Andreas frowned slightly. 'Libby-'
'I don't want to take the morning-after pill,' she said flatly, unable to be anything but honest. 'It doesn't seem right.'
Suddenly the confusion in her head cleared and her thoughts were clear.
There was absolutely no doubt at all in her mind.
If she was pregnant then she was going to keep the baby.
There was a strange look on his face that she couldn't interpret.
'There's no need to panic,' she muttered, her eyes sliding away from his. 'I don't expect you to take any responsibility.'
Andreas frowned. 'Responsibility? Libby-'
The door opened and one of the staff nurses stuck her head round, interrupting him before he could finish his sentence.
'Dr Christakos, A and E are on the phone. It's urgent.'
Andreas gritted his teeth and strode out of the room, almost sending the nurse flying.
Libby stared after him and she was still staring into space when he returned only moments later.
'That was your brother-in-law,' he said, his mouth set in a grim line. 'There's been a nasty house fire and two children were involved. They're on their way in now but they're already struggling in A and E so he wants some help.'
Libby pulled herself together. 'Of course. I'll just tell Bev.'
She hurried off to find the ward sister and then met Andreas in the corridor and they both made their way to A and E. Andreas didn't make further reference to their conversation but she felt his eyes on her.
The department was frantically busy. The waiting room was bulging with people and the screen was flashing up a waiting time of five hours.
'And it's going to be longer than that,' Katy told them quickly, following their gaze. 'We're having a bad day down here. Thanks for your help. We thought that you could sort the children out-maybe take them straight to the ward if you prefer.'
Andreas gave a brief nod. 'We'll assess them here and then decide. What's been going on?'
'A coach overturned on one of the bridges,' Katy told him, her face drawn and tired. 'We're all struggling. And now Ambulance Control has rung about the fire. Apparently it was a nasty one. The mother jumped from the window with the baby. She's fractured both femurs and she's in a bad way, although they think the baby is fine. The father went back into the house to try and get to the other child.'
Before they could discuss the case any further they heard sirens as several ambulances pulled into the ambulance bay.
'OK, let's move!' Miraculously, Jago and one of the A and E consultants appeared and took charge. He spoke swiftly to the paramedics, conducted brief triage in the back of the ambulance and then reappeared, his expression grim. 'Katy, I want the mother and the father into Resus straight away, and fast-bleep the orthopaedic surgeons. Andreas, do you want the children on the ward or down here?'
'I'll assess them here.' Andreas stepped forward to talk to the other paramedic. 'What's the story?'
'The baby seems to be unhurt. The mother took the brunt of the fall and she was cradling the child so the little one may be all right, but she herself jumped from the bedroom window, which was quite a drop. Baby's been crying non-stop but no signs of burns. The four-year-old is a different matter. Her pyjamas caught fire and she's got nasty burns to her legs. We've given her oxygen at the scene and covered them.'
'OK-take them both through to Paediatric Resus,' Andreas ordered, and Libby hurried ahead of him to the area of A and E that had been designed specially for children.
The paramedics lifted the howling four-year-old onto the trolley and kept hold of the baby, who was also shrieking.
Charlotte, one of the A and E sisters, hurried forward. 'I'll take her while you examine the older child.'
Andreas was already by her side, talking to her gently, trying to assess the degree of damage. 'Can we weigh her quickly? Once we've done that I want to estimate the surface area of the burns and then get this child some pain relief,' he ordered quietly, and Libby did as he'd instructed. 'We need to get a line in and then we'll give her a bolus of morphine.'
Libby gathered the necessary equipment while Andreas examined the screaming child, calculating the percentage of the body surface that had suffered burns.
'If we take her hand to be the equivalent of one per cent of her body surface area, she's suffered about ten per cent burns, most of them partial thickness,' he murmured, as he examined the little girl's legs. 'Would you agree?'
'Sounds about right.' Libby nodded, running her eyes over the burns on the child's legs.
'These blisters have ruptured and they're weeping. She's obviously feeling pain.'
'Which is a good thing,' Libby said softly, and Andreas nodded.
'Absolutely. As we both know, it's a sign that the nerve endings aren't damaged. I've checked her chest and it seems clear so there's no sign of smoke inhalation. What we have to worry about now is fluid loss.'
Libby nodded. She knew that fluid loss was proportionately greater in children than adults.
'Poor little mite. You'll want to admit her,' she said immediately. 'When you're finished here I'll call Bev and see if she can go in the side room. Melanie Parker is well enough to be on the main ward now.'
Andreas nodded. 'It would probably do her good to be mixing with the other children. OK, let's get on with this. What's her name?'
Libby checked the notes that the paramedic had left. 'Jenny.'
'Right, Jenny … ' Andreas positioned himself so that he was close to the girl without actually touching her. She was still screaming hysterically. 'We are going to take that pain away.'
Jenny continued to scream for her mother and Libby exchanged worried looks with Andreas.
'Let's get on with it,' he muttered, and Libby breathed out heavily. It was horrible, seeing the child so distressed.
She was sobbing now and Libby couldn't stand it a moment longer. She pulled up a chair, wrapped the child in a sterile towel and scooped her onto her lap, cuddling her close.
'There, sweetheart,' she crooned. 'Mummy will be coming in a minute. There's a good girl.'
She continued to talk soothing nonsense while Andreas searched for a vein. Libby prayed that he'd find one quickly, watching his lean, brown hands as he tapped and squeezed until he was satisfied.
He rocked back on his heels and pulled a face. 'Well, I think that looks hopeful.'
The A and E sister stepped forward. 'I'll squeeze.' She wrapped her hands around the tiny wrist and squeezed while Andreas slipped the cannula into the vein with ridiculous ease.
Libby let out a sigh of relief and Charlotte whistled in admiration.
'Nice work,' she said cheerfully, taping the cannula in place and attaching it to the bag of intravenous fluids. 'Here's that morphine you requested.'
She waved the syringe under his nose and Andreas checked it carefully before taking it from her and injecting it slowly into the tube.
'We'll start with this and she can have more in ten minutes if it hasn't done the trick.'
Jenny clung to Libby, shivering and sobbing until gradually the drug took effect and the little girl slumped in Libby's arms.
Andreas straightened and rubbed a hand over the back of his neck. 'OK, let's do a map of those burns and dress them, and then I want to pass a catheter so that we can measure her urine output.'
They worked as quickly as they could and Jenny clung to Libby, obviously seeing her as some sort of substitute mother.
Finally Andreas was satisfied that they'd done all they could. 'We need to check that her fluid replacement is adequate. I want an output of one mil per kilogram per hour.'
Libby nodded and she and Charlotte manoeuvred the child onto the scales, recording the result in the notes.
'Right, let's get her up to the ward and make her comfortable. Keep an eye on her pulses in case her circulation is compromised. Now, how's that baby?'
'She seems fine.' While she'd been helping with Jenny, the A and E sister had put the baby safely in a cot and she was now lying there quietly. 'Do you want to check her here or on the ward?'
'I'll do it here.' Andreas unlooped the stethoscope from around his neck and walked across to the baby.
With Jenny still snuggled on her lap, Libby watched as he examined the baby thoroughly, finally picking her up and making her laugh by blowing raspberries on her stomach.
'She seems none the worse for her dramatic fall,' Andreas observed quietly, holding the child with the easy confidence of someone who was thoroughly at home with children.
Libby watched him, unable to stop herself. He was just so good with children.
It was amazing that he didn't have any himself.
But that would have meant settling down with one woman, and that clearly wasn't his style.
And he obviously wasn't that keen to be a father. After all, he'd been the one to suggest that she take the morning-after pill.
Pushing the thought away, she stood up, intending to place Jenny on the trolley so that she could dress her legs, but the little girl clung to her and whimpered pathetically.