When Josh Larven felt his lip start to swell at an outback pub, he had a sinking feeling of what was to come.
As a pilot and customer support officer with aviation software company, OzRunways, 23-year-old Josh’s job takes him to many corners of the country.
His latest adventure in September took him to William Creek, 800km north of Adelaide, for the town’s annual Outback Fly-In event.
“As part of the event, we were delivering a seminar on our Electronic Flight Bag product and how pilots can best use it,” Josh said.
“We arrived late afternoon and got settled in, when we decided to head over to the pub to have dinner.”
Josh was about halfway through his meal when something didn’t feel right.
“I hadn’t eaten anything all day and the first thing I saw was there was curry for dinner,” he said.
“I started getting into it when I started to feel my lip swell. I thought, ‘that’s not normal’, and so I had a chat to the staff and found out there were cashews in the curry.”
As a child, Josh was diagnosed as anaphylactic to various foods, including cashew nuts – but had never experienced a serious episode.
As it’d been a long time since his allergies were front of mind, he didn’t think to ask and wasn’t carrying any medication with him.
“I felt like an idiot for not checking… I was exhausted, hungry and just wasn’t thinking,” he said.
“This was the first ever time I was experiencing anaphylaxis, and I was nearly a thousand kilometres from home.”
Josh knew within minutes of exposure, his life was at risk.
Anaphylaxis causes the immune system to release a flood of chemicals that can cause one to go into shock — blood pressure drops suddenly and the airways narrow, blocking breathing.
Fortunately for Josh, William Creek is home to a new RFDS Virtual Emergency Centre – accessible 24/7 in medical emergencies.
The clinic houses innovative digital health technology, including a telehealth unit with video conferencing, diagnostic devices, and life-saving oxygen and medications that a layperson can give under simple instruction – immediately connecting patients with an RFDS doctor and treatment.
William Creek Hotel manager Taylor Stewart, and Jo Swinton, a retired paramedic who happened to be at the event, accompanied Josh to the clinic.
“It was really easy – like rocking up to someone’s house and ringing the doorbell,” Josh said.
“A doctor popped up on the screen via telehealth and they were extremely professional from the start. Even though they weren’t physically in the room, the first thing they wanted to do was make me feel calm and relaxed, before getting straight into treating me.”
At this stage, Josh’s face had swollen up and he had broken out in hives from neck to toe. He was doing everything he could to avoid going into shock.
“My heart rate just kept spiking – it was sitting at about 130. I could feel myself getting light-headed and was close to falling unconscious,” Josh said.
The whole time, I genuinely felt like I was being looked after as if I was in Adelaide at a hospital. It was extremely professional and it just felt normal.
Josh Larven
Under the guidance of RFDS Rural Generalist Dr Patrick Sprau, Jo assisted with treating Josh utilising the RFDS Medical Chest.
“Having telehealth connectivity and constant communication meant I had the best tools at my disposition to assess and support the patient right from the start,” Dr Patrick said.
“This, combined with having two dedicated community members assist, one of them with medical skills, made monitoring Josh’s vital signs and instructing on the administration of a life-saving adrenaline injection relatively straightforward, even from our Port Augusta Base more than 500km away.
“While this stabilised Josh’s condition for the time being, it was clear he needed to be evacuated to a hospital as soon as possible.”
Dr Patrick Sprau joined an aeromedical team comprising a pilot and flight nurse in an RFDS PC-12 aircraft to retrieve Josh, handing over the telehealth consultation to a second on-call doctor, RFDS Rural Generalist Dr Susie Keynes.
“While Patrick flew to William Creek, I was able to continue monitoring Josh visually,” Dr Susie said.
“When Josh’s condition deteriorated again, as it can with anaphylaxis, I was able to respond immediately and direct a second adrenaline shot to be given. Without the telehealth system, I could not have perceived this as rapidly and a delayed response could’ve had dire consequences.
“Josh responded to the second shot within minutes, before Patrick and the team arrived to take him to hospital in a stable condition."
Outback people are practical people and willing to help each other. In this case, their quick actions and ability to enter the clinic to begin the consult immediately was a life-saving action.
Dr Susie Keynes, Rural Generalist
Josh described the episode as a “wake-up call” and said he would be lying if the worst possible outcome didn’t cross his mind. “If the RFDS didn’t exist, I’d most likely not be alive right now,” Josh said.
“It was such a full-on experience and the thought kept going through my head, ‘What if the clinic wasn’t there?’
“Every time I go out now, my partner and l lengthily check what’s in our food. We know now how easily it can spiral out of control.”
Fully recovered and back at work, as a young pilot Josh’s focus is to build his flying hours and get more experience in the aviation industry.
“I’m just very grateful for the services they provide,” Josh said.
“It’s always been my dream to be in the front seat of an RFDS PC-12, flying people and being part of aeromedical services. Unfortunately, my first experience with the RFDS has been in the back of the aircraft – not where anyone wants to end up.”
Learn more about the Flying Doctor.
