Australia

DIEMS Home Page





General

Capital – Canberra

Land Size – 7,682,300 sq km

Population – 21,515,754

Language(s) – English 78.5%, Chinese 2.5%, Italian 1.6%, Greek 1.3%, Arabic 1.2%, Vietnamese 1%, other 8.2%, unspecified 5.7% (2006 Census)


Prehospital Care


Overview

  • Anglo-American model
  • Provincial


History

  • 1885 – Civil Ambulance and Transport Brigade (Sydney)


EMS System Model

  • New South Wales (NSW)
    • Dual-role ambulances, typically, though single-role is being implemented “to enable a higher percentage of overall vehicles to be staffed by a paramedic” (Trevithick, 165)
    • Ambulance Service of NSW (ASNSW) – primary prehospital provider
      • Gov’t funded; by law, only organization allowed to provide prehospital road ambulance emergency services
        • Private agencies allowed to provide services at major sporting events
        • Motorcycles and four-wheel drive vehicles are also employed
  • Victoria


Lead Agency

  • Provincial DOH


Funding


Levels of Care

  • New South Wales (NSW)
    • Paramedic
      • Intubation (post-intubation sedation only)
      • DefibrillationIV fluid admin
      • Needle thoracostomy
      • Adrenaline, Atropine, Calcium Chloride, Glucose, Frusemide, Glucagon, Glyceryl Trinitrate, Lignocaine, Metoclopramide, MS, Midazolam, Naloxone, Salbutamol, Sodium Bicarb, ASA, inhalational Methoxyflurane.
    • Advanced Life Support Officer
      • Less developed ALS scope
    • Patient Transport Officer
      • BLS
  • Victoria
    • Mobile Intensive Care Ambulance (MICA)
      • Equivalent of Paramedic
    • Advanced Life Support Officer
      • Less developed ALS scope
      • As of 2008, Basic ALS Officers’ scope is being upgraded
      • Broader range of ALS skills and meds


Education & Training

  • “Pre paramedic training is carried out over a 3 year period and involves a combination of classroom theory, hospital attachments and probationary road period” (Trevithick, 165)
  • “Progression to paramedic level is based upon merit” (Trevithick, 165)
  • Specialized training achieved by selection – e.g., high angle or water rescue


Medical Direction

  • Medical oversight provided by Chief Medical Officer and Medical Advisory Committee
    • Includes treatment and hospital bypass protocols


Specialty Services

  • ASNSW
    • Aeromedical Services
      • Fixed-wing transport w/flight RNs
      • HEMS w/ MD/RN; MD/Paramedic; or Paramedic-only
    • Medical Retrieval Unit
  • Royal Flying Doctor Service (RFDS)
    • Established as charity organization to assist with limited medical services in Australian Outback
    • Funding comes from gov’t, donations and fundraising
  • NRMA CareFlight
    • Helicopter medical services through ASNSW
  • Sydney Aeromedical Retrieval Services


Dispatch & National Emergency Telephone #

  • 000 – Nationwide
  • ASNSW – 5 call centers to where all emergency calls are directed
    • Use of Computer Aided Dispatch (CAD) and vehicles equipped with Mobile Data Terminals (MDT) for messaging and Automatic Vehicle Location
    • Recent introduction of Medical Priority Dispatch System (MPDS)


Emergency Medicine & Emergency Care

  • Australasian College for Emergency Medicine (ACEM) – primary training institution for specialist EM MDs in Australia & New Zealand.
  • The Royal Australasian College of Physicians (RACP) – training and accreditation of pediatric EM MDs.
    • “The supply of emergency physicians throughout Australia and New Zealand currently cannot meet demand, and is not expected to do so within at least five years” (Trevithick, 169)
  • EDs in NSW are rated on a 6-level scale
    • Level 6 – Full Trauma Center with 24/7 access to EM MDs, Neurosurgery and Cardiothoracic surgery.
      • 10 Level-6 EDs in NSW (2 are pediatric)


Disaster

  • HEALTHPLAN – NSW DOH major medical incident management plan
  • NSW Health Counter Disaster Unit – responsible for policy, planning and preparedness training
    • “Planning involves purchase, storage and distribution of personal protective equipment, antidotes to Chemical and Biological agents, rapid identification of such agents and training of key personnel” (Trevithick, 169)


DIEMS Home Page

References

  • https://www.cia.gov/library/publications/the-world-factbook/geos/as.html
  • Boyle MJ, Smith EC, Archer FL: “Trauma incidents attended by emergency medical services in Victoria, Australia.” Prehospital and Disaster Medicine 2008;23(1):20-8.
  • Trevithick S, Flabouris A, Tall G, Webber CF: “International EMS systems: New South Wales, Australia.” Resuscitation 2003;59:165-70.


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