Her Christmas Eve Diamond - Page 13

Cassidy spent the next hour doing neurological observations on the two patients every fifteen minutes. Both of them started to respond a little better, even if it was belligerently. It was four o’clock in the morning now—that horrible time of night for the night shift where the need to sleep seemed to smack them straight in the head. Her eyes were beginning to droop even as she walked the length of the corridor to check on her patients. Sitting down right now would be lethal—she had to keep on the move to stay awake.

A monitor started pinging in one of the nearby rooms. ‘I’ll get it,’ she shouted to Claire. ‘The leads have probably detached again.’

She walked into the room of Mr Fletcher, a man in his sixties admitted with angina. Every time he’d turned over in his sleep tonight, one of the leads attached to his chest had moved out of place.

Cassidy flicked on the light, ready to silence the alarms on the monitor. But Mr Fletcher’s leads were intact. His skin was white and drawn, his lips blue and his body rigid on the bed. The monitor showed a rapid, flickering electrical line. Ventricular fibrillation. His heart wasn’t beating properly at all. Even though the monitor told her what she needed to know, she took a few seconds to check for a pulse and listen for breathing.

‘Claire!’ She pulled the red alarm on the wall, setting off the cardiac-arrest procedure as she released the brake on the bottom of the bed and pulled the bed out from the wall. She removed the headrest from the top of the bed and pulled out the pillows. Claire appeared at her side, pulling the cardiac-arrest trolley behind her. ‘I’ve put out the call.’ She was breathing heavily.

Cassidy took a deep breath. Brad was the senior doctor carrying the arrest page tonight. If he was still down in A and E, it would take him at least five minutes to get up here. Glasgow City Hospital was an old, sprawling building, with bits added on over time. It hadn’t been designed with emergencies in mind, like some of the modern, newly built hospitals were. The anaesthetist would probably take five minutes to get here, too.

It didn’t matter what the monitor said. Cassidy took a few seconds to do the old-fashioned assessment of the patient. Airway. Breathing. Circulation. No pulse. No breathing.

‘Start bagging,’ she instructed Claire, pointing her to the head of the bed and handing her an airway as she connected up the oxygen supply to the ambu-bag. She turned the dial on the defibrillator, slapping the pads on Mr Fletcher’s chest and giving it a few seconds to pick up and confirm his rhythm.

‘Stand clear,’ she shouted to Claire, waiting a few seconds to check she’d stood back then looking downwards to make sure she wasn’t touching the collapsed metal side rails. She pressed the button and Mr Fletcher’s back arched upwards as the jolt went through his body.

Her adrenaline had kicked in now. She didn’t feel sleepy or tired any more. She was wide awake and on alert, watching the monitor closely for a few seconds to see if the shock had made any impact on his heart rhythm. Nothing. Still VF.

The sound of feet thudded down the corridor as Brad appeared, closely followed by one of the anaesthetists. Brad’s eyes widened as he realised who the patient was. ‘VF,’ she said as they entered the room. ‘I’ve shocked him once at one hundred and twenty joules.’ Even though she had only been back on the ward for a month, she was on autopilot.

‘What happened?’ asked Brad. ‘He was pain free earlier and we had him scheduled for an angiogram tomorrow.’

‘Alarm sounded and I found him like this,’ she said. ‘He hadn’t complained of chest pain at all.’ She raised her knee on the bed and positioned her hands, starting the chest compressions. The anaesthetist took over from Claire and within a few seconds inserted an endotracheal tube. Cassidy continued the cycles of compressions as Brad pulled the pre-loaded syringes from the crash cart. After five cycles she stopped and their heads turned to the monitor again to check the rhythm.

‘I’m giving him some epinephrine,’ Brad said as he squirted it into the cannula in the back of Mr Fletcher’s hand. ‘Let’s shock him again.’ He lifted the defibrillator paddles. ‘Stand clear, everyone. Shocking at two hundred joules.’

Everyone stood back as Mr Fletcher’s body arched again. Cassidy went to resume the compressions. They continued for the next ten minutes with cycles of compressions, drugs and shocking. Cassidy’s arms were starting to ache. It was amazing how quickly the strain of doing cardiac massage told on shoulders and arms.

‘Stop!’ shouted Brad. ‘We’ve got a rhythm.’ He waited a few seconds as he watched the green line on the monitor. ‘Sinus bradycardia.’

He raised his eyes from the bed. ‘Cassidy, go and tell Coronary Care we’re transferring a patient to them.’

She ran next door to the coronary care unit, and one of their staff members came back through with her, propping the doors open for easy transfer. They wheeled the bed through to the unit and hooked Mr Fletcher up to the monitors in the specially designed rooms. In a matter of a few moments, he was safely installed next door.

Cassidy nodded at Brad as she left him there to continue Mr Fletcher’s care. Claire gathered up his belongings and took them next door while Cassidy quickly transferred him on the computer system.

She took a deep breath and heaved a sigh of relief. The adrenaline was still flooding through her system, her arms ached and her back was sore.

Claire appeared with a cup of steaming tea, which she put on the desk in front of her. ‘Okay, Cassidy? I nearly jumped out of my skin when that alarm sounded. He’d been fine all night.’

Cassidy nodded. ‘I hate it when that happens. Thank goodness he was attached to a cardiac monitor. I dread to think what would have happened if he hadn’t been.’

A loud groan sounded from the room opposite the nurses’ station. Cassidy stood back up. ‘No rest for the wicked. That will be one of our head-injury patients.’

Sure enough, one of the young men was starting to come round. Cassidy started checking his obs again, pulling her pen torch from her pocket to make sure his pupils were equal and reactive. His score had gradually started to improve as he could obey simple instructions and respond—albeit grudgingly. Hangovers didn’t seem to agree with him.

She moved on to the patient next door, who still appeared to be sleeping it off. As she leaned over to check his pupils, his hand reached up and grabbed her tunic. ‘Get me some water,’ he growled, his breath reeking of alcohol and his eyes bloodshot.

Cassidy reacted instantly, pushing him backwards with her hands to get out of his grasp. ‘Don’t you dare put a hand on me,’ she snarled.

‘Cass.’ The voice was instant, sounding behind her as Brad sidestepped around her, filling the gap between her and the patient.

The sunny surfer boy with cheerful demeanour was lost. ‘Don’t you dare touch my staff.’ He was furious, leaning over the patient.

The drunken young man slumped back against the pillows, all energy expended. ‘I need some water,’ he mumbled.

Brad grabbed hold of Cassidy’s hand and pulled her beyond the curtains. He ran his fingers through his hair. ‘He still requires neuro obs, doesn’t he?’

Cassidy nodded. ‘That’s the first time he’s woken up. His neuro obs are scheduled to continue for the next few hours.’

Brad marched over to the phone and spoke for a few moments before putting it back down. ‘I don’t want you or Claire going in there on your own. Not while there’s a chance he’s still under the influence o

f alcohol and might behave inappropriately. Somebody from Security will be up in a few minutes and will stay for the rest of the shift.’

He walked into the kitchen and picked up a plastic jug and cup, running the tap to fill them with water. ‘I’ll take him these. You sit down.’

Cassidy didn’t like anyone telling her what to do, especially in her ward. But for some reason she was quite glad that Brad had been around. It wasn’t the first time a patient had manhandled her—and she was quite sure it wouldn’t be the last. But there was something about it happening in the dead of night, when there weren’t many other people around, that unsettled her.

And as much as she wanted to fly the flag for independence and being able to handle everything on her own, she was quite glad one of the security staff was coming up to the ward.

Brad appeared a moment later, walking behind her and putting his hands on her taut neck and shoulders. He automatically started kneading them with his warm hands. ‘You okay, Cass?’

For a second she was still tense, wondering what Claire might think if she saw him touching her, but then relaxing at his touch. Her insides felt as tight as a coiled spring. What with the cardiac massage and the reaction of her patient, this was exactly what she needed. She leaned backwards a little into his touch.

‘Right there,’ she murmured as he hit a nerve. ‘How’s Mr Fletcher doing?’

Brad’s voice was calm and soothing. ‘He’s in the right place. The staff in Coronary Care can monitor him more easily, his bradycardia stabilised with a little atropine and his blood pressure is good. We’ve contacted his family, and he’ll be first on the list in the morning. He’ll probably need a stent put in place to clear his blocked artery.’

‘That’s good. Mmm...keep going.’

‘Your muscles are like coiled springs. Is this because of what just happened?’

She could hear the agitation in his voice.

‘I hate people who react like that. How dare they when all we’re trying to do is help them? He could have died out there, lying on the street with a head injury, getting battered by the elements. It makes my blood boil. If I hadn’t come in when I did...’ His voice tailed off then he leaned forward and wrapped his arms around her neck—just for a second—brushing a light kiss on her cheek.

Tags: Scarlet Wilson Romance
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