Consultant In Crisis. Alison Roberts

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stated. ‘What we need to do first is get rid of it.’ He made a show of putting real effort into shifting the polystyrene ‘concrete’ slab. ‘Now we can extricate her,’ he announced with satisfaction. ‘Let’s go, team.’

      ‘No hurry now, Kyle,’ Fletch said dryly. ‘You’ve probably just killed our patient.’

      Kyle’s grin faded as it dawned on him that Fletch was being serious.

      ‘That was a large piece of concrete, Kyle. Fortunately it would have taken more than one person to shift it, which would have given us time to give some prophylactic treatment for a crush injury.’

      ‘But it was the concrete causing the injury. The sooner it gets shifted the better. It’s hardly likely to kill her.’

      ‘Actually, it could,’ Kelly told Kyle. ‘We were told in the scenario set-up that Wendy had been trapped like this for more than twenty-four hours. Crushed tissue exudes toxins and when you move the weight the toxins get released into the body. The patient can die very suddenly and very quickly due to a cardiac arrhythmia.’

      Kyle’s face tightened angrily and his voice rose. ‘How the hell am I supposed to know something like that?’

      ‘You’re not,’ Tony said quietly. ‘The lesson here is that no unilateral decisions should be made. Especially by the least medically experienced person on the team.’

      Other groups in the classroom had finished their scenario work. Kyle’s angry query had attracted attention and people edged closer to see what was going on with the crush injury scenario.

      ‘How would you have dealt with this, Kelly?’ Tony queried.

      ‘I’ve only dealt with one serious crush injury victim before and we worked under a radio link to an emergency department at a major hospital in Melbourne.’ Kelly searched her memory eagerly. ‘We gave a huge fluid loading of four or five litres of saline. We didn’t have some of the drugs indicated so we had to make do with what we had. We gave Ventolin and glucose and insulin and I think it was atropine.’ Kelly frowned. ‘It’s a while ago now.’ She looked directly at Fletch without hesitating. ‘How would you deal with it?’

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