Outback Marriage by Meredith Webber

Author:Meredith Webber
Language: eng
Format: epub
Publisher: Mills & Boon Medical
Published: 2017-02-15T00:00:00+00:00

CHAPTER SEVEN

MIRACULOUSLY, once the operation began, once Blythe started the incision, it was as if she’d never stopped operating. With swift, sure movements, she opened up the skin, separating the layers of muscle beneath it, to expose the abdominal organs—or the dam of blood in which they were bathed.

Sue reacted immediately, using large absorbent swabs to clear the blood, standing close so she could continue to reduce it. Blythe continued to search for the problem, lifting the colon out of the way with warm moist gauze, then shifting the stomach with a large clamp, to reveal the broad ligament connecting the stomach to the spleen. Cutting through that would show her the splenic artery, a large, five-branched vessel that came directly off the aorta.

Instinct and the percentage factor in blunt trauma told Blythe the damage would be to the spleen.

‘I’m going to look at the spleen first,’ Blythe explained to her team. ‘The hoof mark is above the lower ribs in the left upper quadrant, right above the spleen, and Byron mentioned pain in his left shoulder earlier, which suggests referred pain from spleen damage.’

She made a small hole in the ligament, gradually enlarging it as she tied off the small blood vessels that ran through it. Eventually, the dense organ was revealed, blood welling from its upper edge.

‘I’m going to tie off the artery,’ Blythe said, glancing up at Cal for confirmation. Above the green mask his eyes met hers and the slight nod he gave was more encouragement than agreement.

Encouragement and something else…

Admiration?

Surely not.

But whatever it was, it boosted Blythe’s confidence as she passed loops of silk around the artery, tying it off. She looked up at Cal, hoping his monitors would show an immediate improvement in the patient’s blood pressure, although she knew instant success wasn’t likely.

Cal was frowning at the monitors but he said nothing, so Blythe continued.

With blood draining out of it, but none coming in, the spleen was shrinking in size. The next stage was to cut a larger hole in the ligament, but even with the artery tied off, blood was still seeping into the abdominal cavity.

‘Blood pressure dropping. There’s still a bleeder in there somewhere, Blythe.’

She turned to the nurse who was acting as runner for the operation, working outside the sterile zone, asking her to set up a second bag of fluid, giving instructions for the rate of flow, but all the time her attention was on her patient as she sought the source of the bleeding.

‘Something small, a capillary, would have closed itself off,’ she muttered into her mask, ‘so it’s big. What’s close? The renal artery. Please, don’t let there be kidney damage as well.’

Anxiety tightened her nerves to the point where her insides quivered, but her hands remained steady as she probed.

‘Finish the spleen and then look,’ Cal suggested, as time ticked by and Blythe’s concern escalated.

She was grateful for the advice. Getting the spleen out of the way made sense, and maybe the blood vessels would seal themselves while she was doing it.

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