pulled Cate aside. ‘I don’t blame them a bit, it must be awful to be away from all the specialists they need, but I think they’re really making Jason more upset. Harry was talking about transferring him to the children’s hospital and getting them to send out their emergency transfer team, but Lisa, the mum, got really distressed. Apparently Jason is petrified of flying, especially given that he’s had more than his fair share of emergency transfers.’
They went through the drugs Jason had been given so far, before a grateful Mary headed for home.
Juan had been speaking with the parents, and had only just started to examine Jason. The little boy was exhausted but, despite that, his eyes were still anxious.
‘So, you’re a regular on the ICU at the children’s hospital, are you?’ Juan asked, after listening to his chest, and Jason nodded. ‘I was working there last week and I’ll probably be there again soon. Do you know Paddy?’
‘We know Paddy,’ Jason’s mum said.
‘Ken...do you know Ken?’ the little boy said. He could still talk but only just.
‘Do you mean Kent?’ Juan checked. ‘The ICU nurse?’ Jason nodded. ‘He’s good fun. I might just have to give Paddy a call and let him know that you’re here.’
Cate knew Juan was just putting the boy at ease, letting Jason know that he knew the staff there, while letting the parents know he worked there too.
He must be as popular there as he is here, Cate thought, strangely jealous of the other worlds of Juan.
‘I just want a look in your mouth, Jason. Can you open it, please?’ Juan removed the mask that was delivering medication and shone a light in. He looked carefully and then replaced the nebuliser, which was nearly finished.
‘Okay, Jason,’ Juan said. ‘Just rest now and let the medicine start to work.’ Juan looked over at Harry. ‘Continuous nebulisers now...’ Juan said, which moved Jason from severe to critical; but Juan seemed calm and Cate was a little surprised how Harry was stepping back and letting Juan take over the case. She knew Juan was good and a trained anaesthetist, but as it turned out Cate didn’t know just how good he really was.
‘He does need to be transferred, Lisa.’ Juan spoke now to the mother. ‘But I’m happy to keep a close eye on him here at this stage. I think we can wait for the rush hour to pass and then we will go by road ambulance...’
‘What if something happens in the meantime?’ Lisa was clearly petrified of being stuck in the outer suburbs without all the specialist doctors. But it was then that Cate realised exactly why Harry had been so pleased to see Juan this morning, and why he was so readily stepping back. ‘What if something happens in the ambulance?’ Lisa said, her eyes filling with nervous tears.
‘I have worked with a lot of children who have similar problems to Jason,’ Juan said, and went on to explain that he had spent a year as an anaesthetist in America, working at a major craniofacial hospital, and was very used to performing the most difficult of intubations on children.
‘You’ve seen children with Jason’s problems before?’ Lisa asked.
‘I have.’ Juan smiled at Jason but Lisa still wasn’t quite convinced.
‘Jason had to be put on a ventilator the last time he had an asthma attack,’ she said. ‘They couldn’t wean him off and in the end they couldn’t keep the tube in his throat for any longer and so he had to have a tracheostomy...’
‘Let’s just focus on today,’ Juan said, and started checking all the equipment. Harry had already brought over the difficult intubation box and Juan commenced pulling up drugs and taping the vials to the syringes, as relaxed as if he were making a coffee rather than preparing for a difficult intubation, and chatting away to Jason as he did so.
In a child with severe asthma everything was assessed clinically, there were no blood gases taken as it would simply upset Jason further. The fact that he