If burns covered 15 or 20 percent of the body, it could be fatal. The flat of a hand, including the fingers, was equal to 1 percent. She measured with her eyes. Her shoulders loosened. Ryan’s burns only covered 3 or 4 percent.
“B is breathing, right?” Wyatt looked at Natalia for confirmation. She nodded.
He turned back to Ryan. “Can you take two deep breaths for me?”
When he did, they didn’t sound labored, and he didn’t cough.
“Awesome,” Wyatt said.
Still, Natalia thought, what if Ryan had breathed in a lot of smoke? It might have inflamed his lungs and airway. If they started swelling, even CPR wouldn’t save him. Her own breathing sped up. She reminded herself that Ryan had been in the outdoors. Not trapped in a house where the smoke was filled with toxic fumes from burning drywall, synthetic carpeting, and household chemicals. Where there was no place for it to go except in your lungs.
“And C is … cardiac?” Wyatt ventured.
She forced herself to focus. “Close. Circulation. But it’s pretty easy to see he’s not bleeding. Let me just check his pulse.” She took Ryan’s left wrist, rolling her gloved fingertips until she found the notch. Fast but not shallow. She knew she should count the beats, but her thoughts were still skittering. “Great,” she said, not elaborating, as she released his wrist.
“How long is this going to take?” Jason demanded from behind them.
“Just shut up and let her help him,” Beatriz said. “What if it was you?”
“Okay, let’s see what we’re dealing with.” Wyatt plucked the wet cloth from Ryan’s shoulder. Part of the burn was obscured by Ryan’s T-shirt.
From her first aid kit, Natalia took out the small pair of shears with slanted blades. But looking closer at his shoulder, she hesitated. The remaining fabric seemed fused to his skin.
Ryan twisted his head and grimaced. “I think it melted. Hundred percent polyester. Great for hiking. Not so great, it turns out, for forest fires.” When she leaned closer and squinted at an odd black spot on his biceps, he added, “And that’s just a Swoosh tattoo. I work at Nike.”
“Let’s leave his shirt be.” Wyatt looked at Natalia. “How many burn pads do we have?”
She started with her own first aid kit. The contents were all neatly organized and labeled. But there was only one burn pad, just three by four inches. That wasn’t nearly enough.
Wyatt’s kit had clearly seen heavy use, with different brands of supplies and some half-used tubes of ointment. There was even a flattened roll of silver duct tape, the cardboard center removed.
But just one more burn pad. Which meant they had enough for Ryan’s shoulder, but not his hand. Or his hand, and only half his shoulder. She and Wyatt exchanged a glance.
“Those are second-degree burns, right?” Marco leaned in, his expression curious. “Because there’s blisters.”
“They’re called partial-thickness burns now,” she said. “But it’s the same thing.”
“All I know is they hurt like hell,” Ryan said through clenched teeth.
Better they hurt than they didn’t. That was what the nurses had told her. Natalia didn’t think Ryan would find it any more comforting than she had.
Forcing herself to take a deep breath, she mentally repeated the Red Cross instructor’s advice. “Do the best you can with what you have.” It was similar to Dr. Paris’s advice: “Control what you can and leave the rest.”
“Let’s use one pad on his shoulder and the other on his right hand,” she said to Wyatt. “It’s his dominant hand, which means he’s still going to use it even if he doesn’t mean to.”
She peeled open the packaging. In her head, the Red Cross instructor said, “Anything that opens like string cheese—that you grab at the top and pull down on each side—is sterile.” And sterile was important, because Ryan’s burn was basically an open wound.
Careful not to touch the pad, she laid it gently on top of the worst part of the burn.
“Ow!” He jerked.
She winced. “Sorry.” In the smoky light and with Ryan’s naturally darker skin, it was hard to tell how he was doing. Did he look pale? Was his skin clammy? She wasn’t sure. Maybe. But even if Ryan was starting to go into shock, they couldn’t exactly have him lie down while they elevated his feet and waited for help. Even though she felt helpless, she was glad her thinking was no longer as muddled.
Natalia lightly pressed the pad into place, glad to see the skin around it turn paler as she did. Skin that didn’t blanch—that stayed red under pressure—would mean the burns were worse than they looked. Half her supply of antibiotic ointment went to smearing one side of a piece of dry gauze, which she put on a different section of his shoulder. She wrapped both with more gauze. Then she applied the second burn pad to his blistered palm and wrapped it with the last of the gauze from her kit, ignoring how the breath hissed between his teeth.
Now that she actually was using the first aid kit, it felt more like a toy. She poked through the remaining supplies. There weren’t many more bandages, and a bunch of stuff just seemed useless. A triangular bandage. Four large safety pins. Two cotton swabs. Six antiseptic wipes. A bunch of Band-Aids. Short metal tweezers in a tiny plastic vial. A pencil and paper to record notes. Wyatt had a few more things but not many. If anyone else got seriously hurt, what would they do?
She also had little packages of medications that Wyatt didn’t: ibuprofen, acetaminophen, aspirin, antihistamine, and antidiarrheal pills. The acetaminophen wouldn’t do anything for swelling. And if there was any bleeding she’d missed, the aspirin would only make it worse. Opening up a package, she shook two pills into Ryan’s good left hand. “Here’s some ibuprofen.”
“Don’t you have anything stronger?” He shaped his mouth into something like a smile. “Like whiskey?”
“Whiskey wouldn’t keep the swelling down, and those will.” She handed him the half-empty bottle of water. “Keep drinking this. Little sips.”
Before they started off again, Wyatt moved to Ryan’s wife. “Hey, Lisa.” His voice was soft. “Why don’t you let me take Trask? I’ll give my pack to someone else.”
“No.” She took a step back, shaking her head. “I can carry him.”
“I’m sure you can, but we’re going to need to move fast. And if I carry Trask, it’ll be easier for you to keep an eye on how Ryan’s doing.”
“Let him do it, Lisa,” Ryan said.
There was a general shuffling of belongings. Marco gave his small pack to Beatriz and then took Wyatt’s. With assistance from Lisa and Natalia, Wyatt hoisted Trask onto his back. The toddler only fussed a little.
“Damn it!” Beatriz said.
“What?”
Her hands were on her hips. “That stupid Jason guy must have taken off again.”
And while a few people complained or cursed, no one was really surprised.
CHAPTER 7
ORANGE TWILIGHT
8:28 P.M.
MINUS JASON, THEY STARTED back on the trail. Lisa and Ryan were just ahead of Natalia. The hillside turned rocky. She plodded forward. Even if her boots felt like they weighed five pounds each, at least her feet were protected. Beatriz kept stumbling. How long until one of the rubber straps on her flip-flops broke?