couldn’t be the highest-ranking person in the room. Far from it, in fact. She only looked in her mid-twenties.
Firecracker? He couldn’t remember what the Japanese word was but somehow the nickname suited her. It seemed to sum her up perfectly.
It was obvious that in this room people respected her. He liked that. He liked that she was direct and efficient at her job.
Her eyes shifted and focused on the ID. She turned without a word and started shouting orders at others in the room. ‘Get an IV run through.’ She glanced at the endotracheal tube in the hand of her colleague. ‘I think we’ll need something smaller.’
Perfect. A nurse he could work with. All air force and military nurses and personnel were efficient and well trained. But he always worked best with those who could think ahead and weren’t afraid to voice their opinion. He had a sneaky suspicion that Katsuko—was that her name?—would never be afraid to voice her opinion.
Avery tried to ignore the bedlam around him. He tried to cut out the noise. There were two trolleys in the resus room and another team was working on another patient. They were moving like clockwork, performing cardiac massage.
He moved swiftly. ‘Any other doctors in here?’
‘Two are up on the helipad. They haven’t even managed to get the patient down yet.’ She pressed her lips together. ‘Blake won’t give up on the other kid. Not until he’s tried everything.’
The doctor attending to the little boy on the other trolley. Blake Anderson. The guy he was supposed to report to tomorrow. The scene on the other trolley was disheartening and he didn’t feel the urge to introduce himself right now. If he didn’t pay attention to the kid directly in front of him, he might end up resuscitating him too.
Avery took a breath and held out his hand. The area around this little boy’s neck and chest was swelling, a reaction to the severe injury that could compromise his airway. His sallow skin was losing its natural colour rapidly. A nurse was poised next to the IV meds, awaiting his instructions. He gave them quickly. Something for pain control. Something to sedate the boy and steroids to reduce the swelling and allow him to intubate. Airway first. Everything else later.
The nurse nodded and inserted the drugs into the IV cannula on the inside of the kid’s elbow.
‘ET tube.’ Avery held out his hand, bending down at the top of the trolley and tilting the little boy’s head. ‘Do we have his name?’
‘Mahito. His name is Mahito.’ The firecracker nurse was watching his every move.
‘Mahito, I’ve given you something for the pain and something to relax you. I’m going to have to slide a tube down your throat. Don’t panic. We’ll take good care of you.’ It didn’t matter that the little Japanese boy might not understand a word of English, or his Ohio accent.
He’d done this a hundred times before and he’d do it a hundred times again.
He gave Katsuko a few seconds as she translated his words rapidly. The little boy was barely conscious. He probably had no awareness of what was going on right now and that wasn’t a bad thing.
He tilted the little boy’s head back, lifting his jaw and sliding the silver laryngoscope into place. He could barely visualise the cords—if he waited any longer he’d probably have to do an emergency tracheotomy—but thankfully he had time to slide the thin blue ET tube into place and inflate the cuff. It took less than four seconds to secure the airway. He attached the bag to the end of the tube and let the nurse take over.
With the airway secure he could now take a few minutes to assess the situation properly. ‘We’re going to need to take him to Theatre. Can I get a portable chest X-ray?’
A woman in a blue tunic stepped forward, pushing the machine towards them. She’d been waiting for his signal. Like in most military hospitals, radiographers were always available in the ER.
A heavy lead-lined apron was dropped over his head. He didn’t even question where it had come from. A few people stepped from the room for a second.
‘Done,’ said the radiographer.
She glanced back at Avery. He could see the question on her face. ‘Avery Flynn. I officially start tomorrow.’
Satisfied with his answer, she gave a nod. ‘Dr Flynn, I’ll have your X-ray in a few minutes.’
Avery nodded. ‘Can anyone tell me what actually happened?’ He could see his counterparts still working on the kid on the other trolley, the flat line on the monitor almost mocking them.
‘Some kind of explosion. Lots of penetrating injuries. It was outside a local factory. The kids were playing, waiting for their parents to finish their shifts.’
‘Major Anderson,’ a voice boomed through the resus room doors. Everyone froze for a second then immediately resumed what they’d been doing. Eyes glanced at each other and the noise level in the room plummeted.
Avery frowned at the uniformed figure in the doorway. He had three people standing nervously behind him. The rank was instantly recognisable—as was the glint of the two silver stars—and he could hardly hide his surprise. He’d never seen a major general in an ER before.
He looked to be in his fifties and had a mid-Western accent. He was well over six feet tall with broad shoulders and what looked like thick dark hair under his hat. There was something about him. An aura. An air. And it wasn’t all about the rank. What had brought him to the ER? He could understand any major general in charge of a base this size wanting to be informed about incidents. He just wouldn’t have expected him to attend personally.
Blake glanced upwards but didn’t stop what he was doing. ‘General Williams.’
The Major General was watching Blake carefully as he continued his resus attempts. ‘I heard there was an explosion. Does your team require assistance?’
Blake kept working steadily. He glanced in Avery’s direction but the Major General didn’t follow his glance. He was focused on Blake.
‘I have all the assistance I need. If anything changes, I’ll let you know.’
‘I’ll expect an update in a few hours.’
‘General.’ Blake gave a nod in acknowledgement. He was attaching defibrillator pads to the young boy’s chest. ‘All clear.’
There was a short ping.
Avery was holding his breath and bent to pick up an oxygen mask that had landed on the floor. Major General Williams turned to leave, his eyes lingering for a second on Avery.
Was he looking at him?
Two seconds later the major general disappeared down the corridor.
Avery straightened up, his gaze shifting around the people in the room. The noise level increased instantly. Katsuko was still bagging but her gaze was fixed on the door.
That was who he’d been looking at. What was going on there?
The male nurse he’d met earlier shouted towards the door, ‘Two emergency theatres are open. The guy from the helipad is in the first one. We can take our kid to the other.’
There was a tiny second of silence, then it was broken with a little beep. Every head in the room turned. The monitor for the other patient. They finally had an output.
Avery paused as the doctor he hadn’t even had a chance to meet yet raised his head from the bed. The look of pure relief on his face made him catch his breath. ‘Do you need the theatre?’ Avery asked.
He had to. This was another doctor’s ER. He might be treating a patient but this was the military. He had to follow the chain of command.
Blake shook his head. ‘No. I’m heading to paediatric ICU.’ He frowned for a second. ‘Do you need assistance?’
Avery shook his head. ‘Is there a surgeon?’
Blake