trying to stem the flow.
The woman was right. This young patient needed an airway now.
The large penetrating wound—a spear of some kind through the chest—told him everything he needed to know.
He moved to the top of the bed and nudged her out of his way. Or, at least, he tried to.
Her hips stayed firmly in place. ‘Who are you?’ She was practically growling at him.
He glanced at the nearby trolley, opening the first few drawers until he found what he needed. ‘Do we have IV access?’ he asked a nurse to his left.
‘Just,’ she said promptly.
A small, firm hand closed over his. He turned around. The woman who’d sent him flying was just about in his face. Her dark brown eyes could have swallowed him up. She spoke so quietly he was sure no one else could hear. ‘I’m not going to ask you again.’ She gave a squeeze over his hand—and this time her grip was like iron. ‘I’m just going to break your hand.’
He lifted his ID and slid it between both their faces. ‘Let me do my job. We’ve got six months to fight with each other.’
She was small, obviously of Japanese descent but her skin was slightly darker than he would have expected. Her hair was poker straight, cut very short at the nape of her neck but becoming longer down past her ears. From straight on it looked like a bob. A smart cut for a nurse, short enough to be off her collar but not long enough to need tying up every day.
There seemed to be something about her. A presence. She was like a cannonball. People paid attention to her even though she couldn’t be the highest-ranking person in the room. Far from it, in fact. She only looked in her mid-twenties.
Firecracker? He couldn’t remember what the Japanese word was but somehow the nickname suited her. It seemed to sum her up perfectly.
It was obvious that in this room people respected her. He liked that. He liked that she was direct and efficient at her job.
Her eyes shifted and focused on the ID. She turned without a word and started shouting orders at others in the room. ‘Get an IV run through.’ She glanced at the endotracheal tube in the hand of her colleague. ‘I think we’ll need something smaller.’
Perfect. A nurse he could work with. All air force and military nurses and personnel were efficient and well trained. But he always worked best with those who could think ahead and weren’t afraid to voice their opinion. He had a sneaky suspicion that Katsuko—was that her name?—would never be afraid to voice her opinion.
Avery tried to ignore the bedlam around him. He tried to cut out the noise. There were two trolleys in the resus room and another team was working on another patient. They were moving like clockwork, performing cardiac massage.
He moved swiftly. ‘Any other doctors in here?’
‘Two are up on the helipad. They haven’t even managed to get the patient down yet.’ She pressed her lips together. ‘Blake won’t give up on the other kid. Not until he’s tried everything.’
The doctor attending to the little boy on the other trolley. Blake Anderson. The guy he was supposed to report to tomorrow. The scene on the other trolley was disheartening and he didn’t feel the urge to introduce himself right now. If he didn’t pay attention to the kid directly in front of him, he might end up resuscitating him too.
Avery took a breath and held out his hand. The area around this little boy’s neck and chest was swelling, a reaction to the severe injury that could compromise his airway. His sallow skin was losing its natural colour rapidly. A nurse was poised next to the IV meds, awaiting his instructions. He gave them quickly. Something for pain control. Something to sedate the boy and steroids to reduce the swelling and allow him to intubate. Airway first. Everything else later.
The nurse nodded and inserted the drugs into the IV cannula on the inside of the kid’s elbow.
‘ET tube.’ Avery held out his hand, bending down at the top of the trolley and tilting the little boy’s head. ‘Do we have his name?’
‘Mahito. His name is Mahito.’ The firecracker nurse was watching his every move.
‘Mahito, I’ve given you something for the pain and something to relax you. I’m going to have to slide a tube down your throat. Don’t panic. We’ll take good care of you.’ It didn’t matter that the little Japanese boy might not understand a word of English, or his Ohio accent.
He’d done this a hundred times before and he’d do it a hundred times again.
He gave Katsuko a few seconds as she translated his words rapidly. The little boy was barely conscious. He probably had no awareness of what was going on right now and that wasn’t a bad thing.
He tilted the little boy’s head back, lifting his jaw and sliding the silver laryngoscope into place. He could barely visualise the cords—if he waited any longer he’d probably have to do an emergency tracheotomy—but thankfully he had time to slide the thin blue ET tube into place and inflate the cuff. It took less than four seconds to secure the airway. He attached the bag to the end of the tube and let the nurse take over.
With the airway secure he could now take a few minutes to assess the situation properly. ‘We’re going to need to take him to Theatre. Can I get a portable chest X-ray?’
A woman in a blue tunic stepped forward, pushing the machine towards them. She’d been waiting for his signal. Like in most military hospitals, radiographers were always available in the ER.
A heavy lead-lined apron was dropped over his head. He didn’t even question where it had come from. A few people stepped from the room for a second.
‘Done,’ said the radiographer.
She glanced back at Avery. He could see the question on her face. ‘Avery Flynn. I officially start tomorrow.’
Satisfied with his answer, she gave a nod. ‘Dr Flynn, I’ll have your X-ray in a few minutes.’
Avery nodded. ‘Can anyone tell me what actually happened?’ He could see his counterparts still working on the kid on the other trolley, the flat line on the monitor almost mocking them.
‘Some kind of explosion. Lots of penetrating injuries. It was outside a local factory. The kids were playing, waiting for their parents to finish their shifts.’
‘Major Anderson,’ a voice boomed through the resus room doors. Everyone froze for a second then immediately resumed what they’d been doing. Eyes glanced at each other and the noise level in the room plummeted.
Avery frowned at the uniformed figure in the doorway. He had three people standing nervously behind him. The rank was instantly recognisable—as was the glint of the two silver stars—and he could hardly hide his surprise. He’d never seen a major general in an ER before.
He looked to be in his fifties and had a mid-Western accent. He was well over six feet tall with broad shoulders and what looked like thick dark hair under his hat. There was something about him. An aura. An air. And it wasn’t all about the rank. What had brought him to the ER? He could understand any major general in charge of a base this size wanting to be informed about incidents. He just wouldn’t have expected him to attend personally.
