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Kitty grabbed a slide board and prepared to transfer Carlos from the stretcher. She stood next to Joe and waited while Anna and the other paramedic carefully rolled Carlos. She and Joe slid the board under their patient.
‘On three.’ The transfer went smoothly and Joe and his partner stepped out of the way, removing their stretcher and leaving Kitty and Anna to get to work. With a wink in her direction, Joe was gone.
Kitty didn’t waste time. Anna was cutting Carlos’s shirt away as Kitty replaced his oxygen mask and attached monitors. She and Anna worked together well. She was an experienced ED doctor and Kitty liked working with her. She was methodical and didn’t miss much.
‘Carlos, I’m Dr Lewis. Kitty and I will look after you. Do you have any medical issues we need to be aware of? Any heart problems, diabetes? Anything like that?’
Carlos shook his head.
‘I’m just going to take your oxygen mask off to check your airway,’ Anna explained softly.
Kitty recorded Carlos’s heart rate, blood pressure and respiration rate while Anna did her examination. She replaced the oxygen mask with tubing once Anna was finished, looping it over his ears and sliding the pegs into his nose. She recorded his oxygen levels as Anna kept talking.
‘We need to replace your lost fluid and get these burns cleaned up. I’m going to give you something for the pain, OK?’
They worked quickly through their initial assessment, needing to get a handle on the extent of Carlos’s injuries. Some, like his burned skin, were obvious but damage to his lungs was less easy to spot and more likely to cause problems, although often not for a day or two. They had to prioritise.
Anna attached a bag of saline to the cannula in Carlos’s elbow to replace the fluids he’d lost while Kitty distracted him, asking questions about his family. ‘Is there anyone you want us to call?’
‘The paramedics called my wife. Someone is bringing her to the hospital, but can you tell me how the boy is?’ His voice was raspy and breathless. It sounded painful to talk and Kitty was sure she’d heard correctly. Boy?
She frowned. Was Carlos delirious? Her gaze flicked to the monitors. His temperature was raised but not excessively. ‘What boy?’
‘The one I pulled from the bus. Did he make it?’
Kitty realised he was talking about the other victim. Their first patient. ‘You pulled him out?’ The vision she’d watched on the television flashed back in her mind. The man dragging the other body from the bus. The standing man. The one who’d looked as if he’d been about to collapse only Joe had caught him just in time. That had been Carlos. ‘Is that when you got burnt?’
Carlos nodded and struggled to talk. To explain. ‘When the fire started it was just a bit of smoke. I stopped and told everyone to get off but the boy only got as far as me and said something about his bag. He ran back down the aisle before I could stop him. Then something exploded. The windows of the bus blew out and he got caught in the flames. I couldn’t leave him.’
Kitty glanced at Anna, communicating mutely. Carlos would be hailed a hero, which meant the hospital would be swarming with media. They would all want a piece of him.
In silent consultation they agreed to take their time treating him, giving him a chance to catch his breath, and then they’d see if he wanted to make a statement. There were lots of variables and it wasn’t Kitty’s place to comment on what he should do.
‘He was in a bad way. Do you know how he is?’ Carlos asked, oblivious to the silent exchange going on between Kitty and Anna. He appeared to be more concerned about the boy than himself.
‘He’s here,’ Kitty told him. ‘He was brought in just before you. He’s being looked after.’
‘So he’s alive?’
‘As far as I know,’ she said. She didn’t know what else she could tell Carlos. She didn’t have any more information and she wouldn’t be able to disclose anything she did know. She was sure that if the boy survived he’d want to thank Carlos personally. She hoped so.
Anna and Kitty worked slowly and meticulously. They washed the burnt skin on Carlos’s arms and hands and debrided the blisters, applying antibiotic cream before carefully separating his fingers and wrapping them individually.
‘Will your wife be able to manage at home with you?’ Kitty asked as she finished wrapping the last finger. ‘We will need to keep you here for a few hours, just to keep an eye on you, but then if your readings are all within normal limits you’ll be able to go home. You’ll need to have some follow-up appointments for your lungs, though, and we will also make you an appointment with the burns unit in a few days. It’s here in the hospital. Will someone be able to drive you here?’
