Page 56 of On the Edge

“I’m Jonas.” I crouched so she could see my face before I resumed assessing her condition. “I’m a nurse practitioner, and I’m going to help evaluate you.”

“Thank fuck. Midwife here.” Forehead creasing, she briefly shut her eyes. “Coming back from a birth, not a wild bar bender.”

Eric chuckled at that as he backed out of the room. His job was done, and mine was just beginning. We exchanged nods as he left. He’d gotten her this far, and it was up to me to keep her stable. While she was conscious, she was still a critical case, and I’d already noted a concerning lump on her temple, a possible broken leg, and more.

“Oh? How’d the birth go?” I needed to keep her talking. Her breathing was labored, undoubtedly from pain, but I had one eye on her vitals all the same.

“You planning a report?” Marissa narrowed her blue eyes.

“I was a homebirth myself, as were my siblings.” I didn’t go into detail beyond that, but I’d always respected the midwife profession. “Just curious.”

“Ah. In that case, it was a wonderful birth. Third baby, quick labor. Big sisters watching his arrival. Left the family with both grandmothers making midnight pancakes.” She paused to wince, a deep shudder. She was undoubtedly in a lot of pain. Eric had started an IV, but we were limited in what I could give her until more severe head or spine injuries had been ruled out. “I’m supposed to go back to the family in the morning. Stupid fluffing drivers.”

“Who can we call to cover for you?” I asked as we cut her ripped jeans off. At least the leg wasn’t a compound or open fracture, but I had no doubt the X-rays would show a break.

“My mother.” Marissa’s expression shifted to one of pride. “Already asked someone to call Mom. She’s on her way.”

“You’re a second-generation midwife?” I guessed. All this talking was a decent sign as far as head injuries went, and she was moving her hands and toes with good neurological signs. Her pupils were dilated from pain but otherwise fine.

“Third generation.” Marissa’s tone was proud, even as her speech was labored.

“Did the other two ride motorcycles too?” I asked as one of the nurses and I cut off her motorcycle jacket. Sucked to ruin something I knew was pricey, but I needed to examine her torso.

“Just me…” Marissa trailed off with a pained gasp as we revealed her torso. “Fuck. It hurts to breathe. Why does it hurt to breathe?”

I didn’t like the panic in her tone or how her skin had paled further. “Where is the pain?”

“Mountain. No.” Frowning, she licked her lip and then tried again. “Left. Left side.”

Confusion. That was a bad, bad sign, as was the pain being localized to her left side. I touched her rib cage, and she groaned.Spleen.I’d seen it enough times, and it was never good. Had to hope it was bruised, not rupturing, but I moved with more purpose, as did the rest of the room.

“Blood pressure’s dropping.” The nurse who had helped me cut Marissa’s clothes off pointed to the monitor.

Fuck.A rupture was a definite possibility, or other internal bleeding.

“Stay with us, Marissa,” I urged as she shut her eyes. “Tell me about the baby?”

“There’s a baby?” She frowned, voice going high and thready. “Where?”

More confusion. Her blood pressure continued to dip as her heart rate increased. Yeah, we had a bleeder somewhere.

“She’s crashing,” I called out. “Where’s Munson? We need an OR stat.”

“Working on it,” a nurse called back. “Munson’s evaluating the other patient, and we’re waiting on anesthesia.”

“We need an E-FAST.” There was no time for an ultrasound or CT scan to check for rupture, but the rapid portable sonograph to look for free fluid was standard in cases where we suspected internal bleeding. “Prepare for transfusion as well.”

Transfusion would only get us so far, but it might buy us enough time until a surgeon could get in here.

“Blood pressure still dropping.”

“Heart rate unstable.”

The room descended into a controlled storm of activity as we worked to stabilize Marissa as a team.

“Come on, Marissa.” My voice was more strident now. “Stay with us.”

Time was running out, and lord, where was that surgeon? My own heart rate was sky-high and sweat ran down my back.

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