St Matthew's Passion - By Sam Archer Page 0,8

lower limb, which looks like a femoral fracture. GCS seven. Latest BP 115 over 63.’

GCS – the Glasgow Coma Scale – was a measure of a patient’s responsiveness after a head injury. Fifteen was normal. Seven wasn’t good at all. Melissa noticed another man hovering alongside the stretcher.

‘Are you a friend or relative?’ she asked.

He was in overalls too, his face streaked with grime and sweat, a man of about forty. ‘I work with Sunil,’ he said. ‘I was there when the scaffolding collapsed. Helped pull him out.’

‘Are you hurt?’ said Melissa.

He shook his head. ‘Nah. Just caught a light tap from one of the poles.’ He nodded at his friend. ‘Is he going to be all right?’

As a group of nurses helped the paramedics to transfer the patient on to the bed in one of the cubicles, Melissa snapped on a pair of latex gloves and set to work. She assigned tasks to two other nurses and requested that the portable CT scanner be brought across. Her gloved hands moved expertly across the patient, probing and tapping, examining for penetrating injuries, unusual percussion notes suggesting air or fluid where it shouldn’t be. With a tiny torch form her pocket she established that the man’s pupils were equal and reactive to light, a promising sign.

She became so absorbed in the activity that for a moment she wasn’t aware of somebody at her shoulder. Looking up and round from where she was listening to the patient’s chest with her stethoscope, she saw Fin, his broad chest inches from her face.

‘What have we got?’ he asked.

She gave him the summary. The CT scan revealed no intracranial abnormality, and there was no immediately obvious neurological deficit. The man’s right leg was a mess, fractured in several places. Of more immediate concern was the crush injury to his thorax, which had broken most of the ribs on the right hand side and had collapsed the underlying lung. He needed to go to theatre as soon as possible.

‘Okay, good,’ said Fin when she’d finished. ‘Care to assist me?’

‘Of course.’ Melissa hadn’t spoken to him since the day before, when there’d been the awkwardness about his seeing Mrs Reynolds. She’d spent the night in turmoil, her feelings swinging from a creeping shame that she’d overreacted to a minor issue, to hot anger at Fin for his arrogance. Yes, he was the boss… but that didn’t mean he was always right. Was he toying with her in some cruel way?

Now, though, she jumped at the chance both to re-establish the goodwill between them and to assist him in a complicated case. He said, ‘See you in theatre,’ and headed out.

Melissa cast a final glance at the patient’s vital signs – blood pressure, pulse and oxygen saturation all acceptable – and scribbled some notes in her quick, unusually neat hand. She gave instructions to the nurse to prepare Mr Khan for theatre and to alert the anaesthetist on duty, and stepped outside the cubicle.

Mr Khan’s friend, his fellow construction worker, was seated on one of the orange plastic chairs outside. He looked up anxiously.

‘How is he?’

‘He’s going to need surgery,’ said Melissa. She gave the man a quick layman’s account of his friend’s injuries. While she did so she saw him rise to his feet and grimace.

Melissa frowned. ‘Are you all right?’

‘Yeah.’ He winced. ‘Bit of pain in the shoulder, that’s all.’

His face was putty-coloured. Melissa took him by the arm and guided him into one of the adjoining cubicles.

‘You said you had a slight tap from one of the scaffolding poles?’

‘Yeah.’

‘Where?’

He allowed her to lay him on his back, though Melissa could see from the contortion of his face that it hurt him to do so. ‘Just here.’ He waved his hand over his abdomen. ‘Fell across one of the bars.’

‘From a height?’

‘Only ten feet or so. Not like Sunil.’

Melissa felt her pulse quicken. She called, ‘Deborah.’

Deborah Lennox, the trauma ward sister, was passing. Accident & Emergency wasn’t one of her usual haunts but she sometimes came down here to ‘majors’ to see who would be ending up under her care after surgery. She came over.

‘Could you get a BP on Mr – what was your name, sir?’

‘Barry Davis,’ he hissed between his teeth. ‘Call me Barry.’

‘Sure thing,’ said Deborah, and busied herself with the cuff. Melissa propped the man’s feet up to raise them above the level of his head, and felt his carotid pulses. His heart was going at over 120 beats per minute. She