Queensland Ambulance Service
Encyclopedia
The Queensland Ambulance Service (QAS) is the chief provider of out-of-hospital emergency care and ambulance transport in the state of Queensland
, Australia
. It falls under the control of the Queensland government's Department of Community Safety, and is the fourth-largest ambulance service in the world.
The service provides a high level of emergency care and transport services to over 4.1 million people in Queensland, covering an area of 1.77 million square kilometres. They provide such services as emergency response, pre-hospital patient care, specialised transport services, coordination of aero-medical services and inter-hospital transfers.
Approximately 2,780 paramedics are employed by QAS, who deliver their services from over 260 response locations across the state. In 2005/06, the service handled 746,275 cases, of which 536,227 were emergency cases and 210,048 were non-emergency cases. In the same period, QAS trained 63,092 first aiders.
operated out of the Brisbane Newspaper Company; the first officers possessed a stretcher, but no vehicle, and so transported patients on foot.
The Queensland Ambulance Service (QAS) as currently known was formed on July 1, 1991 from the amalgamation of 96 individual Queensland Ambulance Service Transport Brigades (QATB). QAS operated under the banner of the Department of Emergency Services however in 2009, the Queensland Government restructured the organisational hierarchy and appointed new Ministers. Today it is a part of the Queensland Government's Department of Community Safety, along with the Queensland Fire and Rescue Service, Emergency Management Queensland and Department of Corrective Services.
Ambulance operations of the Queensland Ambulance Service are performed by its operational staff. QAS operational staff include Student Paramedics, Advanced Care Paramedics (ACPs), Intensive Care Paramedics (ICPs), Patient Transport Officers (PTOs) and Emergency Medical Dispatchers (EMDs).
Advanced Care Paramedics possess either a Diploma of Paramedical Science (Ambulance) or a Bachelor of Health Science (Paramedic) or equivalent qualifications. In addition to this, an Intensive Care Paramedic possesses a Graduate Diploma in Intensive Care Paramedic Practice or equivalent. ACPs and ICPs attend medical, surgical and trauma emergencies. Patient Transport Officers possess a Certificate III in Non-Emergency Patient Transport or equivalent, and provide non-emergency patient transport services. Emergency Medical Dispatchers have completed a Certificate III in Ambulance Communications (Call Taking) and a Certificate IV in Ambulance Communications (Dispatch) or equivalent. EMDs receive emergency calls and direct ambulance services to the emergency, and advise callers in performing first aid until the ambulance arrives on scene. In Brisbane, ambulances (and the QFRS) are dispatched from AFCOM
.
ACPs are competent in many emergency medical skills, including airway management (oropharyngeal
and nasopharyngeal airway
, oropharyngeal suctioning, laryngoscopy
and Magill's forceps, laryngeal mask airway
, intermittent positive pressure ventilation), cardiac management (cardiac monitoring - basic ECG interpretation and 12-lead ECG, manual defibrillation), drug/fluid administration (intramuscular injection
, intravenous cannulation
, fluid replacement
), and the administration of basic and advanced drugs (aspirin
, glucose
, glyceryl trinitrate
, adrenaline, morphine
etc.).
Intensive Care Paramedics typically respond when their level of clinical practice is required. In some areas, they will respond as a single officer. These ambulances are not equipped to transport patients, but contain much of the same equipment as a regular ambulance, as well as advanced equipment. ICPs are competent in all ACP procedures, as well as advanced emergency medical skills, such as endotracheal intubation, synchronised cardioversion
, transcutaneous cardiac pacing, decompression of tension pneumothorax, extra-jugular venous cannulation, procedural sedation (midazolam
, ketamine
etc), pre-hospital thrombolysis (tenecteplase
), intraosseous access
, as well as the administration of advanced drugs (atropine
, heparin
, ketamine
etc.).
Intensive Care Paramedics (ICPs) often drive 'interceptor pods' (commonly station wagons, or in some areas, dual-cab utes). These vehicles cannot carry patients, however they carry much of the same equipment as the Sprinters, and are able to get to scenes relatively quickly.
Previously, the QAS used Ford 'F-Trucks' (Ford F-250 and F-350). These are still in use in rural areas, however are not common in the Metropolitan areas.
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...
, Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
. It falls under the control of the Queensland government's Department of Community Safety, and is the fourth-largest ambulance service in the world.
The service provides a high level of emergency care and transport services to over 4.1 million people in Queensland, covering an area of 1.77 million square kilometres. They provide such services as emergency response, pre-hospital patient care, specialised transport services, coordination of aero-medical services and inter-hospital transfers.
Approximately 2,780 paramedics are employed by QAS, who deliver their services from over 260 response locations across the state. In 2005/06, the service handled 746,275 cases, of which 536,227 were emergency cases and 210,048 were non-emergency cases. In the same period, QAS trained 63,092 first aiders.
History
Ambulance services in Queensland first began in 1892, and the City Ambulance Transport Brigade held its first meeting on September 12 of that year. Queensland's first ambulance stationAmbulance station
An ambulance station is a structure or other area set aside for storage of ambulance vehicles, medical equipment, personal protective equipment, and other medical supplies. Most stations are made up of garage bays or a parking area, normally undercover...
operated out of the Brisbane Newspaper Company; the first officers possessed a stretcher, but no vehicle, and so transported patients on foot.
The Queensland Ambulance Service (QAS) as currently known was formed on July 1, 1991 from the amalgamation of 96 individual Queensland Ambulance Service Transport Brigades (QATB). QAS operated under the banner of the Department of Emergency Services however in 2009, the Queensland Government restructured the organisational hierarchy and appointed new Ministers. Today it is a part of the Queensland Government's Department of Community Safety, along with the Queensland Fire and Rescue Service, Emergency Management Queensland and Department of Corrective Services.
Structure and operations
The QAS Medical Director is responsible to the Commissioner for the overall Clinical Governance of the Service and specifically for ensuring that patient care services provided by officers of the Queensland Ambulance Service are delivered at a consistently high standard. The Medical Director is also responsible for QAS Policy on Staff Health and Wellbeing and setting medical priorities for ambulance resource dispatch.Ambulance operations of the Queensland Ambulance Service are performed by its operational staff. QAS operational staff include Student Paramedics, Advanced Care Paramedics (ACPs), Intensive Care Paramedics (ICPs), Patient Transport Officers (PTOs) and Emergency Medical Dispatchers (EMDs).
Advanced Care Paramedics possess either a Diploma of Paramedical Science (Ambulance) or a Bachelor of Health Science (Paramedic) or equivalent qualifications. In addition to this, an Intensive Care Paramedic possesses a Graduate Diploma in Intensive Care Paramedic Practice or equivalent. ACPs and ICPs attend medical, surgical and trauma emergencies. Patient Transport Officers possess a Certificate III in Non-Emergency Patient Transport or equivalent, and provide non-emergency patient transport services. Emergency Medical Dispatchers have completed a Certificate III in Ambulance Communications (Call Taking) and a Certificate IV in Ambulance Communications (Dispatch) or equivalent. EMDs receive emergency calls and direct ambulance services to the emergency, and advise callers in performing first aid until the ambulance arrives on scene. In Brisbane, ambulances (and the QFRS) are dispatched from 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...
.
ACPs are competent in many emergency medical skills, including airway management (oropharyngeal
Oropharyngeal airway
An oropharyngeal airway is a medical device called an airway adjunct used to maintain a patent airway. It does this by preventing the tongue from covering the epiglottis, which could prevent the person from breathing...
and nasopharyngeal airway
Nasopharyngeal airway
In medicine, a nasopharyngeal airway, also known as an NPA or a nasal trumpet because of its flared end, a type of airway adjunct, is a tube that is designed to be inserted into the nasal passageway to secure an open airway. When a patient becomes unconscious, the muscles in the jaw commonly relax...
, oropharyngeal suctioning, laryngoscopy
Laryngoscopy
Laryngoscopy is a medical procedure that is used to obtain a view of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anesthesia or cardiopulmonary resuscitation or for procedures on the larynx or other parts of the upper...
and Magill's forceps, laryngeal mask airway
Laryngeal mask airway
The laryngeal mask airway is a supraglottic airway device invented by Archie Brain, a British anaesthetist.-Description:Laryngeal masks consist of a tube with an inflatable cuff that is inserted into the pharynx. Laryngeal mask airways come in a variety of sizes ranging from large adult to infant...
, intermittent positive pressure ventilation), cardiac management (cardiac monitoring - basic ECG interpretation and 12-lead ECG, manual defibrillation), drug/fluid administration (intramuscular injection
Intramuscular injection
Intramuscular injection is the injection of a substance directly into a muscle. In medicine, it is one of several alternative methods for the administration of medications . It is used for particular forms of medication that are administered in small amounts...
, intravenous cannulation
Intravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
, fluid replacement
Fluid replacement
Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced via oral administration , intravenous administration, rectally, or hypodermoclysis, the direct injection...
), and the administration of basic and advanced drugs (aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
, glucose
Glucose
Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate...
, glyceryl trinitrate
Glyceryl trinitrate
Glyceryl trinitrate is a chemical substance used as:* a drug; see glyceryl trinitrate * an explosive; see nitroglycerin...
, adrenaline, morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...
etc.).
Intensive Care Paramedics typically respond when their level of clinical practice is required. In some areas, they will respond as a single officer. These ambulances are not equipped to transport patients, but contain much of the same equipment as a regular ambulance, as well as advanced equipment. ICPs are competent in all ACP procedures, as well as advanced emergency medical skills, such as endotracheal intubation, synchronised cardioversion
Cardioversion
Cardioversion is a medical procedure by which an abnormally fast heart rate or cardiac arrhythmia is converted to a normal rhythm, using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart, at a specific moment in the cardiac cycle...
, transcutaneous cardiac pacing, decompression of tension pneumothorax, extra-jugular venous cannulation, procedural sedation (midazolam
Midazolam
Midazolam is a short-acting drug in the benzodiazepine class developed by Hoffmann-La Roche in the 1970s. The drug is used for treatment of acute seizures, moderate to severe insomnia, and for inducing sedation and amnesia before medical procedures. It possesses profoundly potent anxiolytic,...
, ketamine
Ketamine
Ketamine is a drug used in human and veterinary medicine. Its hydrochloride salt is sold as Ketanest, Ketaset, and Ketalar. Pharmacologically, ketamine is classified as an NMDA receptor antagonist...
etc), pre-hospital thrombolysis (tenecteplase
Tenecteplase
Tenecteplase is an enzyme used as a thrombolytic drug.Tenecteplase is a tissue plasminogen activator produced by recombinant DNA technology using an established mammalian cell line...
), intraosseous access
Intraosseous infusion
Intraosseous infusion is the process of injection directly into the marrow of a bone. This technique is used in emergency situations to provide fluids and medication when intravenous access is not available or not feasible.-History:...
, as well as the administration of advanced drugs (atropine
Atropine
Atropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects...
, heparin
Heparin
Heparin , also known as unfractionated heparin, a highly sulfated glycosaminoglycan, is widely used as an injectable anticoagulant, and has the highest negative charge density of any known biological molecule...
, ketamine
Ketamine
Ketamine is a drug used in human and veterinary medicine. Its hydrochloride salt is sold as Ketanest, Ketaset, and Ketalar. Pharmacologically, ketamine is classified as an NMDA receptor antagonist...
etc.).
Vehicles
QAS is in the process of upgrading its fleet of vehicles in metropolitan areas to Mercedes Sprinters with the new livery, which is intended to allow for a uniform vehicle across Australia. However, in some areas, use of such vehicles is limited, thus other vehicles(for example 4WDs, troopies or converted Commodores) are used. These vehicles (Mercedes Sprinters) are used by both Advanced Care Paramedics (ACPs) and Patient Transport Officers. The acute vehicles carry one (1) stretcher and the patient transport vehicles carry two (2).Intensive Care Paramedics (ICPs) often drive 'interceptor pods' (commonly station wagons, or in some areas, dual-cab utes). These vehicles cannot carry patients, however they carry much of the same equipment as the Sprinters, and are able to get to scenes relatively quickly.
Previously, the QAS used Ford 'F-Trucks' (Ford F-250 and F-350). These are still in use in rural areas, however are not common in the Metropolitan areas.
Funding
Since 2003, the service has been funded by the Community Ambulance Cover scheme, a levy added to all customers of electricity retailers in Queensland. In 2009, the amount payable was a flat fee just above $100 annually. This amount and collection method is designed to provide a reliable flow of income to the service.See also
- Ambulance Service of New South WalesAmbulance Service of New South WalesThe 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....
- Health in Australia
- Paramedics in AustraliaParamedics in AustraliaA 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...