nurse, on to special him for the morning at least.
The next patient was a woman with similar but less severe problems. Jennifer Adams had sustained a ruptured bowel and a messy abdominal tear when her steering-wheel had snapped and penetrated her abdominal wall.
She was, Lizzi thought, extremely lucky to have got off as lightly as she had.
Oliver joined in again. ‘There was a minor abrasion on her left ureter, and her left ovary was also slightly bruised. Apart from that she’s fine, and came through surgery very well. She’s had two units of whole blood but she’s on saline now. Her worst problem will be scarring, I suspect. I’ve done my best, but she’ll probably need plastic surgery later.’
Lizzi nodded. She had seen these sorts of injuries before.
The third patient to catch her attention was a young man of twenty, Michael Holden, who had been thrown clear of his car and then run over by another vehicle, causing a whole range of internal injuries.
‘He should definitely be in ITU!’ Lizzi protested, mentally assigning herself the task of specialling him.
‘He will be,’ the sister replied. ‘They’ll take him as soon as they can clear a bed. They’ve got a head-injuries patient they’re hoping to transfer to Addenbrookes, and a spinal injuries case for Stoke Mande ville as soon as he’s stable enough. That should clear two beds. I would think they’ll take him then. Of course, if the bloody fool had been wearing a seatbelt——’ Jean Hobbs looked up and smiled. ‘That’s it, then. Over to you!’ She flipped the Kardex shut, stood up and stretched. ‘You’re welcome, let me tell you!’
Lizzi smiled grimly. The week had really got off to a flying start, she thought with disgust.
She sent Sarah Godwin off to relieve the night nurse with Roger Widlake, put her other staff nurse Lucy Hallett in charge of the ward and headed off with Oliver to see Jennifer Adams and Michael Holden.
Jennifer was feeling very sorry for herself and Oliver wrote her up for more powerful pain relief before leaving her and taking Lizzi into Michael Holden’s room.
His breathing was very light and harsh, and his face was pale and clammy—the bits that weren’t bruised and cut, at least.
‘How is he?’ Oliver asked the staff nurse sitting at the head of the bed.
‘His respiration’s very irregular, and he seems to be in pain. His pupils are still uneven and unresponsive, and he doesn’t react when you talk to him, but he’s very restless. We had to tie his hands down because he kept going for the drip.’
Oliver nodded and studied the chart for a moment, then the heart monitor. ‘It’ll be a miracle if he makes it. He’s a mess. I don’t think I’ve ever seen such massive internal injuries except in a post mortem.’
‘I’m surprised he hasn’t broken anything apart from a few ribs,’ Lizzi commented.
‘He probably has. The radiographer’s coming up to X-ray him again. There was so much blood mass obscuring the plates it was difficult to see, but his pelvis is a definite candidate. The orthopods will come and see him later if he hangs on long enough. I reckon the head of his left femur cracked the acetabulum as he landed, but we’ll see. He could also have a slight skull fracture.’ He glanced at his watch and gave a short, tired sigh. ‘I must get on. Will you be all right?’
Lizzi gave him a wry grin. ‘I’ll do my best. What about Roger Widlake?’
‘Ross will be down to talk to you about him before long, I expect. See you later.’
Lizzi scanned the charts, smiled at the nurse and told her she could go. ‘I’ll special him,’ she said. ‘Could you ask Lucy Hallett to come and see me in a minute?’
But it was Ross and not Lucy who opened the door a few minutes later. He walked over to Lizzi and stood close to her as he studied the chart.
‘How’s he doing?’
Lizzi shrugged. ‘Not well.’
Ross shook his head. ‘I doubt if he’ll make it. He’s so badly shocked, and he was under the anaesthetic for hours. Oliver and I were working on him together.’
Lifting up the edge of the bedclothes, Ross frowned at the drainage bag from the catheter.
‘His kidney’s been bleeding a bit.’
‘Kidney? Just one?’
‘We had to remove the left one. It was shot to bits.’
They watched dismally as a steady trickle of blood ran into the bag.
‘Damn.’
‘Will you have to open him up again?’
Ross shrugged. ‘Maybe.’ He opened up the drip a little so that the whole blood ran faster, and checked his blood-pressure. ‘Pressure’s OK. I think we’ll just watch him closely. It may stop on its own. The last thing he needs is another anaesthetic. He’s got so much alcohol in his system that he really can’t take it. His system is depressed enough.’
‘He was drunk?’
‘As a skunk. The police are waiting to talk to him.’
As the old familiar rage swept over her, Lizzi lost all compassion. ‘Why the hell was he driving?’
‘Good question. He caused the accident, apparently. Ploughed into Jennifer Adams—it’s her husband in ITU with the head injuries, by the way—and then spun off and caught Roger Widlake and his wife broadside. She’s fortunately only slightly injured.’
‘Bastard,’ Lizzi whispered, it would serve him right if he died!’
Ross blinked. That’s a little harsh, isn’t it?’
‘It’s no more than he deserves!’ Lizzi said bitterly.
Just then there was a dramatic drop in blood-pressure, and the heart monitor registered a flat trace.
‘Here we go again,’ Ross said with a sigh, and rolled the man carefully on to his back, tipped back his head and breathed into his mouth while Lizzi automatically slid a board under his chest, then, locating his sternum, he crossed his hands and pumped steadily.
‘Get an airway in, Lizzi.’
Lizzi hit the alarm button, ripped open a Brook’s airway and inserted it carefully into the man’s mouth, forcing her professional side to take over from the unprecedented surge of emotion. Suddenly the room was full of people. Someone took over the air bag, attaching it to the airway and squeezing it steadily in the gaps between Ross’s rhythmic cardiac massage.
‘Do you want the defibrillator?’ someone asked.
‘No, he’s gone into asystole. He’s just given up—he may have a ruptured aneurism. We’ll have to keep him going if we can. If it isn’t that, he may pick up again.’ Ross snapped out instructions which had already been anticipated by the well-trained team. The atropine, calcium and adrenalin were already drawn up, and were injected into the giving set in the patient’s arm,
