Emergency Response

by Nicki Edwards

  “And?”

  “And he’s incredibly sexy,” Mackenzie said with a laugh, “and I’ll be the first to admit I’d be crazy if I wasn’t interested in him. Problem is I’m not sure why he’d be interested in me?”

  Chapter 13

  It was Mackenzie’s final shift before her well-earned weekend off. She hadn’t left Iron Ridge except to go to Paraburdoo or Tom Price for shopping and she couldn’t wait to explore further afield. At the rate time was flying, her three months in the Pilbara would be over in a flash.

  Nathan had promised to take her to see what he described as “the most magnificent gorges and waterfalls in the world” and she could hardly wait. As much as she was dying to see the “real” Australian Outback, as Nathan had called it, she was also secretly looking forward to spending two full days alone with him. She hadn’t seen him all week, but they’d talked every day and she’d received numerous text messages from him as he arranged all the details of their overnight camping trip. She was getting more excited with every conversation.

  She eyed the darkening sky and hoped the weather would hold. She didn’t want to have to cancel their trip because of a storm. For some reason she felt unusually antsy and she didn’t think it was simply due to the weather. She pulled her hair up into a knot on top of her head and pinned the wispy pieces back from her forehead and headed out the front door to work, wincing at the sudden blast of hot northerly wind against her skin. In the distance, thick clouds were building on the horizon, bringing with them humidity and the hopeful promise of rain. Since she’d arrived, it hadn’t rained once.

  Spring had arrived in the Pilbara, but it felt hotter than any summer Mackenzie had ever experienced. Only days after she’d arrived in August, the temperatures had soared from pleasant mid-twenties to high thirties every day. They were now up to their sixth day in a row of temperatures above thirty-five degrees. The bureau of meteorology simply altered the forecast day to day from “hot with plenty of sunshine” to “partly sunny and very warm.” The days were unbearably hot, and without air-conditioning everywhere, Mackenzie would have melted into a pool of sweat. The only positive aspect of the heat was she wasn’t eating as much and already her scrub pants felt a little less snug around her thighs, which was something that brought a smile to her face. The hot weather normally didn’t bother her, but after six days with no sign of a reprieve, she wondered how much longer she could cope with the heat.

  Mackenzie arrived at work to find Charlotte and Amy in the resus bay with a young girl sitting up on the bed between them, gasping for breath. Mackenzie’s heart sank. She had treated the same little girl the week earlier.

  “Hey Mackenzie,” Charlotte greeted her, worry evident in her eyes. “This is little Georgia. She’s nine. Known asthmatic. Multiple presentations. And that’s her mum, Donna.” She pointed to the woman leaning disinterestedly against a doorframe.

  “We’ve met.” Mackenzie heard Georgia’s wheeze from where she stood without needing a stethoscope. She glanced at Donna again before turning her attention back to Georgia.

  “We’ve done hour of power and she’s improved, but still struggling,” Charlotte said.

  Mackenzie had given the same thing to Georgia on her last admission. Ventolin and Atrovent at regular intervals, along with Prednisolone. It had worked well then and with luck, it would do the same this time.

  “Hi Donna,” she said. “I looked after Georgia the other day.”

  The woman looked up from her phone and nodded. “Yeah I remember. You took over from Doc. Charlotte said you have an ICU background. I’m glad, because Georgia’s already had two ICU admissions with her asthma in the past twelve months. I forgot to tell you that last week.”

  In the back of Mackenzie’s mind, an alarm pinged. Georgia could deteriorate very quickly and they weren’t set up to intubate if they couldn’t get her airways open with bronchodilators.

  Mackenzie smiled warmly at Georgia. “Hi. I’m Mackenzie. Do you remember me? How are you feeling, sweetie?”

  “Better,” Georgia wheezed, glancing at her mother. She was clearly lying.

  “It’s the change of weather,” Donna said with a wave of her hand. “Happens all the time. I had her home all day yesterday. She’s had a bit of a cold and wasn’t well this morning when she woke up. I knew her asthma would flare today as soon as I saw those storm clouds building. Is she all right here with you? I’m just gonna pop outside for a quick smoke.” Without waiting for an answer she headed to the glass doors which led outside.

  Mackenzie tried to ignore the annoying niggle of frustration which was building. Didn’t Donna care about her daughter? She turned to Georgia, smiling again. “Do you mind if I lift up your T-shirt and have a listen to your chest, sweetie?”

  Georgia stared bleakly at Mackenzie as she lifted the shirt up and onto the little girl’s shoulders.

  “Tracheal tug, use of accessory muscles,” Mackenzie said quietly. “Has her respiratory rate dropped at all since she got here?”

  Amy nodded. “Yeah, heaps actually. She was barely speaking one or two words when Donna brought her in and that was after her usual Ventolin at home. Rate was almost sixty. Back down to forty now. She mightn’t look it, but she’s heaps better.”

  “And her oxygen levels?”

  “She’s maintaining sats of ninety-three percent on room air now,” Charlotte answered.

  Mackenzie listened to Georgia’s chest, noting the high-pitched squeal at the end of each expiratory breath. “Have you been using your puffers at school?”

  Georgia hesitated before nodding vigorously. Once again Mackenzie didn’t believe her for a second.

  “Still a considerable wheeze. When is she due for the next dose?”

  Amy consulted the chart. “Another five minutes.”

  “Okay. Make sure we listen to her breathing before and after the next neb, then I’ll call the RFDS if I need to.”

  “Oh, we’re not giving nebs, we’re only using the spacer,” Amy said. “That’s what her mum said she’s used to at home.”

  “Are you using it properly though?” Mackenzie asked Georgia. “The way I showed you last time?”

  There was a long pause. “Sometimes.”

  “Her mum said she doesn’t like taking it to school. She said it’s too bulky and the kids make fun of her when she uses it, so she only makes her use the spacer at home,” Amy said.

  Mackenzie frowned, debating whether it was worth having an argument with Georgia’s mother when she returned about the risks of not using the inhaler properly. Donna’s apparent disinterest in her daughter’s asthma meant it would probably fall on deaf ears.

  “How about the next one we try using a neb,” Mackenzie said. “I know best practice says use the spacer but if she’s having difficulty breathing it in properly, she might not be getting the full benefit of the drug.”

  “Okay,” Amy replied. “It’s certainly worth a try.”

  Mackenzie grabbed an oxygen mask with a canister from the container at the back of the bed and tore the packaging open. Charlotte handed her two small plastic ampoules. She snapped the lids off. Squirting the liquid into the container, she screwed the connections together and attached the tubing to the oxygen on the wall. She fitted the mask over Georgia’s face and tightened the orange elastic, securing the mask in position. Georgia continued to struggle to catch her breath. Amy turned the oxygen flow up high and immediately the nebulizer steamed as the oxygen mixed with the drugs, bubbling away while steam emitted from the mask.

  Mackenzie stood back to observe Georgia. She was a skinny girl and with every strained breath her whole upper body moved. A strand of blonde hair was plastered across her forehead, falling into her right eye. Mackenzie brushed it back. Donna had returned but her head was down, tapping away on her phone, not even watching her daughter. Mackenzie wanted to pick up the phone and throw it across the room. Did the woman not realize how sick her daughter was?

  “You’re doing great, Georgia,”
Mackenzie reassured her. “Keep taking nice deep breaths. Try to slow your breathing down.” She turned to Charlotte and Amy and spoke quietly. “I think we should get a drip in just in case.”

  Amy pointed to Georgia’s arms. Local anesthetic, referred to as “angel” cream, covered in occlusive dressings was on the back of her hands and the inside of Georgia's elbows to numb those places in case she needed to have a cannula inserted. Clear plastic dressings covered the cream. “One step ahead of you sister,” she said with a smile.

  *

  Half an hour later, Georgia had visibly improved. Charlotte and Amy finished their shift and headed home. Georgia was chatting to Mackenzie about her new puppy and no longer struggling for each breath. Her chest sounded clear and both her respiratory rate and heart rate had reduced. Once again the drugs had worked their magic.

  Mackenzie’s own heart rate returned to normal as she watched Georgia. She kept her in the hospital for another hour to observe her, but eventually Georgia’s boredom at being cooped up inside was more than either Mackenzie or Donna could stand. Mackenzie discharged them both home after attempting to explain the severity of Georgia’s asthma to Donna. She then went and made herself an early dinner. If the past three Friday nights in Iron Ridge were any indication, it would be wise to eat early before it got busy and she missed out on a meal altogether.

  Outside, heavy drops of rain had begun to fall and they landed like golf balls on the tin roof. A cool breeze had sprung up and Mackenzie walked around the small hospital closing up windows. The temperature had dropped considerably and Mackenzie sighed in disappointment as she glanced out at the dark sky. It looked like they would have to cancel their trip.

  She stood in front of the microwave waiting for her dinner to reheat when the sound of the phone made her jump. She rushed back to the front desk to answer it. It was the police, on their way with a young man they’d picked up outside Hendo’s pub. He was drunk and they needed somewhere to dump him. It was too late to tell them a hospital was not the place for people to come while they sobered up – they were already on their way. It looked like dinner would have to wait.

  Five minutes later two police officers in blue uniforms stumbled through the front door, their arms hooked around the upper torso of a skinny indigenous man. His dragging feet left a dirty trail of mud along the floor. The three of them were soaking wet. The wind caused the front door to slam shut behind them and Mackenzie jumped as though slapped. Her senses were on overdrive. She loved storms, but for some reason tonight’s weather had put her on edge.

  “Gotta dump him and run,” the older of the two policemen said when they’d hoisted the man onto the narrow bed. At first glance Mackenzie thought he looked like an old man, but on closer inspection she realized he wasn’t much older than a teenage boy. “There’s been a rollover out near one of the black fella communities outside of Para.” He must have seen the apprehension in Mackenzie’s eyes. “Don’t worry, love, we’ll take any of the survivors over to Para or Tom Price – closer than here. We were heading out that way when someone called this in.” He pointed to the man on the bed. “He was found lying in the rain outside the pub covered in his own piss. People were tripping over him.” The cop laughed without mirth and Mackenzie felt an instant dislike toward him. “He was ruining everyone’s good night out.” He chuckled again. “Anyway, good luck. He’s all yours, love.”

  The police left and Mackenzie began her assessment. As hard as she tried, she was unable to rouse the young man. She yelled at him, squeezed his trapezius muscles and even resorted to pressing the edge of a pen hard against his fingernail. At least that elicited a grunt from him. She checked his blood pressure, which was on the low side of normal and checked his heart rate, which was fast, but wasn’t what she considered was tachycardia. She took his temperature and it was low, but not surprising depending on how long he had been lying outside in the rain. Covered in dried vomit and urine, he smelled of alcohol. Mackenzie tried not to grimace as she peeled off his T-shirt and jeans, covering him in a hospital gown and crisp white sheet. Dumping his clothes in a plastic garbage bag, she knotted the top and then threw it beneath the bed. She then pulled both the rails up on either side of the bed. He might as well sleep off his hangover.

  While she waited for him to stir she ate her reheated dinner and rang Nathan. “Will we have to cancel tomorrow?” she asked when he finally answered on the fifth ring. She heard loud cheers in the background. “Where are you?”

  “I’m at the pub,” came his shouted reply. “A few of the guys are leaving for Perth in the morning and I’m watching them play a game of pool. Macka just pocketed four balls with one shot.” There was more shouting. “What did you say about tomorrow?” he asked, still shouting. It was clear he was having difficulty hearing her over all the cheering and laughter.

  “Will we have to cancel the trip?” she repeated slowly.

  She heard muffled sounds and the noise in the background faded. “Sorry Mackenzie, I couldn’t hear you. I’ve stepped outside now. What did you ask?”

  “Oh, I’m sorry. I don’t want to take you away from your friends.”

  “They’re just the guys I work with. You met some of them last week. It’s no big deal. Now, what did you ask?”

  Mackenzie hesitated. “I was a bit worried the storm would mean we’d have to cancel our trip tomorrow.”

  “Not at all. In fact, the rain will mean all the waterfalls and gorges are full. We may not be able to swim and there will be some parts we won’t be able to cross if the river is up, but we’ll still go.”

  “But what if it’s still raining tomorrow?”

  “I can assure you the sun will be out and the skies will be royal blue again by seven o’clock tomorrow morning when I pick you up. You can trust me on that one.”

  “Oh, okay.” Mackenzie regretted calling him. She probably sounded like a whining city girl and she certainly didn’t want him to get that opinion of her.

  “I forgot to check with you. Do you have any hiking boots? Or at least some good quality runners with heavy soles?” he asked.

  “I don’t, but Charlotte does. She’s already warned me I’ll need good shoes and thick socks so I’m borrowing hers. I just hope I can keep up with you.” Mackenzie pictured Nathan’s long, lean legs effortlessly climbing over rocks while her own shorter legs struggled to keep up with him. “What else do I need to bring?”

  “Make sure you’ve got plenty of sunscreen on, and dress in layers. I suggest you wear shorts but throw in a pair of pants because it will get cooler in the evening. Don’t forget a hat and bring a few water bottles. Fill them with ice before you go so they’ll keep cold longer. I’ve got a pack already put together with a basic first aid kit and I’ll bring everything we need for lunch.”

  “It sounds like you’ve thought of everything. Although should I be asking why we need to bring a first aid kit? You told me this wasn’t a dangerous walk. I have to warn you, Nath, I’m not the fittest of girls.”

  “You’ll be fine. We can go at your pace. As for the first aid kit, it’s merely a precaution. I hope we don’t need it. You’ve already seen what I’m like with blood!”

  “Does that mean you’ll leave all the medical emergencies to me?” Mackenzie teased.

  “Absolutely! You’re the expert.”

  “Oh, I don’t know about that.”

  “Don’t put yourself down, I’ve been told you’ve settled in brilliantly at the hospital and you’re doing a fabulous job.”

  “Well thank you,” Mackenzie said. “It’s nice to know I’m appreciated.”

  “Let me tell you, I’ll appreciate you if you take care of any first aid tomorrow. Truly, I can’t cope with blood at all.”

  Mackenzie laughed. “I remember. You just about fainted and it was only a scratch.”

  A groan behind her reminded Mackenzie she was at work. “I’d better go, Nath. I’ve got an aboriginal kid in here sleeping off what will probably be a nasty hangover tomorrow morni
ng.”

  “Is that the guy who was outside the pub earlier tonight?”

  “I guess so,” Mackenzie said. “The cops brought him in about half an hour ago. Dumped him here and headed out to a car accident near Paraburdoo.”

  “That’s weird. They don’t generally bring them into hospital when they pick them up,” Nathan said. “They normally lock them up at the station overnight.”

  “Does it happen often?” Mackenzie asked.

  “Too often. Towns like ours have been the death of too many indigenous communities. Don’t get me started – I tend to get on my soapbox about it.”

  The phone at the front desk rang.

  “I’ve gotta go.”

  “I’ll see you tomorrow, bright and early.”

  “I can’t wait.”

  She hadn’t lied. She couldn’t wait. She did a little happy jig on the spot. She was about to spend the weekend with the sweetest guy in Australia. And it certainly didn’t hurt that he was the hottest-looking guy she knew too. She wasn’t into bushwalking, but the knowledge she’d be spending two entire days with Nathan Kennedy made the thought of every single blister totally worth it.

  Chapter 14

  Mackenzie answered the phone and the words she heard were enough to instill fear.

  “Four fatalities. Six badly injured. Another seven are headed to Paraburdoo and Tom Price. Two more are on their way to you now with the police.”

  The line kept cutting in and out and she could only make out some of what he was saying.

  “Did you say two are coming here?” she clarified.

  How many people had he said were involved in the accident? Four fatalities? Her heart pounded as adrenaline kicked in and the implications of what he was saying hit her. She instantly forgot about her plans for the following day.

  “Yeah, that’s right. A mother and child are coming to you. They’ve only got minor injuries and will simply need observing overnight.”