DJ’s carotid pulse.
Pierre glanced at her. ‘Go and get yourself checked out,’ he said roughly.
‘I’m okay,’ she fired back, shouting to make herself heard above the sounds of the sirens.
He looked at her sharply, his blue eyes drilling into hers. ‘I don’t have time to argue,’ he said, lowering his head and beginning to breathe for his patient.
Finding what she was looking for, a faint but discernible pulse, Julie knew that they had to get some oxygen into his lungs and some fluids into his veins as quickly as possible.
‘I’ll get help,’ she said, scrambling to her feet. ‘Someone must have emergency supplies.’ As she stood, an ambulance pulled up, its flashing blue lights adding to the red pulses of the fire engines, making it all seem even more surreal. Thank God, Julie thought. There was little she and Pierre could do for the DJ without medical equipment. Almost before the paramedics were out of the ambulance, Julie was by their side. She pointed to Pierre and the inert form of the DJ. ‘Over there! They need oxygen and a drip, and any other medical equipment you might have. Stat.’ The paramedics nodded and, gathering their loaded bags, rushed across to Pierre. Another couple of ambulances pulled up, their sirens cutting the cold night air, their occupants leaping out ready to offer aid.
As Julie turned back towards Pierre, Susan and Richard ran across to her.
‘We’ve got Martha and everyone else. Are you all right?’ the young girl asked, her eyes wide. Then she burst into tears.
‘Hey, I’m fine.’ Julie assured them, grabbing hold of Richard’s arm. ‘Rich, get your friends together and move them to a safe position on the other side of the road. Stay there until someone checks all of you over. Okay?’
Richard nodded and, taking the still sobbing Susan by the arm, moved away.
Julie raced over to Pierre, who was still attending to his patient. ‘I’m back,’ she said quietly. ‘What do you want me to do?’
Pierre looked up as his patient coughed and struggled for breath. Julie took an oxygen mask from one of the paramedics and placed it over the DJ’s mouth.
Pierre was looking worried. ‘His throat is swelling,’ he said. ‘The oxygen won’t get to his lungs that way.’ He spoke a few words to one of the paramedics, who rushed back towards one of the ambulances. Then he turned to Julie. ‘There are two main problems with someone as badly burnt as our patient. Firstly, the swelling of his throat is restricting his breathing. I’ll need to do an emergency tracheostomy here—right now. If we leave it until we get him to hospital, it will be too late.’ The paramedic returned and Pierre began searching through the bag she had brought. In the meantime, Julie had taken the line and drip the paramedic had passed to her earlier and found an undamaged vein in the man’s groin to insert the cannula.
‘The other problem is that as we resuscitate him, his skin will also start to swell, becoming like leather squeezing tighter and tighter on his chest wall. As it constricts, it squeezes down on the chest, preventing the lungs from inflating properly.’ Pierre continued. ‘Once I’ve made the hole in his throat and we’re getting oxygen into his lungs, I may well have to make a few incisions into the skin on his chest.’ He seemed to have found what he was looking for in the bag, and a scalpel flashed in the light. He looked straight into Julie’s eyes. ‘I’m going to need you to help me. You’ll have to hold him steady. Can you do that? If you can’t, I need to know now.’
Julie returned his look steadily. ‘Just tell me what to do.’
Whatever he saw in Julie’s eyes must have reassured him. He bent low over the injured man. ‘I’m going to do something that will help you breathe,’ he said. ‘I may have to cut into your chest. It won’t hurt, but I’ll give you something for the pain, and then we’ll get you to hospital.’
He glanced at Julie and she could tell from his expression that he didn’t hold out much hope for the man on the ground. ‘He won’t be aware of what we’re doing,’ he said. Gently he tipped the man’s head backwards so the front of his neck stood out and he felt below the prominence of his Adam’s apple. Then swiftly, but confidently, he inserted the scalpel into the victim’s trachea. Julie used a sterile swab to dab away the blood, and then Pierre inserted a tube through the incision into the throat. ‘Bag him,’ he instructed Julie. She fixed an ambu-bag over the tube and squeezed air into the lungs. Within seconds Julie could see the colour seeping back into the victim’s face. But as Pierre had predicted, almost immediately his breathing started to become laboured again.
‘Merde!’ Pierre cursed. ‘It is as I thought. He will need an emergency escharotomy—where we incise the skin on his chest to help him. I hoped the tracheostomy would be enough until we got him to hospital.’ Once more he bent over the patient and, using the scalpel, scored two deep incisions across the chest. Immediately the skin parted, leaving deep furrows across the chest. To Julie the procedure seemed almost barbaric.
Pierre glanced up and, catching her questioning look, said, ‘The burnt skin will have to be removed later once we are sure he is stable. He won’t have felt anything even if he was conscious as the nerve endings are too badly damaged. This way he has a better chance of survival.’
‘Does he?’ Julie whispered. ‘Does he have a chance, do you think?’
‘The extent of his burns…’ He shook his head. ‘Well, they are bad. But I am hopeful. The sooner we get him to hospital the better. Let’s get him into an ambulance.’
As the paramedics helped Julie and Pierre load the injured man onto a stretcher, Pierre said to Julie, ‘I need to go with him in the ambulance.’
‘I’ll come with you,’ she offered. ‘I just need to make sure the people I’m with are okay.’
Pierre shook his head. ‘We can’t wait. He has to go now. Anyway, there is only room for one of us to go with him. And it is better that I go.’ He hesitated, glancing over Julie’s shoulder. ‘Could you do something for me?’
Julie looked around. There were still four or five casualties needing medical attention but they were being attended to by paramedics. Furthermore, she could see a fluorescent jacket with ‘Doctor’ emblazoned on the back. It seemed as if her help here was no longer required.
‘Sure,’ she said. ‘Just tell me what.’
‘Can you drive?’
Julie was surprised at the question.
‘Yes,’
‘Do you have a car with you and have you been drinking?’
‘No and no,’ she replied.
Pierre dug around in his pocket before pulling out a set of keys and pressing them into Julie’s hands. ‘I don’t like to ask you, but see that girl over there?’ He pointed to a young woman who was leaning against a wall, looking dazed. ‘She is my niece. It’s her I came to find here. She is alone. Please, could you take her home? See that she’s all right? Tell her that I’ll be back as soon as I can.’
He watched as his patient was loaded into the ambulance. Julie could see he was worried. For his patient, his niece, or both, Julie couldn’t be sure.
‘Okay,’ she said, a little reluctantly. She would much rather have followed
