Surgeon On Call. Alison Roberts

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СКАЧАТЬ Joe continued. ‘A foil sheet if you have one. Jeff will be poikilothermic with a spinal injury.’

      Felicity’s raised eyebrow mirrored Stanley’s expression. Perhaps Joe wasn’t treating Stanley as a colleague after all. Did the paramedic know that poikilothermic meant that a body would assume the temperature of the environment? Maybe Joe was deliberately using terms even medical staff might not recognise easily in order to show superiority and demonstrate his command of the situation.

      ‘We need to get him off the ground as quickly as possible,’ Joe continued. ‘Do you carry backboards or scoop stretchers?’

      ‘Both.’ Stanley’s glance at Jeff’s position made him notice Felicity for the first time. His eyes widened dramatically. Felicity’s smile was intended to indicate that this wasn’t the moment for Stanley to be distracted by her presence, and the paramedic took the hint with his customary astuteness. ‘A scoop stretcher will let us pick him up with minimal disruption but they are cold. If we log-roll him onto a backboard it would also give you the chance to check his lower back.’

      ‘What’s going to be quicker?’

      ‘Probably the scoop.’

      ‘We’ll do that, then.’ Joe watched as Stanley and his partner, Ray, introduced themselves to Jeff and explained what they were about to do. They moved the sandbags and eased a cervical collar into place.

      ‘Grab a towel,’ Stanley directed Ray. ‘We want that under his head to maintain neutral alignment. You can get the scoop out as well. I’ll take some vitals while you set it up.’

      Stanley wrapped a blood-pressure cuff around Jeff’s arm. Ray brought the metal scoop stretcher from the back of the ambulance. When Joe moved to take over unfolding and setting out the stretcher, Stanley caught Felicity’s gaze.

      ‘Does he have any idea who you are?’

      ‘No.’ Felicity couldn’t help a quick grin. ‘I haven’t exactly had the opportunity to introduce myself.’

      ‘Hmm.’ Stanley’s noncommittal grunt acknowledged the level of authority Joe had assumed. ‘At least he seems to know what he’s talking about.’

      Felicity nodded. She rubbed her hands together. They were cold and stiff after the long minutes of stabilising Jeff’s head and neck. ‘I think I’ll leave you guys to it,’ she told Stanley. ‘I’m late for a meeting and I’m sure Mr Petersen can give you any medical assistance you need.’

      Stanley was taking some IV supplies from his kit. He had the line in Jeff’s hand within seconds. Joe frowned as he noticed the action that had been taken without his direction. He laid down the half of the scoop stretcher he was carrying.

      ‘Blood pressure’s 85 over 60,’ Stanley told him. ‘I won’t run any IV fluids unless the systolic drops below 80.’

      Joe nodded and Felicity could sense his satisfaction. The low blood pressure with a spinal injury was likely to be due to vasodilation below the level of injury rather than blood loss. As long as the systolic blood pressure remained above renal filtration pressure of 80 mm mercury it was not advisable to give extra IV fluids, which could cause complications from over-hydration.

      Joe was eyeing the drug supplies in Stanley’s kit. ‘Are you able to give a loading dose of methyl prednisolone?’

      ‘No.’ Stanley shook his head. ‘That’s not in our procedures.’

      ‘We do it in some parts of the States.’ Joe frowned again. ‘Have you got a specialist spinal unit we can transfer him to directly?’

      ‘We go through the emergency department at the main hospital. It’s only five minutes away. They’ll stabilise him and then transfer. It takes nearly an hour for a slow transport of an acute case to the spinal unit.’ Stanley’s glance at Felicity suggested that it was time she introduced herself but Felicity was quite happy with the management of their patient.

      ‘I’d better go,’ she announced. ‘Unless I can help in some other way?’

      ‘No, of course not.’ Joe looked vaguely surprised at the offer. ‘We’ve got plenty of extra hands here. Thanks for your help.’

      ‘My pleasure.’ Felicity threw a glance over her shoulder as she walked back towards her car. The blades of the scoop stretcher had been eased, one side at a time, beneath Jeff. The halves had been clicked into place and Jeff was now being strapped into position. The scene had been well managed and any injury Jeff had sustained had been in no way exacerbated. No doubt she would see the young fall victim later on in the emergency department. He would probably still be accompanied by the neurosurgeon, who seemed determined to take complete control of his management.

      Felicity shook her head as she joined the line of traffic again. Maybe she should have asserted herself and let him know that she wasn’t simply a useful pair of extra hands. It had been a little immature to take offence at the suggestion that she didn’t know what she was doing. It wasn’t as if he could have had any idea she was remotely qualified to act as a colleague, but his attitude had rankled. She had worked long and hard to get where she was now. His dismissal of her, based presumably on what she looked like, had got right up her nose. She was regretting the decision to stay anonymous now, however. It would have been more interesting to have had a professional discussion. She’d like to know where in the States they were doing methyl prednisolone protocols in the field and whether it had been going on long enough to have results on any improvement in long-term outcome. The lights changed and Felicity moved off with a sigh. It was too late now. Best she forget about the whole encounter.

      The intention to forget wasn’t easily acted upon. The encounter had left an impression that lasted well past the meeting with the cardiology department. It was still ready to jump into prominence later that morning when Felicity noticed Stanley and Ray handing over another patient to the sorting nurse. She waited until they had transferred their patient to a bed.

      ‘You guys did a good job with that spinal patient this morning.’

      ‘Thanks,’ Stanley responded warmly. ‘It was a surprise to see you there, Fliss.’

      ‘I was just passing. I became rapidly redundant.’ Felicity’s smile gave no hint of her persistent dissatisfaction with the incident. ‘How did the transport go? Did Mr Petersen go with you?’

      ‘No, thank goodness.’ Stanley grinned. ‘He probably would have complained about every bump on the road. He was a bit over the top, wasn’t he?’

      ‘He knew what he was doing. I think he was just determined to manage things as well as possible.’ Felicity was surprised to find herself defending Joe, but it would have been unprofessional to complain about another doctor to Stanley despite their long association and Felicity’s appreciation of the paramedic’s level of skill. ‘Jeff was lucky to have someone that experienced on the scene. I imagine that Mr Petersen is only visiting. It sounded as though he’s come from the States.’

      ‘He’s been in the States but he’s just moved back to New Zealand.’ Stanley fished in his pocket and extracted a slip of paper. ‘He gave me his phone number. He said he’d like to hear some follow-up if I had the chance.’

      ‘Oh.’ Felicity dismissed the errant thought that she could do the follow-up and contact Joe herself. Why on earth would she want to do that?

      ‘He’s looking for a job,’ СКАЧАТЬ