Emergency medical services in Australia
Encyclopedia
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
.
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 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 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.
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 helicopters being provided under a contract with CHC Helicopters Australia Limited. 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, air ambulance services are primarily provided by Emergency Management Queensland (EMQ Helicopter Rescue) and a mixture of other providers such as RACQ CareFlight may fill service gaps. 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.
and Sydney
, Hatzolah provides first responders to the Jewish Community. These organisations respond to the scene but do not transport patients.
the Metropolitan Fire Brigade, Melbourne
(MFB) provides a fully professional Emergency Medical Response (EMR) capability for the City of Melbourne
. Commencing in 1998 the MFB's EMR program is run in partnership with Ambulance Victoria
(AV) to ensure rapid trained response to AMPDS "priority 0" (suspected cardiac arrest) medical emergencies across Melbourne.
EMR 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 advanced 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.
EMR Program Benefits
Under the EMR program, MFB firefighters are simultaniously dispatched with AV paramedics to all priority 0 medical emergencies within the City of Melbourne. 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.
, arguably the highest trained and most advanced level is New South Wales Intensive Care (ICP) and Extended Care Paramedics (ECP) and Victoria's Mobile Intensive Care (MICA) Ambulance Paramedics. The term ‘paramedic’ is not legally protected in Australia; 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, Paramedicine or Clinical Practice (Paramedic), including classroom lectures, clinical practice, and internship components. The intent is to make this qualification the only path of entry into the field but so far only the state of Victoria has phased out all other methods of entry. Ambulance services in South Australia
, New South Wales
and Queensland
now draw the majority of their paramedics from degree programs and continue to use the older-style, internal diploma programs only to fill service gaps and shortages in forecasted requirements . These older programs continue to be necessary to ensure ambulance services are able to directly train additional staff to fill shortages and as the numbers of degree graduate paramedics being produced by the university system are insufficient to meet ambulance services’ requirements for new employees.
Training as a Mobile Intensive Care Ambulance Paramedic in Victoria
, and equivalent Intensive Care Paramedic programs in other states 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 which may include intubation, Rapid Sequence Intubation (RSI
), additional drugs, and in some cases, certification of death. Those certified as MICA-Paramedics in Victoria
function on protocols, working independently and with minimal medical supervision.
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, 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, apart from the visual identity provisions. This compliance is, however, incidental.
is 000. This number rings at the Telstra Global Operations Centre, where an operator determines the caller’s needs and then directs the caller to the appropriate emergency service (police, fire, ambulance). Callers then speak to an operator at a dispatch centre, managed by the relevant state ambulance service (E.g. AFCOM
in Brisbane, QLD) or may even speak to an individual officer in the case of rural/remote stations. 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.
Emergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...
in Australia are provided by state ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...
services, which are a division of each state or territorial government, and by St John Ambulance in both Western Australia
Western Australia
Western Australia is a state of Australia, occupying the entire western third of the Australian continent. It is bounded by the Indian Ocean to the north and west, the Great Australian Bight and Indian Ocean to the south, the Northern Territory to the north-east and South Australia to the south-east...
and the Northern Territory
Northern Territory
The Northern Territory is a federal territory of Australia, occupying much of the centre of the mainland continent, as well as the central northern regions...
.
Land Ambulance
AmbulanceAmbulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...
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
Western Australia
Western Australia is a state of Australia, occupying the entire western third of the Australian continent. It is bounded by the Indian Ocean to the north and west, the Great Australian Bight and Indian Ocean to the south, the Northern Territory to the north-east and South Australia to the south-east...
, and in the Northern Territory
Northern Territory
The Northern Territory is a federal territory of Australia, occupying much of the centre of the mainland continent, as well as the central northern regions...
, statutory ambulance services are provided by the state/territorial government, as a single-entity, third-service model, government department. In Western Australia
Western Australia
Western Australia is a state of Australia, occupying the entire western third of the Australian continent. It is bounded by the Indian Ocean to the north and west, the Great Australian Bight and Indian Ocean to the south, the Northern Territory to the north-east and South Australia to the south-east...
, and in the Northern Territory
Northern Territory
The Northern Territory is a federal territory of Australia, occupying much of the centre of the mainland continent, as well as the central northern regions...
, all statutory ambulance service is provided by St John Ambulance Australia
St John Ambulance Australia
St John Ambulance Australia is a self-funding charitable organisation dedicated to helping people in sickness, distress, suffering or danger. It is part of an international organisation that consists of eight Priories that form the Order of St John.- History :St John First Aid training centres...
, 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.
Air Ambulance
Air ambulance
An air ambulance is an aircraft used for emergency medical assistance in situations where either a traditional ambulance cannot reach the scene easily or quickly enough, or the patient needs to be transported over a distance or terrain that makes air transportation the most practical transport....
service is accomplished in Australia by means of a variety of arrangements and providers. In the majority of New South Wales
New South Wales
New South Wales is a state of :Australia, located in the east of the country. It is bordered by Queensland, Victoria and South Australia to the north, south and west respectively. To the east, the state is bordered by the Tasman Sea, which forms part of the Pacific Ocean. New South Wales...
for example, the Ambulance Service of New South Wales
Ambulance Service of New South Wales
The Ambulance Service of New South Wales , an agency of the Department of Health of the New South Wales Government, is the main provider of pre-hospital emergency care and ambulance services in the state of New South Wales, Australia....
provides the service directly, with the service providing paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
flight crews, and the helicopters being provided under a contract with CHC Helicopters Australia Limited. 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
Search and rescue
Search and rescue is the search for and provision of aid to people who are in distress or imminent danger.The general field of search and rescue includes many specialty sub-fields, mostly based upon terrain considerations...
service in New South Wales, and provides some of the air ambulance service for other locations in Australia. Some states, such as Queensland
Queensland
Queensland is a state of Australia, occupying the north-eastern section of the mainland continent. It is bordered by the Northern Territory, South Australia and New South Wales to the west, south-west and south respectively. To the east, Queensland is bordered by the Coral Sea and Pacific Ocean...
share air ambulance resources with other public agencies; in the case of Queensland, air ambulance services are primarily provided by Emergency Management Queensland (EMQ Helicopter Rescue) and a mixture of other providers such as RACQ CareFlight may fill service gaps. In other states, such as South Australia
South Australia
South Australia is a state of Australia in the southern central part of the country. It covers some of the most arid parts of the continent; with a total land area of , it is the fourth largest of Australia's six states and two territories.South Australia shares borders with all of the mainland...
a mix of service providers, including other emergency services such as the police
Police
The police is a personification of the state designated to put in practice the enforced law, protect property and reduce civil disorder in civilian matters. Their powers include the legitimized use of force...
, 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.
First Responders
In MelbourneMelbourne
Melbourne is the capital and most populous city in the state of Victoria, and the second most populous city in Australia. The Melbourne City Centre is the hub of the greater metropolitan area and the Census statistical division—of which "Melbourne" is the common name. As of June 2009, the greater...
and Sydney
Sydney
Sydney is the most populous city in Australia and the state capital of New South Wales. Sydney is located on Australia's south-east coast of the Tasman Sea. As of June 2010, the greater metropolitan area had an approximate population of 4.6 million people...
, Hatzolah provides first responders to the Jewish Community. These organisations respond to the scene but do not transport patients.
Firefighter Emergency Medical Responders
In MelbourneMelbourne
Melbourne is the capital and most populous city in the state of Victoria, and the second most populous city in Australia. The Melbourne City Centre is the hub of the greater metropolitan area and the Census statistical division—of which "Melbourne" is the common name. As of June 2009, the greater...
the Metropolitan Fire Brigade, Melbourne
Metropolitan Fire Brigade (Melbourne)
The Metropolitan Fire Brigade , also known as the Metropolitan Fire and Emergency Services Board, provides firefighting, rescue, and hazardous material incident response services to the metropolitan area of Melbourne, Victoria, Australia...
(MFB) provides a fully professional Emergency Medical Response (EMR) capability for the City of Melbourne
City of Melbourne
The City of Melbourne is a Local Government Area in Victoria, Australia, located in the central city area of Melbourne. The city has an area of 36 square kilometres and has an estimated population of 93,105 people. The city's motto is "Vires acquirit eundo" which means "She gathers strength as she...
. Commencing in 1998 the MFB's EMR program is run in partnership with Ambulance Victoria
Ambulance Victoria
Since 1 July 2008 emergency ambulance services in Victoria have been provided by a single provider known as Ambulance Victoria. It was formed from the three previous providers of emergency ambulance services: the Metropolitan Ambulance Service , Rural Ambulance Victoria , and the Alexandra District...
(AV) to ensure rapid trained response to AMPDS "priority 0" (suspected cardiac arrest) medical emergencies across Melbourne.
EMR Training
To qualify as a Firefighter Emergency Medical Responder, MFB professional firefighters undertake a 12 month training program provided by Monash University
Monash University
Monash University is a public university based in Melbourne, Victoria. It was founded in 1958 and is the second oldest university in the state. Monash is a member of Australia's Group of Eight and the ASAIHL....
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 advanced life support
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
care including oxygen resuscitation and airway management, CPR, defibrillation, spinal and trauma care. When required, firefighters may also provide assistance to ambulance paramedics.
EMR Program Benefits
Under the EMR program, MFB firefighters are simultaniously dispatched with AV paramedics to all priority 0 medical emergencies within the City of Melbourne. 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.
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 several levels of paramedics in AustraliaParamedics in Australia
A paramedic in Australia is a health care professional who responds to and treats all types of medical and trauma emergencies outside of a hospital setting before and during transportation to an appropriate medical facility...
, arguably the highest trained and most advanced level is New South Wales Intensive Care (ICP) and Extended Care Paramedics (ECP) and Victoria's Mobile Intensive Care (MICA) Ambulance Paramedics. The term ‘paramedic’ is not legally protected in Australia; 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, Paramedicine or Clinical Practice (Paramedic), including classroom lectures, clinical practice, and internship components. The intent is to make this qualification the only path of entry into the field but so far only the state of Victoria has phased out all other methods of entry. Ambulance services in South Australia
South Australia
South Australia is a state of Australia in the southern central part of the country. It covers some of the most arid parts of the continent; with a total land area of , it is the fourth largest of Australia's six states and two territories.South Australia shares borders with all of the mainland...
, New South Wales
New South Wales
New South Wales is a state of :Australia, located in the east of the country. It is bordered by Queensland, Victoria and South Australia to the north, south and west respectively. To the east, the state is bordered by the Tasman Sea, which forms part of the Pacific Ocean. New South Wales...
and Queensland
Queensland
Queensland is a state of Australia, occupying the north-eastern section of the mainland continent. It is bordered by the Northern Territory, South Australia and New South Wales to the west, south-west and south respectively. To the east, Queensland is bordered by the Coral Sea and Pacific Ocean...
now draw the majority of their paramedics from degree programs and continue to use the older-style, internal diploma programs only to fill service gaps and shortages in forecasted requirements . These older programs continue to be necessary to ensure ambulance services are able to directly train additional staff to fill shortages and as the numbers of degree graduate paramedics being produced by the university system are insufficient to meet ambulance services’ requirements for new employees.
Training as a Mobile Intensive Care Ambulance Paramedic in Victoria
Victoria (Australia)
Victoria is the second most populous state in Australia. Geographically the smallest mainland state, Victoria is bordered by New South Wales, South Australia, and Tasmania on Boundary Islet to the north, west and south respectively....
, and equivalent Intensive Care Paramedic programs in other states 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 which may include intubation, Rapid Sequence Intubation (RSI
Rapid sequence induction
Rapid Sequence Induction is a medical procedure involving the expeditious induction of general anesthesia and subsequent intubation of the trachea. RSI is generally used in an emergency setting or for patients who have an increased risk of aspirating stomach contents into the lungs...
), additional drugs, and in some cases, certification of death. Those certified as MICA-Paramedics in Victoria
Victoria (Australia)
Victoria is the second most populous state in Australia. Geographically the smallest mainland state, Victoria is bordered by New South Wales, South Australia, and Tasmania on Boundary Islet to the north, west and south respectively....
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, provided the statutory rescueRescue
Rescue refers to responsive operations that usually involve the saving of life, or prevention of injury during an incident or dangerous situation....
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, the ambulances are roughly similar from one state to another, and all generally comply with the European Standard CEN 1789
CEN 1789
CEN 1789:2007 is the European Union standard for ambulances and medical transportation vehicles. This European standard specifies requirements for the design, testing, performance and equipping of road ambulances used for the transport and care of patients...
as published by the European Committee for Standards, apart from the visual identity provisions. This compliance is, however, incidental.
Dispatch
Ambulances and paramedics in Australia are centrally dispatched. Australia’s national emergency numberEmergency telephone number
Many countries' public telephone networks have a single emergency telephone number, sometimes known as the universal emergency telephone number or occasionally the emergency services number, that allows a caller to contact local emergency services for assistance. The emergency telephone number may...
is 000. This number rings at the Telstra Global Operations Centre, where an operator determines the caller’s needs and then directs the caller to the appropriate emergency service (police, fire, ambulance). Callers then speak to an operator at a dispatch centre, managed by the relevant state ambulance service (E.g. AFCOM
AFCOM
AFCOM is an acronym for the Ambulance and Fire Communication Centre at Spring Hill in Brisbane, Queensland. It forms the primary communication centre for the Queensland Ambulance Service and Queensland Fire and Rescue Service operations. The centre answers urgent triple zero calls from the public...
in Brisbane, QLD) or may even speak to an individual officer in the case of rural/remote stations. Dispatch technologies, including automated vehicle locating (AVL
Automatic vehicle location
Automatic vehicle location is a means for automatically determining the geographic location of a vehicle and transmitting the information to a requester....
) and decision-support software are either identical (as with AMPDS) or comparable with those found in North America and Europe.