Emergency Response (24 page)

A week before Christmas two paramedics walked through the ambulance bay doors wheeling a man between them on their narrow stretcher. Mackenzie stared at the paramedic pushing the patient.

“That’s Liam!”

What was he doing in Birrangulla? Didn’t he work in Sydney?

Lily stared at her. “You
know
him?”

Mackenzie nodded.

Lily leaned over and whispered in Mackenzie’s ear. “You
have
to introduce me. He’s new and he’s hot.”

“He’s also Kate O’Connor’s brother-in-law,” Mackenzie whispered back. “Joel’s identical twin brother.”

Lily’s eyes widened and she clasped her hands to her chest. “Oh please, please,
please
tell me he has a cute Irish accent!”

“He does!” Mackenzie said with a chuckle. “Now put that out of your mind and let’s get on with our job.”

“Hey Liam,” she greeted him when he got closer.

“Mackenzie! Hi. Good to see you.” He smiled warmly. “When did you start here?”

“Just over a week ago.”

“Seriously? I didn’t know you’d moved to Birrangulla. When did you get back from the Pilbara?”

“About a month ago. My dad passed away actually.”

His face fell. “I’m sorry to hear that. Was it unexpected?”

“Yeah, he had a stroke and was doing okay and then had another stroke.” She tucked her hair behind her ear. “Anyway, who have you got for me here?”

Liam’s face changed and suddenly he was all business. “This is a forty-year-old man who has come off his bike today while out riding with a group of friends. He’ll tell you he’s a MAMIL.”

Mackenzie lifted the blanket slightly and hid a smirk. Yep, her next patient was definitely a Middle Aged Man In Lycra. The clothing did very little to hide the fact the man was very fit. His skintight top was unzipped to his waist, exposing a smooth, hairless chest.

“Head strike and possible loss of consciousness and he’s now suffering some mild amnesia. No other obvious injuries we can see,” Liam added.

“GCS?” Mackenzie asked. The GCS or Glasgow Coma Scale was an objective neurological scale used to record a person’s conscious state after a head injury.

“Hard to say for certain. He’s orientated to place, but not to time or person. He thinks it’s still twenty-ten and Julia Gillard is Prime Minister.”

“He’s collared now, but was he mobile at the scene?” Mackenzie asked.

“Yeah, he ambulated to the truck with us. Helmet’s damaged though so we collared him due to mechanism of injury.” The other paramedic handed Mackenzie the bike helmet. She inspected the front section, which had been snapped in half.

“And you said he’s got amnesia?”

“Yeah, he keeps asking what happened.”

At that moment, the man attempted to lift his head up from the stretcher to look at them. Everyone standing around him growled.

“Keep your head down, mate.”

“Don’t move.”

“Stay still.”

Mackenzie leaned over and smiled. “G’day, I’m Mackenzie. I’ll be your nurse this afternoon.”

“What happened?”

“You came off your bike. Do you remember?” He attempted to shake his head until she put a restraining hand on his shoulder. “You have to lie still, mate. We’ll get you moved across to the other bed now.”

While another nurse held his head, they transferred him from the ambulance stretcher to the narrow bed, rolling him so Mackenzie could cut off his clothing and inspect his back for any obvious injuries or deformities. She was happy to find nothing other than a few scrapes and grazes. It seemed his head had borne the impact of the fall.

When everyone had dispersed, Mackenzie began her full assessment.

“Can you tell me your name?”

“Yeah, it’s Alex. Alexander Thompson. With a P.”

“And can you tell me where you are?”

Alex stared at the ceiling for a few seconds, moving his eyes from side to side. He’d gotten the message he was supposed to lie still and keep his neck straight. “I guess I’m at the hospital.”

“Do you know which hospital?”

He screwed up his face, concentrating hard. “Um, Orange? Bathurst? Dubbo?”

“Close. You’re in the right state at least. You’re at the Birrangulla Base.”

“It hurts a bit here,” Alex said, indicating the lower left side of his abdomen.

“How bad is it?” she asked.

“Not too bad.”

“What about your head? Your neck? Does it hurt anywhere?”

“No,” Alex replied. “Although this thing around my neck is digging in.” His hands reached up in an attempt to remove the collar.

Once more, she placed her hand on his shoulder. “We have to leave it on until we clear your neck and spine.”

“Oh, okay, no worries.” His hands flopped back to his side. “So, what happened?”

Mackenzie took a deep breath. It was the fourth time he’d asked in less than ten minutes. She gave him the same answers while she continued her assessment.

“And who are you?”

“I’m Mackenzie, your nurse.”

“You’re very pretty. Are you single?”

Liam walked back into the cubicle and handed Mackenzie some paperwork, overhearing Alex’s question.

“Oi, watch out, mate, she’s already taken. Trust me, you do not want Nathan Kennedy to find out you’re muscling in on his girl. And whatever you do, don’t try to kiss her!”

Mackenzie glanced at Liam, glad to see a teasing look in his eyes. She laughed. “Yeah, sorry Alex, I’m not available.”

“My loss.” He pointed to his stomach again. “It hurts here.”

“I know,” Mackenzie said. “We’ll get you into x-ray soon and make sure nothing’s broken. Do you want some pain relief?”

“No. I’m okay.”

Stepping out of the cubicle, Mackenzie turned to Liam who was finalizing his paperwork. “It’s good to see you, Liam.”

“Yeah, you too, Mackenzie. If I don’t see you before Christmas, I’ll see you then. Joel said you’ll be there for lunch with the family.”

Mackenzie nodded.

“Oh, and, um, by the way, I never apologized to you for being such an idiot at Joel and Kate’s wedding. I shouldn’t have hit on you like that. I’m really sorry.”

Mackenzie touched him lightly on the arm. “It’s fine, Liam. Forgiven and forgotten a long time ago.”

“Yeah, well I don’t want you to think I’m always an idiot. You never know, one day I might want to be introduced to one of your friends, and I’d hate you to have to tell her what a jerk I was.”

Mackenzie followed his gaze and saw he was watching Lily in the next cubicle. “I promise she’ll never know.”

“Thanks. And good luck to you and Nathan. You deserve a lifetime of happiness. He’s lucky to have found someone like you.”

“Thank you, Liam, I appreciate that.”

They said good-bye with a brief hug and Mackenzie went back to Alex. She was actually very concerned about his memory loss. As comical as it was hearing him ask the same question over and over and over, it was troubling her.

A man’s face appeared around the curtain. “Is this Alex Thompson?”

“Yes,” Mackenzie said. “And you are?”

“His friend. Scott. We were out riding together. I went home to get changed first.”

“Oh fantastic. Perfect timing. You might be able to fill me in on some of the story.”

“I was following behind him – about fifty meters away. His front tire blew as he was going around a corner and he went straight over the handlebars.”

“Did he lose consciousness?”

“I don’t think so. He was sitting up talking to me when I pulled up seconds later. Made a mess of his bike and his helmet though.”

“Come in and see if he knows who you are,” Mackenzie said. “He’s got mild amnesia.” She tried to keep her tone light but she saw the way Scott frowned in concern. “He should be okay, but every couple of minutes he keeps asking what happened. He also forgets who I am. If he asks, just tell him I’m the nurse he keeps asking to marry.”

Scott’s eyes widened.

“I’m joking,” Mackenzie said with a laugh.

“G’day mate,” Scott said, leaning over Alex. “You don’t muck around do you? And nothing wrong with your eyesight either, you’ve picked the cutest nurse here.”

Mackenzie blushed. “Alex, do you know who this is?”

“Yeah, that’s Scott. What happened?” he repeated.

Scott glanced at Mackenzie. “When do you think he’ll get his memory back?”

She shrugged. “It’s hard to tell. He’ll be going for an x-ray soon and then we should know more.”

While she drew blood and inserted a cannula into Alex’s arm, she listened to the continued cyclic conversation between the two men. Mackenzie looked around. Where was the doctor? She rechecked Alex’s blood pressure. It had slightly decreased but she wasn’t alarmed. He was hypertensive when he came in, which was a combination of shock and pain. If it dropped much lower he might need some fluids, but for now he was doing okay.

“Scott, do you have any idea about Alex’s medical history? Allergies? Anything like that?” Mackenzie asked.

“Sorry, I don’t know anything. We haven’t known each other all that long. He has a brother in Cootamundra though. His number should be in Alex’s phone.”

Another man appeared and pulled the curtain closed around the bed.

“Hello Mr. Thompson. My name is Connor. I’m one of the doctors here. I just want to ask you some questions and then examine you, is that okay?”

Alex began his round of questions again and Mackenzie and Scott gave him the same answers.

Connor frowned. “Alex, do you know what day it is?”

Confusion creased Alex’s brow. “Mm. Is it Tuesday?”

“Not quite. What about the year?”

“Two thousand and ten.”

Not even close.

Mackenzie’s gut told her she needed to let the nurse in charge know what was happening. In her opinion, they needed to call the trauma team and get Alex into the resus bay. It took her a few minutes to find Ben and she quickly filled him in, pleased when he took her concerns seriously.

“Just let the consultant know,” he said.

Mackenzie found Karen, the ED consultant, and told her the same story she’d told Ben. Karen didn’t appear concerned.

“This is not his first accident,” Mackenzie heard Scott telling Connor a few minutes later. “Two years ago he was riding and was hit by a car. Came off and fractured just about everything. Skull, jaw, ribs, collarbone. Broke his leg in two places. Internal damage to his liver and spleen. He was hospitalized for months.”

“It hurts here,” Alex said, touching his lower left side.

“I’ll write him up for something,” Connor said. “Do you know if he’s allergic to anything?” he asked.

“No idea,” Scott and Mackenzie said in unison.

Connor shrugged. “He can have some Endone and then we’ll just have to wait for the scans and see what’s going on.”

“Have they been ordered?” Mackenzie asked.

Connor screwed up his face and raked his fingers through his hair. “Oh, do I have to organize that?”

Mackenzie took a deep breath before she answered. “Yes, you need to book them.”

Connor left and Mackenzie rechecked Alex’s blood pressure. It was now one hundred on forty-five. She wasn’t alarmed, but if Connor didn’t hurry up and order some fluids, Mackenzie was going to go over his head once more and speak to the consultant again.

“He’s really sweaty,” Scott said a few minutes later.

Mackenzie touched Alex’s skin. Scott was right. It was cool and clammy. Not a good sign.

“How are you feeling, Alex?” she asked.

“It hurts here,” he said, pointing to his left hip.

“He keeps saying that,” Scott said with a frown. “Do you think it’s just the amnesia?”

“To be honest, I’m not sure,” Mackenzie said. “It could be, but the fact is, he’s not saying his head or neck hurts, just his abdomen.”

Alex needed a scan and he needed it now. Where the hell was Connor? She inhaled and exhaled sharply before she rechecked Alex’s pupils and felt his pulse. Other than his slightly lowered blood pressure and clammy skin, the only other sign something wasn’t quite right was his color. His face was flushed when he arrived, but now it was waxy pale. Mackenzie didn’t want to be an alarmist but her nurse’s instinct told her something wasn’t right.

“Karen, I’m still worried about my cyclist guy,” Mackenzie said a few minutes later when she finally managed to track the consultant down at the other end of the department. She quickly explained why.

“Have you sent bloods?” Karen asked.

“Yes.”

“Has he got a line in?”

“Yes.”

“ECG?”

“Done. Normal sinus rhythm at the time. Now slightly tachy.” Mackenzie handed the ECG to Karen who gave it a cursory glance.

“So what’s the problem?”

“I’m not sure,” Mackenzie hedged. “It’s just that Connor—”

“You’re worried because he’s only an intern.” It was more a question than a statement.

Mackenzie nodded.

“Has he ordered an x-ray yet?” Karen asked.

“He has now.”

“Then let me know when it’s been done and I’ll check it out when it comes up on the computer.” She turned her back and Mackenzie drew in a deep breath before she headed back to Alex. There was nothing more to do.

Connor was still questioning Alex – asking all manner of inane questions as far as Mackenzie was concerned. And he still hadn’t had an x-ray.

“What’s the hold up with the x-ray?” she asked.

“I don’t know.”

“Did you tell them it was urgent?”

“Er, no. Should I have done that?”

Mackenzie swore under her breath.
Yes!

“He’s still saying he’s got lots of pain,” Scott said.

Mackenzie looked at Alex’s closed eyes and at his face bathed in a fine sheen of sweat. Had Connor not noticed? Mackenzie hit the button on the monitor and waited for the blood pressure cuff to inflate and deflate. Eighty systolic. This guy was going to crash if she didn’t do something. Without a word Mackenzie left Connor and Scott standing either side of the bed and marched up to Karen again. The consultant was in the middle of a phone conversation but the look on Mackenzie’s face was enough for her to interrupt the caller and hang up.

“What’s up?”

“I’m worried about him. He’s gray, clammy, BP’s dropping.”

“Is Connor still with him?”