The red and blue emergency lights were flashing, although the ambulance's siren had stopped wailing shortly before it stopped at the entrance to the emergency room of Christchurch Queen May Hospital.

The morning shift emergency team was ready. Ten minutes earlier, they had been radioed that a critically ill patient was on the way, and they had quickly prepared one of the resuscitation machines.

Head nurse Amy Brooks glanced quickly at the stretcher being unloaded from the ambulance. IV bags were hanging from it, and the team already had several more ready.

They knew the patient had serious respiratory problems, and the ventilator and lung drainage equipment were also ready.

As the head nurse in the ER, it was her responsibility to ensure everything was ready and to assist the physicians. She had to have IV bags ready and help place them; she had to help the other nurses undress patients and take vital signs. This was the most demanding job in the hospital, but Amy Brooks relished the challenges each critically ill patient presented. She even enjoyed the initial chaos of receiving and transferring these patients. It took a special skill to remember every detail, focus on each task, and prioritize quickly if the situation demanded it.

"His name is Daniel Lever. He's nineteen years old," said the ambulance commander, confirming what had been reported over the radio. "His car crashed into a truck at high speed and rolled over several times. He was the only occupant."

They placed the ambulance stretcher next to a bed. Amy noticed that the boy was wearing a neck brace and was strapped to a backboard. He almost certainly had spinal cord injuries.

"He's been trapped in the car for forty-five minutes," the ambulance chief said, moving the heart rate monitor away. "Ready? One, two, three..."

Amy approached to help lift Daniel off the board; he'd been pinned there too long. He had chest wounds and a multiple fracture in his left femur.

Jennifer Bowman, the ventilator specialist nurse, was the first to spring into action.

"Hi, Daniel. Can you open your eyes?" Jennifer said as she disconnected the portable oxygen tank and reconnected the tube to the hospital's ventilator.

Daniel groaned in response to her question.

While Jennifer adjusted the mask, Amy used scissors to remove the remnants of clothing from Daniel's chest. As she did so, she heard her colleague whisper comforting words to the patient. Amy greatly appreciated her ability to quickly establish a bond with patients. Gareth Harvey, the senior emergency room specialist, listened to Daniel's chest with a stethoscope as the ambulance crew briefed him.

–We have given him one and a half liters of saline solution and ten milligrams of morphine.
heart rate has remained stable.