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‘Ninety over fifty? That’s low, isn’t it? Is she going to be OK?’ The woman’s husband was pacing the floor, his hands clasping his head. ‘I can’t believe this has happened. I didn’t even know that we had poisonous snakes in the UK. If I’d known, I wouldn’t have let her walk in sandals. But it was hot and—’
‘They rarely show themselves and the bite doesn’t always cause such an extreme reaction. She was unlucky.’ Logan took the second syringe from Evanna and injected the contents into his patient. ‘Let’s give her some antihistamine and hydrocortisone and I’m going to put a line in, just as a precaution.’
Evanna reached for the IV tray that she kept ready. ‘Do you think she needs antivenin?’ She knew nothing about antivenin but she knew that it existed.
‘Possibly. She’s obviously absorbed some venom.’
Evanna watched the ECG trace carefully but could see nothing amiss. ‘That seems all right. What exactly are you looking for?’
‘Non specific changes—ST depression or T-wave inversion.’ Logan frowned and leaned closer. ‘That seems all right. Leave it on until we transfer her to the helicopter. I want to keep an eye on it.’
‘You’re sending her to the mainland?’ Evanna knew that Logan never requested a helicopter transfer unless he was absolutely confident that the patient needed hospital help fast. In his years as the island GP, he’d shown himself to have an uncanny instinct for exactly when to call in the air ambulance.
‘Yes.’ His eyes were still on the ECG trace. ‘Can you get the poisons unit on the phone for me? I want to talk to them.’
‘Her blood pressure is coming up,’ Evanna said, recording the reading and then reaching for the phone. She looked up the number and dialled swiftly, aware that Logan was examining his patient.
It was impossible to work with him and not admire him, she thought as she waited for someone on the other end to pick up the phone. In all the years that he’d been the doctor on Glenmore Island, she’d never seen him panic. Even that awful night with Catherine, he’d been in control. He was incredibly skilled and his confidence had a soothing effect on patients who were often anxious at finding themselves ill or injured so far from what they considered to be civilisation.
Logan removed the ad hoc dressing that they’d applied. ‘Her leg is swelling up,’ he said quietly, ‘and I can see fang marks on her foot. So it was definitely a venomous bite. Do you know if her tetanus is up to date?’
‘I have the poisons unit on the phone for you.’ Evanna held out the phone and Logan stepped towards her and took the receiver.
‘Can you clean and dress it, Evanna?’ He lifted the phone to his ear. ‘It’s Logan MacNeil here.’ His voice deep and steady, he swiftly outlined what had happened and discussed the best management with the person on the other end.
‘Her colour looks better,’ Pete said, and Evanna nodded as she checked her pulse again.
‘Her breathing seems easier. We haven’t even had a chance to take details from you. What’s her surname?’
‘Winchester. Alison Winchester. I’m Peter. We’re staying at the Glenmore Arms. We only arrived yesterday.’
Evanna scribbled down the details and then checked the woman’s pulse again and gave a nod. ‘It’s ninety-five now. Better. I’m just going to clean the wound and splint that leg properly.’ She washed her hands, laid up a trolley and quickly cleaned and dressed the wound.
Logan replaced the phone. ‘The air ambulance will be here any minute and we’re going to transfer her to the mainland. They’re expecting her in the hospital. I’ll just write a quick letter so that they know what we’ve given.’
‘I feel better.’ Still pale, Alison lifted a hand to try and move the mask but Logan stopped her.
‘Keep that on for the time being. The drugs I’ve given you are obviously taking effect and that’s good, but we’re going to fly you to the hospital on the mainland just in case you need some more treatment.’
‘Will they keep me in?’
‘It’s likely, at least in the short term.’
‘Are you going to go with her?’ Evanna glanced out of the window as she heard the approaching helicopter.
‘I ought to.’ Logan’s eyes were on the computer screen as he quickly drafted the referral letter. Then he pressed the print key and turned to look at her, and she read his mind.
Kirsty.
‘I was just planning to have a quiet day so I’d be happy to have her,’ she said softly, and he let out a long breath and ran his hand over the back of his neck.
‘I feel guilty asking.’
‘Don’t. I love her, you know that. We’ll have fun.’ Evanna checked Alison’s blood pressure again. ‘That’s much better. You go and talk to them, Logan.’
‘Will I be able to go with her?’ Pete glanced between the two of them and Logan nodded.
‘That shouldn’t be a problem. Unless you’d rather take your car over on the ferry and drive. That way, you could pack a few things.’
