Emergency medical services in Australia

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territorial government, and by St John Ambulance in both Western Australia and the Northern Territory
.

Organisation

Land ambulance

Ambulance in New South Wales

Ambulance service within Australia can be divided into two basic groups: the

Australian states, with the exception of Western Australia, and in the Northern Territory, statutory ambulance services are provided by the state/territorial government, as a single-entity, third-service model, government department. In Western Australia, and in the Northern Territory, all statutory ambulance service is provided by St John Ambulance Australia, under contract to the state/territorial government. In all other states and territories, the activities of St John Ambulance are all limited to first aid training and special events support, with the occasional disaster response. In all states with the exception of Queensland and Tasmania, users who are not on welfare benefits are billed directly for their usage of an ambulance. In addition, while not strictly ambulance services, some jurisdictions also have private companies offering medical transportation services on a fee-for-service basis. Ambulance services in Australia operate on the Anglo-American (as opposed to the Franco-German) EMS service delivery model.[1]

Air ambulance

ASNSW
Rescue Helicopter
Ambulance Victoria Rescue Helicopter
Ambulance Victoria Aeromedical Super Kingair

fixed-wing aircraft are the preferred mode of transport. In these cases, the statutory ambulance services often operate the aircraft, in cooperation with Australia's Royal Flying Doctor Service
.

First responders

There are a number of different first responders in Australia that supplement ambulance services. First responders provide a rapid response to the scene but do not transport patients.

Firefighter Emergency Medical Responders

In Melbourne the Metropolitan Fire Brigade, Melbourne (MFB) provides a fully professional Emergency Medical Response (EMR) capability for the metropolitan fire district. Commencing in 1998 the MFB's EMR program is run in partnership with Ambulance Victoria (AV) to ensure rapid trained response to Computer-aided Dispatch (CAD) "priority 0" (suspected cardiac or respiratory arrest) medical emergencies across Melbourne.

Training

To qualify as a Firefighter Emergency Medical Responder, MFB professional firefighters undertake a 12-month training program provided by Monash University following a training curriculum developed specifically for professional firefighters by the MFB and Monash University Faculty of Community Emergency Health & Paramedic Practice. MFB Firefighters are trained to provide basic life support care including oxygen resuscitation and airway management, CPR, defibrillation, spinal and trauma care. When required, firefighters may also provide assistance to ambulance paramedics.

Programme benefits

Under the EMR program, MFB firefighters are simultaneously dispatched with AV paramedics to all priority 0 medical emergencies within the metropolitan fire district. In 60% of these EMR events, MFB firefighters arrive first on scene and commence initial patient assessment and provide care as required. On arrival, AV paramedics take over responsibility for patient care with MFB firefighters then providing assistance as required. As a result of EMR response, two minutes have been cut from the response time to cardiac arrest cases in the metropolitan fire district covered by the MFB. This program and the expansion of emergency and MICA ambulance services in Melbourne in recent years is providing the Melbourne community with a higher cardiac arrest survival rate than other Australian capital cities. Due to the reported success of this program it has been expanded to include some full-time stations run by Victoria's

Fire and Rescue NSW
but has faced strong opposition from the Fire Brigade Employees Union.

Standards

Training and staffing

Ambulance services in Australia use, for the most part, well educated professional staff, supplemented in low volume rural areas by volunteers. The level of training for volunteers is considered to be a high level of skill at advanced first aid. Paid staff fall into two categories: Transport Officers and Paramedics. Transport Officers complete certificate level training, and are normally only used for the non-emergency interfacility transportation of patients. Anyone employed on an emergency ambulance must be trained as a paramedic. There are several levels of paramedics in Australia.[4] The term "paramedic" is now legally protected in Australia, with paramedics requiring registration with the Australian Health Practitioner Regulation Agency (AHPRA) since 1 December 2018.[5]

The preferred level of entry into practice for new paramedics is a multi-year, bachelor's degree program in either Emergency Health, Paramedicine or Clinical Practice (Paramedic), including classroom lectures, clinical practice, and internship components.

NSW Ambulance
is transitioning to tertiary entrance but this process will be phased in over several years and may be achieved by 2020.

Training as a Mobile Intensive Care Ambulance Paramedic in

Victoria
function on protocols, working independently and with minimal medical supervision.

Vehicles

ASNSW Holden Trailblazer Supervisor Vehicle

Ambulance services in Australia provide emergency medical services by means of a number of service delivery methods. These include both conventional ambulances and aircraft, but also include a variety of rapid response vehicles with single paramedics, including both all-wheel drive type vehicles (

SUVs) and motorcycles. Supervisory vehicles are also equipped with medical equipment, and capable of providing first response service, when required. Some services, most notably New South Wales, provided the statutory rescue service in addition to their role in pre-hospital care, this has recently changed however, ASNSW Rescue Units are currently in the process of being disbanded with their rescue duties and resources being reassigned to the NSW Fire Brigade. There is no national standard for the design of conventional ambulances in Australia. All ambulance services have their vehicles built to their own internal specifications. That being said, Australia's ambulances are roughly similar from one state to another with the majority of general paramedic/intensive care ambulances in Australia being based on the Mercedes Sprinter which are upgraded every three years. They all generally comply with the European Standard CEN 1789 as published by the European Committee for Standards,[10]
apart from the visual identity provisions. This compliance is, however, incidental.

Ambulance Victoria Single Paramedic Motorcycle in Bourke Street Mall

Dispatch

Ambulances and paramedics in Australia are centrally dispatched. Australia's

AMPDS and Computer-aided Dispatch) or comparable with those found in North America and Europe.[11]

Response times

Australian ambulance services generally publicise a response time standard of 'around 10 minutes' on high priority emergency calls.[12][13] Ongoing monitoring suggests that compliance is improving, many "Code one" (i.e. Lights and Siren) calls are reached well within 10 minutes.[14]

See also

References

  1. ^ Cooke MW, Bridge P, Wilson S (2001). "Variation in emergency ambulance dispatch in Western Europe". The Scandinavian Journal of Trauma and Emergency Medicine. 9 (2): 57โ€“66.
  2. ^ Chevra Hatzolah
  3. S2CID 45119591
    – via mja.com.au.
  4. ^ "Paramedicine Role Descriptions" (PDF). paramedics.org. 23 January 2019. Archived from the original (PDF) on 23 January 2019. Retrieved 23 January 2019.
  5. ^ "Paramedicine Board of Australia โ€“ 'Paramedic' to become a protected title". paramedicineboard.gov.au. Retrieved 23 January 2019.
  6. ^ "Paramedic". Paramedics Australasia. Archived from the original on 23 January 2019. Retrieved 23 January 2019.
  7. ^ "Ambulance and Paramedical Studies". Monash University. Archived from the original on 17 February 2009. Retrieved 30 September 2008.
  8. ^ "Council of Ambulance Authorities document" (PDF). Retrieved 30 September 2008.[permanent dead link]
  9. ^ "Becoming an Ambulance Paramedic in Australia". Archived from the original on 23 July 2008. Retrieved 30 September 2008.
  10. ^ "European Committee for Standards website". Retrieved 19 September 2008.,
  11. ^ "ASNSW Operations Centres (web page)". Archived from the original on 20 July 2008. Retrieved 30 September 2008.
  12. ^ Andrews, Daniel (1 February 2018). "Ambulance Response Times Keep Improving" (PDF). Archived from the original (PDF) on 17 April 2018. Retrieved 23 January 2019.
  13. ^ Shapievsky, Kay. "Response Times โ€“ NSW Ambulance". ambulance.nsw.gov.au. Retrieved 23 January 2019.
  14. ^ "New South Wales Health Department website". Archived from the original on 14 September 2008. Retrieved 30 September 2008.
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