Page 25 of Prognosis Christmas Baby

Maggie accessed the arterial line for the blood while Linda hooked up the extra fluid.

‘Her abdo’s quite distended,’ Nash mused, palpating the tense dome. They’d been treating Ruby for an illeus since admission due to her lack of bowel sounds and bruising from the seat belt. Abdominal ultrasounds had shown no acute trauma but they’d kept her nil by mouth while her gut recovered from the impact.

‘Yes,’ Linda agreed, ‘I reckon it’s blown up just in the last hour.’

Maggie added the blood to the culture bottles, a heavy foreboding settling in her bones. She reached up to the monitor to adjust the alarm settings as Ruby’s heart rate climbed to one hundred and eighty. The little girl started to gag and cough and then vomited. Bilious liquid spilled from her mouth and nose, streaming down her face and over the sheets.

Maggie quickly whipped out the yankeur sucker and, turning Ruby’s head to the side to try to prevent aspiration, she suctioned the girl’s airway while Linda aspirated the nasogastric tube. Alarms trilled all around them as Ruby’s heart rate again breached the set limits.

‘I’ll call the surgical reg for a consult,’ Nash said, walking briskly to the nearest phone.

Maggie wiped Ruby’s face with a towel and used a couple more to sop up the excess stomach contents around her. Dr Hannah Oakland arrived fifteen minutes later as the second ten per kilo bolus was almost finished. Nash could see it was having no impact on the flagging blood pressure. ‘Let’s start some inotropes,’ he ordered.

Maggie and Kylie, Ruby’s nurse who had returned from her tea break, drew up some dopamine while Hannah and Nash consulted.

‘You want an ultrasound?’ Nash asked her

Hannah shook her head. ‘I think we need to go in and have a look. I’ll organise it. Where are her parents?’

‘Mother’s asleep in the parents’ lounge,’ Kylie volunteered.

Maggie, Nash, Linda and Kylie worked to stabilise Ruby for Theatre while Hannah talked to her tearful mother and gained consent for exploratory abdominal surgery. Maggie averted her eyes as Ruby’s mother stroked her daughter’s hair, tears trekking down her face.

‘It’s okay, Rube,’ she whispered, ‘you’re going to be okay.’

Even after fifteen years Maggie found it impossible not to become involved and she hoped desperately that Ruby’s mother was right and her gut feeling was wrong.

The sky was lightening when they finally wheeled Ruby into the operating theatre at the end of the corridor. Maggie and Linda, who hadn’t had a break yet, left Kylie to clean up the bed area confident that Ruby wouldn’t be back until the end of their shift, maybe even after that.

Nash joined them in the tearoom and they all sat round staring into their coffees still a little dazed by rapid-fire events of the night. Sure, these nights happened every now and then but they were both physically and emotionally draining.

Linda drained her mug and stood. ‘I’ll go check on Kylie,’ she said.

‘You haven’t finished your break yet,’ Maggie protested.

Linda shrugged. ‘I’m too wired to sit still.’

Maggie nodded. That happened sometimes. Adrenaline was vital to cope with the emergencies they’d had to face tonight but it did have its jittery side effects.

Linda departed and Nash was grateful to be left alone with Maggie. ‘Are you okay?’ he asked. She looked weary. Good, but tired around the eyes and tense around the shoulders.

‘Sure,’ she answered automatically, staring into the milky depths of her coffee. ‘What about you?’ she asked, remembering that Nash’s sister had been about Ruby’s age when she’d died.

‘I’m okay.’ He nodded. ‘It’s been a hell of a night.’

Maggie nodded, swirling the muddy liquid in the mug. That it had.

‘I thought we’d pulled our last all-nighter,’ he murmured.

Maggie flicked her gaze up from the drink. A small smile lifted the corners of his beautiful mouth and he looked sexy and inviting and she wanted to crawl onto his lap and snuggle her head into his neck.

She returned his smile, her heart light for the first time this shift. Opening her mouth for a sexy rejoinder, it was abruptly cut off by a rattling noise up the corridor and the trilling of an alarm had her frowning instead. ‘That can’t be Ruby already?’ She looked at her watch. ‘It hasn’t even been half an hour.’

But it was. Which could only mean two things. The problem had been trivial and easily remedied. Or the problem was so big it just couldn’t be fixed. Unfortunately for Ruby, it was the latter. She’d thrown a clot into her mesenteric vasculature, infarcting her entire bowel. Toxins were flooding her system.

She was dying and there was nothing anyone could do.

To say they were all shocked was an understatement. The nine-year-old had survived a horrific car smash but had been expected to make a full recovery from her head injury.

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