‘Lethargic and poor feeding today. Mum had babe at the GP when she had a prolonged apnoea, resolving with stimulation. GP called the ambulance. Three further episodes en route, requiring vigorous stimulation and oxygen therapy.’
‘Rilla!’
Rilla turned, startled by the hysterical call, shocked to see Beth getting out of the passenger side of the ambulance.
‘Beth?’ Rilla gasped, looking at her sister’s tear- stained, frantic face. ‘What the …?’ She swivelled her head back to the tiny baby on the gurney, looking small and defenceless on the huge trolley. Bridie? Beth reached her and Rilla enfolded her distraught sister in her arms, her heart hammering madly as her sluggish brain connected the dots. This apnoeic, seriously ill baby was her niece?
‘It’s all my fault,’ Beth sobbed. ‘I gave her my cold. Her lungs are too premature to cope with it. Oh, my God, I don’t want her to die.’
Rilla would have given anything at that moment to be in possession of a magic wand. Anything. Instead, she was it. The only senior nurse they had around until Julia got back from the arrest, and she had only a very junior doctor at her disposal.
Her brain raced as she prioritised. ‘Bridie’s going to be fine, just fine,’ Rilla soothed as she hurried inside, dragging Beth with her, keeping up with the gurney. ‘You know she’s in the best hands here,’ she said, ‘the best.’
Rilla prayed to every god she could think of plus the ones she couldn’t, that she was right. She froze out the sickening worry of an aunt and the more basic pull of sisterhood. She had to remove herself emotionally from her tiny niece, struggling to breathe, and her frantic sister.
‘You’re going to have to intubate,’ Rilla told Henry briskly as she hooked Bridie up to the monitors and another apnoea required Rilla to give a vigorous sternal rub before it resolved. This time Bridie’s heart rate slowed and her oxygen saturations dipped. The situation was worsening.
‘We need to secure her airway,’ Rilla said, ignoring the frantic beat of her heart as she handed the laryngoscope, endotracheal tube and other equipment to Henry. One of the junior nurses was drawing up some intubation drugs.
‘Brenda, go put out a code blue page,’ Rilla ordered as Henry prepared to intubate. His hand shook and Rilla had the awful feeling he was going to foul it up.
Intubating a child or baby was always a little fraught, but in an emergency and for the first time? She knew Henry had to be feeling the pressure. Better to get as many medical people as possible down here so someone more experienced could take over. Hell, she’d ring the chief of staff, if she had to. Her father may not have had recent clinical experience but she’d bet her last cent he could intubate Bridie with his eyes closed.
Beth was crying and clutching at Rilla’s uniform, begging them both to do something as alarms shrilled all around them. Damn it! Rilla felt like her heart was being torn in two. She wanted to be over there comforting Beth but Bridie needed her too. At this moment even more than her sister.
‘Did you notify Gabe?’ Rilla asked as she administered the muscle-paralysis drug so Henry could pass the tube through Bridie’s vocal cords.
‘I paged him. He’s in Theatre. He didn’t want to go in today,’ Beth cried. ‘But he was fussing so much and it was only a short list. She wasn’t that bad this morning. I shouldn’t have made him go,’ she wailed.
‘It’s OK, Beth,’ Rilla assured her, her pulse rate skyrocketing as Henry attempted to insert the endotracheal tube. ‘I’ll send someone for him, I promise. Let’s just do this first, OK? It’s going to be fine. Nearly done.’
Only Rilla knew it wasn’t. Knew Henry was having trouble, and as she saw Bridie’s saturations plummet and her heart rate drop, she knew he was going to have to stop, re-oxygenate and try again.
‘Do you want me to give some atropine?’ she prompted Henry, and gave it when he nodded.
‘Oh God,’ Beth cried.
Where was the team? It seemed like an hour but in reality it had only been a minute. Satisfied that Bridie’s heart rate had stabilised and that Henry had control of the airway, Rilla made a decision.
‘I’ll be back in two seconds,’ she announced.
‘Ril, no! Where are you going?’ Beth demanded, her voice raising several octaves.
Rilla turned and looked at her sister. She grabbed her arms and gave them a gentle squeeze. ‘I’m going to call Dad.’
Beth’s face crumpled. ‘OK.’
Rilla paced out of the resus area into the corridor. Taking a couple of deep cleansing breaths, her hands shaking, she headed for the nearest phone. Before she could pick it up, her gaze met Luca’s.
‘Rilla? What’s wrong,’ he demanded, striding towards her. She looked like hell. Pale and shaken and about two seconds away from collapsing.
‘Luca. Thank God,’ Rilla said, putting her hand out to steady herself on his outstretched arm. She knew he wasn’t officially at work yet but she didn’t care. Bridie’s life depended on him. She’d never been more pleased to see him. Not even in the bush ten days ago. ‘I need you. It’s Bridie.’
Luca didn’t ask any questions, just followed her brisk lead. He listened as she prattled off the details and he swore under his breath as his sharp gaze took in the situation in the resus area.
‘Luca,’ Beth sobbed. ‘Oh, Luca.’
Luca gave Beth’s hands a brief squeeze before muscling a relieved Henry aside and with Rilla’s assistance slid the endotracheal tube past the vocal cords and into the trachea in one smooth movement.
‘It’s OK now, Beth,’ Luca soothed, as he held the tube with one hand and bagged with the other while Rilla, hands still shaking, secured the tube with brown tape. ‘She’s going to be OK. We won’t let anything happen to our little bush baby.’
Julia and Karen arrived in the resus bay, along with a PICU consultant, just as Rilla was satisfied the tube was secure. Luca and Henry filled in the details and Rilla was pleased to let them take over so she could comfort her sister. So she could be a worried aunt.
‘Come on out with me,’ Rilla encouraged. ‘Bridie’s in good hands. She’ll be up in ICU before you know it.’
‘No,’ Beth shook her head vigorously, wiping at her eyes with her hands. ‘I can’t leave her.’
Rilla nodded, knowing if it was her baby she wouldn’t be able to either. ‘I’ll ring Dad. We’ll get him to go and talk to Gabe.’
‘Oh God, Gabe.’ Beth dissolved into more tears.
‘Shush,’ Rilla soothed, rubbing Beth’s arm. ‘He’ll be here soon.’
Rilla didn’t even get three paces out of the resus bay before the enormity of the situation overwhelmed her. She groped for a nearby wall and sagged against it. Her breath hurt in her chest and tears stung her eyes as visions of her niece’s still body and pale lips replayed in her head. The what-ifs were crippling.
‘Rilla?’
She looked up to find Luca standing in front of her, his gaze gentle, a frown marring his forehead. She sucked in some much-needed air.
‘Are you OK, cara?’
Rilla nodded her head vigorously as his quiet endearment brought her perilously close to breaking down. She breathed in and out a few more times, grabbing at the sharp pain in her side. ‘I’ll be OK.’ Her voice was shaky and she knew it. ‘I was just … It was just …’
Luca nodded. She didn’t have to explain. ‘I know.’
They