Emily Forbes - Georgie's Big Greek Wedding?

She decided she needed to chill out. She nodded. ‘No further dramas,’ she said as she filled him in on the outcome of the English tourist’s medical emergency from the previous day. ‘He was admitted to the Cairns hospital overnight but when I checked on him this morning he’d had an uneventful night and they were expecting to discharge him.’

‘The hospital doesn’t mind you following up?’

Georgie shook her head. ‘As you said, it’s a small world.’ She shrugged. ‘Cairns isn’t a big town, everyone seems to know everyone else and that’s especially true in the medical field. I think the hospital staff expect us to ring. Most of the QMERT doctors work in the hospital too, and we all like to know what happened to our charges. Will you be doing any shifts at the hospital while you’re here?’

He nodded. ‘I’ll do one or two a week but I’m in Cairns to get as much experience as I can with retrievals, particularly primaries. I imagine it’s vastly different from working in a first-class A and E department.’

Georgie finally relaxed. This was her area of expertise and discussing this topic kept her mind focussed. ‘You’ll find you’ll have to strip your medicine back to basics. The principles and the goals are the same, you just won’t have the same state-of-the-art equipment at your fingertips or the specialist services you’re probably used to. We become everyone from anaesthetist to scout nurse out here.’

‘Luckily I like a challenge,’ he said. ‘So what should we expect when we get to Tully?’

For the remainder of the flight they ran through possible scenarios that might greet them on landing, including the possibility that they might need to intubate the baby. Together they checked the medical kits to make sure they had everything they might need. Small regional hospitals would have standard supplies but they might not always have the less commonly required equipment.

Josh was methodical in his checking but that wasn’t surprising. It was a character trait attributable to most of the team—organised, meticulous and logical would describe almost all of them—and by the time they circled over the landing site in Tully Georgie was feeling confident that they would be able to work together comfortably.

She watched out of the window as Pat landed the chopper on the cricket oval. Tully had the highest annual rainfall in Queensland and light drizzle was falling as they climbed out of the helicopter and into the ambulance that was waiting to transport them to the hospital. Within minutes of landing they were walking into the tiny hospital.

The local doctor, who looked like he must only be just out of medical school, gave them a rundown on the patient’s condition as they followed him to her bedside. ‘Carrie is four months old but she was born eight weeks prem so her adjusted age is nine weeks. She’s of Aboriginal descent and this is her third admission for breathing difficulties. The first two admissions we managed to control her and discharge her home with her mum. This time we can’t get her oxygen sats up—they’re actually falling.’

They were at her bedside now and Georgie and Josh both glanced quickly at the monitors showing Carrie’s vital statistics. Her heart rate was 98 beats per minute, low for a baby, and her oxygenation was below 88 per cent. That was dangerously low. The medical staff had a tiny oxygen mask over Carrie’s mouth and nose but the baby was listless and her chest was barely moving on inspiration. She was only just breathing.

‘What were her oxygen sats when she came in?’ Josh asked.

‘Ninety two.’ Even that was low, and if they hadn’t been able to improve her saturation since she got to hospital Carrie was in trouble.

Josh checked the monitor again. Carrie’s vital signs were unchanged. ‘Right, we need to get some improvement in her vitals. We’ll have to intubate to see if we can get her oxygen levels up and we’ll have to take her with us back to Cairns. I’ll need a straight blade laryngoscope, size one, and a 4.0 endotracheal tube,’ Josh told her.

Georgie unzipped the medical kit she’d carried in with her. It included all the items they’d need for intubating an infant. As they’d had no way of knowing whether the hospital would have equipment that was small enough, it had been safest to bring it from the chopper. She passed Josh the items he’d requested and he deftly inserted the tube. Carrie was so sick she didn’t resist and the moment Josh was happy with his positioning Georgie taped the tube in place and attached the ambubag. She would need to manually squeeze the air into Carrie’s lungs and she’d need to do this all the way back to Cairns. But if it kept Carrie alive she was happy to do it.

As Georgie squeezed the air in they could see the baby’s chest rise and fall with each pump. It looked like Josh’s intubation had been millimetre perfect. She looked up from the infant and her gaze met his.

She was impressed with his skills—intubating a child of this age was no easy task. ‘Nice work,’ she said, and was rewarded with one of his heart-stopping smiles. He looked incredibly pleased with himself but not in an arrogant way. His grin was infectious and she had to smile back. Things were good. They’d succeeded. Carrie’s oxygen sats and heart rate were climbing. She was stable enough to transport back to Cairns in the chopper. They would manage to keep her alive and get her to specialist care. Their first job together had gone smoothly.

By the time they were ensconced back at the Cairns base after transferring Carrie to the Cairns Hospital, Georgie had almost forgotten it was Josh’s first day on the job. She’d ducked across to the Cairns airport terminal building to buy a drink and when she returned she could see Josh chatting to Louise in the comms centre. He was perched on the edge of the desk, one leg swinging lazily, looking quite at home.

Georgie walked slowly towards him, taking a moment to admire the view. His jumpsuit was undone and his grey T-shirt, the colour an identical match to his eyes, hugged his chest. She could imagine the ridge of his abdominals underneath that T-shirt. That image was burned into her memory from the day before. He was rolling a pen through his fingers and his biceps flexed with the movement, drawing her eye to his arms. She could remember how his arms had looked as he’d pulled himself through the water, the sunlight bouncing off his muscles as he’d swum out to the reef. He was an impressive sight.

She was within a few metres before he noticed her but when he looked up he greeted her with a smile. Even though Louise was sitting right beside him Georgie felt as though they were the only two in the building. How could he make her feel as though the rest of the world didn’t exist with just one smile?

She was vaguely aware of the phone ringing as she smiled back at him. She forced herself to watch Louise answer the telephone, forced herself to concentrate on what was going on around her.

Louise was scribbling details onto a notepad. ‘Male patient, early twenties, he’s fallen from the back of a moving vehicle, severe head and chest injuries, possible spinal injuries. He’s on a cattle station about a hundred kilometres south-west of here.’

Ten minutes later Georgie was back in the helicopter beside Josh. This time she’d deliberately chosen to leave an empty seat between them. She needed to concentrate. They needed to work out their priorities for when they reached their destination. The anticipated flight time was thirty to forty minutes and every one of those minutes would be spent making sure they had a plan of action so they could hit the ground running. A road ambulance was also on its way but travelling on dirt roads it would take closer to ninety minutes for it to reach the accident site. The QMERT team would be the first team on site. This would be Josh’s first primary and Georgie needed to make sure they both had a handle on what they might be facing.