* * *
Her patient, Leo, had his bloods done and sent off, and also an X-ray that showed osteoarthritic changes and some mild widening in the joint space of his knee. The blood cultures wouldn’t be available for three days, but his Hb levels were normal.
As the knee itself was hot and swollen, she felt it was wise to do a fine needle aspiration to draw off some of the fluid for testing. As she did so she noted that the fluid was quite cloudy, and she marked the tests to check for white blood cell count with differential, gram stain and culture.
She suspected a septic arthritis, and knew the joint would probably have to be drained until dry, as often as was necessary.
‘It shouldn’t affect your holiday as it’s important you keep moving, Leo.’
Mr Rosetti and his wife smiled at each other, and she was about to leave them alone and send the aspirated fluid to Pathology, when Jacob pulled open the curtain and asked if he could have a quick word.
Excusing herself from her patient, she stepped outside of the cubicle with him, feeling her heart race once again. What did he want? Had he found out about Seb?
Her brain quickly tried to formulate an answer about that. ‘Look, I meant to—’
‘There’s been a road accident. We’ve been phoned to let us know that a number of child casualties are coming our way.’
Children? Eva’s heart sank. She could only hope that the children about to come into the department would have simple minor injuries.
They began a hurried walk to Resus. Eva’s mind was focused firmly on the news. ‘Any idea of the number of casualties?’
‘Not at this stage. But it was a school minibus carrying a number of children across town. The police suspect they hit some black ice.’
Her heart thumped hard. She knew Seb’s school had been attending a Christmas church service today.
‘What age range?’
‘We don’t have any more details yet.’
It couldn’t be Seb’s school, Eva thought. Someone would have phoned her already.
‘Has anyone let Paeds know?’
He nodded. ‘I did. They’re sending a team down as soon as they’ve got people to spare.’
‘There’s no one free now?’
What was she doing? She shouldn’t raise her voice at him. It wasn’t his fault, was it?
They burst through into Resus.
‘What’s the ETA?’
A nurse put down the phone. ‘Seven minutes.’
‘Let’s get organised. Check equipment trolleys, monitors, sterile packs, gauze—everything and anything. We’ve an unknown number of paediatric casualties coming in and I want this to run smoothly. Let’s prepare for crush injuries, possible fractures, whiplash and maybe burns. Have we ordered blood?’
Sarah and another doctor, Brandon, arrived in Resus.
‘We’re on it.’
She nodded at both of them. ‘I’ll lead team one—Sarah, you can be team two... Brandon three.’
‘Where do you want me?’ asked Jacob.
Ideally as far away from me as possible.
‘Work with Brandon.’
‘Okay.’
He wrapped a plastic apron around himself and grabbed for gloves before glancing at the clock, walking away to join Brandon.
She watched him go, knowing that at some point she was going to have to tell him the truth.
Just not now.
Six minutes to go.
Eva pulled on her own apron and donned gloves, her heart pounding, her pulse thrumming like a well-oiled racing car.
Five minutes.
All eyes were on the clock.
Watching it tick down.
AMBULANCE SIRENS GREW louder and closer as the staff waited, tense and raring to go. These were the moments that Eva both loved and hated.
Loved because of the way Resus went quiet as they all waited, pensive, with adrenaline urging their muscles to get moving.
Hated because she never quite knew what horrors she might yet encounter.
Still the paediatric team had not arrived.
Outside, there was the sound of rumbling engines and then the distant beeping sound of a reversing vehicle. Hospital doors slid open as the first patient came in.
Eva spotted a small dark-haired child, wearing a neck brace and on a backboard, and heard the paramedic firing off details about the patient.
‘This is Ariana, aged three. Ariana was restrained by a seat belt but endured a side impact of about thirty miles an hour. Head to toe: small abrasion on the forehead, complaining of neck pain, score of eight, bruising across the chest and middle, due to the seat belt, lower back and pelvis pain, which is secured with a splint, GCS of fifteen throughout, BP and pulse normal.’
Ariana? Didn’t her son Seb know a girl in his nursery school called Ariana?
Eva tried not to panic. She had to focus on the little girl in her care. Surely the school would have rung her if anything had happened to Seb? Although her phone was turned off, of course, and in her locker. She’d run and check as soon as she got the chance. Ariana was her priority right now.
‘Ariana? My name’s Eva. I’m one of the doctors here and I’m going to look after you.’
The way you dealt with any patient was important, but when it came to dealing with children—children who didn’t yet have their parents there to advocate for them—Eva felt it was doubly important. You had to let them know it was okay to be scared, but that they would be looked after very well and that the staff would do their utmost to get the child’s parents there as quickly as possible.
Ariana looked terrified. She had a bad graze on her forehead, probably from smashed glass, and her eyes were wide and tearful. Her bottom lip was trembling and it was obvious she was trying not to cry.
Eva’s heart went out to her. How terrifying it must be to be that small, alone and hurt, in a strange place that smelled funny and sounded funny, surrounded by strangers who all wanted to poke you and prod at you and stick you with needles, saying they’d make you feel better.
‘We need to check you’re okay, Ariana. What a pretty name! Now, I’m just going to use this—’ she held up her stethoscope ‘—to listen to your chest. Is that all right?’ Eva always made sure her paediatric patients understood what she was doing.
Ariana tried to nod, but her head’s movement was restricted by the neck immobiliser. ‘Ow! It hurts!’
‘Which bit hurts, honey?’
‘My neck.’
‘Okay, I’ll check that out for you in just a moment.’
Ariana’s chest sounded clear, which was a good sign. However, neck pain was not. It could simply be whiplash, but with neck pain you never took a chance.
‘We’ll need to take a couple of special pictures. But don’t you worry—they won’t hurt. It’s just a big camera.’
She looked up at the team she was working with, awaiting their feedback. One was checking the patient’s airway, another was checking