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As Mattie headed for the casualty, Kane yanked open the vehicle door and snatched on the handbrake. The bone sticking through the lad’s leg and trousers were obvious the moment she arrived.
‘Bring my medical grab bag,’ she ordered, barely glancing up at Kane as she concentrated on the corporal. ‘Okay, Daryl, isn’t it?’
The lad made what sounded like a confirmation, though it wasn’t clear over his cries of pain.
‘Okay, Daryl, you have a compound fracture so what I’m going to do is stem the bleeding, immobilise the area, and see if we can’t reduce your pain. But first I just want to check you for any other injuries. Does it hurt anywhere else?’
Quickly she began to check over his body. She suspected it was just the fracture of the lower leg, but she didn’t want to miss any internal bleeding caused by some impact she hadn’t quite seen.
‘All right, Daryl, mate, it’s going to be okay, Doc’s treating you now.’ Kane returned with her bag then knelt next to the corporal, taking his hand and beginning to talk, his low voice calm and soothing. Then he turned to her. ‘What do you want me to do?’
‘Can you get some scissors and cut his trousers? I want to pack this field dressing around the bone to staunch the bleeding and protect the injury, then elevate the limb.’
Dutifully Kane searched through her bag, quickly producing a pair of scissors and some field dressing kits. As he cut the trousers, she pulled off the soldier’s boot and sock and checked for a pulse in the foot, relieved when she found it. At least the neurovascular state of his leg was good. She had known some soldiers who had ended up needing the foot amputated because a leg fracture had resulted in circulatory deterioration.
Pulling the field dressing apart, she lowered it around the protruding bone, working quickly and efficiently as she pressed it to the wound to staunch the bleeding.
‘Right, apply pressure here,’ she told him. ‘Then I can pack the wound.’
‘His breathing is becoming rapid,’ Kane noted quietly, so that the young lad couldn’t hear, and Mattie nodded grimly.
‘His colour and temperature aren’t looking too good either. I’m concerned about hypovolaemia.’
Ideally, she would give the lad oxygen, but she didn’t have any with her. But she could give an intravenous saline solution to replenish his fluids, and she still needed to splint the leg.
‘There’s a box splint in the cab,’ she told Kane. ‘But I’d prefer to put his leg into traction. Can you see if there are any long sticks or branches by those trees? I need one longer than the other, one to run on the outside from the chest down to the ankle, and the other to run on the inside from the groin.’
‘Diameter?’
‘Enough to take some strain, maybe around five centimetres or so?’
‘On it,’ Kane confirmed, heading quickly towards the trees.
She plunged back into her med pack, talking to Daryl all the while. If she wanted to manipulate the corporal’s leg she was going to need to administer some pain relief, and there was a morphine injector in her kit. And prepping a few bandages to use as ties would save time.
Kane was back quicker than she had hoped, bringing with him a decent selection of thick sticks.
‘Great,’ she approved, selecting the best, straightest two. ‘Now, I’m going to need you to grab his ankle and pull the leg down.’
As Kane obliged, Mattie quickly set up the traction, constantly checking for signs of neurovascular compromise each time she made an adjustment. And then they were done, and whilst Kane called it in, she focused on keeping the injured man warm, and talking, reassuring him all the while.
‘Okay, the heli-med will be here in ten. But we’re going to need to get him off this patch of ground. They won’t be able to land here.’
Mattie glanced around quickly.
‘I don’t want to put him in that vehicle, not the way it will toss him around. We’re going to have to tab him out.’
‘Understood,’ Kane confirmed. ‘I’ll get the stretcher from the cab.’
By the time they’d loaded the corporal on the stretcher and carried him out of the dip to more level ground, she could already hear the helicopter in the distance.
Instinctively, Mattie stood over her patient, protecting him as best she could from the downdraught of the rotors, waiting as her guys jumped off the back and hurried over to carry out her handover with a few additional instructions besides. Before long, they were loading the corporal into the heli.
‘Will you be returning with us, ma’am?’
She could feel Kane’s eyes on her. Boring into her back. She didn’t dare turn. Still, as she shook her head, she was grateful for the ability to keep her tone light yet professional.
‘No,’ she confirmed. ‘We still need to determine the location for the new medical phase of the exercise. The first two locations didn’t turn out to be appropriate.’
