in. I want vital signs recorded every five minutes and get his clothes off fast—I want every inch of him examined.’
Using sharp scissors, they cut off his clothes and Katy reached for the man’s wrist to insert another line. One of the nurses handed her a swab and venflon and she searched frantically for a vein.
‘Everything’s shutting down,’ she murmured, her fingers slipping on the man’s skin as she nervously tried to find a vein.
‘Let Harry try,’ Jago said sharply, and she gritted her teeth and felt around again for a vein.
‘Give me one more go—I think I felt something then.’
Please—please …
Something moved under her fingers. Was that it?
She slid the needle through the skin and breathed a sigh of relief as blood came back into the venflon.
‘I’ve done it. I’m in.’
‘Well done.’ Harry gave her an encouraging smile but Jago merely barked out more instructions.
‘Take blood for group and cross-match, full blood count, urea and electrolytes, and get a catheter in so that we can assess his fluid output. What’s his blood pressure doing?’
‘It’s falling.’ Annie checked the reading and recorded it on the chart.
‘Remember that there is a consistent fall in the systolic blood pressure only after 30 per cent of blood volume is lost,’ Jago said, his tone cool. ‘Get him attached to an ECG monitor and let’s give him a bolus of fluid. Start with a litre of warm colloid and then we’ll reassess.’
There were so many questions that Katy wanted to ask but she knew they were going to have to wait until the patient was stable.
She watched while Jago examined the patient’s abdomen, his hands moving skilfully as he looked for signs of tenderness.
‘There’s bruising and tenderness under the ribs,’ he murmured, and then glanced at Annie. ‘Phone down and see if they’ve confirmed the blood group yet. It’s been ten minutes so they should have. Once they have, get some blood up here,’ he ordered sharply, and Annie hurried to the phone just as another nurse popped her head round the door.
‘His wife is in the relatives’ room. Is there someone who can see her?’
Jago glanced at Charlotte. ‘Can one of your team go to her until we’ve stabilised him? Tell her we’ll be with her as soon as we have some news.’
Charlotte moved towards the door. ‘And if she wants to come and see him?’
Jago didn’t hesitate. ‘Then let her.’
Katy frowned and Jago raised an eyebrow in her direction. ‘Something wrong, Katy?’
At least he was calling her by her first name now, instead of referring to her as ‘Dr Westerling’. ‘I just thought it might be distressing for her to see him like this.’
‘It is distressing …’ Jago glanced across to check the ECG and the blood-pressure reading ‘… but studies have shown that on balance it’s probably better for the relatives to see the patient in Resus than not to see them.’
Annie looked up. ‘His blood pressure is falling, Jago.’
‘He needs blood and we need to call the surgeons and warn them that he’s likely to need a laparotomy.’
Jago looked impatiently towards the door and at that moment one of the nurses came hurrying in, carrying the blood bags.
‘At last.’ Jago reached out a hand and took one of the blood bags, attaching it quickly to the giving set. ‘Open the tap and let’s see if that helps.’
They worked to stabilise the man but the blood transfusion seemed to have no effect.
‘Still no improvement. OK, that tells us one of two things.’ Jago’s expression was grim. ‘Either the shock isn’t caused by bleeding, or he’s bleeding faster than we can infuse the blood—my money’s on the latter. He needs urgent surgical intervention. Has someone bleeped the surgeons?’
Charlotte nodded. ‘Mr Hart is on his way.’
‘Well, he’d better be quick.’ Jago turned his attention back to the patient, who was deteriorating by the minute.
‘His blood pressure is still falling.’ Annie looked at Jago expectantly and his mouth tightened.
‘Push that blood through faster.’
At that moment the door swung open and a tall, blond man strode into the room. ‘Jago?’
Jago gave a succinct report on the man’s condition and the surgeon examined him briefly.
‘You’re right. He’s bleeding. Let’s take him straight to Theatre.’
There was a flurry of activity and the man was transferred to the operating theatre for a laparotomy which would allow the surgeons to assess any internal damage.
Katy found herself alone in Resus with Charlotte. ‘Phew, what a mess!’ She glanced around the room, taking in the discarded blood bags, needles and other equipment.
‘What happens now?’
‘We clear it up ready for the next patient,’ Charlotte said immediately, thrusting needles into the sharps bin and scooping up soiled dressings. ‘Jago’s gone to talk to the relatives with Annie. Can I ask you something?’
‘Of course.’ Katy checked the intubation tray and ran another bag of saline through a giving set.
‘How do you two know each other?’
Katy’s eyes flew to hers and she thought about denying their past acquaintance, but Charlotte’s next words made her realise the futility of that approach.
‘When you were brought in here two weeks ago, he was the one who identified you.’
‘Oh.’ Katy concentrated on the equipment she was checking, wondering what Jago had felt when he’d seen her lying on the ambulance stretcher. Had he felt any guilt at all? ‘We knew each other years ago. He used to work for my father.’
‘In the bank?’ Charlotte’s eyes widened. ‘He’s filthy rich and we’ve all been dying to know how he made his money. I suppose that answers the question.’
‘I suppose so.’
Katy moved away, hoping that was the end of it. She hated gossiping about people.
Charlotte was still looking at her in fascination. ‘Did you know him well?’
Katy shook her head and avoided eye contact. ‘Not that well.’
She’d thought that there had been gentleness under the strength but she’d been wrong.
Charlotte gave a wistful sigh. ‘He’s the hospital heartthrob.’
Katy kept her eyes fixed on the intubation tray. Of course he was. Jago Rodriguez was seriously rich, stunningly good-looking and single. A prime target for every woman on the planet.
Except her.
She’d learned her lesson the hard way eleven years ago and she wasn’t that innocent, naïve girl anymore.
Charlotte sighed. ‘Every available woman in the hospital dreams of being the one to tame him and marry him.’
Katy looked up at that, unable to hide her incredulous expression. ‘Marry him?’ Well that showed how well they knew Jago. I don’t do commitment, Katy. ‘If you know him then you’ll know he isn’t the marrying kind.’
Charlotte shrugged. ‘Everyone’s the marrying kind if they meet the right person.’
‘I don’t think so.’ Katy’s voice was soft and thoughtful.