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Case 2

A 30 year old trauma patient fell from 15 metres height at around 8 o'clock at night. The patient suffered a pelvic fracture and was haemodynamically unstable. On call radiologists and nurses were called back for an emergency pelvic angiogram and embolization. Departmental guidelines state that all on call staff should arrive at the department no later than 1 hour after the call time. On that day, the 2 on call radiologists arrived at the department about 20 minutes after the call time, but the on call nurse did not arrive so early.

The on call consultant radiologist ordered the Accident and Emergency Department radiographer to start the angiogram at once without the on call nurse. However, the radiographer had not received any nursing training and the cubicle for the angiogram consumables (such as puncture needles, guide wires, catheters etc.) were locked. Moreover, the radiographer could not find the key for the locked cubicles and the patient's condition was deteriorating. It is known that pelvic angiography can be life-saving in selected patients with pelvic fracture and related hemorrhage. Thus, the doctors were very eager to start the angiogram in order to save the patient's life.