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‘Check her BMG and her urine for glucose and ketones,’ he instructed, and one of the other nurses did as he requested while Hannah checked the girl’s blood pressure and pulse.
Josh scanned the machine with a nod. ‘Hypotensive and tachycardic. I’m pretty sure that we’re looking at a case of diabetic ketoacidosis. It would fit her signs and symptoms.’ He tried talking to the girl but her answers were incoherent and gave them no clues at all. Josh gave up. ‘Hannah…’ He glanced up, his expression urgent. ‘Can you get someone to talk to the friends? We need som
e history here. Is she an uncontrolled diabetic? There are no marks on her skin so it doesn’t look as though she’s been injecting. I need everything they have on her medical history.’
‘I’ll get some details from them.’ Hannah vanished from the room and Josh looked at Kat.
‘Let’s get an IV in and an infusion of saline started. If that hypotension persists then we might need to increase the rate and switch to colloids.’
Moments later Hannah was back in the room. ‘They say that she isn’t a diabetic but she’s been behaving oddly for the past couple of days. They thought she had a bug.’
‘Diabetic ketoacidosis can develop over several days in younger, undiagnosed diabetics.’
Kat slid a venflon into the vein. ‘What blood tests do you want?’
Josh’s eyes flashed a challenge. ‘What do you think, Dr Sullivan?’
‘Blood glucose obviously.’ Quickly she selected the right bottle. ‘U&Es, creatinine, osmolality…’ She listed the others and Josh gave a nod.
‘And a full blood count and arterial blood gases. Let’s send off blood cultures and get an ECG done. And call the radiologists. I want a chest X-ray.’
Kat finished taking the blood and labelled the bottles. ‘Do you think she has an infection?’
‘I think it’s possible. We’ll send a sample of her urine for microscopy and culture and do a throat swab.’ Josh checked her plasma glucose level. ‘All right, folks, let’s give her 20 units of insulin to start with, and then we need to monitor that level every hour. Has someone called the medical reg? Obviously she’s going to need to be admitted.’
Hannah nodded. ‘He’s on his way. He’s already in the department actually, so he’ll be along in a minute.’
They worked until the girl was stable and then handed her over to the medical team. ‘I’ll take her up to the ward and then I’ll come back and sort this place out,’ Hannah said, glancing around Resus with a rueful expression on her face. ‘What a mess.’
With the help of a porter, she guided the trolley through the doors and they swung shut behind her.
Silence descended on the room.
Kat swallowed. Suddenly it was just the two of them again. ‘That was a really interesting case.’ She kept her voice bright and professional. ‘I love the way you always think laterally. You see abdominal pain but you don’t automatically think acute surgical abdomen. You always manage to—’
‘Kat.’ Josh interrupted her in a soft tone. ‘You’re chattering. What the hell’s the matter with you?’
He was the matter with her!
‘You were good, that’s all,’ she said gruffly, and there was a long silence. A silence that made her so uncomfortable that she turned away and concentrated on restocking Resus. As far as she knew, there was no substitute for work when it came to taking your mind off a problem.
And Josh Sullivan was definitely becoming a problem. A big problem.
Reaching for a new bag of saline, she ripped off the protective cover and attached a giving set. Then she did the same with a bag of dextrose, aware that Josh was just lounging against one of the low cupboards, watching her.
She became more and more flustered and turned her attention to the intubation tray. She snapped open laryngoscopes to check the bulbs; she counted ET tubes and checked tapes.
Then she was forced to go into his cupboard. ‘Excuse me.’ She moved closer to him and then realised her mistake. It was like stepping into a force field, programmed to draw her in.
She felt the brush of his arm against hers, the warmth of his breath, and for a microsecond she stilled, feeling the shock waves pulse through her sensitised body.
And then he moved.
Swiftly and without hesitation he hauled her against him, turning her so that she was pressed against the cupboard, giving her no option of escape.
But she didn’t want to escape. They’d been building towards this from the first second their eyes had met on the beach, and the moment his mouth crashed down on hers she was lost. The heat that had been building consumed her, the sudden blaze of passion burning through reason and resolve.
Without lifting his mouth, his fingers found the hem of her top and he jerked it upwards, his hand sliding, searching until it closed over one breast. The ache between her thighs rose to almost intolerable levels and she pressed against him, squirming to get closer and closer, feeling him rock hard and male through the thin fabric of his scrub suit.
