Page 35 of Stranded with the Surgeon
‘Is the trauma room clear?’ Status one meant that these patients were in a critical condition from their car crash. They could need every resource the department had available.
‘Just been cleared.’
‘Activate the trauma team. John or Adam can lead if they’re free. I’ll be tied up for a few minutes.’
A woman with a shrieking toddler in her arms stepped out of their way, but Jennifer had to swerve to avoid a bed being rapidly manoeuvred.
‘Sorry, Prof,’ the orderly called.
‘Not a problem, Deane. I’m just as bad with supermarket trollies!’
The patient with the UTI was looking extremely unwell. Doug rapidly gave her the information that added up to a shocked condition. Colin Smith was febrile, hypotensive, tachycardic and confused. He had a forty-eight-hour history of urinary frequency and pain, had been to his GP that morning, having passed blood, but hadn’t filled his prescription for antibiotics yet.
‘It was Grandparents’ Day at Alice’s kindy,’ his wife explained to Jennifer. ‘He said he was fine and he’d start the pills later, but then he just got so sick so quickly. He started vomiting then so there didn’t seem much point in trying to get him to swallow pills.’
Colin had tufty grey hair rather like Digger’s had been. Jennifer could just imagine him toughing it out and pretending he was fine. She picked up his hand, noting the cool, clammy feel of his skin.
‘Colin? Can you open your eyes?’ She smiled at him when he complied. ‘Hi, there. I’m Dr Allen, one of the consultants here.’
‘You’d better watch out.’ Her patient managed to return her smile. ‘My wife might see you holding my hand.’
‘Do you know where you are, Colin?’
‘Heaven,’ he murmured. ‘Are you the boss angel?’
‘We need to get an intravenous line into you to treat your infection,’ Jennifer told him. ‘And your veins aren’t cooperating so I’m going to put one in just under your collarbone. Are you happy for me to do that?’
‘You do whatever you like, love. I’m just…’ The words trailed off into an incoherent mumble and he closed his eyes again.
Mrs Smith pressed her hand to her mouth. ‘He’s really sick, isn’t he?’
‘You hold his hand,’ Jennifer said. ‘And we’ll get on with getting him better.’ She plucked a mask from the wall dispenser. ‘Let’s have a head-down tilt, Doug. Is there some local drawn up on that trolley?’
‘I’ll get it.’ An assisting nurse was holding a gown out for Jennifer. Another nurse was preparing to swab Colin’s chest for the sterile procedure.
‘Thanks.’ Jennifer turned to get the ties on her gown attended to. ‘I’ll need one large glove to get over this cast.’
Seconds later, they were ready. With the skin well infiltrated with local anaesthetic, Jennifer picked up a ten-gauge cannula.
‘Turn his head for me, Doug, and keep things nice and still.’ Feeling along the clavicle, Jennifer chose the point of entry and was pleased to find an instant flashback. She withdrew the needle, leaving the plastic cannula in place. ‘Okay. I’m ready for the guide wire.’
The flexible wire was passed into the vein and then a catheter introduced over the wire. Jennifer watched the screen of the monitor as she threaded the guide wire, making sure it didn’t travel far enough to irritate the heart and cause a rhythm disturbance.
Now that access had been established, the rest of this procedure was straightforward. The catheter would be stitched into place and covered with a dressing. A chest X-ray would confirm its correct positioning and blood samples could be drawn before fluids and drugs were administered.
‘Do you want me to take over?’ Doug asked.
‘I’m fine for a minute or two.’ Jennifer reached for the suture needle. ‘You’re doing really well, Colin. We’re almost done.’
The relief on Mrs Smith’s face was patent, but she still held her husband’s hand tightly. ‘You’re going to be fine, love. Alice is going to come in to see you later. She’s drawing you a special picture.’
‘How old is Alice?’ Jennifer queried.
‘She’s four. Her little brother’s two. We’ve got six grandchildren now… and they all adore their grandad.’
‘I’m sure.’ Jennifer smiled as she tied off the last knot. ‘Do they get lots of time with him?’
‘Now that he’s finally retired they do. It was hard to get him away from work, though.’
