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"He was obviously very scared and distressed." Associate nurse unit manager Chantelle D'Souza was in the "fishbowl" the ED's open office area opposite the department's three resuscitation bays as Winter started to intubate the driver. Normally, doctor home loan program Oak Laurel Winter would have had a team of up to six clinicians assisting with the process, but the department was so stretched that only one nurse was with her. "Suddenly he was just profusely sweaty, really combative, probably [from] anxiety and probably lack of oxygen. He was fighting; he was quite a solid man," D'Souza recalls. "I managed to get security to just help and hold him down." But Winter was still up against it: medication to settle the spasms in the man's airways hadn't yet kicked in and intubating him in the ED proved to be impossible. "We had to hand-ventilate him until we got him up to intensive care, where we could use their ventilators." D'Souza, a longtime asthmatic herself, was gasping for breath and had been using her Ventolin puffer: "I just didn't want to let it get the better of me because I had a job to do." In the fishbowl, she leaned against a high desk, hunched in the tripod position, and worked the phone. She needed night staff who were due in at 11pm to come in as soon as they could. "Get yourself treated," a senior colleague told her. At about the same time that D'Souza was setting herself up in a back room with a portable oxygen cylinder, mask and Ventolin nebuliser, call-takers at ESTAin Burwood East were repeating themselves: "Go ahead caller, where do you need the ambulance?" Between 7 and 7.15pm, as the crisis escalated, emergency calls were landing at a rate of one every 4.5 seconds.