Page 24 of Prognosis Christmas Baby

Maggie nodded admiring his way with the devastated woman reminding herself of their one-night-only deal. ‘No problems.’

Gwen and Nash accompanied their patient to CT twenty minutes later and Maggie watched them go with a heavy heart. She shook her head and wondered how many blond-haired, blue-eyed immersions she’d looked after.

She’d lost count over the years.

Glancing through the glass window separating the two side rooms she took in the red-headed burns boy next door. Why were they always red-headed? She wondered if anyone had done a study on hair colour and its correlation to specific types of accidents?

Maggie laughed out loud, the sound echoing in the empty room strewn with discarded packaging, used linen and multiple bits of medical plastic that had wound up on the floor. It seemed like such a trivial thought but anything that kept her mind off the horrifying prospect that Billy might be severely brain damaged was more than welcome.

He and his mother had managed to touch her heart.

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Checking the wall clock, Maggie couldn’t believe it was nudging midnight and she’d only just managed to get around to all the patients. Thankfully Linda and another experienced nurse were helping to run the shift tonight so Maggie knew everything was being taken care of including the staff breaks.

There were two patients of concern.

Toby, who had been extubated yesterday after a few weeks of ventilation, appeared to be struggling again. And Ruby Wallace, a nine-year-old with a closed head injury thirty-six hours post-MVA, had a grumbling temp.

Billy had returned from CT. He’d warmed up, his heart rate had improved and he was reasonably stable. The CT showed global swelling but no specific areas of concern. Hopefully he was going to be one of the lucky ones.

No sooner had they got Billy settled back in when Linda entered the side room. ‘Nash, Ray needs you. Toby’s just not coping.’

Linda stayed to help Gwen get Billy sorted and Maggie went with Nash. The situation at bed three didn’t look good at all and one look at Toby had Maggie pulling the Resus trolley closer.

Toby, who usually beamed at anyone who came close to the bed, even with an endotracheal tube sticking out his nose, was looking exhausted, using all his accessory muscles in his chest again to help him breathe. He certainly had no energy left to smile. His oxygen sats were eighty-five on a hundred per cent rebreather mask and his arterial blood gas was abysmal.

‘Shall we trial him on mask c-pap?’ Maggie queried.

Nash nodded. ‘I think so.’ He popped his stethoscope in his ears and listened, not liking the decreased air sounds over his right chest. ‘Let’s get an X-ray too.’

Toby’s father, Brett, was staying overnight and seemed very relieved when Nash explained to him that Toby would need to go back on non-invasive ventilation. Maggie could tell that watching his son struggle to breathe was increasingly distressing for the father too.

Toby wasn’t having any of it, though, fighting the claustrophobic confines of the mask. The harder he fought, the more he taxed his respiratory system. He was also in a lather of sweat, which made maintaining a good seal on the mask very difficult.

The X-ray showed a marked deterioration from the morning’s picture but no pnemothorax, as Nash had suspected. It took several doses of sedation to finally settle the boy with another blood gas finally showing an improvement in his gaseous exchange.

With the imminent crisis averted at bed three Maggie was able to grab her first cup of coffee. Considering it was almost three a.m. she was hanging for one. She made one for Nash too and brought it out to the central nurses’ station, plonking it down beside him where he sat at the doctor’s computer, making an electronic entry into Toby’s chart.

Nash glanced up. He hadn’t had a chance tonight to think about their tryst but the smoulder in her fudge-brownie gaze put him straight back in her bed. ‘Thanks,’ he murmured.

Maggie’s breath stuttered to a halt at the heat in his loaded gaze. Watching him in action tonight should have helped to put him firmly in the colleague category, but his calm capability, his decisive authority, his dedication to his job made him even more desirable.

She nodded and turned away. The night had been crazy and there was much to catch up on. She didn’t have time to moon over his blond good looks. She sat at the computer console furthest away from him, planning to review all the patients’ charts. She’d just clicked on the first one when Linda called her over to bed eight, where she was doing a meal relief.

‘I don’t like the look of her, Maggie.’

One look at Ruby Wallace and Maggie could understand Linda’s concern. She was tachycardic, hypotensive and febrile.

The little girl had been in a high-speed car accident two days ago. She’d been restrained but her head had still smashed sideways into the window, resulting in a large subdural haemorrhage. She’d had emergency neurosurgery to evacuate the blood but was still in a coma requiring ventilatory support.

‘She’s been grumbling along most of the day with this fever but just in the last twenty minutes she’s spiked her temp and her heart rate. Her oxygen requirement has increased. Her lactate on her blood gas is rising and her blood pressure’s bottoming out. I think she may be septic.’

Maggie nodded. ‘Nash?’ she called as she grabbed the Resus trolley again.

Nash wasn’t sure if it was because he was so attuned to her or whether it was the note of concern in Maggie’s voice but he stood immediately, joining her and Linda at bed eight. He listened to their concerns, more than a little alarmed at the deterioration in Ruby’s condition and the rising lactate.

‘Yes. I think she may be septic too. Let’s get some blood cultures and give her a ten per kilo bolus of colloid for her blood pressure to start with.’

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