accepted enough to earn a nickname. She stole a glance at her partner. He was rather bear-like. Tall and solid with brown hair and brown eyes. Not at all fierce, though. He seemed to be enjoying the exchange as much as Kathryn, and his smile was the most genuine she had seen so far.
‘We need to go and check the truck,’ Tim said, after a glance at the wall clock. ‘We’ll get a coffee after that if it’s still quiet so you’ll get a chance to talk to Kathryn later.’ He turned towards her and his smile became simply polite. ‘These guys don’t have to work nearly as hard as we do. They spend most of their days sitting around drinking coffee and talking. Just don’t believe everything they tell you.’
‘We get bacon and eggs for breakfast in summer,’ one of them said.
‘That is true.’ Tim’s gaze veered towards the kitchen but there was no sign of the porridge-maker. He lowered his voice anyway. ‘Roll on summer!’
The appreciative chuckle followed the two ambulance officers as they left the commonroom. Clearly Tim was far more relaxed with this group of men than he was with her but that was hardly surprising. They didn’t know each other and they had started their acquaintance with Tim’s astonished recognition of Kathryn as the member of the public who had assisted a woman in trouble in a restaurant, rapidly followed by his unsuccessful attempt to cover up why he hadn’t bothered to phone her.
At least he had recognised her. It would have been even more of a let-down to find she had made no impression on the man who had been in her thoughts with astonishing frequency over the last few months.
She followed Tim towards the garage where the fire engine and ambulance were parked. Let it go, she told herself firmly. It really doesn’t matter that he didn’t ring you. He probably just got busy with another emergency and forgot. Perfectly reasonable if that was the case, but why hadn’t he just said so?
The outgoing crew was happy to hand over their pagers and head home for some sleep.
‘Good luck,’ they told Kathryn. ‘And just tell Tim to shut up when you get sick of him talking all the time.’
Kathryn raised an eyebrow and Tim smiled wryly. ‘I’m known for being a bit on the quiet side,’ he explained. ‘You’re more likely to get bored stiff with my company than sick of listening to me talking.’
‘I doubt very much that I’ll get bored,’ Kathryn told him. ‘You might need to tell me to shut up if I ask too many questions.’
‘I’m happy to answer anything I can. That’s part of what taking on a probationary officer is all about.’ Tim handed Kathryn a paging device and showed her how to scroll through messages.
‘The job number and date come up first. Then the priority for the call. P1 is a life-threatening emergency and the only one we use lights and sirens for. P2 is non-urgent but requires a response time of less than thirty minutes, and P3 is routine stuff like inter-hospital transfers. P4 is a private hire.’
‘What sort of reasons do people hire an ambulance for?’
‘To take a relative back to a rest home or hospice after they’ve had a few days at home maybe. Usually it’s a rest home bringing a resident back after they’ve been checked out after a fall or something.’
‘OK.’ Kathryn nodded, tucking the information away. P1s were going to be the calls she would be most nervous about.
The thought of heading off to an unknown emergency with the wail of a siren distracting her from remembering even well-rehearsed protocols was enough to make the back of her neck prickle. Thank goodness she had someone like Tim McGrath for a partner. He looked to be in his mid-thirties and had the aura of a relaxed attitude to his job that could only come from a combination of competence and experience.
Kathryn had also had the advantage of seeing Tim in action thanks to that incident in the restaurant. She knew he was competent and could stay calm in an emergency. She’d be OK with a partner like Tim. Becoming good at this job wasn’t just a fantasy. She could do it.
‘Of course, dispatch can only make a priority decision based on the information they get given,’ Tim continued thoughtfully. ‘Quite often a P1 is nothing significant, but you can get some of the sickest people on a P2.’
Kathryn chewed her bottom lip as the flash of confidence faded. She’d have to worry about both P1s and P2s, then.
Tim’s amused expression made her flush with embarrassment at showing obvious nerves, but his smile was reassuring. ‘They get it right most of the time. Like that restaurant case you were involved in. Having got the job definition on the pager as ‘‘abdo pain’’ at a restaurant, we thought we were going to a case of food poisoning and thought the P1 response was a bit of overkill. Turned out it was a life-threatening emergency, wasn’t it?’
‘I’ve never been more relieved in my life than I was when I heard that siren getting closer,’ Kathryn confessed. ‘I could tell she was really sick and I had no idea why. A heart attack seemed the most likely cause but the abdominal pain didn’t exactly fit.’
‘Some MIs do present with epigastric or back pain so it wasn’t so far off the mark for a diagnosis. At least you knew how important it was to get urgent help.’
‘And at least I know a bit more about triple-As now. I paid particular attention to that lecture.’
‘So tell me, then.’ Tim leaned against the back doors of the ambulance, swinging his pager by the curly elastic cord attached to a clip. The awkwardness of revisiting that particular case seemed to be receding and he was obviously warming to his new role as a mentor. ‘What do you know about triple-As?’
A chance to impress Tim was welcome. Maybe he was uncomfortable with her because he had no idea what she was capable of. ‘The signs are a pulsating mass in the abdomen and you might hear a bruit over the mass. If they rupture, it’s a medical emergency. Signs and symptoms include a severe, tearing pain and blood loss leading to shock.’
‘Causes?’
‘Usually arterial disease. You can get a false aneurysm caused by trauma.’
‘Do you know why the heart rate can stay normal?’
Kathryn frowned. ‘I don’t think we covered that in class…unless I’ve just forgotten.’ She chewed her lip again. So much for impressing her new partner. ‘With shock associated with blood loss you’d expect a tachycardia, wouldn’t you? Seeing as that’s the compensatory mechanism to try and keep the blood pressure up.’
Tim nodded, seemingly not bothered by any lack in her knowledge base. ‘That’s why it’s such a good marker for a triple-A. An aneurysm causes the walls of an artery to bulge. When the aorta gets stretched it stimulates receptors into thinking that the blood pressure is actually high. Therefore the compensatory mechanism is to reduce the heart rate to keep the blood pressure down.’
‘Not good for hypovolaemic shock.’ Kathryn was delighted to have something explained so simply. Tim was obviously a good teacher and some of the excitement at the prospect of working with him returned to lift her spirits. ‘And no wonder she started to feel better lying down with her feet up and then fainted when she sat up again.’
‘Two litres of saline got the pressure up enough for us to be able to give her some morphine. She wasn’t feeling too bad at all by the time we got her out of the restaurant. In fact, she was
