid Hamish wanted and began to warm the first bag. ‘And that means inserting a hollow needle into one of your veins. But because you’re pretty dehydrated, your veins will have gone flat so it won’t be an easy job. I’m betting Hamish will need at least two goes to get it in.’
‘I’ll have you know, Sister Winship, I’m known as One-Go McGregor,’ Hamish said huffily, taking the tourniquet Kate passed him and winding it around Jack’s upper arm, hoping to raise a vein in the back of his hand or his wrist.
The needle slipped in. ‘See, told you!’ Hamish turned triumphantly to Jack. ‘Aren’t you glad you didn’t bet?’
Kate had tubing and a bag of fluid ready, and she turned her light onto the cliff-face behind their patient in search of small ledges where they could place the bags.
They changed places, Kate starting the fluid flowing into Jack’s vein, then setting the bag so it would continue to gravity feed through the tube. And all the time she talked to him—not about how he’d come to have a bullet in his leg, but about what she was doing, and how it would help.
‘Once Hamish has you hooked up on that side, we can start pain relief and antibiotics. It’s the infection from your wound that’s making you feel so lousy.’
‘Actually,’ Hamish said mildly, ‘getting shot in the first place would make me feel pretty lousy.’
Jack gave a snort of laughter, and relief flowed through Kate. Surely if he could laugh he’d be OK. But he was very weak and the wound, now she could see it, was a mess. A deeply scored indentation running from halfway down his thigh towards his hip, then disappearing into a puckered, blue-rimmed hole. Dried blood on the bandages suggested it had bled freely—but not freely enough to keep infection at bay.
Hamish set the second bag of fluid on the ledge behind Jack, then probed through the contents of the backpack.
‘I’ll get some antibiotics into you with that fluid, then I want to check your distal pulses and test sensation in your foot and lower leg. Kate, would you watch for renewed bleeding from the wound? We know you’ve been lucky, Jack, in that the bullet didn’t go into your femoral artery. And how do we know that?’
Hamish had found what he wanted—a small bag of fluid Kate recognised as IV antibiotic medication diluted with saline. He spiked it with an IV administration set, connected it to a second port in the IV line he had running, then placed the small bag on the ledge so the drug could be administered simultaneously with the fluid.
‘Because you’d have bled to death by now—that’s how we know the bullet didn’t hit your artery,’ he said cheerfully. ‘But it might have damaged a nerve, which is why I’m going to prick your foot, or the velocity of the bullet might have chipped a bone and sent that as a secondary missile to squeeze against the artery, which is why I’m going to check to see if blood is still flowing in your foot.’
Kate watched Jack’s face and saw that Hamish’s matter-of-fact approach was just what the young man needed. In fact, he was interested enough to ask, ‘Why does Kate have to watch for bleeding?’
‘Good question! Go to the top of the class.’ Hamish smiled at him. ‘Kate has to watch because you’ll have damaged some blood vessels, but smaller veins and capillaries have the ability to close themselves off if that happens. Problem is, once we build up your fluid levels, they might get all excited and open up again—bleeding all over the place.’
‘Ouch!’
Jack jerked his leg, and the bleeding Kate was watching for began right on cue.
‘Well, you’ve feeling in your toes and a weak but palpable pulse in your ankle, so I’d say you’ve been a very lucky young man. Unfortunately, that luck’s about to change. I need to clean up that wound and, although I’ll anaesthetise the area around it with a local, it won’t be comfortable. Kate, how about you shift over to Jack’s other side and talk to him while I work? Can you talk and pass instruments and dressings?’
Kate stared at the man who was taking this situation so calmly, chatting away to Jack as if they were sharing space on a city