‘It’s my back,’ he said, his face contorted with pain. ‘I think I caught it on the side of the lorry as I went over. I thought I felt something crack.’
The thought of the damage that might have been done to his spine made her sick with fear. All those old feelings of dread that she’d experienced back in the UK came flooding back to her, but she knew she had to get a grip on her emotions for her patient’s sake. Small beads of perspiration broke out on her brow.
‘Okay,’ she said, disguising her inner fears with an air of confidence, ‘try not to worry. We’ll soon have you feeling more comfortable.’ She dialled emergency services, calling for an ambulance and warning them of a suspected spinal injury, and then she turned to Alex once more. ‘I just need to check you over to see what the damage is.’ All the colour had drained from his face, but at least he was still conscious and able to talk to her. That was perhaps a good sign, but she’d seen the way he’d fallen, and it didn’t bode well.
‘I can’t believe I … could have messed up like that,’ Alex said in a taut, strained voice. ‘I thought … I thought it was going to be okay …’ He broke off, and small beads of perspiration broke out on his brow.
‘Are you in a lot of pain?’ she asked. ‘On a scale of one to ten?’
‘Twelve,’ he said, squeezing his eyes closed and pushing the word out through his teeth.
‘All right.’ Her head was swimming—the shock of this awful event was beginning to crowd in on her, but she made a huge effort to cast her feelings to one side. ‘I’ll give you something to take that away, just as soon as I’ve done a preliminary examination. Try not to move. It’s very important that you stay still.’
She made a brief but thorough check of his injuries and noted his blood pressure and pulse, before injecting him with a painkiller. ‘I need to put a collar around your neck to immobilise it and make sure there’ll be no further damage.’
Alex didn’t answer her. His strength seemed to be ebbing away, and she realised that he might be slipping into neurogenic shock through a combination of pressure on the spinal cord and possible internal bleeding. A wave of panic swept through her. It was down to her to get him through this. What if she couldn’t do it?
‘Would you like some help?’ Connor came over to her, and she guessed he’d been standing by, waiting to see if he was needed.
‘Yes, that would be great, thanks.’ Alyssa sent him a fleeting glance. His expression was serious, but he was calm, and his long, lean body was poised and ready for action. If only she could experience some of that inner composure. She said quietly, ‘His blood pressure and pulse are both dropping rapidly, so I’m going to try to stabilise him with intravenous fluids.’
It was a very disturbing situation. When she tested his reflexes, Alex wasn’t aware of any sensation in his legs and that was tremendously worrying, because it meant the eventual outcome could be disastrous. It was possible the damage was so great that Alex might never walk again.
She dashed those thoughts from her mind and breathed deeply to try to overcome the chaotic beat of her heart, concentrating on doing what she could for her patient. It was down to her to bring about the best outcome possible for him and the responsibility weighed heavily on her. ‘I want to get a rigid collar around his neck … that’s all important … and we must give him oxygen.’
He nodded. ‘I’ll do that for you.’ He knelt down and supported Alex’s neck while Alyssa carefully fixed the protective collar in place. Then he placed the oxygen mask over their patient’s nose and mouth and started to squeeze the oxygen bag rhythmically. All the time, Alyssa was aware that Alex was slipping into unconsciousness.
She sucked in her breath. ‘His heart rate is way too low. I’m going to give him atropine and have the defibrillator standing by, just in case.’ Simply, if the heart didn’t pump blood around his body effectively, her patient would die, but the atropine should help to increase the heart rate.
She quickly prepared the syringe while Connor continued with the oxygen. ‘Okay,’ she murmured, ‘let’s see if that will bring him round.’ While they waited for the drug to work, Alyssa placed pads on Alex’s chest and connected him to the portable defibrillator.
‘It’s not happening—the heart rate’s not picking up enough,’ Connor observed with a frown a short time later. ‘Maybe it’s time to deliver a shock to the heart.’
She nodded and set the machine to the correct rate and current. ‘Stay clear of him while I do that.’
Connor moved back a little, and both of them waited. For a second or two, nothing happened, and Alyssa’s mouth became painfully dry, the breath catching in her throat. She realised she was praying silently. This had to work.
Then there was a faint bleep, and the display on the defibrillator began to show a normal heart rhythm. She breathed a sigh of relief. The rate was still slow, but at least he was out of the woods for the moment.
The ambulance arrived as she and Connor continued the struggle to regulate Alex’s blood pressure. The paramedics greeted Connor as a friend, as if they’d known him for a long time, and then they listened as Alyssa quickly brought them up to date with what was going on.
‘I’m very worried about any injury to his back,’ she said quietly, ‘so we need to take great care when we move him. We’ll help you to get him onto a spinal board.’
She and Connor knelt with one of the paramedics alongside Alex’s still form, each one ready to lift and gently roll him on his side towards them on Alyssa’s command. ‘Okay, let’s do it … three … two … one … go.’
The second paramedic slid the board underneath Alex, and then they carefully rolled him onto his back once more.
‘That was well done.’ Alyssa stood back as the paramedics strapped him securely in place and lifted him on to a trolley stretcher. Alex was still not speaking and she was dreadfully afraid his condition was deteriorating fast. ‘I’ll go with him to the hospital.’
‘Okay.’ The paramedic nodded and turned to Connor. ‘Will you be coming along, too?’
‘Yes. I’ll follow in my car.’
Alyssa watched as they trundled Alex towards the ambulance, and saw, out of the corner of her eye, that Ross was hovering nearby. Seeing that she had finished working on her patient for the time being, he hurried over to her.
‘Is he going to be all right? I couldn’t believe what I was seeing. It’s my worst nightmare.’ The lively, boyish young man he’d been just a short time ago had disappeared completely. He looked haggard, devastated by what had happened.
‘We’ll know more after they’ve done tests at the hospital.’ She laid a hand on his arm, wanting to comfort him. ‘It wasn’t your fault, Ross. All stunts carry danger, you know that. It was plain bad luck.’
‘Even so, I feel terrible about it.’ His face was ashen. ‘Maybe I shouldn’t have been directing today, but Dan had to be somewhere else, so I had to step in. I know he wanted to be here for this scene. Maybe it was an omen …’
‘Ross, you mustn’t blame yourself. No one could have foreseen what happened.’
His shoulders sagged. ‘I don’t know … I thought I had everything covered …’ He pulled himself together, straightening up. ‘I want to go to the hospital to be with him, but I have to get in touch with his wife, and stay here and talk to the police, and try to explain what went wrong. There will be all sorts of questions, accident reports, insurance forms to be dealt with … I’m going to be sifting through all that over the next few hours, but tell him we’ll take care of his family and see to anything that he needs, will you? Anything he wants, he just has to ask.’
‘I’ll tell him.’
‘Thanks. I’ll come along to see him just as soon as I can.’
‘Of