‘How long ago did the pain start?’
‘I dunno. Maybe an hour. Or maybe a bit longer. The fight started because Brendan didn’t like what I was making for lunch and he...he...’
Ari lowered his voice, even though the kitchen door had been slammed behind Brendan. He knew that Kelly was coming back to this side of the room and would be able to hear him.
‘Did he hit you, Vicky? Is that how the pain started?’
‘N-no...he just...shook me a bit, that’s all.’
Again, his gaze met that of the paramedic for a heartbeat. He could see that Kelly, as a frontline member of the emergency services, had seen it all before. He could also see a fierce determination to help a vulnerable mother-to-be. He recognised that determination easily because it was something Ari had lived with himself for almost as long as he could remember. A need to protect and care for those more vulnerable than himself. Especially babies. Including babies that hadn’t been born yet and had no idea how tough life could be.
Kelly had her fingers on Vicky’s wrist but Ari knew she wouldn’t be able to locate a radial pulse because that had been the first thing he’d tried to assess. The tiny frown that appeared between her eyes was confirmation that she’d taken on board the warning that they needed to move fast. An absent radial pulse was an indication that the blood pressure was far too low.
‘Vicky?’ Kelly’s tone was reassuring. ‘I’m going to put a mask on you so that we can give you some oxygen. And I’m going to put an IV line into your arm, love. You’ve lost a bit of blood and we need to give you some fluids to get your blood pressure back up again. Then we’re going to get you into hospital. Is that okay with you?’
Vicky nodded wearily, lying back as she closed her eyes, her response no more than a mumbled assent. Kelly must have noticed that Ari was watching her rather intently because she flicked him a sideways glance. One that acknowledged what they both suspected—that Vicky’s placenta could be separating from the uterine wall and the amount of blood she was losing could put her into haemorrhagic shock that could be life threatening—both for this young mother and her baby.
There was a question in Kelly’s eyes. ‘You okay with staying here?’ she asked quietly as she opened her backpack and took out an equipment roll. ‘Want me to call for police back-up? There’s an ambulance on its way but we could try and get Vicky next door in the meantime.’
Ari kept his voice just as low—no more than a murmur that Vicky probably couldn’t catch. ‘I’d prefer to get her stable before we move her. Her GCS is dropping already. I reckon we can handle this between us...’ He tilted his head towards the kitchen door. ‘In fact, I think you could handle it all by yourself.’
A brief curl of one side of Kelly’s mouth acknowledged the compliment but her nod was an agreement with his preference to stay put and get some fluid resuscitation started. Movement could make the loss of blood more rapid and Vicky’s condition could deteriorate rapidly, tipping her into a possibly irreversible state of shock. Kelly had the tourniquet and the foil packet containing an alcohol wipe in her hands, ready to start establishing an intravenous line.
Ari reached for a cannula, peeling back the plastic cover before holding it out for Kelly to take as soon as she cleaned the skin over the vein she’d chosen in Vicky’s forearm. In that moment, they became even more of a team than they had when they’d agreed to stay here and try to stabilise their patient’s condition.
‘Vicky? Sharp scratch, love, but it’s only for a second.’ She slid the needle in, slid the cannula into place and released the catch on the tourniquet so swiftly and smoothly it looked like a single action.
Impressive.
‘There’s a bag of zero point nine percent saline in the kit. Top pocket.’
Ari pulled it out. Then he read out the expiry date for her.
‘Thanks...’ Kelly paused, a finger pressed onto the vein above the small, plastic tube in Vicky’s vein as she reached for the Luer plug he’d left beside her knee. ‘Sorry... I didn’t catch your name.’
‘We didn’t exactly get the chance for introductions.’ Ari was unwinding the giving set to poke the spike into the bag and then run enough fluid through the tubing to remove any air bubbles. ‘I’m Ari. Ari Lawson. I’m a midwife attached to Kensington Hospital.’ He held the end of the tubing out to Kelly who took it to attach to the Luer plug. With the IV line securely taped, she worked just as swiftly and smoothly to attach ECG electrodes to Vicky’s chest and flick the defibrillator into monitoring mode. Almost immediately, an alarm started sounding.
‘She’s tachycardic,’ Kelly noted. ‘And look...’ She pointed at the screen, where the bizarre shapes of ectopic beats were interrupting a trace that was rapid enough to have tripped the alarm. She silenced the alarm but it seemed like it had triggered a new wave of tension. Chaos, even?
The kitchen door was flung open behind them.
Ari could feel the surge of adrenaline that made every muscle in his body tense as he started to get to his feet. He could sense the same reaction from Kelly as she gathered her inner resources to face whatever new threat might be coming. After what he’d seen earlier, Ari had every confidence that she could deal with it but, this time, he was going to be the one in front. Protecting her.
Or maybe he didn’t need to. He could hear a commotion coming from the hallway of this small house. Loud shouting that told him that the police had apparently responded to the neighbour’s call—perhaps because they knew an ambulance officer had been dispatched and might be in need of back-up?
He could also tell that the arriving officers were both male because it felt like the wave of testosterone arrived in this room before they burst in, and although their equipment like telescopic batons, pepper spray and handcuffs were still attached to their belts or stab-proof vests, it felt like they were demanding attention and advertising their ability to enforce authority. Ari found himself turning his glance towards Kelly again. She’d had the authority to command respect without any kind of weapon, hadn’t she?
Except...
She looked different now that these male officers had arrived. Okay, her head was probably dipped because she leaning in to try and calm Vicky, who was trying to sit up and pull her oxygen mask off at the same time, but, for a split second, it almost seemed to Ari that Kelly was ducking her head for another reason. Trying not to be seen, even?
r /> ‘Brendan...’ Vicky was still trying to push past Kelly’s hands. ‘Don’t do anything stupid...’
Ari moved to help Kelly keep Vicky still. The last thing they wanted was an increase in the rate at which she was losing blood.
‘It’s really important that you keep still, sweetheart,’ he said. ‘We’ve got this, okay?’
Even if Brendan hadn’t been drunk enough to make it difficult to stand up straight, he would have been incapacitated within seconds by the two police officers.
Ari wondered if one of them, in particular, was enjoying the opportunity to use physical force to restrain someone a little too much as he flourished his baton and raised his voice. He was a big man with buzz-cut blond hair that accentuated uncompromising features, including a very square jaw. Kelly was watching as well as the officer twisted Brendan’s arm behind him with enough force to make him cry out in pain.
Kelly’s expression made Ari suspect that she shared his opinion that too much force was being used here. It certainly looked like her desire to protect an underdog was automatically overriding any desire to remain in the background. She jumped to her feet, although her words were almost tentative.
‘H-he hasn’t hurt anybody,’ she told the police officers. ‘He’s drunk, that’s all. Noisy. He was just...making some verbal threats.’
She was being ignored as the officer issued a rapid, almost bored-sounding caution.
‘You do not have to say anything. But it may harm your defence if you do not mention when questioned something which you later rely on in court...’
What Kelly had said wasn’t exactly true, Ari thought as he reached for Vicky’s wrist to feel for her pulse again. Throwing a full beer can as a weapon was definitely assault. But ambulance staff often got to know local police officers pretty well when they were working in the same area of a city. Was she minimising what had happened here as a form of protection because she knew what this officer might be capable of in the heat of the moment?