OUTBACK MEDICINE: Royal Flying Doctor Service flying into Jundah – the hospital is left of shot, golf course on the right and (inset) pilot Ross Thomas, doctor Jon Outridge and nurse Courtney Bylett.
OUTBACK MEDICINE: Royal Flying Doctor Service flying into Jundah – the hospital is left of shot, golf course on the right and (inset) pilot Ross Thomas, doctor Jon Outridge and nurse Courtney Bylett.

Classic outback rescues just one part

HE HAD been lying in the dust next to the cattle yards, with his girlfriend shooing flies from his face, for about two hours.

This young fellow had been mustering cattle not long before he learned the damage 500kg of frightened horse could do.

The steed had slipped, tripped or shied, throwing the rider who landed on the left side of his torso.

Ruptured left kidney and spline. Blood in the chest and abdomen. Punctured lung.

It is a case the Royal Flying Doctor Service's Jon Outridge and Courtney Bylett recount vividly.

"That was the sort of patient John Flynn would have understood intimately - classic outback," Dr Outridge said.

"That stuff can be diagnosed with the portable ultrasound machine we carry but, unfortunately, a lot of the equipment doesn't cope with the outback sun.

"So I crawled beneath a little tarpaulin and was able to scan his chest and prove he had a punctured lung.

"I couldn't scan his belly, the detail wasn't there, it was just too bright even with a tarp over my head.

"So he got intravenous fluid, oxygen, pain relief and screening for spinal injuries.

"If people have air in their chest and you fly with them, the trapped air expands with altitude and that can compress the heart and vessels.

"So we drained his chest to release the air and blood and flew him out safely."

Ms Bylett said the rider recovered but she suspected he could have died had he been left any longer.

"This was one those dirty, horrible ones but it's what we do this for," she said.

That life and death emergency stuff is just a fraction of what the RFDS does for our regions.

Clinics (49,000 a year), hospital transfers (more than 10,000 a year) and telehealth calls (more than 13,000 a year) are much more likely to occur on a daily basis than aeromedical evacuations (about 1000 a year).

"I've worked in hospitals and I'm doing the same job, I'm just in a plane now," Ms Bylett said.

Dr Outridge grew up in Gympie but now lives at Maleny with his wife, three kids and 60 head of cattle.

He works long shifts on his 10-day rosters based at Charleville but then has 18 days off. At age 53, he said he could do this until he retired.

With his own practice in the Sunshine Coast hinterland, private hospital patients at weekends, nursing home patients and surgical assisting on the coast, Dr Outridge said there was little more he could do until he joined the RFDS.

He was Rural Doctors Association of Queensland president when the Bundaberg Hospital fiasco involving Dr Jayant Patel occurred, leading to changes in Queensland Health.

An illness then landed him in hospital for three months.

"When I came back it was an opportunity to stop and pause and think, is this what I really want to be doing?" he said.

"The difference out here is an extreme resource deprivation. You're left to do things the old-fashioned way before there was a lot of investigations.

"The beginning of my career was about focusing on diagnosis and less on ordering every test - I'm getting back to those roots."

Ms Bylett spent a lot of time with her grandparents at Blackall and studied at University of Southern Queensland, in Toowoomba, so she is used to rural settings.

"It's just like being back home. This is my country," she said.

"When you go and retrieve someone you might not know them but you'll know their family.

"It's really hard when we go to big accidents, though, because you'll generally know one or two if not the whole family."

Ms Bylett spent her uni-versity placements working throughout Queensland and then worked between Charleville and Cunnamulla. After further training interstate, Ms Bylett has learned extra competencies for rural nurses to work effectively with RFDS.

"I love it, I wouldn't want to do anything else," she said.

"I can do my general hospital stuff as well as emergency retrievals and primaries, which is primarily why I wanted the job because I love that aspect of it."

Her country connections have come in handy when locations are sketchy, she said as she recalled a fatality with others injured.

"You very much use all your local knowledge, to the point where I'd heard of the property so I rang a friend of mine who told me which road it was," she said.

"I asked her if anyone knew if there was a strip near there.

"She put me on to someone else, I rang that person and then rang her dad."

Unfortunately Ms Bylett also knew the family in the crash, something that has haunted her since.

"It was a horrible, horrible day, I'm sad for that family," she said.

Ross Thomas, who has been at Charleville for four years, is among a team of pilots who keep the doctors flying. He said working for such a well-respected service gave his career more purpose.

"There's always a feeling of satisfaction when you get someone to Brisbane or Toowoomba hospitals who definitely needed to get there," he said.

"I'm the driver and I get them there but the rock stars are in the back, the doctor and nurse.

"What they do with some of these cases with limited space and how they manage these quite serious patients is just amazing."

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