Isolated at sea – Mission first?

Sunday, 22h00, the emergency phone of the on-call dotcor in the military medical permanence rings the nurse of a nuclear submarine that is on a mission in the Atlantic. She is the only medical personnel on board of the ship.

"Hey? Doctor? Hey? No, I hear you bad. One of our kitchen/logistics slipped from a ladder and fell down 4 meters. He's screaming, he has probably a back injury as he cannot move his legs. We cannot move him despite the morphine."

After some advice regarding neccessary immediate care, a MEDEVAC seem to be the best option from a medical perspective. "Where are you exactly?" – "No, a helicopter won't be able to land on our boat. We are in open waters with heavy swell."

After the new advice of the stabilisation and of supervision, a negotiation begins with the commandant of the submarine to discuss the possibility to change its course in order to reach a harbour. However, two interests compete against each other: the continuation of the mission and the medical treatment of the patient.