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'Zoe, let's give her some nebulised adrenaline.' Hopefully that would buy her some time until the team arrived. She turned back to the mother. 'And has she had all her childhood immunisations?'
Mrs Potter suddenly looked wary. 'No. No, she hasn't. I don't believe in all that, I'm afraid. I think children are better off picking up the germs and developing their own immunity.'
Keely swallowed her frustration, reminding herself that everyone had the right to make their own choice about immunisation. The trouble was, she had a strong suspicion that Alice Potter was suffering from a disease that had been virtually eradicated thanks to the success of the vaccination programme.
'Shall I check her BP?' Nicky asked quietly, and Keely shook her head vigorously.
'No. Don't disturb her at all.'
Mrs Potter looked up. 'What's wrong with her?'
Keely took a deep breath. 'I think she has something called epiglottitis,' she said finally, and Mrs Potter frowned.
'I've never even heard of it.'
'It's extremely rare now,' Keely told her quietly, 'because most children are vaccinated when they're babies.'
Mrs Potter went slightly pale. 'But she'll be all right, won't she?'
Keely hesitated. 'She's seriously ill, Mrs Potter—very seriously ill.'
'Are you sure it's not just a bad sore throat?' Mrs Potter became slightly belligerent. 'You haven't even looked in her throat.'
'It could be very dangerous to look in her throat,' Keely explained. 'If she is suffering from epiglottitis, examining her could totally obstruct her airway.'
Even as she watched, the child started to gasp for air and Keely turned to Nicky, her expression urgent.
'Let's get her on the trolley and call Zach quickly. And crash-bleep the paediatrician again. If he doesn't arrive soon I'll have to intubate her, and I'd like Zach here.'
'She's not breathing,' Zoe said quickly and Keely moved to the head of the trolley.
'OK, give me a small endotracheal tube and an introducer.'
While Zoe hurried the mother out of the room, Keely tried to intubate the child.
'It's all too swollen,' she muttered grimly as she tried to insert the tube into the little girl's airway. 'Damn. This is impossible. Give me an IV cannula—where the hell's Zach?'
'I'm right here,' came the calm reply, and she looked up with a sigh of relief.
'She's in respiratory arrest but I can't intubate her because her airway is so swollen. I'm going to do a needle cricothyroidotomy.'
With Zach's reassuring presence by her side she managed to perform the procedure successfully, and his quiet words of praise increased her confidence dramatically.
Then all of a sudden the room was full of people and the paediatricians took over.
'She's arrested.' Tony Maxwell snapped out some instructions and they all worked to save the little girl.
An hour later Tony shook his head, his expression grim. 'I think we should stop now. Does everyone agree?'
'No!' Keely's cry was anguished. 'We've got to keep trying. She's only four years old.'
Zach put a hand on her shoulder and his voice was gruff. 'Keely, she's not responding.'
'But we can't let her die.'
'She's already dead,' Tony said gently, his eyes bleak as he looked down at the tiny figure on the trolley. 'Agonising though it is, I think we have to leave it at that.'
'It needn't have happened.' Keely felt a lump building in her throat and fought for control. Zach already thought she wasn't emotionally tough enough to cope with A and E work. She didn't want to prove him right. 'It's just so unfair...'
