Lifesaving skills for the bush

Imagine this scenario… You’re living in remote western Queensland. Your young son has an accident causing extensive burns to his upper body, face and throat. He’s in critical need of medical attention. You are thousands of kilometres away from the nearest city burns unit…. What happens next is entirely dependent on the abilities of your local rural doctors and health professionals.

Dr Louis Peachey, Senior Medical Officer at Atherton District Hospital, knows all too well the importance of a rural doctor in such a situation.

Dr Peachey has spent 26 years honing his skills as a GP, Rural Generalist and Anaesthetist to provide the best heath care he can in times of need.

Those skills were put to the test in that exact situation while he was working in a remote western Queensland town.

“I had been called by the guys in the Emergency Department to help with an intubation. It was a four year old child who had severe burns that virtually incinerated everything around his chest, neck and head. His airway was also badly burned, which meant we were going to have to secure his airway,” said Dr Peachey.

With the nearest burns unit 1600km away in Brisbane and a two-part flight standing between him and specialist attention, Dr Peachey knew he had to act quickly to stabilize the boy for the journey.

“I was doing a nasal intubation. I went in and it really was the thing of nightmares. I had a look and everything down the back of the throat was just swollen and blistered and all the usual identifiable structures just weren't there.”

Dr Peachey drew on his years of experience in paediatric dental anaesthetics to overcome the obstacles he was faced with.

“I had done this sort of an intubation at least 500 times. Even though I couldn't see the structures I knew where things should be. I was able to grab the Magill’s Forceps and pop the tube forward, give it a little twizzle around the nose and it felt like it dropped into place. We connected it up to the circuit and I could see carbon dioxide coming back and forth, so we knew we were certainly in the lungs and we had this child's airways secured.”

Dr Peachey said it was going to be a long road to recovery for the boy. A road that he and the rural emergency department played a big role in.

“This child absolutely needed a very good paediatric intensivist, absolutely needed very good paediatric surgeon, needed a whole bunch of very good paediatric burns nurses, and needed a whole bunch of paediatric occupational therapists and physio therapists. There's a whole swag of people who were necessary for this child to survive and thrive and have a normal life again,” he said.

“But the reality is, if there wasn't someone who could stick a tube down his throat, it didn't matter how many other specialists were available in Brisbane, the child was never going to get there.”

The Dean of James Cook University’s College of Medicine and Dentistry, Professor Richard Murray, said Dr Peachey is a prime example of how the right training and experience can make a real impact on the lives of those in regional, rural and remote communities.

He said Rural Generalist, local GPs, nurses and other rural health professionals are vital when things go wrong in the bush.

“Rural communities suffer poorer health outcomes than their city counterparts but have less access to healthcare. They need high quality, affordable healthcare as close to home as possible. 

“That means training local GPs and ‘Rural Generalists’ as well as other medical specialists who are attracted to the regional and remote work and lifestyle.”

Professor Murray said attracting and training more doctors like Louis Peachey requires a shift in focus and investment.

“Universities must train fit-for-purpose medical professionals who are invested in regional, rural and remote communities. Not just mass produce doctors for cities.

“It’s also vital that the government invest in joined-up regionally-based medical training,” Professor Murray said.

This is something James Cook University has developed over the nearly 20 years of its medical program.

Reflecting on the intubation of the four year old, Dr Peachey said it was moments like that he was very, very grateful for his skill set.

“If I didn’t have those skills this little life was just going to die and we were too far away for anyone else to help.”