Page 37 of Stranded with the Surgeon

Jennifer stepped forward. ‘What’s going on?’

‘Midazolam’s wearing off,’ the paramedic told her.

‘History?’

‘Police were called to a department store where he was slicing up women’s clothing with a carving knife.’ The paramedic raised an eyebrow. ‘He was cross enough to be rather uncooperative. Seems that his girlfriend doesn’t find his company too appealing anymore so she left… in the company of his best mate.’

The man on the stretcher spat on the floor near Jennifer’s feet and struggled against the restraining hands. An IV pole crashed to the floor.

‘Bitch!’ he screamed again. ‘It’s your turn next!’

‘Call security,’ Jennifer ordered. She caught the eye of a junior registrar emerging from a cubicle to see what the commotion was. ‘Michelle, could you draw me up some more midazolam, please? Matt, can you give us a hand? Mel, call Psych and tell them we need an urgent consult.’

The ambulance bay doors were sliding open and a young girl could be seen struggling for breath.

‘Resus 3,’ Jennifer called.

She pulled Doug from Resus 2 to help, leaving Matt and a very nervous registrar to deal with the psych patient.

‘We need two secure IV lines,’ she instructed Doug. ‘Continuous nebulised salbutamol and some adrenaline, IV. What’s the oxygen saturation?’

‘Less than 90 per cent,’ the paramedic reported.

‘We’ve got one patent IV. Sixteen gauge.’

‘Good. Let’s get her off the stretcher. Doug, get someone down from Anaesthetics. We may well need to intubate.’

‘On the count of three,’ someone said. ‘One, two…three!’

‘Sit her up,’ Jennifer ordered. ‘It’s okay, sweetheart,’ she told their patient. ‘We’ll get on top of this really soon.’ She had her stethoscope in position, noting with dismay an almost silent chest and increasing panic in the girl. They were on the verge of a respiratory arrest. It was no problem to tune out the scream from behind the curtains.

‘Bitches!You’re all the same! Don’t touch me!Ahh!’

Twenty minutes later, Jennifer’s young asthmatic patient was on the way to the intensive care unit. Colin, the man with the septic shock from his urinary tract infection, had also gone to Intensive Care. The car accident victims were under control, two having gone to Theatre and one having a CT scan. The disturbed psychiatric patient was well sedated and had two burly security officers in attendance pending his transfer to a secure ward. Peter, the young man with the spontaneous pneumothorax, was still stable but the chance to grab a cup of coffee remained elusive.

‘How long has the nosebleed been going on for?’

The epistaxis patient in Cubicle 7, Mrs Bennett, had presented enough of a challenge for a junior registrar to go in search of assistance. ‘Over an hour,’ she told Jennifer. ‘And there’s no response to direct pressure.’

‘Spontaneous bleed?’

‘Started after she sneezed.’

‘Any past history?’

‘Not of nosebleeds. She has hypertension and angina and she’s on a high dose of aspirin daily.’

‘That won’t be helping. Is the bleeding anterior or posterior?’

The registrar looked disconcerted. ‘I’m not sure. Presumably posterior, if direct pressure isn’t enough to control it.’

‘Get a Y suction catheter,’ Jennifer instructed. ‘And find out where the site of bleeding is. When the catheter is passed beyond the bleeding site you’ll get blood appearing at the nostrils again.’

The registrar nodded.

‘Take bloods for haemoglobin, blood group and a coagulation profile. What’s the blood pressure?’

‘One-ten over sixty.’

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