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Wondering why she’d suddenly lost all her bounce and energy, Lara joined the team in Resus and worked on automatic, relying on experience to carry her through.
She wasn’t going to look at Christian more than was absolutely necessary.
She wasn’t going to admire him.
‘He’s arrested.’ Penny’s voice rose slightly. ‘There’s blood everywhere. They must have hit his heart when they stabbed him. The cardiothoracic team are waiting for him in Theatre.’
‘He isn’t going to make it to Theatre,’ Christian said grimly. ‘Start external chest compressions. Lara, get me a thoracotomy pack.’
Penny’s face was white as she followed his instructions. ‘You’re going to open his chest here?’
‘He’s arrested,’ Christian said bluntly. ‘We’re not exactly overwhelmed with options.’
As Lara scrubbed and put on a gown, she glanced towards Penny and wondered whether she’d ever witnessed severe trauma before. ‘You’re doing really well, Penny,’ she said quickly, opening the pack for Christian and handing him gloves, a face shield and an apron. ‘I’ve called blood transfusion.’
‘Good. Let’s hope he’s going to need it.’Christian moved to the patient’s left side and lifted his arm. ‘Stop chest compressions, Penny.’Without hesitation he made an incision in the left chest wall.
Lara handed him a rib retractor and adjusted the light. ‘Is that better?’
‘All I can see is blood.’ His fingers swift and decisive, Christian widened the incision. ‘I can see the pericardium—it’s bulging.’
Hoping that Penny wasn’t going to faint into the wound, Lara watched as he skillfully evacuated the blood from the pericardial sac.
‘Right—now I just need to work out what’s going on here…’ He put a finger over the defect and performed internal cardiac massage. ‘Lara, give me a prolene suture.’
She ripped open the appropriate packet and he took it swiftly and worked to repair the damage to the heart. ‘The knife must have gone straight between his ribs.’
‘Yes.’ Christian paused and glanced at the monitor. ‘Check cardiac rhythm and output.’
‘He’s in VF.’
‘Give me the internal defibrillation paddles.’ Without hesitation, Christian placed a paddle either side of the heart and delivered the shock.
‘He has a pulse,’ Lara murmured. ‘Gosh. It’s our lucky night. More Christmas miracles.’
‘Lucky?’ Penny looked at her, her face white. ‘How can you call him lucky?’
‘Because if Christian hadn’t opened his chest, he’d be dead now.’ Lara was still watching the monitor. ‘Do you want to put in a catheter?’
‘Yes, and an arterial line.’ Christian looked at Penny. ‘We need to check his bloods again. U and Es, FBCs, glucose and clotting. And give him 1.5 grams of cefuroxime.’
Penny didn’t answer and Lara glanced towards her. The young doctor’s face was ashen.
Noticing her sway slightly, Lara dropped a pair of forceps on the floor. ‘Oops. Silly me.’ Her voice was calm. ‘Do you mind picking that up for me, Penny? Just put them on the side, over there.’
The action of stooping to retrieve the forceps restored the blood to Penny’s head and, when she straightened and put the forceps down, she had some colour in her cheeks. She gave Lara a hesitant smile of thanks, clearly aware that Lara’s sudden display of ‘clumsiness’ had been intentional.
Christian was still involved with the patient and hadn’t noticed anything amiss.
‘It’s jolly hot in here,’ Lara murmured. ‘Why don’t you go out and take a breath of fresh air, Penny?’
Christian lifted his head and frowned but at that moment the cardiothoracic team strode into the room and the focus of his attention shifted. ‘Gregg.’ He nodded to his colleague. ‘We have a patient for you.’
The cardiothoracic surgeon walked up to the trolley and Lara took advantage of the extra staff to give Penny a little push.
‘Someone else can take those bloods. You go outside and breathe. Then go to the staffroom and have a cup of tea.’
Penny didn’t argue and Lara turned back to the patient who was now in the hands of the cardiothoracic team.
