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critical issue now.
    ‘The tourniquet’s on. What
else is there we can do?’ Charley asked, trying to keep the desperation out of
her voice.
    ‘He needs fluids,’ said
José. ‘To replace the blood loss.’
    Searching through the med-kit, he pulled
out a pouch of saline solution and handed Charley a cannula. ‘Get thisin
him,’ he said.
    Charley tore off the wrapper round the
sterile needle and tube. Pulling up the boy’s sleeve, she hunted for a
suitable vein. Her hands trembled as she held the needle over his bare skin.
She’d only ever practised inserting a cannula on a false limb during their
first-aid training. In a real-life situation – under pressure – it was
far more difficult.

    ‘Let me do
it!’ Jason snapped.
    Charley bit back on her tongue as he
snatched the needle from her grasp. Jason always lost patience with her and his
attitude made her feel inadequate.
    While Jason inserted the cannula,
José kept an eye on the boy’s blood pressure and David rechecked the
tourniquet. This left Charley feeling like a spare wheel on the team. Not surewhat
else to do, she continued talking to the casualty.
    ‘Don’t worry, Blake, an
ambulance is on its way,’ she told him. ‘We’ll get you to a
hospital in no time. You’ll be fine. So tell me about Manchester – is it
a nice place to visit? I’ve heard that …’ Charley knew she was
babbling, but the boy seemed reassured. That is, until his breathing started to
accelerate abnormally.His face screwed up in agony as he fought for every breath.
‘What’s wrong?’ she asked.
    ‘Check his chest,’ David
suggested, his calm manner poles apart from the panic she was experiencing.
    Charley lifted the boy’s shirt.
The whole right-hand side of his chest was bruised purple.
    ‘Looks like a possible tension
pneumothorax,’ said José.
    ‘A tension
what
?’
criedCharley, vaguely recalling the term but not the condition. With every passing
second, she felt even more out of her depth.
    ‘Air in his chest cavity!’
exclaimed Jason as he grabbed the oxygen cylinder strapped to the side of the
medical kit. ‘It’s crushing his lungs.’
    He fitted a mask to the patient and
began the oxygenflow to reduce the risk of hypoxia, a dangerouscondition that could lead to permanent brain damage and even death.
    ‘We’ll need to perform an
emergency needle decompression,’ said José, handing Charley a large-bore
needle with a one-way valve.
    Jason and David repositioned the
casualty so he was lying flat. Charley stared at the disturbingly long needle.
Determined not to hesitate this time, she located the second intercostalspace on
the boy’s chest and prepared for insertion.
    ‘NO!’ cried José,
grabbing her wrist. ‘It must go in at a ninety-degree angle or you could stab
his heart.’
    Charley’s confidence drained away.
She’d almost made a fatal error. Suddenly the boy’s body fell limp and
his eyes rolled back.
    ‘He’s stopped
breathing!’ Jason exclaimed.
    David checked the boy’scarotid
artery on his neck. ‘No pulse either.’
    ‘He’s gone into cardiac
arrest!’ said José, taking the needle from Charley. ‘Assume
decompression procedure complete. Begin CPR.’
    Jason screwed up his face at the idea.
‘Well, I’m not going mouth-to-mouth with him!’
    ‘Nor me,’ said David.
    All eyes turned to Charley.
    ‘Fine, I’ll do it,’
she said, shifting intoposition and tilting Blake’s head to deliver the
initial rescue breaths.
    Jason looked at José and whispered
under his breath, ‘She’s eager.’
    Charley glanced up
and narrowed her eyes at Jason. ‘What did you say?’
    ‘Nothing,’ he replied.
‘I’ll do the chest compressions.’
    Between them they worked at CPR,
delivering thirty chest compressions to every two rescue breaths.As he pressed down
on the boy’s chest, Jason sang to himself, ‘
Ah, ah, ah, ah, staying
alive! Stayin’ alive!
’
    ‘This is no time for
singing,’ snapped Charley, irritated by his