and efficient, she reached into the cupboard, removed the tray and placed it on the trolley next to him. ‘Just breathe normally through that mask, Doug. That’s great. I’ll squeeze while you find a vein, DrWalker.’ She put her hands around Doug’s arm, watching while Ethan stroked the back of his hand, searching for a vein.
‘Do we have the facility to start an IV?’
‘Of course. I’ll run a bag of fluid through for you.’
‘You have good veins, Doug.’ He cleaned the skin, inserted the cannula with the ease of someone who had performed the same procedure successfully a million times before. Kyla gave a faint nod of approval and released her grip on Doug’s arm.
‘You’re doing fine, Doug. Dr Walker will soon have you feeling better. I’ll get the notes up on the screen for you,’ she said to Ethan. ‘That way you’ll be able to see what Logan has been doing.’ She moved over to the desk, flicked on the computer, crossed the room and grabbed the ECG machine from the corner. ‘That computer will just take a minute to wake up.’
Doug gave a grunt of pain, his hand on the mask. ‘I was always afraid that this might happen. It’s why I tried to lose weight. I managed to stop smoking but I just ate more.’ He grimaced and leaned back against the pillow as Ethan connected a bag of fluid. ‘I’ve been trying, really I have. But it’s so hard.’
‘You’ve been doing brilliantly, Doug, you know that. Don’t worry about it now,’ Kyla said quickly, wrapping the blood-pressure cuff around his other arm. ‘We just need to find out what’s happening.’ She checked his BP, showed Ethan the result and he gave her a nod.
‘Can we do a 12-lead ECG?’
‘Already on it.’ Kyla quickly stuck the pads onto the patient and applied the chest leads and limb leads. ‘Just hang in there, Douglas, you’re going to be fine. Dr Walker is a real whiz kid from the mainland. People usually pay a fortune to see him, but you’re getting him free so this is your lucky day.’
She was aware of the sardonic lift of Ethan’s dark brows but chose to ignore him. This was her territory, she reminded herself. There was no way she was going to allow herself to be intimidated by a locum doctor, no matter how slick and handsome.
Doug closed his eyes and gave a wan smile. ‘It doesn’t feel like my lucky day, hen.’
Kyla felt her heart twist at the endearment. She’d known Doug since she’d been a child. ‘Of course it’s lucky because I’m on duty,’ she said lightly, switching on the machine. ‘If you had to be ill then you’ve done it in the right place. You’re going to be OK, Doug.’ She chatted away in a steady, reassuring voice and then looked up as the door opened and a dark-haired girl in a blue uniform hurried into the room.
‘I just drove past Logan breaking the speed limit on the coast road and, judging from the look on his face, I thought you might need some help here.’ Her eyes were gentle and concerned and her ponytail swung as she moved her head. ‘Doug? What have you been doing to yourself?’
‘This is Ethan Walker, the new GP. Ethan, this is Evanna, the other island nurse. Logan’s gone to see Janet’s mother who’s had a fall and our Doug here is having nasty chest pains. Can you call the air ambulance?’ Kyla glanced up at her friend and colleague and used her eyes to transmit the message that the request was urgent. ‘Whatever happens, we’re going to need to transfer Doug to the mainland. Doug, I need to call your wife and let her know what’s happening. Is she home?’
Evanna slid out of the room without argument and Kyla felt a flicker of relief. She knew she could trust her friend to get the air ambulance to the island as quickly as possible.
‘No.’ Douglas turned his head, his face pale and sweaty and his voice urgent. ‘You’re not to worry Leslie. She’s got enough on her mind at the moment with our Andrea going through a rebellious phase. She doesn’t need this. I’m having a heart attack, I know I am. It’ll be too much for her.’
‘She loves you, Doug,’ Kyla said firmly, starting the machine and watching the trace. She didn’t like what she saw but she was careful not to let her worry show on her face. But she was definitely calling his wife. ‘You’re a partnership. A team. What do you think she’d say when she discovers that you’ve flown off on a minibreak to the mainland and left her here?’
ST elevation, she thought to herself, studying the pattern. She’d seen it often enough in her short time in A and E.
Doug gave a wan smile and shook his head. ‘She’s always on at me to leave the island for a break.’
‘Well, there you are, then.’ Kyla stood to one side so that Ethan could watch the trace. ‘There’s ST segment elevation in two leads. I expect you’ll want to give him heparin and reteplase. I’ll get it ready.’
Ethan looked at her and she saw approval and a flicker of surprise in his eyes. ‘Do we have morphine and GTN spray?’
‘Of course.’ The question amused her. So he thought he was working in a backwater, did he? She unlocked the drug cupboard, found what she needed and prepared it, listening as he talked to Doug.
‘I’m afraid the ECG shows that you’re right about the heart attack, Doug. Probably caused by a blood clot in one of the vessels leading to your heart.’ His tone was calm and steady. ‘I’m going to give you a drug that will break it down.’
‘One of those clot-busters I’ve been reading about?’
‘That’s right. We need to get the blood flowing back through that artery for you. Before I give it, I need to ask you a few questions.’
Doug winced, his face pale behind the mask. ‘I ought to warn you that I hate quiz night at the pub. I never go. If you’re about to start on capital cities, you can forget it. I left school at sixteen and went out on my father’s boat.’
Ethan smiled. ‘You don’t suffer from any bleeding disorders? Haven’t had surgery lately?’ He asked a series of rapid questions and then took the drugs from Kyla. ‘How long does the air ambulance usually take to arrive and where do they land? I’m not sure he’s stable enough to travel.’
‘The paramedics are skilled and you can go with him. They carry a defibrillator, along with all the other gear you’re likely to need.’
Ethan administered the drug carefully. ‘And they can fly here?’
‘Oh, yes, providing the weather is all right, and today it should be fine.’ Kyla took the empty syringe from him and disposed of it with swift efficiency. ‘We need to call the hospital and fill out details for the transfer.’
‘If I go with him, that will leave you with no doctor.’
Kyla smiled. ‘Logan’s still on the island and he won’t be long, I’m sure. Don’t make the mistake of thinking that you’re indispensable, Dr Walker,’ she said cheerfully, her eyes sliding to Doug’s taut features. ‘We nurses are extremely versatile.’
His gaze followed hers and he frowned and checked Doug’s pulse. ‘How’s the pain now? Any improvement?’
Doug nodded. ‘Better,’ he rasped, just as Evanna came back into the room.
‘Air ambulance will be here in fifteen minutes,’ she said in her calm, gentle voice. ‘I’ve explained to the patients in the waiting room that there will be a delay until Logan gets back.’
Kyla looked up. ‘Did you call him?’
‘Yes. Mrs Taylor has a nasty laceration of her leg and she’s very shaken up but nothing’s broken. He’s going to bring her back here to be sutured and I’ve said that one of us will spend some time in the home with her, discussing how to avoid falls.’
Kyla frowned as she reached for the phone. ‘She ought to join your exercise class, Evanna. Did she trip over something?’
‘Not sure. Janet just found