Accidental Reunion (13 page)

‘I’ll pay you.’

Lila winked. ‘Take it as a first payment on the bandages and breakfasts.’

‘And you won’t write it down on my casualty card.’ She watched as Lila frowned. It could be relevant. ‘Of course, you’ll have to let the doctor know but, Sister Bailey, you know as well as I do that everyone who comes in contact with my casualty card will be sure to have a good read.’

Lila nodded. Hester had a point. Just the fact she now knew Hester’s age was more personal detail than five years in the department had given her.

‘I wouldn’t worry, Hester.’ Lila couldn’t resist the
dig. ‘When do I get a chance to document things properly? You know yourself how bad I am at that.’

Once cleaned up and in a crisp lemon gown, Hester was the perfect patient, answering Declan’s questions politely, gratefully accepting the painkilling injection Lila gave her.

Once she was safely wheeled off to X-Ray, with her rather nervous-looking husband hurrying behind, Declan gave Lila a grin.

‘I’ve rung Mr Hinkley and he’s on his way, I know she said not to but I’m sure it’s expected really. He’ll have a look at her X-rays and make a few polite noises. Hopefully that will appease her. She should really be admitted overnight for neuro obs.’

‘Not a chance.’ Lila shook her head. ‘The obs ward’s full and there’s no way you’ll persuade her to go up to a ward. You know how difficult she can be.’

‘What if she stays down here on a trolley? You could do her obs and I’ll check her over before the day staff arrive and hopefully she’ll be able to go home. It would save her the embarrassment of a full admission.’

‘I don’t have a problem with it, so long as Hester doesn’t moan when she audits the trolley times.’

Declan laughed. ‘I’m sure she will. Still, there’s obviously more to Hester than meets the eye.’

‘In what way?’ Lila found herself smiling as Declan started to laugh.

‘Well, not that I’ve ever pictured Hester in her undies but, if pushed, black velvet wouldn’t have been the image I’d have come up with.’

Thumping him on the arm, Lila laughed as she blushed. He probably knew the undies were hers—
after all, she had told him about Hester’s accident. Still, it was a good reason for a giggle.

And heaven knew, they needed it. The tension between them recently had been almost unbearable.

‘Over here a minute, Lila.’ Sue’s voice had a note of urgency in it that snapped Lila to attention. Helping Sue with the trolley she was pushing, she guided it into Resus, looking at the flushed child lying drowsily on it.

‘What’s the problem?’

‘She was just lining up with her parents in the waiting room and the triage nurse asked me to see her straight away. Flu-like symptoms, pain in the legs, reluctant to walk. I’ve told her parents to wait in the interview room.’

‘What’s her temp?’ Declan’s deep voice had an edge of concern as he pulled his stethoscope from around his neck and Lila put the tympanic thermometer into the child’s ear.

‘Thirty-nine.’

Declan started his examination as Lila undressed the little girl. Pulling off the child’s jeans, Lila felt her throat tighten. ‘Declan.’ The note in her voice was enough to immediately get his attention. Looking down to where she was pointing, Lila watched his brow furrow as he saw the insidious purple rash appearing on Amy’s legs.

‘Sue,’ Lila called. ‘Page Paeds now. Do you want me to set up for a lumbar puncture?’ she added, addressing Declan.

He shook his head, concentrating on trying to find a vein so he could insert an intravenous bung—no mean feat in a child as sick as this. ‘Not yet. I’ll take
some blood off now and then let’s get some antibiotics and fluids into her, stat. Put on some oxygen.’

As Lila did so he looked up briefly. ‘Do we have a name?’

Peeling the name band off the top of the casualty card, Lila wrapped it around the child’s limp wrist. ‘Amy Phillips.’

He stopped for a second. Although time was of the essence, so was reassuring the patient, however sick.

‘Amy, my name’s Declan. I’m a doctor. You’re just going to feel a small scratch in your hand and then I’ll be able to give you some medicines that will make you feel better soon.’

As Lila attached the intravenous infusion, Sue arrived back, breathless. ‘Paeds are stuck with a collapsed child on the ward, the anaesthetist too.’

‘What the hell is this, then?’ Declan retorted sharply, and Lila could hear the tension in his voice.

‘Sue.’ Lila’s voice was calm and assured. ‘Tell Switchboard to page the paediatric consultant at home. Declan or I will speak with him. Tell them also to page the second-on paediatricians. Then ring ICU and check if they’ve got a paediatric bed.’ She glanced over at Declan, who was administrating the intravenous antibiotics. ‘Do you want the second anaesthetist?’

‘Yep. Get these bloods off stat and tell the lab I want the results yesterday.’

‘Sure.’

The rash seemed to be darkening with lightning speed. A huge infection was literally overwhelming the little girl as they spoke, and the paediatricians were involved with another sick child.

Sue returned, and with one look at her anxious face Lila knew more trouble was coming.

‘The paramedics just alerted us. They’re at a house fire, four children inside and one adult. Two firefighters are suffering from smoke inhalation.’

Lila felt her heart plummet for a second. Catching Declan’s eyes for a second, she knew he felt it too.

This was the how quickly the wind on the front line could suddenly turn.

This was night duty in Emergency.

‘How long till they get here?’

‘Ten minutes.’

Amy was desperately ill, they had a department full of sick people, but in just ten short minutes four children and three adults were going to arrive, possibly all desperately ill.

Lila had to think on her feet. There was a thin line in Emergency between overreacting and calling a major incident or waiting to see how the events unfolded and running the risk of calling it too late.

‘Fast-page the nurse supervisor. I want the wards rung and told to come immediately and get the patients that are assigned to them.’

‘Right.’

‘Get the other staff down to Resus.’

The paediatric emergency trolley had already been opened for Amy and quickly Lila filled kidney dishes with intravenous bungs, alcohol swabs, paediatric airways.

Any patient that could be was moved out of the area in an attempt to clear some room. As the wail of sirens heralded the arrival of the first ambulance, Lila took the phone from Sue.

‘Dr Harper here.’

Lila felt a wave of relief wash over her. Gerard Harper wasn’t only a brilliant paediatrician, he was also a nice man, happy to share a coffee and a chat. At least it wasn’t a virtual stranger on the other end of the line. ‘Gerard, it’s Lila Bailey here—I’m the nurse in charge of Emergency tonight. We have a five-year-old with suspected meningococcal disease and also an alert from the paramedics of an attempt to rescue four children from a house fire.’

‘I’m on my way, Lila. I’ll ring a couple of colleagues on my mobile.’

Lila didn’t bother to say thank you. There truly wasn’t time.

Mr Hinkley arrived with the first ambulance and Lila quickly briefed him. Mercifully the child the paramedics were dashing in with was crying loudly, a good sign by any standards.

‘Sister Bailey, what on earth’s going on? I heard all the emergency pages over the Tannoy.’ Hester’s face was anxious as she struggled to sit up.

Even though Hester was a patient, she was still the unit manager. The potential gravity of the situation would have made Lila consider ringing her boss even if she’d been at home, so Lila told her, watching as Hester’s eyes widened.

‘Are you calling more staff in?’

‘Not at this stage.’ Lila saw the flash of doubt in Hester’s expression. ‘Mr Hinkley was already here to see you and Gerard Harper is on his way to see a child with suspected meningococcal disease. I’ve spoken to him on his mobile and he’s going to alert some
colleagues. I’ve also got the nurse supervisor plus an ICU nurse coming down.’

‘I should be out there. Sister Bailey, get me off this trolley and into a wheelchair.’ For a second the sight of Vera flashed through Lila’s mind, desperate to be of some assistance but getting in the way.

‘Hester, you’ve got a head injury and a fractured ankle. You’re a patient,
my
patient. The best thing you can do is rest quietly and let me get on with my job. I promise if I need advice you’ll be the first person I come to.’

Hester looked at her suspiciously. ‘You promise?’

Lila nodded. ‘Look, Hester, I have to go.’ As she left she turned briefly. ‘But I’m really glad you’re here.’

The strangest thing was, she was actually speaking the truth.

A blue light was flashing past the windows of Resus. Dashing out to the ambulance bay, the cool night air hit Lila. Running, she pulled open the rear ambulance door, praying that the sight that would greet her would be another crying child.

It wasn’t.

The pink face of the five-year-old girl belied how sick she was. Carbon monoxide, a silent killer, caused the skin to turn a false, healthy-looking pink.

Lila took over the cardiac massage as the paramedics raced the trolley into the resuscitation room.

‘Pulled out of the front bedroom, no pulse or respiratory effort, we’ve been working on her for fourteen minutes now.’ A paramedic reeled off the drugs the child had been given. They had already intubated the little girl and the anaesthetist took over, pushing
the oxygen gently but rapidly into the child in an effort to increase her oxygen concentration.

‘There’s another ambulance working on child number three at the scene. She was flat when they pulled her out but I just heard from Ambulance Control that she seems to be picking up.’

Lila nodded, not looking up as she carried on the necessary conversation. It was imperative they knew what else to expect, but she continued with the cardiac massage. ‘I thought there were four children.’

The paramedic nodded grimly. ‘The firefighters are still searching.’

‘What about the parents?’ Declan’s voice sounded strangely hoarse as he pushed some drugs into the intravenous line that had been inserted into the child’s hand. No one liked dealing with such sick children and Lila knew he was devastated by the turn of events that had seen a usual busy night turn into a disaster for one family and an emotional roller-coaster for all the emergency staff involved.

‘Dad’s away on business, Mum’s got facial and hand burns but she won’t leave till we find the fourth child. The police are contacting the father now, poor guy. Imagine picking up the telephone and hearing about this.’

‘How old is the child that’s missing?’

‘Two.’ He turned and made his way down the corridor. Back to the ambulance, back to the scene to do whatever had to be done.

There was no goodbye. No cheery ‘Catch you later’.

Two.

The tiny number said it all.

‘S
TOP
the massage.’ Declan raised one hand as he watched the cardiac monitor. The other hand was placed on the child’s neck, his eyes, his ears, his fingers straining to acknowledge even the tiniest sign of life in this precious young child.

Lila rested back on her heels. Long ago she had abandoned standing on the floor as she’d given cardiac massage. Up on the trolley, astride the patient, the massage was more effective. On a small child like this it was important not to apply too much force, but in prolonged resuscitations such as this one it was tiring work. It was the fourth time Declan had told her to stop, the fourth time they’d held their breaths as they’d willed the drugs, the massage, the utter energy they’d been expending to somehow do its magic and work.

They didn’t say anything—there was no need. But as the flat line on the monitor suddenly blipped, then blipped again, the flickering of a rhythm as it picked up the electrical impulses in the child’s heart, she heard Declan exhale and realised he’d been holding his breath also.

‘Come on, baby,’ he urged. ‘Come on.’ As if hearing the urgency in his voice, the rhythm picked up, slow and tentative at first but gaining in momentum until a steady pulse could not only be seen but palpated in her neck and her wrists.

But this was only the first step. The real test came later. They might have got her heart beating again, but there was still a long way to go. Now she needed to breathe unaided, to show a sign that her brain hadn’t been damaged. There was no way of knowing how long she had been down before the firefighters had got to her.

Her fixed, dilated pupils were an ominous sign of brain damage but, as Declan optimistically pointed out, the drugs she had been given at the scene of the fire and again in Resus would cause that also.

‘I’ll keep hyperventilating her,’ the anaesthetist said as the latest blood-gas results were thrust at him. ‘Blow off some of this carbon monoxide. She should have some mannitol as well—there’s bound to be some cerebral oedema. Apart from that, it’s wait and see.’

‘Have you got a bed?’

The anaesthetist shook his head. ‘We’re getting Amy up there. I’ve got a patient that can be moved in the morning but it will mean keeping this little lady down here till then.’

Lila chewed her lip. ‘I’ll have to see—we’re so busy. If not, the supervisor will have to do a ring around the other hospitals and see where there’s a bed.’

‘No worries,’ the anaesthetist said with an easy smile. ‘Let me know what happens. I’m not going anywhere for the moment.’

‘How’s Amy?’ Lila asked as Sue made her way in.

Sue’s grimace spoke volumes. ‘Not the best. They’ve intubated her and I’m going to get her up to
ICU now. Declan’s in with her parents. Any news on the fourth child?’

Lila shook her head. ‘The nurse supervisor will take Amy up for you. Can you set up this bed for child three? They’ve alerted us to say she’s on the way now, though happily this one’s breathing. Once you’ve got the bed set up, help the anaesthetist with child two. I’d better go out—the firefighters are starting to trickle in.’

She stood in the corridor, directing traffic for a moment. Catching sight of Hester’s stricken face, Lila popped her head in.