The crash of his footsteps was still audible when the lad’s respiration rate abruptly dropped and his pulse took a similar nosedive. Jem positioned the ventilation bag and used it to support his faltering breaths.

“I need help out here,” she shouted into her radio, too stressed to go through the proper channels. “This lad’s about to arrest and I can’t move him on my own.”

“Police are en route,” Ryan said. “No ETA.”

“Thank fuck for that,” she muttered. Then, louder, “Cheers. Better than nothing.” She let the radio go, reaching for the suction as the lad gagged and coughed, the bag and mask falling aside to allow a thick spray of blood and vomit to splatter across her shirt. His hands flew up without warning, ragged nails clawing at her arms and clothing.

“Shh, it’s all right,” she said, fighting to keep him still. “You’re all right. I’m a paramedic. No one’s going to hurt you.”

A thin wail sent goose pimples rippling across her skin, and for an irrational moment she thought he might wake, until the noise cut off as if a switch had been hit, his hands falling limp, his body tensing and then relaxing. She watched, horrified, as eight breaths became five, then two, then stopped altogether.

“Shit.” She looked at the monitor, its screen now showing an irregular mess of rapid spikes. “Bear, move! Get clear.”

She hit charge on the defib as Bear stared, open-mouthed. The shock she administered made the lad’s limbs jerk in unison and turned the spikes into an ominous flat line. She immediately started CPR, counting out the rate as she pushed on his bony chest, and wincing at the flex and crack of a rib beneath the heel of her hand. Thirty compressions to two breaths: she repeated the cycle without pause, willing the monitor to show even the slightest sign of recovery, but there was nothing except the beat she created, the line falling flat every time she stopped to give a breath. Time passed by in a blur of pumping first his chest and then the bag, as the rain continued to pour and further bursts of river water washed toward them. The exertion stopped her from feeling the cold, but she could feel the muscles in her arms beginning to shake, and she knew she had to rest.

“Bear, can you help me? Here, like this.” She positioned his hands and started the metronome on the monitor. “This’ll keep you to a rhythm. Don’t push too hard. That’s perfect.”

Holding the torch in her mouth, she dragged her bag closer and found the IV pouch. Hypothermia ruled out a peripheral line, so she tried for the external jugular, letting out a short gasp of surprise when she hit it first time.

“Adrenaline’s in,” she said, marking the time on her glove.