Miscellany: A bad night's sleep

As night falls, I am beaming in to assist the team resuscitating a local man who was engulfed by bushfire flames, sustaining severe burns. A bushfire rages near them, the town and indeed the very hospital they are in have already been evacuated ahead of the fire front. It is an intense two hours before the patient leaves my screen on a stretcher to be choppered to the city. Fine work by the team of local docs, chopper paramedics, nurses and assistants. I continue my shift and clock off late in the evening knowing I will have difficulty winding down. Bad burns get to me.

I am up and down all night, reflecting on thirty five years of emergency medicine. What stands out? The hardest things to deal with: kids drowning and severe burns. Scariest to manage: asthma resuscitations and severe gastrointestinal bleeding - get it right and the patient is made whole - get it wrong and the outcome is on you. Things that are yuck: bad smells - especially teenage feet and melaena.

The best bits? Reassuring a first-child parent that their child won't shrivel up like a prune and die just because they have vomited a couple of times with a fever. Competently packaging a aeromedical retrieval patient. Reducing the anxiety of a lone nurse at any number of tiny nursing posts, no matter what the patient concern is. Lots of swirling thoughts and feelings.

I recall a happier outcome from earlier in last night's shift. A firefighter with very minor burns to one side of his face and ear. He sustained the burn as a fire front passed over him while lying sprawled on the ground, shielding another person with his bulk and professional fire protective clothing. The other individual was completely unharmed.

How many more bushfire burns will I see during this and future summers?

We have set a hot weather record this summer in the Southwest. Thirteen days (so far) over 40^oC in Perth - more than double the previous record set in 2016. Will this summer prove to be one of the cooler or hotter summers over the next decade or two? Probably one of the coolest, given global heating is baked in.

The last couple of bushfire days should serve as warning. Here in the Southwest we are yet to replicate the widespread destruction by bushfire the East Coast experienced two summers ago. However, we still have a very hot February and March to get through this summer. And then there are the hotter summers to come.

There will be more bushfires and more property destruction. I can only hope everyone stays safe despite the risks. Review and ready your bushfire plan. And when the time comes, stick to it and get out of harm's way.