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The door opened and one of the staff nurses stuck her head round, interrupting him before he could finish his sentence.
‘Dr Christakos, A and E are on the phone. It’s urgent.’
Andreas gritted his teeth and strode out of the room, almost sending the nurse flying.
Libby stared after him and she was still staring into space when he returned only moments later.
‘That was your brother-in-law,’ he said, his mouth set in a grim line. ‘There’s been a nasty house fire and two children were involved. They’re on their way in now but they’re already struggling in A and E so he wants some help.’
Libby pulled herself together. ‘Of course. I’ll just tell Bev.’
She hurried off to find the ward sister and then met Andreas in the corridor and they both made their way to A and E. Andreas didn’t make further reference to their conversation but she felt his eyes on her.
The department was frantically busy. The waiting room was bulging with people and the screen was flashing up a waiting time of five hours.
‘And it’s going to be longer than that,’ Katy told them quickly, following their gaze. ‘We’re having a bad day down here. Thanks for your help. We thought that you could sort the children out—maybe take them straight to the ward if you prefer.’
Andreas gave a brief nod. ‘We’ll assess them here and then decide. What’s been going on?’
‘A coach overturned on one of the bridges,’ Katy told him, her face drawn and tired. ‘We’re all struggling. And now Ambulance Control has rung about the fire. Apparently it was a nasty one. The mother jumped from the window with the baby. She’s fractured both femurs and she’s in a bad way, although they think the baby is fine. The father went back into the house to try and get to the other child.’
Before they could discuss the case any further they heard sirens as several ambulances pulled into the ambulance bay.
‘OK, let’s move!’ Miraculously, Jago and one of the A and E consultants appeared and took charge. He spoke swiftly to the paramedics, conducted brief triage in the back of the ambulance and then reappeared, his expression grim. ‘Katy, I want the mother and the father into Resus straight away, and fast-bleep the orthopaedic surgeons. Andreas, do you want the children on the ward or down here?’
‘I’ll assess them here.’ Andreas stepped forward to talk to the other paramedic. ‘What’s the story?’
‘The baby seems to be unhurt. The mother took the brunt of the fall and she was cradling the child so the little one may be all right, but she herself jumped from the bedroom window, which was quite a drop. Baby’s been crying non-stop but no signs of burns. The four-year-old is a different matter. Her pyjamas caught fire and she’s got nasty burns to her legs. We’ve given her oxygen at the scene and covered them.’
‘OK—take them both through to Paediatric Resus,’ Andreas ordered, and Libby hurried ahead of him to the area of A and E that had been designed specially for children.
The paramedics lifted the howling four-year-old onto the trolley and kept hold of the baby, who was also shrieking.
Charlotte, one of the A and E sisters, hurried forward. ‘I’ll take her while you examine the older child.’
Andreas was already by her side, talking to her gently, trying to assess the degree of damage. ‘Can we weigh her quickly? Once we’ve done that I want to estimate the surface area of the burns and then get this child some pain relief,’ he ordered quietly, and Libby did as he’d instructed. ‘We need to get a line in and then we’ll give her a bolus of morphine.’
Libby gathered the necessary equipment while Andreas examined the screaming child, calculating the percentage of the body surface that had suffered burns.
‘If we take her hand to be the equivalent of one per cent of her body surface area, she’s suffered about ten per cent burns, most of them partial thickness,’ he murmured, as he examined the little girl’s legs. ‘Would you agree?’
‘Sounds about right.’ Libby nodded, running her eyes over the burns on the child’s legs.
‘These blisters have ruptured and they’re weeping. She’s obviously feeling pain.’
‘Which is a good thing,’ Libby said softly, and Andreas nodded.
‘Absolutely. As we both know, it’s a sign that the nerve endings aren’t damaged. I’ve checked her chest and it seems clear so there’s no sign of smoke inhalation. What we have to worry about now is fluid loss.’
Libby nodded. She knew that fluid loss was proportionately greater in children than adults.
‘Poor little mite. You’ll want to admit her,’ she said immediately. ‘When you’re finished here I’ll call Bev and see if she can go in the side room. Melanie Parker is well enough to be on the main ward now.’
Andreas nodded. ‘It would probably do her good to be mixing with the other children. OK, let’s get on with this. What’s her name?’
Libby checked the notes that the paramedic had left. ‘Jenny.’
‘Right, Jenny…’ Andreas positioned himself so that he was close to the girl without actually touching her. She was still screaming hysterically. ‘We are going to take that pain away.’
