Solo Rural GP at 3am
MMIHardAnswer the question
Solo Rural GP at 3am
You are the solo doctor in a rural town. At 3am, a child presents with anaphylaxis. The retrieval helicopter is 2 hours away due to weather. Walk us through your approach.
What is your immediate clinical priority?
How would you use the RFDS telephone consultation service?
What does this scenario reveal about rural workforce vulnerability?
Speak it out loud and we'll type it for you (free), or type your own notes — then mark yourself below.
- SPIKES for breaking bad news: Setting, Perception, Invitation, Knowledge, Empathy, Strategy.
- Listen → empathise → check understanding → agree a plan together. Calm voice, no jargon.
What strong answers doReveal the benchmark
Hidden so they don't bias your answer. Score yourself first, then reveal them to compare.
- Lead with the resuscitation: immediate IM adrenaline (1:1000, 0.01 mg/kg, anterolateral thigh), supine positioning unless the airway is compromised, high-flow oxygen, IV access for fluids and second-line treatments, and an adrenaline infusion ready if the response is poor, all according to APLS principles rather than as a delay until transfer.
- Call the RFDS or state retrieval coordinator early for real-time decision support, bridging treatments and transport once the weather clears, and mobilise the local nurse and family.
- Step back to the system: single-doctor coverage is normal in many MM5-MM7 settings and fragile, so a sustainable rural workforce needs 'two doctor' towns where the population supports it, locum and leave relief, and reachable overnight retrieval and telehealth support. Never delay adrenaline or treat the retrieval call as the main intervention.
Mark yourself
Score each skill against the rubric, then add a line of evidence. Scale:
Communication
0/3Structured emergency framing
Healthcare Knowledge
0/3Specific anaphylaxis management and retrieval coordination
Critical Thinking
0/3Prioritises real-time vs awaiting transport
Insight
0/3Workforce vulnerability framing