Emergency medical services in Australia

Infobox Country
common_name = Australia

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capital = Canberra [cite web|url=https://www.cia.gov/library/publications/the-world-factbook/geos/as.html|title=All facts unless otherwise cited are from: CIA World Fact Book|accessdate=2008-10-06]
area_km2 = 7741220
population_estimate = 21,450,000Cite web|url=http://www.abs.gov.au/ausstats/abs%40.nsf/94713ad445ff1425ca25682000192af2/1647509ef7e25faaca2568a900154b63?OpenDocument|title=Population clock|publisher=Australian Bureau of Statistics|accessdate=2008-07-22]
population_estimate_year = 2008
population_density_km2 = 2.6

Emergency medical services in Australia are provided by state ambulance services, which are a division of each state or territorial government, and by St John Ambulance in both Western Australia and the Northern Territory.

Organization

Land Ambulance

Ambulance service within Australia can be divided into two basic groups; the statutory services and also volunteer groups. In all Australian states, with the exception of Western Australia, and in the Australian Capital 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 limited to first aid training and special events support, with the occasional disaster response. 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. [cite journal|author=Cooke MW, Bridge P, Wilson S.|title=Variation in emergency ambulance dispatch in Western Europe|journal=The Scandinavian Journal of Trauma and Emergency Medicine|volume=9|issue=2|pages=57-66|year=2001]

Air Ambulance

Air ambulance service is accomplished in Australia by means of a variety of arrangements and providers. In the majority of New South Wales for example, the Ambulance Service of New South Wales provides the service directly, with the service providing paramedic flight crews, and the url=http://www.chc.ca/international_australia.php|title=CHC website|accessdate+2008-09-30] This arrangement began in 2006, following re-awarding of a long-standing contract with Westpac Life Saving Rescue Helicopter Service. Westpac continues to operate a search and rescue service in New South Wales, and provides some of the air ambulance service for other locations in Australia. Some states, such as Queensland share air ambulance resources with other public agencies; in the case of Queensland, with the hydro-electric utility. In other states, such as South Australia a mix of service providers, including other emergency services such as the police, continue to operate. While helicopters provide good service in coastal areas with high population density, in the more sparsely settled interior, distances can be vast, and 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.
Westpac_Rescue_HelicopterImage:VHMSH.jpg|Flying_Doctor_ServiceImage:SHSC_Bell412.jpg|ACT and NSW Joint-Service Helicopter

tandards

Training and staffing

Ambulance services in Australia utilize, 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 two levels of paramedics in Australia, the second, and more advanced level, being Mobile Intensive Care Ambulance Paramedic. The term ‘paramedic’ is not legally protected in Australia;Fact|date=October 2008 as a result the potential exists for those who have not met the accepted standard of education and training to represent themselves as ‘paramedics’. This practice does not occur within the statutory ambulance services, which routinely validate the educational credentials of all paramedics prior to employment.

The preferred level of entry into practice for new paramedics is a multi-year, Bachelor’s degree program in either Emergency Health or Paramedicine, including classroom lectures, clinical practice, and internship components. [cite web|url=http://www.monash.edu.au/pubs/handbooks/aos/med-ug-study-ambulance-paramedic.html|title=Ambulance and Paramedical Studies (Monash University website)|accessdate=2008-09-30] The intent is to make this qualification the only level of entry into the field, and some ambulance services, including the state of Victoria, have phased out all other methods of entry. Some ambulance services, however, continue to train some paramedics using the older, internal certificate-based programs. These continue to be necessary, at least over the short term, as the numbers of degree graduate paramedics being produced by the university system are insufficient to meet the ambulance services’ requirements for new employees. [cite web|url=http://www.dest.gov.au/NR/rdonlyres/2F515244-5225-4DFF-BE37-1898BF1F9C7D/15848/048TheCouncilofAmbulanceAuthoritiesRevised.pdf|title=Council of Ambulance Authorities document|accessdate=2008-09-30]

Training as a Mobile Intensive Care Ambulance Paramedic involves the completion of a post-graduate certificate program. The program, which typically takes an additional year to complete, involves theory, clinical and supervised practice components. Graduates possess an expanded skill set with respect to intubation techniques, including Rapid Sequence Intubation (RSI), additional drugs, and in some cases, certification of death. [cite web|url=http://www.paramedic-resource-centre.com/overseas/australia1.htm|title=Becoming an Ambulance Paramedic in Australia|accessdate=2008-09-30] Those certified as MICA-Paramedics function on protocols, working independently and with minimal medical supervision.

Vehicles

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, also provide the statutory rescue service, in addition to ambulance service. These services are also equipped with purpose-built heavy rescue trucks. 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, the ambulances are roughly similar from one state to another, and all generally comply with the European Standard CEN 1789 as published by the European Committee for Standards, [cite web|url=http://www.cen.eu/cenorm/homepage.htm|title=European Committee for Standards website|accessdate+2008-09-19,] apart from the visual identity provisions. This compliance is, however, incidental.

Dispatch

Ambulances and paramedics in Australia are centrally dispatched. Australia’s national emergency number is 000. This number rings at the telephone company, where an operator determines the caller’s needs and then directs the caller to the appropriate emergency service (police, fire, ambulance). Dispatch technologies, including automated vehicle locating (AVL) and decision-support software are either identical (as with AMPDS or comparable with those found in North America and Europe. [cite web|url=http://www.ambulance.nsw.gov.au/about_us/ambulance_operations/operations_centres.html|title=ASNSW Operations Centres (web page)|accessdate=2008-09-30]

Response times

Australian ambulance services generally publicize a response time standard of 'within 10 minutes' on high priority emergency calls. In reality, even in some of the major population centers that standard is only met approximately 50 percent of the time. Ongoing monitoring suggests that compliance is slowly improving. [cite web|url=http://www.health.nsw.gov.au/hospitals/performance/perfresp.asp|title=New South Wales Health Department website|accessdate=2008-09-30]

ee also

*Australian Capital Territory Ambulance Service
*Ambulance services in Victoria
*South Australian Ambulance Service
*Royal Flying Doctor Service of Australia
*Westpac Life Saver Rescue Helicopter Service

References