Solemn Oath Read Free Page B

of a siren echoed through the doors, then the reflection of ambulance lights bounced against the bay entrance. “Are you okay with that?”
    â€œYeah, Doctor. We’ll get him there.”
    â€œGood. I’ll see you then.”
    Lukas hung up and got up to walk out to the ambulance bay just as the EMT threw open the back doors of the van. He stepped over to the foot of the first cot that was pulled out.
    The patient was a female in a nonrebreather mask, fully immobilized on a long spine backboard with head blocks. She had a large bore IV in her right arm, and blood splattered her clothing. Blood also concentrated in a dark, thick stain that had seeped through a bandage over her right lower leg, where her jeans had been cut free, and a Harris long traction splint held firm.
    â€œIs this the worst?” Lukas asked.
    â€œSure is. She looks pretty bad.” The EMT gestured to the other patient, who was still inside the van. “That’s her husband in there.”
    Lukas didn’t like the looks of the patient’s right foot—almost white from lack of circulation. She moaned, but her eyes remained closed.
    The paramedic stepped out of the back of the van. Connie was a muscular, seasoned professional with short boy-cut blond hair and a chronically serious expression. “Hi, Dr. Bower. This is Alma Collins, forty-five years old. First responders had to free her from between the car and the concrete balustrade of the courthouse.” Her voice remainedmonotone, a habit she practiced when she worked with patients to keep from alarming them. “She was unconscious on scene, but she’s been coming around since we’ve been en route, and she’s in a lot of pain. She has an obvious open tib-fib fracture, badly mangled leg, no pulse on the foot. Vitals initially on scene, heart rate 115, BP 90 over 60, respiratory rate rapid, with slight improvement following a liter bag of normal saline wide open. She’s received 700 cc’s so far. A lot of bleeding on scene from right lower extremity, but we managed to control it some after we placed the splint.”
    â€œWhat about the other patient?” Lukas gestured toward the cot still in the van.
    â€œThat’s Arthur Collins, the husband,” Connie said. “He has a deep scalp laceration, and it looks like he may have a dislocated or broken right shoulder. He lost a lot of blood from the scalp, but it’s been controlled by direct pressure.”
    Lukas reached forward to check Alma more thoroughly while he continued to talk to Connie. “What else is coming?”
    â€œTwo more are on their way in the BLS ambulance, and one’s coming in by private car.”
    Lukas placed his hands over the sides of Alma’s hips and gave a gentle but firm squeeze. There was no reaction of pain. Good. He would get a film on it, but if she didn’t have a pelvic fracture, it would be a lot easier for her. As Connie continued with the report, Lukas helped her rush the patient through the doors and into the first trauma room, leaving the EMT and E.R. tech to handle Alma’s injured husband.
    â€œJudy, get a chopper on standby,” he called over his shoulder as he and Connie transferred Alma to the exam bed. “And let Lab know we’ve got stat blood work for them.” He turned to Lauren, who had come in behind them. “Start another IV, and draw blood for a stat trauma panel.”
    Alma’s pupils reacted briskly, and her breathing, thougha little fast, was even. Her eyes remained open after he checked them. She moaned again, and Lukas bent toward her. “Mrs. Collins, I’m Dr. Bower, the E.R. physician here.” Because Connie’s businesslike manner could sometimes make a patient feel cut off from human support, he injected even more tenderness than usual into his own voice. “Can you hear me?”
    Physical pain etched itself in the lines of the woman’s face. Her eyes filled