by Annie O'Neil
Either he ran the winery his father’s way, turning his back on the CFS, or he left River’s Bend, leaving his sister to pick up the reins.
Even that seemed to be going wrong.
Seeing Liesel had been a bad idea. He was 100 percent certain he had not been 100 percent focused tonight. He just couldn’t keep his thoughts away from Liesel. What it would be like to run his fingers through her hair. Tasting her, touching her, falling into a first-class sensory overload. Having Liesel in his life simply wasn’t going to work if he couldn’t focus.
“Earth to Jack.”
“Yeah, mate—sorry?” Jack tried to snap himself back into the room.
“Who is she?”
“Who?”
“The girl—the woman—you’re mooning over. I haven’t seen such a dopey expression on your face in—well, ever.” The chief tugged a blanket over his shoulders, appearing visibly amused with himself for having hit all the right buttons.
“She’s not— It’s not what you think. She’s a nurse I’m trying to persuade to volunteer down at the station. Just putting in a bit of personal time with her to talk her through how it all works.”
Yeah, right! Who’s going to buy that load of malarkey?
“Don’t worry, mate.” The chief stuck a ringed finger out from under the khaki blanket and wiggled it in front of Jack’s dumbstruck face.
Obviously not the chief.
“Twenty-two years in February. She made us get married on Valentine’s Day so I wouldn’t forget the anniversary.”
“Clever.” No way he was going to contribute more to this conversation. Holes were getting dug everywhere and he didn’t have the energy to dig himself out.
“That she is, mate. That she is.” The chief rolled over toward the wall, throwing a few words over his shoulder as he went. “Just make sure your girl can handle your lifestyle—because the fire service is in your blood. That’s one thing about you she won’t be able to change.”
Jack pulled his unlaced boots off and tugged on a fresh T-shirt but his guaranteed shut-eye from a few minutes ago was off the radar now. From a casual night out to advice on long-term wedded bliss. Thanks a million, Chief!
CHAPTER FIVE
IT HAD BEEN four days and...Liesel flicked her eyes up to the office wall clock clicking away the slow-motion seconds...ten and a bit hours since Jack had dropped her and Liam off and she hadn’t heard a peep since. Despite her best efforts, each time the phone rang, her entire body responded with a whoosh of adrenaline and an accelerated heartbeat.
A huge chunk of her wanted to shake off her concerns and ring him or at least drop him a thank-you note—to just go for it and see what sparks might fly between them. Maybe even have a good old-fashioned snog!
The other part? Not quite ready to part with her fears over his chosen profession. If she was truly being sensible, Jack Keller wasn’t an option in the romance department. She didn’t want to date. Didn’t want to hang out. She wanted to fall madly in love and start a proper family with someone. How did you put all of that in a greeting card?
Maybe she should just choose the teenager way of dealing with it and blank him. Out of sight, out of mind—problem solved!
She tipped her chin up and closed her eyes to try it out. A vision of Jack in his formfitting CFS T-shirt tangoed past her closed lids. He moved in closer, took her face in his big man hands and lowered his mouth to—
Hmm. That plan might need some work.
“What’s got you so blue?”
Cassie’s high-beam smile failed to lighten her mood. Liesel pointed at a stack of paperwork on her desk.
“More data entry.” She made a stab at returning the toothy grin still shining away at her from the doorway. “The joys of nursing!”
“Not enough excitement for you out here in the back of Bourke, Miss Adler?” Cassie waggled a reproachful finger at Liesel then placed it on the side of her nose, her face settling into a reflective pose. “Or could it be there hasn’t been enough action with the local fire department?”
Liesel scrunched up a scrap of paper and threw it at her friend, trying her best to laugh away the accusation. “Don’t be ridiculous.” Was she that easy to read?
Cassie’s attention shifted abruptly from Liesel to someone behind her. “What are you doing out of class, mate? I hope it wasn’t another fight.” Liesel couldn’t make out the mystery boy’s muttered response. “Are you all right, love?”
Liesel shot out of her chair. Cassie’s tone was not good. Neither was the scene playing out in front of her office door.
“Kev? Kev, what’s going on, love?”
Cassie was on the floor, kneeling by her ashen-faced son, who was doubled up in obvious agony. Cassie’s face was wreathed in terror. Liesel felt the familiar coils of fear start to constrict her own breathing. She knew part of her job was to provide calm in a situation like this, to embody common sense and active pragmatism, but seeing Kev gasping for breath was overreaching the parameters of her remit of scraped knees and brushing a few tears away. It wasn’t outside her training, though. And there was no time to lose.
“What’s going on? He doesn’t have asthma!” Cassie’s voice was low but the tone screamed volumes. Kev needed help. “Call an ambulance, Cass. Now.”
Liesel dropped to her knees, fingers flying to Kev’s carotid artery to check his pulse. It was racing and anyone could see he was barely getting any breath with each painful attempt to inhale. She placed hands lightly on either side of his chest. One definitely responded more than the other as he fought for breath. Collapsed lung. It had to be.
Primary spontaneous pneumothorax.
Liesel had seen it before. When a fast-growing, lanky teen like Kev had yet another growth spurt not all of the organs had a chance to catch up and occasionally a tiny tear in the outer part of the lung allowed air to escape, which would then get trapped between the lung and the chest wall.
“Hurts...” Kev wheezed the word out.
“I know. You’re going to be all right. We’re going to patch you up but you’re going to have to stay as calm as possible to help slow your breathing down. I think you’re just working on one lung right now, okay, Kev?”
Kev’s eyes flew wide-open, a sheen of sweat visibly breaking out on his forehead. Liesel wanted to bite her tongue the moment the words were out. She was there to calm him down, not distress him more.
The truth of the matter was this was a dangerous situation and, without help arriving soon, any number of problems could arise. His heart rate was fast and if it went over one hundred and thirty-five beats a minute Kev could quickly begin to suffer from tachyarrhythmia. He was young, but even a teenager needed a steady flow of blood and oxygen to the heart and body. Without it, permanent tissue damage to the heart and brain could begin to occur in as little as three to four minutes. Next came the kidneys—
“He’s on his way.”
“Who?”
“Jack Keller. The closest proper ambo is an hour’s drive away.”
“What?”
“The hospital always uses the CFS when they don’t have anyone around.”
“We’d be just as well driving to the hospital ourselves, then. What is it, about twenty minutes away?”
“More. He said he’s bringing the station’s paramedic SUV. It’s part of the Community Emergency Response Unit and we can put on the lights and siren. He’ll get us there faster.”
Liesel sat back on her heels, mind racing. If Kev did, in fact, have a collapsed lung, he must have waited some time to come to her for help. He would’ve felt some tugging in his chest, tightening, possibly a whoosh of air and further tightening until the condition began presenting itself as it was now. Very seriously.
She locked eyes with Cassie. “We’ve got to keep Kev as calm as possible. Technically
, as a school nurse, I am not allowed to administer aid to him but, in the same vein, I have a duty of care to help him if there is no one around to do so. I believe there’s air in his pleural space—”
“What’s that? I don’t know what you’re talking about, Liesel!”
“It’s air trapped outside his lung by the chest wall.” She gave Cassie a moment to steady her own breathing and blink back some tears. “We’re going to get through this, all right?”
“That’s right, Cassie, you couldn’t ask for a better trauma nurse. I’ve seen this one in action.”
And there he was. Brigade Captain Jack Keller. Filling the doorway with his six-foot-something good looks. Capable, calm, ready for action and completely off-limits.
* * *
“Is the gurney locked in?”
“Securely.” Jack gave Liesel a quick nod and glanced at Cassie. “You’re going to want to buckle up for this, Cass. All right?” Without waiting for an answer, he closed the back door of the enormous SUV, quickly jumped in the front, threw a few switches, and, lights in full swing, they shot past the school principal, who was soberly waving them off.
“What’s our ETA?”
Liesel was grateful she didn’t have to shout over any sirens. The roads were relatively clear out here and the lights on their own should give other drivers ample warning.
“Ten to fifteen minutes, traffic pending. Are you going to be all right?” Jack’s eyes were firmly on the road but Liesel knew his mind was on the patient. It wasn’t looking good. Kev was presenting all the signs of a tension pneumothorax, a life-threatening condition. This was different from a spontaneous pneumothorax, which often occurred when just sitting or resting. Kevin had managed to tell them he’d been out on play break with the other students when the pain had started.
She looked down at him, an oxygen mask secured loosely to his mouth. There were no telltale signs he’d been in another fight. That would’ve been her first guess. His last set of black eyes had faded and he showed no other external injuries.
She gave the elastic band a small tug, ensuring Kev could get maximum airflow. The large SUV was kitted out to the nines for emergency medical scenarios, just the sort of vehicle she would’ve wanted if she’d— Nope. Not going there. At the very least she could thank her lucky stars they hadn’t attempted the drive on their own. Avoiding face time with Jack wasn’t worth risking Kev’s life. The teen was definitely going to need more assistance than she could offer and the oxygen tank was vital. She knew they’d be safe in Jack’s hands. Whatever her personal feelings were, he was a professional you could depend on.
When they arrived at hospital, she was certain Kev would need immediate attention—specifically, a needle aspiration. Liesel had only witnessed it being done, had assisted. It was generally a doctor’s job to insert the needle into the chest cavity in order to release the trapped air. Some doctors preferred to use tubing in the chest but research she’d seen in her nurses’ journal had proven it to be more traumatic for the patient and generally increased the hospital stay. She hoped the Murray Valley Hospital was up to date on that front, for Kevin’s sake.
“Do you think it was the other kids? The ones from last time?”
“Sorry, Cass?”
“Do you think he was roughed up by those lads again?”
Liesel shook her head at her friend, confused. “I don’t think this has anything to do with a fight. Besides, I thought it was the other way round.”
Cassie huffed out a solitary “Ha!” before letting her head fall into her hands.
“What’s going on Cassie?”
“They’re bullying him, Liesel.” Cassie’s eyes were filled with anguish as she continued. “He puts on such a brave face, trying to be the man of our family, but the boys are relentless. I told him to be bigger, better than they are by not fighting back, but if I’ve put him in danger...” A ragged sob filled the closed space in the back of the SUV.
Liesel reached over Kev and squeezed her friend’s shoulder. “You don’t know that. Let’s wait until we hear the whole story.”
Returning her focus to Kevin, Liesel’s eyes shot wide-open, alarm bells ringing dangerously. Kev’s chest had become distended and after a quick check she confirmed his trachea had deviated to the opposite side of the collapsed lung. This was a sign ER teams usually only found when examining X-rays. But Jack was thin enough that she could see the shift of location despite the fact it was located behind the sternum. She pulled off Kevin’s oxygen mask and checked for breath. They didn’t have time to wait anymore.
“Jack. Pull over.”
He didn’t wait to hear it a second time.
“What do you need?”
“I am going to have to aspirate Kevin’s chest. The risk of the car hitting a bump while I’m inserting the needle is too high.” She heard him snap back the seat belt and pull open his door as she signaled to Cassie that she would be best out of the car while she did it.
“I want to stay here.”
“Please, Cassie—you’ll be right outside the car. Just give us a few minutes. It’s all we need.” Liesel felt horrible as she made her friend climb out of the back of the SUV, but this was a first-time procedure for her and Kevin’s life depended on it. She needed absolute focus. Jack was in her place before she’d taken in Cassie’s absence.
“What can I do?”
Liesel was already pulling on gloves and protective face-and eyewear, which had been easily visible in the vehicle’s storage boxes.
“Can you find a fourteen-gauge over the needle catheter that’s about three to six centimetres long?”
“Give me a minute.”
“We don’t have a minute.”
“I’m here to help, Liesel. Not hinder.” His voice was quiet, reassuring. He handed her the needle catheter with hands already sheathed in the precautionary blue gloves. One glimpse into his clear eyes and she knew it was true. Knew Jack’s presence added to her confidence. He was the one her mind had leaped to when she’d needed confidence with Mrs. Dales. And he was here for her again. She felt a charge of the old Liesel flash through her. She could do this.
Liesel made a lightning-fast scan of the storage boxes. She couldn’t see any devices for creating a one-way valve, an essential part of the procedure. She’d have to use an EMS trick Eric had taught her. She grabbed a protective glove and ripped off a finger, quickly inserting the IV catheter into the sterile nitrile.
“Is there any saline solution?”
“Just over here.” They had a rhythm now, a cadence to their work. Fluid, swift, focused.
Liesel pulled a ten-millimeter syringe out of its sterile packaging, quickly drawing five millimeters of the saline into it. Here, on the side of the road with traffic passing by, she couldn’t be sure she’d hear the gush of escaping air when she inserted the catheter needle into Kevin’s chest. If—when—she hit the right spot, the air would create bubbles in the saline, giving her a visible indicator she had done the job properly.
“Can you cut open Kevin’s T-shirt, please?” She would need full access to his chest. Inserting the needle in exactly the right spot was vital. The midclavicular line. Inserting it into the medial sternal or axillary lines could only worsen an already bleak scenario.
“Stay with us, Kev. We’re going to help you, mate.”
Jack’s rich voice was like a soothing tonic in the charged atmosphere of the SUV. She knew the words were meant for Kevin, but they were just what she needed as she palpated her fingers downward from the teen’s collarbone to his third rib. There was no messing this up. She held the loose “finger” of glove over the needle, having wiped antiseptic over the midclavicular line she’d marked with a pen. She needed to direct the needle into the intercostal space just above the third rib and nowhere else.
She glanced up at Jack, his eyes the
only thing visible above the protective face mask he’d pulled on. She could see the confidence in them as he nodded at her. She felt a charge of readiness and pulled herself into a strong-seated position.
Poising the IV needle over the small “X,” she held her breath, steadied her hand and inserted it through his skin with a quick, sure movement. Almost instantaneously the fluid in the syringe began to bubble. It wasn’t over yet, but they had won the first major battle. She lifted her eyes up to Jack’s questioning gaze, only trusting herself to answer him with an affirmative nod.
She waited until the bubbling stopped then withdrew the needle, leaving the “finger” of glove in the puncture wound to act as an exit valve until they got to the hospital. She disposed of the needle in the sharps box attached to the wall of the cab and quickly taped the blue glove finger into place. It wasn’t pretty—but it was functional and that’s what counted.
“Can I look?” Cassie’s head peeped round the corner of the back door.
Jack’s long legs unfolded themselves from the back of the vehicle to make room. Liesel resecured the pure-flow oxygen mask to Kevin’s mouth and, out of the corner of her eye, saw that Jack had folded the worried mother in his arms.
“He’s going to be all right, Cassie. I’m sure of it. Why don’t you jump in the back again and we can get your boy to Valley Medical?” She could hear the relief and conviction in Jack’s voice that Cassie’s son would be all right. If there was some way she could tap into his confidence and let it refill her own depleted resources, she would do it in an instant.
The women rode in focused silence in the back of the vehicle, each holding one of Kevin’s hands, after Jack gave them a seven-minute ETA.
Liesel caught Jack’s eye every now and again in the rearview mirror. She’d tried to stop herself from looking, but found she couldn’t help herself. What was she, seventeen again?