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Which was a relief because she felt completely and totally out of her depth.
He kept his voice low, explaining what he was doing as he worked. And he worked quickly.
‘Normally we wouldn’t handle the injured part without splinting,’ he told her after they’d given the man drugs to control the pain, ‘but in this case there’s severe deformity and the blood supply is compromised.’
‘So that could damage the soft tissues?’
‘Exactly. A good blood supply is vital to limb survival. So in this case I’m going to apply gentle traction to restore the alignment of the bones. Then we’ll splint.’
Katy blinked in surprise as one of the paramedics took a Polaroid photograph of the wound before covering it with a sterile dressing.
‘Why did he do that?’ She spoke in a low voice even though the patient was drifting in and out of consciousness, barely aware of what was happening.
‘Because exposing the wound again in the A and E department will increase the risk of infection, so if we can we take a photo at the roadside before we cover it,’ Jago explained. ‘No one will disturb the dressing now until this chap reaches Theatre.’
Katy watched while he reduced the fracture and then checked the pulses in the limb.
‘OK.’ He glanced up at the paramedics and ran a hand over his face to clear his vision, his thick, dark lashes clumped together in the rain. ‘I need a long leg splint.’
They produced one immediately and Jago immobilised the leg with help from Katy and one of the paramedics.
‘Splinting the leg will help control the pain but we need to get him to hospital fast. Blood loss from limb wounds and internal bleeding from fractures contribute to shock so we need to resuscitate him carefully.’ His eyes flickered to Katy. ‘Don’t forget that blood loss from open fractures can be two or three times greater than that from closed fractures.’
Katy listened, taking in everything he was saying, totally in awe of his amazing ca
lm and the amount of knowledge he displayed.
He seemed totally indifferent to the rain and darkness, acting with the same degree of supreme self-confidence that he displayed in the well-equipped A and E department.
He was talking again. ‘One of the advantages of attending the scene of the accident is that you get a real picture of what happened and that helps you assess the possible injuries.’
She was eager to learn from him and for a brief moment their past history was forgotten, the tension between them easing as they concentrated on the patient. ‘And that’s why you always question the paramedics about whether the patient was a passenger or the driver?’
Jago nodded, his attention fixed on the patient. ‘It’s important to know whether they were in the vehicle or a pedestrian. Whether they were restrained by a seat belt. The direction of impact and the degree of damage to the car.’
‘So if you know that someone was thrown from a vehicle—’
‘Then you know that you’re dealing with potentially fatal injuries,’ he slotted in, nodding to the paramedics to indicate that they could load the patient into the ambulance. ‘It’s one of the reasons we always make you undress trauma patients in the A and E department. You never know what injuries may be hiding and clinical signs may be subtle, particularly in the unconscious patient.’
He directed operations as the patient was carefully lifted into the ambulance and then sprang into the vehicle, his movements swift and athletic.
‘You and Charlotte bring the car. I’ll see you back in A and E.’
She turned back to the car feeling a huge range of emotions. On the one hand she felt that she’d learned a lot but on the other she felt helpless and cross with herself, knowing that she hadn’t dealt with the situation well.
The truth was, she’d been horrified by the extent of the injuries she’d seen and too panicked to know where to begin.
Was that normal?
Had other doctors found themselves in the same situation?
Charlotte walked up to her, carrying some equipment. ‘Slick, isn’t he?’
Katy helped her lift it into the boot of the car. ‘He’s very confident.’
‘Well, that’s because he knows what he’s doing.’ Charlotte slammed the boot shut. ‘He’s ferociously intelligent and he never loses his cool.’
Except with her.
