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Still, before focussing all her attention on the obvious injury she wanted to ensure that there wasn’t another, less obvious but potentially more life-threatening, injury to prioritise. Distracted by the open wound, the road crew might have missed potentially fatal internal bleeding into the patient’s chest, his pelvis or his stomach.
To her surprise Ben, as though anticipating her immediate priority, stepped away to the rider’s girlfriend, to ask what had happened, as she took the opportunity to ask the rider himself. Her account might shed light on something the patient himself had missed—like the angle of his fall. It might help Thea to decide if there was another test she needed to carry out.
After running through her checks Thea stepped away to discuss a treatment plan with Andy. Ben quickly joined them.
‘A startled duck took sudden flight off the canal, spooking his horse. The horse bucked and the rider fell onto the gravelly, tree-root-riddled path,’ Ben advised.
‘I got the same account.’ Thea nodded. ‘Plus he was clear, concise and calm. My gut says that although he’s in some pain, there are no underlying issues. He’s stable.’
‘Agreed.’
‘That blood supply concerns me,’ she murmu
red. ‘I want to try an open reduction before we move him.’
‘Good plan, but you’re going to need some strong pain relief if you want to get that bone back under the skin,’ Ben noted.
‘I’ll get the Ketamine,’ Andy said, jogging back to the helicopter.
‘That’s a pretty powerful drug.’ Ben looked surprised. ‘I didn’t know emergency vehicles carried it.’
‘The road ambulances don’t,’ Thea agreed. The drug could effectively unplug a patient’s sight, hearing—the lot. ‘But it’s another advantage of the Air Ambulance having trauma doctors. We can carry a range of equipment and drugs other rapid responders can’t.’
‘Nice.’ Ben looked impressed. ‘So is that why the road crew called us out instead of just packing the rider into the ambulance and taking him to hospital?’
‘Yep.’ Thea busied herself getting her kit together to perform the reduction procedure. ‘The road crew can only scoop and run, whilst with our knowledge and our kit we can, as they say, stay and play. Treating an injury like this in the field can mean the difference between the foot needing to be amputated and saving it.’
‘Right...’ Ben nodded in agreement. ‘It’s a very battlefield-orientated approach.’
Thea blushed. Of course he would already know that as well as anyone. Still, he wasn’t rolling his eyes or complaining at the lesson. Perhaps her initial fears about them working together were unfounded. And it felt good to be in control of something—of Ben—when up until half an hour ago she’d been feeling as if she was drowning.
‘Exactly. Right, I’m going to update them back at base. Do you want to go and explain to the rider what we’re about to give him and why?’
‘Sure.’
Ben jogged off immediately and Thea contacted Jack. She couldn’t help noticing a slight stiffness in his gait. The cold weather, she realised instinctively. She’d noticed he always seemed to be in that bit more pain when the temperature dropped, or if a storm was brewing. He was like a human barometer.
As she checked in with Jack she took the opportunity to snag a high-vis puffer jacket from the helicopter, and she tossed it to Ben as she returned to the rider.
‘I need you to go to the end of the lane when you’ve finished with the patient and flag down the second road crew who are on their way. Put that on and they’ll see you better.’
She studiously ignored Ben’s sharp look as she administered pain relief to the patient, but noticed that he was quick to wriggle into the jacket’s cosiness. The pain must have been twisting into his bones.
She sat back thoughtfully for a moment whilst the drug took effect. Ben had turned towards the rider, and his reassuring voice was repeating information to ensure the guy understood.
‘Okay, so Ketamine’s what we call a dissociative drug. It’s going to make you feel a little strange, maybe a little spaced out, and you might not remember any of this—all right?’
The patient muttered something which she didn’t catch, but Ben was clearly completely in control.
‘It’s going to take your pain away and enable us to do our job. We’re going to try to save that foot.’ Ben glanced up as Thea took the ankle and gave him the nod. ‘Okay, are you ready?’
Confident that Ben had the rider’s trust and attention, Thea knew all she needed to do was get on with her job. With any luck she would have five, maybe six minutes to reduce the open fracture. If the patient wasn’t compliant, she would have to administer a second dose.
‘Just try to relax,’ Ben soothed the rider. ‘This stuff will work much better if you’re relaxed.’
Andy and Ron were both good, and she was proud of her team, but there was no doubt that Ben had an extra edge. It wasn’t just his Army training, or his skill as a trauma surgeon, it was something essentially Ben. He was still talking to the patient, looking up to give her a brief nod when he saw the drug was starting to work at the same moment as she was already moving in to work on the ankle. They seemed to be completely in sync.
Working carefully and quickly, she tried the procedure, but the man was becoming agitated, and with only a look to Ben Thea was able to confirm that the rider wasn’t responding adequately to the drug. She wouldn’t be trying a second time.
