FIRST by CAA | Issue 5 June 2021

ISSUE 05 | JUNE 2021

Ambulance Victoria’s sustainability warriors

THE ACE TRAINING CENTRE

Australia’s world-class aviation and aeromedical training centre.

FIT FOR DUTY

The science of Physical Employment Standards

www.caa.net.au

Dear friends and colleagues, Just like that half of the year is behind us. For CAA and the ambulance services it has been a very busy six months, between the incredible demand growth for our services, campaigns and working group meetings it's no wonder we didn’t notice the first half of 2021 is gone.

We hope you had a chance to catch up with the winners from the CAA2021 Women in Ambulance Awards, these ladies represent wonderful examples in the sector, something we wish to see more of in the future.

May brought our focus back to Infection Control, reviewing good and bad hand hygiene practices. Last year CAA released a bad practice hand hygiene video, showing how quickly bacteria can spread when poor hand hygiene is present during the patient journey. Last month, in line with World Hand Hygiene Day we released the good practice version. If you missed it, you can view the video on our Youtube Channel.

June marks Sustainable Ambulance month and while for our sector this is a relatively new focus, we are excited to start seeing progress in this space following the adoption of the CAA Sustainable Ambulance strategy in 2020.

It is our great pleasure to feature on June’s cover, Ambulance Victoria’s sustainability champions Sally Mangan, Catherine O’Shea and Tony Walker, AV’s CEO who is the driving force behind AV’s sustainable efforts. We are excited to share with you their plans and incredible work over the last few years that will no doubt inspire the rest of our sector down the sustainable path.

Lean back, rug up and enjoy the latest CAA FIRST magazine.

Mojca xx

Contents ISSUE 05 | JUNE 2021

14 03

Letter from the Editor

06

Data First Sustainability Facts & Tips.

08

Industry First Latest news from around the ambulance sector.

10

CAA First A look back on the first half of 2021.

14

Focus First Aeromedical Crewing Excellence (ACE) Training Centre in Bankstown, Sydney.

4

30

36

18

Opinion First Brian Haskins, Lecturer at Monash University shares why Public Access Defibrillators (PADs) need to be accessible.

24

Services First Showcasing the latest ground-breaking projects from across CAA member services.

32

Awards First The onflow from the CAA2016 Awards For Excellence Star Award Winners, Queensland Ambulance Service Indigenous Paramedic Program.

36

Feature First Ambulance Victoria’s sustainability warriors Sally Mangan, Catherine O’Shea and Tony Walker share their work so far and future plans.

www.caa.net.au

54

68

46

68

Read about leading events in the ambulance sector throughout Australasia.

Meet the wonderful people that make up the Australasian ambulance services.

50

70

Events First

74

People First

Partners First

The Directory

Meet our partners: Australian Stroke Alliance & Police Federation of Australia.

72

Wellness First

54

Research First Sharing the latest innovative research projects from around the ambulance world.

Call it a Gut Feeling! Plus, download Mitch’s ebook ‘Gut Health Guide + Recipe Manual’ for FREE! We also hear from NSW Ambulance on their Medic Fit Program.

For article submissions or to advertise in FIRST by CAA magazine please contact admin@caa.net.au

THE TEAM

PUBLISHED BY:

Editor: Mojca Bizjak-Mikic Relationship and Content Manager: Stephanie Hartley Graphic Design: Alpha State

The Council Of Ambulance Authorities 2/141 Sir Donald Bradman Drive Hilton SA 5033 Australia admin@caa.net.au

Magazine published from paper that is sustainably sourced.

5

Sustainability Facts & Tips Changes you can make towards a more sustainable future

Fact: Up to 90% of the energy used during a washing machine’s cleaning cycle goes into heating the water.

Tip: Switching to the cold setting can significantly reduce energy consumption.

Fact: Lighting accounts for 15% of global electricity use.

Fact: Water use has grown at more than twice the rate of population increase in the last century.

Tip: Try switching to LED lights in your home and workplace.

LEDs use 90% less energy and last far longer than incandescent lights.

Tip: Consider the use of water efficient fittings and fixtures that have the ability to cut water use in homes by 45%.

Fact: 95-98% of the components in your computer or television can be fully recycled.

Fact: 350,000 aluminium cans are made every minute in Australia. 3 billion cans annually.

Tip: Always recycle aluminium cans – they can be recycled endlessly without any loss of quality.

Fact: We dump eight million metric tonnes of plastic into the oceans each year. By 2050, ocean plastic will outweigh all of the ocean’s fish.

Tip: Consider purchasing products such as clothes, toys, and furniture that are made from natural materials and/or that will last for a long period of time.

Tip: Talk to your local council about hard rubbish recycling options if you are unsure about how to dispose of unwanted electronic devices.

REDUCE. REUSE. RECYCLE. Quick and simple tips to help you be more sustainable at home & work

Plastic takeaway food containers and cardboard-based vessels, such as pizza boxes and French fry cartons, can be placed in your recycling bin so long as they are clean and free from food residue.

Often cheap toys, clothes and electrical items don't last. Avoid this if you can by investing in items that will go the distance – reducing waste and saving you frustration and money in the long run.

Go paperless or use less paper where you can.

One sheet of A4 paper uses 10 litres of water, or 5,000 litres per ream.

Glass is 100 per cent recyclable and can be recycled and reprocessed indefinitely.

Always recycle your glass bottles and containers.

Switch to a biodegradable bamboo toothbrush.

Plastic toothbrushes can take 400+ years to break down in landfill.

Look for fruit, vegetables and other food items that can be bought loose, and start making purchasing decisions based on the amount of packaging an item has.

The CAA is committed to supporting the ambulance sector to work towards a more sustainable future. For more tips on #sustainableambulance visit caa.net.au

7

Industry First

Industry News Northmead Medal & Award Presentation NSW Ambulance's Western Sydney team always go above and beyond for the community. Some of the team members were recognised for their work and received medals at the Northmead Medal and Awards Presentation. We’d like to congratulate all worthy recipients. Thank you for your continued service!

National Volunteer Week Volunteers are one of the most important assets who are often on the forefront of community engagement.

They bring a wide range of skills, knowledge and clinical abilities, but most importantly their time, effort and energy. Volunteers are a vital part of emergency service delivery. National Volunteer week was in May for Australia and June for New Zealand and ambulance services around the country recognised the enormous contribution of volunteers throughout the sector.

SA Ambulance Service Excellence Awards The SAAS Mental Health Co-Response service is a success story on many levels. MH CORE recently won a SAAS Excellence award. MH CORE is a partnership between SAAS and Local Health Networks and pairs paramedics with mental health clinicians to help people avoid emergency departments and refer them to appropriate community-based mental health pathways.

Our photo shows paramedic Linda Tame and mental health professional Terri Heavyside.

New Chief Executive at Wellington Free Ambulance Dave Robinson is the new Chief Executive of Wellington Free Ambulance. With more than 20 years’ experience in community and public service, including senior management roles within the NZ Army and NZ Defence Force. He says it is a privilege to join a team of people he has long held in high regard. Dave joins at an exciting time, as Wellington Free looks towards 100 years of service in the Greater Wellington and Wairarapa region.

8

www.caa.net.au

Wellington Free Ambulance Clinical Communications Centre recently achieve second consecutive ACE accreditation Wellington Free Ambulance Clinical Communications Centre recently achieved their second consecutive ACE accreditation! As an Accredited Centre of Excellent they perform among the top 4% of all centres worldwide, with New Zealand one of only eight countries who are fully accredited. Centres who earn ACE status are the embodiment of dispatch done right, and have demonstrated strong local oversight, rigorous quality processes, and a commitment to data-driven continuous improvement.

Warrnambool’s new automated stretcher in HEMS4 helicopter Warrnambool’s HEMS4 helicopter now features an automated stretcher which wipes 20 minutes off patient transfer time. The equipment change has been five years in the making after road ambulances were fitted with the automated Stryker Power Pro Stretchers. HEMS 4 Senior Team Manager Ben Hespe explains: We’ve been working for five years for this, it’s an amazing feat of engineering and it’s going to be fantastic. Mr Hespe said the automatic stretchers would significantly reduce time and work for the paramedics.

French Ambassador to Papua New Guinea visits Nightingale COVID-19 Care Centre French Ambassador to PNG, His Excellency Guillaume Lemoine paid a short visit to the Nightingale COVID- 19 Care Centre. Ambassador Lemoine was accompanied into the patient areas of the coronavirus care centre to get a glimpse of the great work being done by the team of health workers from Port Moresby General, NCD Health Authority, St John and the Johanniter team.

Milestone for paramedic legend Over his 40 year career, Superintendent Andrew Ryan has witnessed some of the most significant events in the history of New South Wales. He said it has been a hugely rewarding career with many memories that will stay with him forever. “There have been so many tragedies – it’s a difficult job that challenges you every day, but there are huge rewards with that. You never forget those jobs,” he said.

When a retirement post was published on social media it was flooded with congratulatory comments and well wishes from mates and colleagues. “Best boss, mate, mentor, colleague and operative paramedic you could ask for,” one read. “Congrats on a stellar career and still leading by example.”

9

CAA First

As we enter the second half of 2021 it is starting to feel like we are getting back to a little normality.

It feels great to be planning meetings and activities where our CAA members can again meet face to face and network like we used to and not having to say “you’re on mute” anymore.

By David Waters 10

www.caa.net.au

11

CAA First

A

lot has happened since our last edition of FIRST in March earlier this year – time flies when you are having fun as they say.

All our Committees, Forums and Working Groups have met over the last couple of months to progress their individual workplans and agendas. Did you know that we have an increasing number of groups coming together under the auspices of the CAA to discuss and collaborate on national topics that impact on the ambulance sector? The infographic that follows shows the wide range of common interests that the CAA team bring the sector together to collaboration on.

The latest area of national interest is stroke care.

Soon we will be working with our members to establish a new workgroup to assist the Australian Stroke Alliance in delivering on their project to transform pre-hospital stroke care by providing earlier access to treatment and diagnosis.

The CAA Board met recently and continue to provide leadership and direction for the CAA and the wider ambulance sector. Of note was the approval of the CAA COVID 19 Vaccination Position Statement which will assist our members to set policy in relation to this important disease prevention activity.

Our CAA Board member Mike Grant resigned earlier this year and we look forward to welcoming Dave Robinson, the new Chief Executive of Wellington Free Ambulance to the CAA. Throughout May we continued to look at Infection Control as part of our Take Five For Hand Hygiene campaign. This year we celebrated the day with a launch of a new video showing how 5 steps for hand hygiene are implemented in the ambulance setting and how good practices can help with the spread of germs and bacteria.

12

This video shows an ambulance trip from when a crew first arrives in a patient’s home to where they are handed over to the hospital emergency department. It shows the variety of people the crew comes in contact with and how not practicing good hand hygiene aids in the spread of infection. The video can be viewed on the CAA Youtube channel.

To round up Hand Hygiene month we put on a special extended webinar on Infection Control – Post Pandemic.

We were excited to host Peter Collignon AM, Mark Reggers and Edward Johnson who shared with us how the COVID-19 pandemic will impact our futures.

Because one webinar in that week wasn’t enough we also co-hosted the Global Resuscitation Alliance webinar on Scientific and Regional Resuscitation Updates which provided a great insight into all the current activities for improving out of hospital cardiac survival being undertaken by our GRA colleagues.

We celebrated National Volunteer Week in Australia and New Zealand which was a great opportunity to thank all volunteers across our member services for their hard work and dedication to the sector. There have been some wonderful highlights posted on our member services social media sites such as the beautiful acknowledgment of the 30-year milestone of Queensland’s ‘Local Ambulance Committees’.

This month we launched our first CAA Virtual Expo which brought together members of the ambulance sector with innovative networking opportunities, sharing sector developments and ground-breaking technologies.

www.caa.net.au

Mâ te rongo ka môhio from listening comes knowledge

The CAA2021 Awards for Excellence nominations closed early June. We were excited to see so many quality submissions this year and will announce the finalists in August.

Mâte môhio ka mârama from knowledge comes understanding

The big news in the CAA office is the celebration of Mojca’s new baby Max who was born on the 24th May. We are happy to report that the whole family is doing well and enjoying this special time.

Mâ te mârama ka mâtau from understanding comes wisdom Mâ te mâtau ka ora from wisdom comes wellbeing

We want to share this proverb from New Zealand as it nicely sums up the way the CAA Committees, Forums and Working Groups collaborate to provide the best possible care to patients across Australasia and beyond.

Occupational Violence Working Group

Fleet & Equipment Working Group

PEPAS

MPDS Working Group

Aeromedical Working Group

Emergency Management Forum

Ambulance Education Committee Stroke Ambulance Working Group

Operations Committee

Global Resuscitation Alliance Working Group Research Working Group

Mental Health & Wellbeing Working Group

Clinical Forum Women in Leadership Working Group

CAA BOARD

Quality Standards Working Group

Infection Control Working Group

Strategic Business Committee Finance & Performance Committee

Audit & Risk Committee

13

Focus First

The ACE Training Centre

T

he Aeromedical Crewing Excellence (ACE) Training Centre in Bankstown, Sydney is a purpose-built centre of excellence that offers a world class aviation and aeromedical training facility and highly realistic mission simulation technology with a focus on technical and non-technical skills for both aircrew and clinical teams.

The ACE Training Centre is the realisation of a vision for an investment in safety. It has delivered a step change in training systems and realises higher levels of professionalisms in aeromedical operations.

Now in its fifth year, the training delivered to staff from Toll, New South Wales (NSW) Ambulance, Australian Capital Territory (ACT) Aeromedical service ‘SouthCare’ and Newborn and paediatric Emergency Transport Service (NETS) staff, as well as aviation and clinical crews from other Australian States, sets a benchmark in the domestic and international market. The centre remains unrivalled internationally. It follows international best practise by utilising the most modern training programs, techniques and the latest simulation technology that is currently available in the training and development space.

14

www.caa.net.au

In 2020, the Toll Ambulance Rescue Helicopter Service was tasked to over 3000 missions.

15

Focus First

T

The NSW and ACT Aeromedical operation is enabled through the efforts of this dedicated training facility and support personnel. It is the first of its kind in the Asia/Pacific region and one of the most significant investments in Helicopter Aeromedical operations in the world.

The ACE Training Centre built a bespoke Training and Proficiency System that inculcates the aeromedical crews with a shared safety ethos and maintains skills that are highly relevant to operations. A ‘cyclic’ program is designed to roster crews through the training program up to four times a year, each ‘block’ addressing a different aspect of operations.

In the past, it was common for aeromedical training to be conducted in isolation & each craft group focussed on individual training requirements. Pilots and Aircrew were sent overseas for simulator experience, the clinicians conducted their own medical and remote area access training on local soil and then would come together at their base and respond on missions as a team with limited knowledge of each other’s operational capacity and safety tolerances.

Today, this bespoke ACE program permits a focus on the individual training needs and the team dynamics in a collective learning environment.

These dynamics are developed in a safe and repeatable training environment with operationally relevant instructional staff to improve team cohesion for operational missions. It is a very deliberate approach that talks to the holistic vision of one team, learning and operating, together.

The ACE Training Centre was built to sit alongside the Toll Ambulance Rescue Helicopter operations and permits a level of continuous standardisation of crews across geographically dispersed bases. This has always been a challenge to any medical rescue organisation that operates across a large area with multiple base locations. By rostering crews through each Cyclic block in The ACE Training Centre, not only does it improve safety outcomes through standardisation and regular training, but it also lends itself to supporting organisational flexibility by allowing Toll, NSW Ambulance and the ACT Aeromedical Service ‘SouthCare’ to rapidly implement policy changes and learning experiences that arise out of day to day operations.

16

In 2020, the Toll Ambulance Rescue Helicopter Service was tasked to over 3000 missions. The environment in which the NSW and ACT Aeromedical operation works is both challenging and diverse. It involves everything from over the horizon search and rescue operations off the NSW Coast to 250’ winch operations in the mountainous regions, with no two rescues looking the same. The importance of individual expertise and training in this environment is not diminished, however is enhanced further through the Cyclic Training Program, focussed on developing the aeromedical team.

Lessons learnt from these missions feed into our safety systems. The cyclic training model then allows for challenges that have been identified to influence the theory and practical training provided to the aeromedical crews.

As an example, the aviation standardisation briefs that are delivered as part of all cyclic programs, play a key role in closing the learning loop. In place of alerts or individual briefings, these procedural discussions are given the space and the time to understand the issues that have been through the safety system.

“Frequency, when you go through a training evolution, helps us address the rapid skill fade after training, we catch the dip earlier so the skill fade is not as significant. Multiple times a year, little and often, achieves a high standard of aviation training”. Tim Frankel, Senior Contract Pilot.

Another advantage of this approach has been an immediate upskilling of the paramedic and doctors in aviation aspects that they previously had not been exposed to. Today, clinical staff play an important role in the safe conduct of helicopter operations. As an example, Aeromedical Doctors have growing knowledge about wire awareness and their role as part of the crew, while Critical Care Paramedics are also able to contribute to assessments made around Helicopter Landing Zones or winch sites. All this supports the aviation aspects of the cockpit and ultimately contributes to the safe operation of the aircraft.

www.caa.net.au

The ACE Training Centre is the key enabler that is setting a new standard in the Helicopter EMS industry by introducing and melding concepts and standards that are the norm in the airline industry with aviation medicine. With a uniquely aeromedical flavour, these norms include crew coordination and teamwork, the extensive use of check lists, simulation and ongoing development and understanding of human factors.

“Critical Care Paramedics are required to develop and maintain three distinct skill sets being Critical Care/ Medical Team role, ‘Down the Wire’ Rescue Crew Officer role and Remote Area/Rope Access skills. The world class teaching facilities and advanced simulators we have at the ACE TC allow for both the development of great technical skills and non-technical skills (human factors) through immersive team-based simulations and dedicated Human Factor programs. Both face-to face and flight training time are valuable resources therefore the ethos of using ‘simulation for competency and beyond, and flying for mastery’ serves us well and allows for the most efficient delivery of our diverse training program” Martin Pearce, NSW Ambulance Critical Care Paramedic Educator.

Multiple times a year, little and often, achieves a high standard of aviation training.

Tim Frankel,

Senior Contract Pilot

“The ACE training facility provides resources and a training environment only previously dreamed of, allowing individuals and teams to develop and grow in confidence and demonstrate enhanced procedural performance. In the unpredictable world of Prehospital Emergency Rescue and Retrieval being predictable through regular training provides a level of control.

Crews appreciating each other’s roles through shared training scenarios promotes a greater safety culture and deeper understanding of the synergism that is at the core of successful aeromedical teams” Ian Crossley.

ACT SouthCare Aeromedical Intensive Care Paramedic Educator.

The ACE Training Centre is creating a culture that supports and nourishes an in-cabin collaborative environment for a shared mental model and behaviour, which encourages pause points and critical assessment of the task and the environment. This all contributes towards decreasing the team workload and increases the safety profile of each mission.

For more information www.acetrainingcentre.com.au www.facebook.com/tollacetrainingcentre www.linkedin.com/company/ace-training-centre

17

Opinion First

In Australia and New Zealand there are approximately 30,000 out-of-hospital cardiac arrests every year, despite the best efforts of paramedics and healthcare professionals only 12% survive

18

www.caa.net.au

The Shocking Truth

by Brian Haskins

S

urvival from out-of-hospital cardiac arrest largely depends on what happens before Paramedics arrive.

In Australia and New Zealand there are approximately 30,000 out-of-hospital cardiac arrests every year, despite the best efforts of paramedics and healthcare professionals only 12% survive. Every experienced paramedic knows that the patient’s chance of survival largely depends on the actions of bystanders in the minutes immediately after the cardiac arrest and before they arrive. To increase survival rates, we must empower the general public to provide the first three links in the ‘Chain of Survival’, namely: (1) Recognition and call for help (000), (2) Early Cardiopulmonary Resuscitation (CPR) and (3) Rapid defibrillation (CALL, PUSH, SHOCK).

1

Installing their PAD in Red Hills, Mornington Peninsula, Victoria.4

Early recognition of a cardiac arrest is vital, as survival rates decrease by 10% for every minute without CPR or delay in defibrillation. By quickly calling 000, the emergency call-takers can dispatch the closest available paramedics and nearby volunteer first responders, if GPS apps such as ‘GoodSAM’ are integrated into the response system. Early bystander CPR ensures the patient’s vital organs remain perfused while extending the period the heart remains in a shockable rhythm. Early defibrillation, while the cardiac cells retain sufficient electrical activity, offers the best chance of conversion to a perfusing rhythm. Survival rates as high at 60 -70% have been reported when rapid defibrillation has been immediately available.

19

Opinion First To empower bystanders to step forward and intervene, we need to educate and motivate the general public that they can make a real difference and potentially save a life. The simplest way to do this is to ‘teach the children’, by including CPR and defibrillator training in both the primary and secondary school curriculum. For homework students could be required to teach their families using free online training programs, such as the ‘Heart Smart Program’, which was developed by the Monash Department of Paramedicine, in partnership with Defibsplus Pty Ltd and RMS Cloud. Another simple way to engage the public, would be to add a QR code to all defibrillator cabinets, to link the public to free online training.

QR code for the free online Heart Smart Program 2

Current public awareness campaigns such as the annual ‘Restart-a-Heart Day’, remain important as they generate media interest helping to increase public awareness.

To ensure defibrillators are available many ambulance services install Public Access Defibrillators (PADs) in locations with high volumes of people, such as train stations, airports and sports stadiums. State and federal governments have also supported the placement of PADs by providing grants to sports clubs, community groups and industries, such as gyms and caravan parks.

Additionally, private companies, such as Coles, Woolworths and Bunnings have identified the benefits to their staff and customers of installing PADs in their stores.

More recently Greg Page and the ‘Heart of the Nation’ campaign have encouraged businesses to install and register a PAD. However, most of these defibrillators are only available during office hours. To enable 24 hour community access, businesses should be encouraged to follow the lead of organisations like Bendigo Bank and Monash University, who have placed defibrillators in 24-hour public accessible cabinets.

These cabinets can be key-coded for security if required, with the access code available from the 000 calltaker in an emergency.

Unfortunately, increasing the numbers of PADs in businesses has little impact on the 80% of out-ofhospital cardiac arrests that occur in the home. The development of ‘Heart Safe Communities’, by the Australian Heart Foundation, state ambulance services and social enterprise groups such as the ‘Michael Hughes Foundation’, has helped increase awareness, bystander training and PAD availability. Other non-forprofit organisation such as the ‘Community Defib Project’, which was founded by Sophie Wills a recent Paramedic graduate from Western Sydney University, place PADs in vulnerable communities.

Some communities have taken the matter into their own hands, the residents of ‘Red Hill’ a small community on the Mornington Peninsula, bought and installed their own ‘neighbourhood’ PAD and organised bystander training from the Ambulance Victoria Community Engagement Officer. They then joined the GoodSAM scheme, to ensure they know when their neighbours require help. We need to do more to facilitate and support all communities to come together and install their own neighbourhood PAD.

The purchasing of neighbourhood PADs may become easier as a new generation of defibrillators is currently been developed which will drastically reduce their size and more importantly their cost. This development will enable families to have their own ‘private access defibrillator’ on their fridge door or in their car. With the potential to have rapid defibrillation available within minutes of a cardiac arrest, it is likely that the number of shockable arrests and the survival rate will both increase, but only if bystanders have the knowledge and confidence to step forward and provide the first three links in the chain of survival. i.e. CALL, PUSH, SHOCK.

CellAED, Rapid Response Revival 5

References 1. Kronick, Steven L., et al. "Part 4: systems of care and continuous quality improvement: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care." Circulation 132.18_suppl_2 (2015): S397-S413.

2. QR code for the free online Heart Smart Program. https://heartsmartprogram.com/ 3. Photo by Brian Haskins, permission given for use.

4. Photo by Elizabeth White, permission given for use.

5. Rapid Response Revival New Zealand Website. [Accessed 2/6/2021] https:// rapidresponserevival.co.nz/investors-media/

Brian Haskins PhD Scholar - Centre of Research Excellence in Pre-hospital Emergency Care Australia and New Zealand (PEC-ANZ).

20

Brian is a PhD Scholar researching ‘The optimisation of first responders for out-of-hospital cardiac arrest in a Victorian setting’ with the Centre of Research Excellence in Pre-hospital Emergency Care Australia and New Zealand (PEC-ANZ), in the School of Public Health and Preventive Medicine at Monash University. He is a lecturer and the director of the Pre-Hospital Trauma Life Support (PHTLS) Program with the Monash Department of Paramedicine. He has over 20 years experience as an advanced paramedic, academic and manager in healthcare organisations and universities in Australia, the United Arab Emirates (UAE), the USA and Ireland.

www.caa.net.au

Public Access defibrillator

Peninsula Campus, Monash University³

21

ENVIROFREI

A REVOLUTIONARY MATERIAL THAT MINIMISES CROSS-CONTAMINATION This revolutionary material is free from hazardous elements, delivers a strong fabric that minimises the chance of cross-contamination and prevents dangerous chemicals remaining on the surface.

• Improved cleanable surface • Antimicrobial, mildew and oil resistant • Abrasion resistant

Distributed by RAPP Australia Pty Ltd

• UV resistant • High elasticity • Extreme hot/cold temperature resistant • Stylish

MEDIS

IT'S NEVER BEEN EASIER TO FIND WHAT YOU NEED AND CHECK THAT IT IS CORRECT MEDIS - NEANN’s Medical Equipment and Drug Identification System - has enabled us to place colour coding, drug labelling and location guides throughout our kits.

• Clear and easy to read identification system • Easy to clean • Reduction in weight

• Removal of catch points, results in less repairs • Customised branding/labelling available

(03) 5284 0901 | sales@rappaustralia.com.au | www.neann.com.au

Services First

The Story of Leigh Higgins ASM. ESM .

1

From Ambulance Tasmania

Rarely, does an organisation get the opportunity to recognise 62 years of contribution from one of its volunteers

L

eigh joined St. John Ambulance Cadets at the age of 12 in 1955. Two days after turning 16, Leigh joined the St John Ambulance Transport Division and commenced his long service as an ambulance volunteer in many capacities and locations. Leigh volunteered as an Ambulance Attendant on weekends and during school holidays. He frequently filled in in the radio room answering phone calls, despatching vehicles (then called Mobiles), operating the radio and completing daily callout sheets. Frequently, when Leigh worked overnight, he was dropped off at school the next morning by ambulance.

24

As a 16-year-old Leigh saw many things not expected of people that age. Seat belts and air bags had not been invented and drink driving was rife. Road deaths were about four times greater than they are today as well as serious trauma. Leigh frequently attended these situations and not only treated injured persons but also transported deceased to Ward 13 (RHH Mortuary) that were then carried on stretchers, not the enclosed casket.

Other natural cause deceased were transported from houses and nursing homes to various funeral parlours – how things have changed!

1. ASM – Ambulance Service Medal, ESM – Emergency Service Medal

www.caa.net.au

At the beginning of 1961, after Leigh had completed High School, he enrolled to attend Teachers College in Launceston which was not to commence until 1st July that year.

In March Leigh was requested by the Secretary-Manager of St John Ambulance, Mr Trevor Jacobs, to go to Burnie to assist in the establishment of the new Ambulance service there which operated from behind the Health Department building in Alexander St. With Ambulance Officers Leigh Bradshaw and George Holloway (also from Hobart), Leigh assisted in the training of the new Volunteers at that station as well as weekly visits to Smithton to train the Volunteers of the newly formed Ambulance Brigade there. Apart from being an ambulance attendant Leigh also operated the Radio Room.

In July 1961 St John commenced the operation of the Launceston Ambulance Service and Leigh became the first volunteer there when he started at Launceston Teachers College. During the early months until volunteer numbers built up Leigh operated the radio room at night in exchange for accommodation. Leigh went ‘on road’ during weekend shifts. He volunteered at the station until May 1963 when he left to commence his teaching career. For the next few years, Leigh volunteered in Hobart as an attendant one night a week and sometimes at other times when there was a staff shortage.

In 1970, Ambulance Services were taken over by Tasmanian Government. Leigh, with wife Janice, were overseas for a two-year period (1969-1970) while Leigh was in New Guinea as the Principal of an all-native school.

Avoca Ambulance Service which was created through community fundraising with Leigh as Chairman, took delivery of an EJ Holden ambulance surplus from the Rossarden Mining Company, later replaced by an F100 ambulance ex Swansea Ambulance Service.

Residents of Avoca paid a $5 annual voluntary levy to assist.

The ambulance was attached to the local District Nursing Centre and the Volunteers would drive for the nurses.

St John Ambulance Service would not permit the Avoca Ambulance Service to join its radio network, so Leigh obtained his trainer’s certificate from the St John Ambulance Brigade and with the assistance Fingal brigade provided first aid training to volunteers.

After a couple of traumatic incidents Avoca Ambulance’s need for the station was recognised and St John Ambulance connected Avoca to the ambulance radio network and provided ambulance training for the Avoca Volunteers in Launceston.

Although we had no ambulance involvement Leigh rendered First Aid there including treatment for tropical ulcers and scabies. He became very proficient at giving penicillin injections.

Leigh’s ambulance qualifications had expired so he volunteered in the Radio Room in Hobart regularly on a Monday night from 1971 – 1972 and then from 1973-1974, Leigh moved to be the Principal at Poatina School.

In July 1961 St John commenced the operation of the Launceston Ambulance Service and Leigh became the first volunteer.

From a quiet beginning 35 years ago, the Bruny service has become much busier with Bruny becoming a popular tourist destination. A large proportion of the callouts are from visitors becoming ill or having car accidents.

Leigh was Principal at Bruny Island District High School from 1981 1991 until his retirement from the Education Department. During this time Leigh also was instrumental in setting up the police boat jetty at Roberts Point, Bruny Island.

Leighs has served the Bruny Island community as: Volunteer Ambulance Officer, Ambulance Tasmania

(1959 - current)

SES member, Bruny Island

(1981 - 2017)

Volunteer, TasFire

(1987 – current)

4th Officer, TasFire

(1997-2013))

Fire Permit Officer, TasFire

(1999-2014)

25

Services First

Bringing Clinical Best Practice to Australia’s Most Remote Regions From St John WA

S

t John WA’s workforce is armed with a new online Clinical Resources database that delivers mission-critical clinical information updated in real time to people working on the front line of the world’s biggest geographic ambulance service.

The database is an online webpage paired with a mirrored offline application that houses official documents including Clinical Practice Guidelines, Clinical Skills, Medication Protocols and Infection Prevention & Control (IPC) Guidelines. By culminating all existing resources into a single-source database, St John WA delivers staff and volunteers with an easily accessible point-ofcare reference tool that allows them to deliver patient care as efficiently and safely as possible.

This means the workforce can access information as and when they need it, regardless of where and when they’re working.

26

Background

The need for change

St John WA is the biggest single provider of prehospital care by land mass in the world. Our workforce is dispersed from Kununurra in the East Kimberley to Eucla on the South Australian border; we have 194 service points and about 12,500 prehospital care providers, working in Ambulance, Patient Transport, our State Operations Centre and Event Health Services. We strive to provide the best available clinical resources to deliver safe care to the community of Western Australia.

Prior to development of the St John Clinical Resources database, our workforce was reliant on highly-individualised practice guidelines in PDF format, which were cumbersome when printed.

Two separate Quick Reference Guides (one for volunteers, one for paramedics) were created to mitigate this issue, but this simply added to the number of documents needing to be maintained.

In 2019, St John WA commissioned a review into the way in which we deliver clinical management information to our frontline crews and whether this could be optimised to modernise our approach, enhance patient safety, and improve the user experience.

There were additional issues such as ambiguous and/or duplicated (and occasionally contradictory) information.

www.caa.net.au

It became apparent that over time, issues and inconsistencies had begun to grow and became harder to manage. A key risk identified was that the onus was on officers to ensure any offline versions of the documents that they maintained (e.g., in iBooks or Dropbox) were always up to date.

Development We identified a replacement platform was required that could host critical operational information including Clinical Practice Guidelines (CPGs) (including Infection Prevention & Control), Clinical Skills, and Medication Protocols. Merging our Volunteer Ambulance Officer, Ambulance Transport Officer, and Ambulance Paramedic CPGs into one central location was a significant task and took several months. We took the opportunity of this revamp to also amalgamate much of the educational or non-specific information into educational articles, which were posted into a medical library in the future solution.

By culminating all our existing resources into a single-source Clinical Knowledgebase, we are providing our staff with a pointof-care reference tool to guide management and IPC decisions.

The platform allows clinicians to browse as minimally or as indepth as needed, knowing that the Guidelines, Skills and Medications are always up to date and provide in a concise format the information necessary to deliver patient care as safely as possible. The platform ensures consistency in layout, that there are no duplications or inconsistencies (eg, not referencing a medication dosage for a particular condition, rather hyperlinking the Medication Protocol itself) and it is far easier to update and modify as required. These updates are then pushed seamlessly down to the end-users.

Patient focused A decision was made to implement a widget that has made the system responsive to the user’s clinical scope of practice. The user can switch between different skill levels to only see the management options relevant to that officer.

The clinician need only indicate their skill level once, and Clinical Resources will remember that choice for future sessions.

The user can move seamlessly between conditions and management by way of integrated hyperlinks and in-built navigation functions and the app will still only display the relevant skillset.

For point-of-care management, we have made available succinct flowcharts for every single Clinical Practice Guideline that guides an officer from patient presentation right through to transport, with colour-coding to indicate which pathway to take depending on the relevant scope of practice. The flowcharts are also completely interactive; if the chart requires IV Access or for a medication to be administered, the clinician need only tap that skill or medication to be taken straight to the relevant guideline.

Delivery Once the product was ready to be tested, the project team engaged a Trial Group of participants comprising of all clinical levels and departments. This group reviewed the new platform and provided feedback. They tested the suitability of the platform across the skill levels, the access to the library as well as more advanced features such as the Medication Calculator.

27

Services First

Future-proofing The solution we sought needed to be robust in that it was to work in an online or offline environment, readable on any smart device. To this end, the team developed a mobile app which we call “St John Resources”. Upon first login, this app downloads a complete copy of the Clinical Resources database locally to the user’s device. This guarantees access to the required resource as quickly as the device will allow regardless of connectivity.

This platform is live and is pre-installed by default on all St John WA issued iPads. The app is also freely available on personal devices across iOS and Android platform and once installed and synchronised, regardless of whether you have mobile signal/internet connectivity, you will always have access to the necessary reference material. The entire project from review to completion took 15 months at an estimated cost of $45,000 and about 2000 hours of workload.

The application is also freely available on personal devices across iOS and Android platforms and to date, the iOS application has had 2,291 downloads and the Android (Play Store) application has had 1,153 downloads. The application has a 4.5-star rating.

The platform hosts: •

10 general information documents

•

16 operational resource documents

•

74 Clinical Practice Guidelines (+ 10 COVID-19 Interim Guidelines)

•

73 interactive QuickCharts

•

71 Clinical Skills

•

19 instructional videos

•

38 Medication Protocols, plus one interactive Medication Calculator

•

11 Infection Prevention & Control Guidelines plus one Quick Reference Guide

•

An ECG self-directed study program, encompassing 14 pages of information

•

43 Medical Library Articles

•

2 ‘specialist’ articles on prehospital management of complex conditions (Primary Adrenal Insufficiency, Left Ventricular Assist Devices)

•

3 prehospital case studies

•

4 lookup tools including acronyms, abbreviations, medication lists

What’s Next St John WA are partnering with St John Papua New Guinea to provide access to and support in a bespoke set of resources for their frontline staff to achieve the same goals that we have managed to achieve here. This is just one of the ways that St John are improving the quality of prehospital care, for the service of humanity.

Outcomes As standard practice, the St John Clinical Resources app is now pre-installed by default on all St John WA issued iPads.

Clinical Practice Guidelines (and related documents) are reviewed on an ongoing basis with medication CPGs reviewed bi-annually. Every time a user access the website or refreshes the App, changes are highlighted under the “Latest Update” tab.

Case Study 1 Peta, an Ambulance Officer was on his way to a 3-year-old child who was experiencing an on-going seizure. Peta used the medication calculator and confirmed the outcome with his crewmate, this took less than a minute The rapid access to the right medication dosage allowed the midazolam to be drawn up and administered in a timely manner.

In Peta’s words “As confident as I am with my clinical knowledge and practice, it’s always good to double check with your partner and your CPG’s before administering any medication, and with the consistent and interactive layout, I have the information right at my fingertips whenever I need it.”

28

Case Study 2 “I have used the Clinical Resources app a few times over the last year both in training and also on call outs in our district. The most recent was a call to at patient with chest pain. Corpuls3 is a new addition to Volunteer Ambulance Officer practice, I was able to use the App on route to refresh my memory on the 12 lead placement.

The job went well and my confidence was boosted a little confirming I was on the right track via the App – Rondel Dancer, Volunteer Development Officer and Emergency Medical Technician.

www.caa.net.au

Turn-key solutions for emergency services

For more information contact sales@interdevtech.com

www.interdev.ca

Services First

New team in Wellington turning independent working silos into an inter-agency response From Wellington Free Ambulance

A

new inter-agency pilot, involving Wellington Free Ambulance, Wellington District Police and Capital & Coast District Health Board is providing enhanced on-scene care to people in need of an emergency mental health response.

The Co-Response Team; a first of it’s kind in New Zealand formed in March 2020. Working as a three-tiered, holistic and patient-centred response to those with an acute mental health need, the team work together to provide more timely, coordinated and specialist mental health care at home or in the community.

Evidence suggests that for some patients the best place for treatment and recovery is often in the community with their mental health support team as well as family and friends.

Paramedic Christine (Chris), Police Senior Sergeants Theresa and Jim and Mental Health Clinicians Deirdre and Ash are the faces of the new Co-Response Team.

Since March 2020 the team have attended over 200 mental health related incidents in the community, and assisted in over 900 other events; significantly helping to reduce crisis presentations to Emergency Departments.

Chris believes mental health in New Zealand has been in crisis for years, and the Co-Response Team is a positive step to addressing this in the community.

“We know that people experiencing mental health distress and those in crisis who are transported to police cells or the emergency department have unfavourable

30

outcomes to their long-term health. Wellington is a small compact city and Wellington Free Ambulance is a small independent ambulance service so it made sense to trial the pilot here; having Police, and the CCDHB on board too, is why this works.”

The team have kept many patients away from hospital, and police cells by directing them to more appropriate care. Some have been existing patients, others known to mental health services and others presenting for the first time.

Interventions include face-to-face assessments and care, collaboration with other mental health services for patient management and providing telephone consultation and advice to police and ambulance staff.

Having interacted with many mental health patients over her 17 years as a frontline paramedic, Chris says many were previously transported to hospital due to lack of information or alternative options, sadly limiting what ambulance services could do.

“Before the Co-Response Team we were all in effect, working in silos, Police, mental health and ambulance services. This was often frustrating and made for disappointing outcomes for some patients.”

www.caa.net.au

Chris recalls many occasions where not knowing how best to help, or who to call left her feeling like she hadn’t done everything possible to help someone.

Many of the questions are similar to what paramedics ask but are a lot more in depth, with emphasis on risk assessment. “It's been a complete mind shift from normal ambulance work.”

“As paramedics we respond to different needs, it may be an elderly patient needing a lift assist and a cup of tea, or it could be someone with traumatic injuries. However, with mental health patients, we haven’t always had the tools and information we need.”

“Unless we are already responding to a high priority job the pace is initially slower. Once we are advised of a job, our mental health clinician and police officer will check to see if they have any existing details.”

Working with partner agencies to create a new model of care has allowed a greater understanding of each other's roles and offered a new perspective.

Looking after everyone is important, says Chris and this includes those with mental health concerns. It means looking after all patients to the best of our abilities; providing reassurance to those stressed or in crisis, and treating someone as if they were our own family wherever possible.

“It’s important to validate a person’s symptoms, so they feel heard and have reassurance that they are going to be ok. We all, for various reasons, experience different issues with mental health at some point in our lives.”

“I know from my own experiences, treating patients with compassion and skill often helps, and if plans are initiated early, this too can help with recovery. If we support patients to get the help they need, they can avoid reaching crisis point.”

Being present at a mental health intake, triage and assessment is fascinating, says Chris.

The mental health clinician, who is not out on the road, can contact a case worker or Te Haika, Mental Health and Addictions Services, while the team are in transit, to advise that a person has come to our attention, and to expect a call to discuss their status and appropriate care. Access to this information helps our paramedic crews out on the road and is incredibly valuable.

Police and the mental health clinicians often have more information available to them regarding patients previously seen. Now with all agencies working together the team have more information to work from and provide more appropriate patient care.

“With the Co-Response Team we know what has happened for each patient prior, if someone already has a mental health support worker, and what medications they are potentially taking. Access to this amount of information has been an incredible boost,” says Chris This type of connection and joint working between agencies was invaluable when the team responded to a patient who had made multiple emergency calls threatening selfharm, resulting in a number of attendances by Police and ambulance.

The Co-Response Team found the patient was already under a community mental health team, and together they reviewed the patient’s plan to make it service-wide. As a result the patient received more support and there was a significant reduction in calls to Police and ambulance, and a corresponding reduction in attendance.

It seems our three different uniforms and inter-agency response work in our favour. The Mental Health clinician is plain clothed in a highvis vest, the Police Sergeant and Paramedic are in full uniform.

“Together, we have had an interesting response from the public, particularly from people we have been called to assist but as a team we seem to diffuse some situations; this has been a somewhat unexpected, yet positive outcome.”

“The Co-Response Team has helped release police officers and paramedic crews from jobs allowing them to get back on the road, either we've taken over, de-escalated the situation, or we've been able to get a mental health team worker to come and assist.”

“On some occasions we’ve taken a person to a place of safety for further assessment.”

Sadly, we’re unable to be everywhere as the pilot is currently in Wellington City and the Hutt Valley, but the pilot has been a fantastic opportunity to make some tangible, positive change.

The successful year-long pilot due to end in March, has now been extended till September, with Otago University set to provide a more detailed evaluation in the coming months. ​

31

Awards First

CAA Awards for Excellence Star Awards winners continue to shine

32

www.caa.net.au

Indigenous health workers deliver trusted medical care to outback communities

I

n 2016, Queensland Ambulance won the CAA Awards for Excellence Star Award with their ‘Indigenous Paramedic Program’, 5 years on they continue to make an important difference in this space.

Young Indigenous healthcare workers in Queensland are following the footsteps of their family members and hope more of their generation will do the same, but one Mount Isa Indigenous doctor says the job is not a 9-to-5 commitment.

and Torres Strait Islander people to become engaged with the health system.

Caleb Pigliafiori, a Gangalidda Aboriginal and Torres Strait Islander man, grew up in Mount Isa listening to his grandmother's, mother's and sister's stories of working in healthcare in the outback city.

"Having a well-known family name in the community makes it easy to attend to these patients as well."

"Seeing my Mum study hard, she worked on becoming a registered nurse, and hearing her relay all her study back to me, it got me interested in wanting to learn about health," Mr Pigliafiori said.

At 22 years old, he has just received his ambulance technician epaulette as part of an Indigenous paramedic cadetship program.

Mr Pigliafiori is working to achieve his Bachelor of Paramedic Science and eventually wants to become an advanced care paramedic.

He said having Indigenous people employed in healthcare could act as a drawcard for other Aboriginal

"I can relate to them on a cultural level, and they can relate to me," he said.

Executive manager of the North West Local Ambulance Superintendent Brad Hardy agreed with Mr Pigliafiori.

"It's very different than in city areas — up here it's a special type of practice," he said.

To have young, eager Indigenous people within the QAS and the greater health system is so beneficial to our work."

33

Awards First

34

www.caa.net.au

Racism a healthcare barrier Tyla West-Chong is a student midwife and Deadly Choices officer for a Mount Isa-based Indigenous primary health provider, Gidgee Healing.

"Ones who can create a rapport with their patients that will motivate them to come in more often, as well as promote the importance of health checks.

She believes Indigenous people in North West Queensland struggle to relate to and understand nonIndigenous healthcare providers.

Like Mr Pigliafiori, Ms West-Chong developed her passion for healthcare while growing up in a family of nurses and healthcare workers.

"A big barrier we encounter is getting regular doctors," Ms West-Chong said.

She said there were many reasons Indigenous healthcare issues were hard to address, but said racism played a part.

Even in 2021, it (racism) is definitely still a barrier."

"Even in 2021, it [racism] is definitely is a barrier," she said.

Tyla West-Chong,

Student midwife and Deadly Choices officer, Gidgee Healing

More than just office hours Marjad Page is the chief medical officer at Gidgee Healing and is of Gangalidda, Kalkadoon and Waanyi descent.

Dr Page, who works in the north-west region, said Indigenous healthcare workers were leaders in their communities and often attended to and relayed medical information to friends and relatives after work hours.

"We need to acknowledge the significant work they [Indigenous healthcare workers] do," he said.

We know the significance of improving our people's health."

Marjad Page,

"We know the significance of improving our people's health."

Mr Page said he had been buoyed by the growing number of young Indigenous health workers in outback Queensland.

"It melts my heart, to be quite honest," he said.

"On many occasions it brings a tear to my eye."

The Close the Gap report published in 2020 revealed that on average Indigenous males were only expected to live to 71.6 years — 8.6 years less than non-Indigenous males.

This figure worsens in remote areas, with Indigenous males only expected to live to 65.9 years.

Reproduced by permission of the Australian Broadcasting Corporation – Library Sales Julia Andre © 2021 ABC

Chief Medical Officer, Gidgee Healing

35

Feature First

S

Ambulance Victoria’s Sustainability Warriors Tony Walker, Sally Mangan & Catherine O’Shea

2020 marked a special year for members of the CAA in looking at our future and what we wish ambulance services across Australia, New Zealand and Papua New Guinea to look like in the next decades from a sustainable point of view.

36

www.caa.net.au

By 2045

Net Zero Emissions By switching to renewable energy at high-use AV sites, we immediately achieved

7% Emission Reduction Vision to source 100% of energy requirements from renewable sources by 2025

100% Renewables

37

Feature First

T

he newly adopted Sustainable Ambulance Strategy is a roadmap of work intended by the CAA and our members to assist us in making our sector a more sustainable space.

While we are very much at the starting point and much needs to be done, it is wonderful seeing services taking first important steps on this roadmap. One service that is leading the way is Ambulance Victoria and FIRST spoke

to AV’s CEO Tony Walker and AV’s sustainability team Sally Mangan and Catherine O’Shea about the work they have been doing, their wins and challenges and plans for a more sustainable AV future.

Tony Walker, CEO Ambulance Victoria F. Tony, it’s safe to say you and AV are the leaders in the Australian ambulance sector when it comes to sustainability. What made you commit to making AV a more sustainable service?

That’s very generous of you – we’ve certainly come a long way in a short period of time.

Our path towards sustainability started with a recognition that climate change was having a direct impact on our response to the community and to our people. We were seeing increasing numbers of heat events, events such as Thunderstorm Asthma and longer and more intense bushfire seasons, each with their unique impacts on demand for our services.

As we adjusted our response to reflect our changing environment, we also challenged that as a significant emissions producer we were also part of the problem and had a moral and leadership responsibility to do something about this as a respected public sector organisation.

This was supported by our Board but also by our growing millennial workforce who strongly value sustainability. We know that many people factor in an organisation’s social stance when deciding where to work, and it’s a stance we’re happy and proud to share. That’s where our sustainability work takes on greater depth because it takes it from something on paper, to a vibrant and important value that is shared widely across the entire organisation.

F. What are some key initiatives that you were driven to start off with?

Some of the immediate key initiatives were initially more related to the environment and climate change, such as reviewing our emissions profile and setting targets, transitioning more of our energy to renewables, and actively managing our climate risk.

However, we are also interested in understanding more about social impact and value for the community. For example, we developed a social procurement approach which means we prioritise the social and environmental impact with whatever we purchase. Social enterprises and other organisations provide lots of opportunity for us to use our buying power for good.

38

F. How are you getting the rest of the team and staff on board the sustainability road map?

Sustainability is a regular discussion at my leadership team and at Board and will feature again in the next Strategic Plan, which we’re currently developing. We have performance targets every year to track and measure improvement.

We have also done a lot of work with local sustainability champions with regular news and opportunities for them to get involved. Our sustainability team has started up an internal podcast where they get our staff and other external subject matter experts along to talk about key issues, as a different way of getting the message to our people.

F. What were some initial challenges you faced?

A personal challenge for me and others is the view that it costs more to be sustainable. The reality is that sustainability provides us opportunities to collaborate, innovate and reduce cost in more ways that we ever imagined. We have found in our work that it’s not necessarily more expensive to be sustainable, and that our work can be both sustainable and financially sound.

For example, when it comes to climate change, we need to be ahead of the impacts and think smarter, not bigger. We need to do things in more efficient and innovative ways. Technology helps us re-imagine and transform our service and future. We’re working closely with communities to help them respond to health emergencies. If we can remain a step or two ahead, we will be in a position to manage extreme weather events and other rising service demands; like mental health and an aging population that are the daily reality in a modern ambulance service.

F. For you personally, is this something that has always been important?

Personally, of course I am concerned for the world my generation is leaving to my children.

My daughter Lucy is only five years old. I am grandfather to three-year-old Ella, and one-year old Flossie. I think the 2019-20 Black Summer Fires really brought home the reality of climate change and the importance of sustainability to most Australians in a way that melting glaciers and stranded polar bears have not. www.caa.net.au

A

mbulance Victoria is so far the only CAA member service with a dedicated sustainability team and we spoke to them about their work and goals they set out to achieve.

Mr Tony Walker – CEO, Ambulance Victoria.

Tony Walker ASM is Chief Executive Officer of Ambulance Victoria. He is is a Registered Paramedic with over three decades experience working in a range of senior clinical, operational and leadership roles within the ambulance sector.

Sally Mangan – Director of Sustainability, Ambulance Victoria.

Sally is Ambulance Victoria’s Director Sustainability who led the development of Ambulance Victoria’s first social and environmental responsibility framework and action plan. Sally established a dedicated Sustainability team and is working to implement priority action.

Catherine O’Shea – Sustainability Analyst, Ambulance Victoria Catherine O’Shea has worked in healthcare for 35 years, beginning her career as a Registered Nurse in the tertiary setting and moving through a wide range of specialty areas. Having completed a Master of Environmental Sustainability in 2009, Catherine transitioned to healthcare environmental sustainability and has spent the last 15 years engaged in a maturing dialogue around climate as a health issue and the implications of this on Australia’s healthcare system. She spent eight years at Western Health as Sustainability Coordinator, melding her practical clinical knowledge with a passion for improved environmental outcomes. Catherine is currently a Sustainability Analyst at Ambulance Victoria, dedicated to rolling out Ambulance Victoria’s ambitious Social and Environmental Responsibility Framework and Action Plan.

In her six years with Ambulance Victoria, she has worked as a Director in different departments supporting strategic projects and change initiatives. Sally has experience across various industries with a background in management consulting. She has managed major organisational transformations projects as both a functional lead and change manager.

39

Feature First

Work to date at Ambulance Victoria

• Project examples: Solar and lighting projects, experimentation with battery storage, and thinking differently about future building design – including the concept of a ‘net zero carbon’ ambulance branch.

• Our People: - Network of ~200 sustainability champions across our workforce help drive local action.

- Increased staff sustainability engagement (measured by the annual Victorian Public Sector Commission People Matter survey).

• Recognition: - Awarded Gold for Climate Leadership and Silver for Renewable Energy in the global Health Care Without Harm 2020 Climate Champion Awards.

Some key achievements of AV’s sustainability efforts include: • Team: First Australian / New Zealand ambulance service with a dedicated sustainability team.

- Finalist, Institute of Public Administration Australia (IPAA) Victoria, Leadership in the Public Sector Awards for Sustainable Communities and Environments 2020.

• Our Sustainability vision and action plan - 5-year plan to 2025.

- Key focus areas: People, Community, Environment and Supply Chain.

• Climate Risk: One of our top organisational risks discussed regularly is climate change, and will be an ongoing focus for us into the future.

• Emissions targets and reduction: Our emissions reduction plan sets our path to implement and report on our actions as we become a net zero organisation. Our vision is a phased transition across AV’s key emissions from road vehicles, building energy usage, and air ambulance services.

- 2021 Target: 7% reduction of emissions this year from a renewable power purchase agreement that commenced in 2020 for our largest sites - Renewables 100% by 2025: “…vision to source 100% of our energy requirements from renewable sources by 2025. This would mean a 27% reduction of our overall emissions profile”.

- Road fleet: Transition to hybrids is underway in our support vehicles, and planning for green ambulance vehicle solutions underway.

40

People Capability building.

Health, safety & wellbeing.

Inclusive & safe culture.

Enabled first responders & volunteers.

Community Engagement & resilience.

Inclusion & accessibility.

Community contribution.

Child safety & family violence.

Social and Supply Environmental Responsibility Social and

Environmental Responsibility

Chain

Responsibility sourcing.

Contract & supply chain management.

Environment Waste lifecycle.

Climate change adaptation.

Infrastructure asset management.

Natural resources.

www.caa.net.au

F. Sally, you are the first Sustainability Director to date in Australian or NZ ambulance services, that must bring some pressure and a set of expectations on you?

Yes and no. Sometimes being the first brings pressure, but I find that doing something first or new also brings the opportunity to make a space your own, so that’s been great.

We consciously took a broad approach to sustainability when we set up our social and environmental responsibility vision, so there’s a lot of variety in the work we do.

I love that no two days are the same. I can go from looking at a social supplier for donations of end-oflife medical equipment, to reviewing environmental performance results, visiting a wind farm or hydrogen centre, presenting at a conference on climate change for emergency services, helping a paramedic communicate a used clothes drive for the homeless, and looking for new ways to reuse or recycle our old uniforms.

I probably put the most pressure on myself. I’m passionate about this work and I want to help Ambulance Victoria (AV) establish itself in this space and leave a legacy. I’d like to think that out of all the roles I’ve had since I joined AV, that this will be the one that will stick with me– where I can see the most meaningful change being delivered. I’m really proud that we’re one of the first Australian health services to have defined our climate action plan.

F. Cath, you joined AV from the hospital sector, what were some of the challenges you faced?

I have found AV to be quite different in regards to its key environmental impacts. I must admit, I knew very little about regular cars, let alone potential zero emission vehicle options and aviation options on the horizon. That has been an interesting education!

The other main challenge was the quality of the environmental data being collected, often by external organisations. As they say, what you can measure, you can manage, however it has taken some effort to improve the quality of information that we’re collecting in order to decide how best to communicate our aspiration.

Then of course, there are the challenges associated with building relationships with the people you work closely with to influence change. I have to say, I was very well supported in this regard, so those challenges weren’t too great.

F. Cath, compared to the hospital sector, how are you finding setting up systems and goals for the ambulance sector?

I’ve been so impressed with how proactive and interested many of our paramedics and local team members are in sustainability. They’re keen to get involved and we’ve been there to help guide them as they establish sustainability initiatives at a local level.

We have more than 200 sustainability champions across the state who are eager to try new things, which makes what we’re trying to achieve much more collaborative. This wasn’t always so easy to do in the hospital sector. We have great examples of our sustainability champions setting up their own gardens, worm farms and waste tracking systems in their branches, running uniform recycling programs, and even getting local auxiliaries involved.

By contrast, the scope and scale of a state-wide ambulance service can be quite challenging, compared to a health service that operates across a few larger locations. Implementing simple environmental programs, like recycling, energy efficiency or solar across 400+ sites requires a whole new approach. Even determining the baseline or getting quotes for such programs can be tricky when it is so broadly distributed.

I’m loving the challenge of learning more about ambulance services and getting out to visit more of our locations. We now use our network of champions for different projects and trials to test out improvement ideas before we share them more broadly.

F. Sally, the ambulance sector is a wonderful community that is always eager to share knowledge and experience. With AV leading the pack in sustainability where have you been able to turn to for advice and help?

We’ve been quite lucky as Catherine joined us from a sustainability role in the Victorian healthcare sector with lots of great networks and connections into teams and professionals who are doing great work. However, we are also drawing heavily on our international colleagues in ambulance, particularly in Europe and the United Kingdom.

We have helped set up a group call the Sustainable International Ambulance Network (SIAN) group with representatives from across different global ambulance services in sustainability.

We’ve also been quite fortunate to join up with the Council of Ambulance Authorities (CAA) on a project this year to look at how the ambulance services across the CAA compare environmental performance wise, the carbon impact of running a service, and how we can compare and learn from each other.

While that is still early stages, I think that we’ll learn a lot from each other as we understand, monitor and improve our impact. This is part of the work that helps us move towards a lower carbon model of healthcare.

41

Feature First F. Cath, what are some of the key goals for AV in the coming two years?

F. Sally, starting from scratch in a field as vast as sustainability, where do you start?

When I started, we were really focused on goals to set ourselves up and get a few wins on the board, such as the renewable energy agreement for our larger sites and establishing partnerships and networks. Nowadays our goals and timelines are more medium to longer term, and we’re working towards some higher targets.

For us, a short project was the best way to get started to define a vision and action plan for the next few years. We had a great opportunity to ask lots of different people what sustainability meant for an ambulance service. Creating a high-level vision and getting commitment from your senior leadership and others is a great starting point.

We have pledged the following reduction targets for our Scope 1 and 2 emissions on our path towards zero net carbon emissions from our 2015 baseline:

Our first priority was setting up a team to make it happen, as we recognised that there needed to be people dedicated to looking after this for the longer term. Sustainability isn’t something that is going to go away in a few years, so setting up a team that can help the rest of AV become more sustainable has been key. We also have a great group of leaders from across the organisation who believe in and help deliver our plan.

2025: 39% emissions reduction 2030: 60% emissions reduction 2045: Net zero emissions We will reach these commitments through renewable energy use (100% by 2025), retrofitting buildings with solar panels and batteries, adopting hybrid vehicles and transitioning to zero emission vehicles.

We also have internal goals that we want to meet to improve our employee engagement scores for sustainability and involve more of our people in improvement projects. We are also working to measure our social and community impact with a big focus on social procurement. We’re asking ourselves how can we generate more social and environmental value and positive impacts from our spending decisions. We want to see the percentage of our spend in social procurement increase in over the next two years and are working closely with our procurement team to achieve this.

As you can see, there’s quite a lot we want to achieve in the next few years, and to keep us honest against our goals, we report to the Executive Team and Board twice a year on a set of sustainability indicators.

F. Sally, how are you finding the rest of the AV team accepting, or not, your role and AV’s sustainability plans?

At first, I think people might have just thought it was about really tangible environmental sustainability items – such as Teslas and electric ambulances, or reducing plastics waste.

F. Cath, what have been some of the highlights working in AV’s sustainability team?

It’s incredibly rewarding to share our successes and progress as a team and our broader network here at AV. One highlight that stands out in my mind is our visit to the Tarwin Lower Wind Farm in Gippsland in eastern Victoria, to recognise our participation in a 10-year agreement to purchase energy via a renewable power purchase agreement.

This immediately reduced overall emissions by 7% annually.

Other highlights have been some speaking events that provide opportunity to influence beyond AV into other ambulance services throughout Australasia.

However, watching the day-to-day growth of social and environment responsibility throughout the organisation is a highlight that cannot be underestimated. It’s very satisfying to see more and more people coming on board with their own great ideas and initiatives, and really owning that responsibility. ​

Now, after having done more work with teams, I think that they are starting to understand more about both our social and environmental focus, and how the small decisions we make can make a difference.

We both love to say that sustainability is everyone’s responsibility at AV, not just ours! The choices we make today will affect us now and into the future so it’s really important that this is a team effort to consider sustainability in decision making.

For more information: AV Sustainability webpage, emissions reduction target announcement, & AV moves towards renewables article Contact: sustainability@ambulance.vic.gov.au

42

www.caa.net.au

43

ADVERTORIAL

Ambition 2039 With Ambition 2039, Mercedes-Benz is pursuing the goal of a fully connected and CO₂-neutral vehicle fleet by 2039.

Let’s be clear what this means for Mercedes-Benz a fundamental transformation of the company within less than three product cycles.

That’s not much time when you consider that fossil fuels have dominated the vehicle industry since the invention of the car by Carl Benz and Gottlieb Daimler some 130 years ago. But as a company founded by engineers, Mercedes-Benz believes technology can also help to engineer a better future.

The way to sustainable mobility is innovation – in a holistic approach along the entire value chain.

The company envisages that more than 50 percent of its passenger car unit sales will be accounted for by plug-in hybrids or all-electric vehicles by 2030. In addition to cars, Mercedes are also electrifying their entire vans portfolio.

Mercedes-Benz Vans goal is a holistic electric solution that not only reduces the strain on cities and the environment, but also offers customers genuine benefits.

Electric mobility is considered way beyond the vehicle itself here: Mercedes-Benz Vans offers a holistic ecosystem which is developed in close cooperation with customers for an outcome precisiontailored to their sector.

But the transformation to electric mobility in particular increases the energy demand in the supply chain. Compared to a conventional combustion engine, the production of an all-electric vehicle is twice as CO₂- intensive, mainly because of the lithium-ion batteries.

Ambition 2039 Despite a higher energy demand in production, Mercedes-Benz plug-in hybrids and electric vehicles offer a clear advantage in terms of CO₂- emissions compared to conventional drives already today. Only when the entire life cycle of the vehicle is considered, a realistic picture emerges.

An important milestone for Ambition 2039 is CO₂-neutral production in all MercedesBenz AG's own plants worldwide as of 2022. The purchase of green electricity is an important part of this.

From 2022 onwards, all of Mercedes-Benz AG's own production plants worldwide will therefore exclusively

procure electricity from renewable sources. Daimler Trucks & Buses is also setting the course for "green" production with all European plants aiming to have CO₂-neutral production and a CO₂--neutral energy supply by 2022.

The goals of Ambition 2039 cover all stages of the automotive value chain – from technical development to the extraction of raw materials, to production, service life and recycling. With this holistic approach, Mercedes-Benz are committed to climate protection and a more sustainable future.

Our milestones until 2039 2022: Electrified variants in all segments of Mercedes-Benz and a CO₂-neutral production at our own Mercedes-Benz car and van plants worldwide.

2025: Up to 25 percent of unit sales to be accounted for by all-electric vehicles (depending on the framework conditions).

2030: Achieving more than 50 percent of car unit sales with plug-in hybrids or all-electric vehicles.

2039: A CO₂-neutral fleet of new cars and a CO₂-neutral supply chain.

Events First

Industry Events What's on in the ambulance world

46

www.caa.net.au

CAA2021 Awards for Excellence Gala Dinner Save The Date Thursday 28 October, 2021 Dockside Darling Harbour Award Categories: • Excellence in Technology (innovation or capability) • Excellence in Clinical Practice (innovation or capability) • Excellence in Staff Development (education improvement or innovation) • Excellence in Patient Care (patient experience improvement or innovation) • Excellence in Leadership (management practice and operational improvement and innovation) New Category: • Excellence in Mental Health and Wellbeing (innovation or operational improvement)

Finalists announced in August More information coming soon 47

Global Resuscitation Alliance Webinar Series The Council of Ambulance Authorities is the Global Resuscitation Alliance (GRA) Secretariat for Australia & New Zealand. The GRA is committed to increasing cardiac arrest survival rates in all corners of the world.

The first event Scientific and Regional Resuscitation Updates Webinar was held on May 27, 2021.

The GRA’s extensive program of information and tools including the 10 Steps to improve cardiac survival are disseminated, promoted and supported by four secretariats in North America, Europe, Asia and Australia/New Zealand.

•

Explore new science and strategies for effective implementation of guidelines

•

Learn about late-breaking science from experts

•

Gain valuable knowledge on best practises from different countries and regions.

The GRA is creating a global leadership network that focuses on the implementation of resuscitation best practices. By working together in communities around the world, based on available evidence, we can significantly increase survival from cardiac arrest to 50%.

The mission of the Global Resuscitation Alliance is to advance the disseminations and implementation of best-practises in resuscitation. To help the continuation of learning in this area they are hosting a series of free webinars.

The key learning points were to:

The recording of this first webinar in the series can be found at: https://www.globalresuscitationalliance.org/ scientific-and-regional-resuscitation-updates-webinarmay-27-2021/ Stay tuned for information on the next event.

CAA2022

CONGRESS 11-13 AUGUST, 2022

International Convention Centre, Sydney Australasia’s premier paramedicine event bringing together pre-eminent thought leaders from across the pre-hospital sector Follow CAA social media channels for Congress updates

Partners First

T

The Australian Stroke Alliance his new, $40 million initiative will take the emergency department to the stroke patient via road and air ambulance.

Paramedics will play an essential role as we work together with neuroscience and technology experts from across the country to provide urgent prehospital stroke care. We will introduce transformative, locally designed tools for use in the field while offering unrivalled support to first responders. Mobile brain scanners and seamless telehealth are coming.

Australians from a range of fields are partnering to offer a high-tech response to urgent stroke care.

They include professionals from paramedicine, neurology, medical research, air medicine, diagnostic technology, engineering, artificial intelligence, brain imaging, health economics and consumer engagement.

With 37 national collaborations in place, there’s a good chance you’ll hear us coming as we begin national pilot studies and a comprehensive education program. Seven principal partners include Ambulance Victoria, the Council of Ambulance Authorities and the Royal Flying Doctor Service.

50

Why become involved?

When treating stroke, we know that ‘time is brain’. Treatment needs to be offered within the first few hours and preferably within the first ‘Golden Hour’. In a country the size of Australia, this is a problem. Every day, time and distance prevent many people from receiving the urgent care they need.

Stroke incidence is 17 per cent higher in rural and remote areas and with this comes twice the likelihood of significant lifelong disability. Unfortunately, only 3 per cent of patients in rural and remote areas of Australia are treated in a stroke unit, compared to 77 per cent of patients in metropolitan areas, with most needing to travel over 200 kilometres to access care.

The solution The Australian Stroke Alliance builds on the successes of the nation’s first mobile stroke ambulance in Melbourne which carries a modified CT scanner.

We are working with partners like the Royal Flying Doctors Service, ambulance services in each state and territory, and engineers from RMIT University, to develop stroke capable road ambulances, fixed-wing aircraft and helicopters to develop the world’s first air stroke ambulances.

This will require the design of ultra-lightweight and low-cost brain imaging devices that will provide essential images of a patient’s brain at the scene of the stroke.

We hope paramedics, nurses and local doctors will be keen to participate in our program so, together, we address the need for faster prehospital stroke care, regardless of location. www.caa.net.au

Telehealth Regardless of geographical location, paramedics will be supported like never before, thanks to a unique, cloud-based telestroke app which is highly customisable and reliable – using a tablet or mobile phone.

When the Alliance's portable brain scanners are ready, they will be added to further enhance hospital care.

Brain images and other essential patient data will be shared with city-based stroke physicians who will diagnose the type of stroke that has occurred – within minutes.

There is a stroke every 19 minutes in Australia. By 2050, his will double to every 10 minutes.

The Stroke Alliance has calculated that some 45,000 DALYs will be saved over 30 years through our interventions. Please join us in our quest.

Connect with the Australian Stroke Alliance Sign up to our e-newsletter at austrokealliance.org.au/ contact-us Connect with us: @AusStroke @AustralianStrokeAlliance

Visit: austrokealliance.org.au

We are pleased to be planning to pilot ambulances with mobile stroke detection and assessment capability in rural Queensland. There is so much potential to improve prehospital stroke care”.

Dr Stephen Rashford,

Medical Director, Queensland Ambulance Service

51

Partners First

The Police Federation of Australia

T

he Police Federation of Australia (PFA), a Registered Organisation under the Fair Work (Registered Organisations) Act 2009, represents the professional and industrial interests of in excess of 65,000 members across every Australian policing jurisdiction.

The PFA is the only organisation that can legitimately speak on behalf of police officers, Australia wide, hence its title as the ‘National Voice of Policing’.

Australian police associations and unions have had a national body since 1946, when the Police Federation of Australia and New Zealand (PFANZ) was first formed as an unregistered organisation constituted by organisations that represented police employed by the AFP and state and territory police forces. The PFANZ was initially formed as a result of emergency war legislation, which brought all state and territory police under federal control and in reaction to the police associations seeking to develop a common set of working conditions in anticipation of the continued federal control post the war, which obviously did not eventuate.

52

The PFANZ survived in one form or another until 1997, when all seven judges of the High Court of Australia, affirmed a 1993 decision and ruled that there could be a Police Federation of Australia.

Discussions around formalising the structure of the then PFANZ and now PFA, began as far back as 1988.

The PFA is located in the Canberra suburb of Manuka and its headquarters were officially opened by the then Prime Minister of Australia, John Howard.

Today, every Australian police officer, who belongs to his or her state, territory or federal police union is, by virtue of that membership, a member of the PFA. The PFA has approximately 96% membership density, nationally.

Australia’s eight police union presidents make up the Executive of the PFA but also remain the heads of their respective unions and a team of appointed staff, led by a Chief Executive Officer, runs the PFA’s Canberra office and implements policy at the direction of the Executive and the Federal Council.

The Council is made up of elected delegates from each affiliate union and is the supreme decision making body of the PFA. The PFA is guided by a Strategic Plan endorsed by the Federal Council.

The PFA is also affiliated with the International Council of Police Representative Associations (ICPRA), which represents in excess of 1.5 million police officers internationally. The PFA CEO is the Australasian representative on the ICPRA Executive.

www.caa.net.au

Integrated Vehicle Component System

iNTRAXX provides crash-ready safety for providers and patients and is infinitely adaptable to enable your vehicle to be configured for mission-specific jobs.

The modular iNTRAXX system features wall-mounted tracks to which all manner of storage solutions, equipment and accessories, seating options and oxygen systems can be attached.

Ambulance Services around the world are using iNTRAXX to devise their own creative ways to meet their patient transfer and operational needs — from ambulance buses for mass evacuation and emergency response, to ambulance boats, 4WD response vehicles and road and aero-medical transport.

If you’re interested in patient and paramedic safety, improved in-car flexibility and infection control, faster turn arounds and reduced system waste, give us a call to see how Ferno iNTRAXX can help.

WWW.FERNO.COM.AU AU: +61 7 3881 4999 | NZ: +64 4 928 3099

Scan to watch videos and to see the full iNTRAXX scope. l.ead.me/iNTRAXX_AU

Research First

Setting the standard: physical employment standards for specialist paramedics

By Ben Meadley

54

www.caa.net.au

FIT FOR DUTY?

T

he very mention of minimum fitness standards, preemployment testing and ongoing assessment of fitness for duty will invoke a wide range of responses from paramedics. Many will agree that some form of a minimum standard is required, and that paramedics should undertake some kind of ongoing assessment to perform what is often a physically demanding job. However, an assumption that employers and employees are in agreement regarding physical standards would be naïve.

For the employee, pre-employment and ongoing assessment of physical capacity may be seen as yet another hurdle or burden in a profession that already requires a significant ongoing commitment to maintaining a standard of practice. For employers, initial physical capacity testing has been a long-standing requirement, but repeat assessment represents an added cost and drain on resources.

In a similar vein to any proposed changes to clinical practice, both parties would and should ask "where is the evidence?".

55

Research First

The science of Physical Employment Standards Most ambulance services have developed physical employment standards (PES) that are required to be met, at least for initial employment. For example, Ambulance Victoria uses PES for its graduate paramedics, and separate PES for other specialist roles such as wilderness paramedics and helicopter paramedics undertaking search and rescue duties.

However, PES are often arbitrary and not based on objective criteria that correlate with actual occupational tasks.

Arbitrary PES may discriminate against capable persons or fail to eliminate persons unsuitable for the role, thus exposing them to risk.

Additionally, if PES are not deemed sufficiently valid nor reliable via a systematic process, then organisations expose themselves to litigation if an unsuccessful applicant challenges the standard.

To assess the utility of PES in paramedicine, our research team investigated specialist paramedics working for Ambulance Victoria’s helicopter emergency medical service (HEMS). The true physical demands of specialist HEMS paramedics have not been quantified, and investigating the physical requirements of specialist paramedic work potentially provides some insight into health and wellbeing across the wider paramedic population.

56

www.caa.net.au

Identifying health status and physiological demands Our first study investigated baseline health in 15 intensive care flight paramedics working for Ambulance Victoria HEMS. Assessments included dietary health, sampling of biomarkers to determine cardiometabolic health risk (e.g., lipid profile, insulin and glucose), maximal aerobic capacity assessment via treadmill running and assessment of health-related quality of life (HRQoL). Additionally, ten of the 15 participants wore a physical activity monitor for one year. For this cohort of HEMS paramedics, HRQoL, cardiometabolic and physical activity outcomes were representative of good health, which was interesting given their long careers in ambulance services and a median age of 45 years. We also noticed that shift work influenced the amount of physical activity undertaken, but paramedics still exceeded minimum recommendations even when rostered to duty. Despite lengthy careers in paramedicine, these specialist paramedics demonstrated an excellent health profile that is likely due to high physical activity levels and healthy body mass index.

However, the physically demanding nature of their roles may also play a role.

To determine the nature of the complex tasks HEMS paramedics undertake, we convened a subject matter expert (SME) focus group to review four years of historical case data. The aim was to generate task descriptions for land and water winch rescue as the basis for development of task simulations to assess physiological workload.

Sixteen HEMS paramedics participated in a one-day SME focus group.

After reviewing data from historical cases, SMEs achieved consensus (≥80%) when generating descriptions of winch rescue, which formed the basis for vital steps in the research project. The process engaged the workforce and was a reliable and collegial format for development of simulations for assessment of the physiological demands of winch rescue. This ultimately enhanced the validity and reliability of the proposed PES for these paramedics.

To determine relative workload and demand, we first needed to ascertain maximal physiological capacity. In 14 HEMS paramedics we evaluated an established treadmillbased maximal aerobic capacity (VO2peak) protocol, then developed a novel pool-based assessment and finally, compared the results. The paramedics demonstrated a very high VO2peak and there was only a small difference between VO2peak in the swim protocol compared to the run. We found that whilst not interchangeable, run VO2peak was a good predictor of swim VO2peak. For HEMS paramedics performing land and water-based rescues, a treadmill test is sufficient to estimate VO2peak for swimming, but swimming and water rescue proficiency would still need to be assessed separately.

By only having to undertake one aerobic capacity test, there is less resource and logistical burden when establishing PES for these specialist groups.

This may streamline pre-employment and ongoing testing processes and remove barriers for organisations employing staff who perform these roles.

And finally, we required HEMS paramedics to undertake task simulations to assess relative physiological workload during complex land and water-based search and rescue tasks. Paramedics undertook the task simulations that were developed earlier on.

During task simulations on land and in the ocean, we measured oxygen consumption, blood lactate, heart rate and perceived exertion, and compared these to the maximal capacity tests, where the same measurements were taken. We found that for land winch rescue tasks, HEMS paramedics worked at approximately 86% of their maximal aerobic capacity for more than half the calculated maximal acceptable work duration (MAWD) in order to rescue one person. For water winch rescue tasks, HEMS paramedics worked at approximately 81% of their maximal aerobic capacity for slightly less than half the calculated MAWD in order to rescue two people.

Our work has shown that although these HEMS paramedics are physically capable, they are not high-performance athletes.

However these intermittent, essential, and lifesaving winch rescue tasks invoke significant physiological demand. Initial and ongoing physical assessments should replicate these demands as part of a formalised physical employment standard. Furthermore, when deploying HEMS paramedics to physically demanding cases, there should be due consideration for the physiological strain that may be encountered, which in turn may influence resource allocation (e.g. sending additional helicopters to a rescue of multiple patients).

57

Research First

The path forward

Citations for Ben’s work:

Our research has provided a framework for the development of scientific physical employment standards in specialist paramedics.

We anticipate that this work will serve as a foundation for the creation of scientifically developed and robust standards across general and specialist roles in ambulance services and other organisations who require staff to perform physically demanding roles. The Paramedic Health and Wellbeing Research Unit at Monash University welcomes conversations and future collaborations.

Ben can be contacted at: benjamin.meadley@monash.edu

Meadley B, Caldwell J, Perraton L, Bonham M, Wolkow AP, Smith KA, Williams B, Bowles KA. The health and well-being of paramedics - a professional priority, Occupational Medicine, Volume 70:(3) April 2020, 149–151, https://doi.org/10.1093/ occmed/kqaa039 Meadley B, Perraton L, Smith K, Bonham MP, Bowles KA. Assessment of cardiometabolic health, diet and physical activity in helicopter rescue paramedics.

Prehospital Emergency Care. 2021 Mar 23:1-5. https://doi.org/10.1080/1 0903127.2021.1907492 Meadley B, Bowles KA, Smith K, Perraton L, Caldwell J. Defining the characteristics of physically

demanding winch rescue in helicopter search and rescue operations. Applied Ergonomics.

2021 May 1;93:103375. https://doi. org/10.1016/j.apergo.2021.103375 Meadley B, Horton E, Pyne DB, Perraton L, Smith K, Bowles KA, Caldwell J. Comparison of swimming versus running maximal aerobic capacity in helicopter rescue paramedics. Ergonomics. 2021 Apr 6:1-31. https://doi.org/10.1080/0014 0139.2021.1910350 Acknowledgements: This work was supported by research grants from the Ambulance Victoria Helimed 1 Auxiliary and the Australasian College of Paramedicine. In-kind support was provided by Ambulance Victoria.

Ben Meadley FACPara, B.App.Sci (Human Movement), Dip.Paramed.Sci, Grad.Dip.Intensive.

Care.Para, Grad.Dip.Emerg.Health (MICA), Grad.Cert.Emerg.Health (Aeromed), PhD Candidate Ben is an Adjunct Lecturer and PhD scholar at Monash University in the Department of Paramedicine.

Ben's doctoral project is investigating the physiological and metabolic health of paramedics, as well as specialist paramedic task performance.

With a background in exercise science and paramedicine, Ben has combined these passions to improve the health and wellbeing of paramedics as well as the clinical care they deliver. Ben is a founding member and researcher at the Monash University Paramedic Health and Wellbeing Research Unit. Ben has more than 23 years’ experience in paramedicine, gaining expertise in prehospital critical care, paramedic education, aeromedical rescue and retrieval, paramedic health and wellbeing research and clinical guideline development. Ben is a senior Intensive Care Flight Paramedic (MICA) with Ambulance Victoria, dividing his time between clinical, teaching and research roles. Ben is also a Fellow of the Australasian College of Paramedicine.

58

www.caa.net.au

Professional development without leaving the lounge!

Join our series of one hour webinars to fill the knowledge gap. Access an incredible line up of speakers, discussing thought provoking and stimulating topics that directly affect Paramedicine of today and tomorrow.

Tuesday, 29 June 2021 Sustainable Ambulance 2.00pm AEST

Alexis Percival Environmental & Sustainability Manager, Yorkshire Ambulance Service NHS Trust

Tuesday, 27 July 2021

Supported by

Mechanical Ventilation 11.30am AEST

Dr. Rosemary St. Clergy MD, MBA will share her extensive knowledge of mechanical ventilation and her own experience of implementing a critical care ventilation protocol at Acadian Ambulance

Tuesday, 31 August 2021

Supported by

Update of AHA/ERC CPR Guidelines 11.30am AEST Dr. Benjamin S. Abella, MD, MPhil, FACEP will be exploring the scientific evidence that led to these changes and updates

For more information go to www.caa.net.au/webinars

Research First

QAS publishes research looking to the skies for out of hospital cardiac arrest

By Queensland Ambulance Service Insight Magazine

I

n a career first, Information Support, Research and Evaluation (ISRE) Unit Cardiac Research Fellow Dr Tan Doan looked to the skies for answers in a bid to better understand the exposure-response relationship between Queensland temperatures and out of hospital cardiac arrest (OHCA).

By pairing thirteen years of meteorological data with QAS cardiac arrest records from 2007-2019, findings revealed that heatwaves can increase the risk of OHCA by up to 1.5 times.

“These conditions claim the lives of many thousands of Queenslanders each year. Our research will contribute to life-saving developments and we are very proud to be fronting this work.”

Dr Doan said the study highlighted the need for sector-wide preparedness and planning in the face of temperature extremes.

As a specialist mathematical modeller with more than a decade’s experience, Dr Doan said the research was possible because of the combined diligence and dedication of paramedics and the ISRE Unit’s clinical coders ensuring the veracity of patient care records from beginning to end.

“We know that environmental conditions affect the health of the population and understanding how this impacts community demand for emergency health care and patient clinical presentations is vital,” Dr Doan said.

“Living in a sub-tropical climate, it is incumbent upon us to plan for and adapt to the forces of nature, and in the case of OHCA, along with other acute cardiovascular diseases, mitigating temperature-related burden is especially important.

“Our cardiac outcomes database is one of the most robust and reliable resources available to the prehospital research community and we thank everyone for their role in maintaining its standard.

It is an invaluable resource to inform progressive updates to clinical and operational service delivery as new insights are uncovered.”

Research shows that heatwaves can increase the risk of OHCA by up to 1.5 times.”

Dr Tan Doan,

Information Support, Research and Evaluation (ISRE) Unit Cardiac Research Fellow

www.caa.net.au

Dr Tan Doan with CCP and recipient of the 2019 KJM Patron’s Research Grant Adam Rolley.

QAS Medical Director, and study co-author, Dr Stephen Rashford ASM, said the work, published in Occupational and Environmental Medicine, built upon initial findings highlighted in the QAS OHCA Annual Report 2019.

“While early days, this research—currently confined to cardiac arrest patients within Brisbane, to be expanded to other clinical presentations and across regional Queensland—will contribute to saving lives by laying vital groundwork for all ambulance jurisdictions to better understand the impact of the environment on service delivery,” Dr Rashford said.

“Broadly, we know extreme heat and cold make the body work harder, putting stress and strain on its systems.

Whether it’s heat or cold, our findings will be the catalyst for further research investigation and investment in this important clinical space, both here and abroad where the literature is sparse.

Article details–Access via CKN: Doan TN, et al. Ambient temperatures, heatwaves and out-of-hospital cardiac arrest in Brisbane, Australia. Occup Environ Med 2021. doi:10.1136/oemed-2020-107018.

Extremes in 2020 Hottest day

48.7 °C at Birdsville Airport on 5 Dec

Warmest days on average

35.0 °C at Julia Creek Airport

Coolest days on average

22.1 °C at Applethorpe

Coldest day

8.0 °C at Applethorpe on 14 Jul

Coldest night

-3.8 °C at Oakey Aero on 24 Aug | -3.8 °C at Applethorpe on 25 Aug -3.8 °C at Oakey Aero on 25 Aug | -3.8 °C at Applethorpe on 27 Sep

Coolest nights on average

9.6 °C at Applethorpe

Warmest nights on average

25.1 °C at Horn Island

Warmest night

33.3 °C at Cunnamulla Post Office on 10 Jan | 33.3 °C at Windorah Airport on 3 Dec

Warmest on average overall

28.3 °C at Normanton Airport

Coolest on average overall

15.9 °C at Applethorpe

Wettest overall

3289.7 mm at Tully Sugar Mill

Wettest day

427.0 mm at Bellenden Ker Top Stn on 20 May

Strongest wind gust

144 km/h at Dalby Airport on 2 Dec

Source: Bureau of Meteorology, 2020

61

Research heating up: Temperature stability of OHCA medication in focus

I

n a QAS first, a multicentre in-field study using High Performance Liquid Chromatography (HPLC) will explore the impact of temperature on selected cardiac medications carried by paramedics.

Leading the research is Critical Care Paramedic and recipient of the 2019 KJM Patron’s Research Grant, Adam Rolley, along with Dr James Falconer and Associate Professor Kathryn Steadman from the UQ School of Pharmacy, Dr Esther Lau from the QUT School of Clinical Sciences, QAS Specialist Pharmacist Danielle Ironside and Advanced Care Paramedic Jordan Grice.

“Using standard issue QAS drug kits, our team will log ambient and kit temperatures for six months, then check the concentration of the cardiac medications using specialised HPLC testing at monthly intervals,” Adam said.

“Worldwide, HPLC is considered the gold standard in producing accurate and timely analysis of drug concentration and this study will be highly beneficial in understanding ‘real-world’ exposure outcomes for these vital medications.

“Any paramedic knows the varied conditions our kits can get exposed to at scene or during our travels—it doesn’t have to be a particularly hot day for us to feel the impacts in Queensland, which is why our study site selection has a broad focus.”

“I extend my heartfelt thanks to my operational peers and their managers in the North West, Townsville, Metro North and West Moreton LASNs, and KJM Foundation. Their positivity from ‘proposal to project realisation’ has been overwhelming—together, everyone’s help has seen this vital research green-lit.”

Adam commended the behind the scenes support provided by many paramedics across the state.

This study will be highly beneficial in understanding ‘real-world’ exposure outcomes for these vital medications.”

Adam Rolley,

Critical Care Paramedic, 2019 KJM Patron's Research Grant Recipient

Adam is leading a team exploring the impact of temperature on selected cardiac medications carried by paramedics.

62

www.caa.net.au

ADVERTORIAL

Leonardo AW139 capability the backbone to Babcock Australasia’s Victorian HEMS and SAR operations Babcock’s fleet of rotary wing aircraft play an integral role in delivering world-class emergency aeromedical response, patient care, and recovery from remote and challenging environments across Australia.

Since entering service in 2016, the state-of-the-art Leonardo AW139 twin engine helicopter has been an essential component to Babcock’s growing emergency medical services (EMS) and search and rescue (SAR) capability.

Over the past four years, Babcock has supplied five AW139s, plus a service assurance aircraft, to support Ambulance Victoria’s Helicopter Emergency Medical Services (HEMS) operations.

and Warrnambool, Babcock’s AW139 crews fly more than 2,700 EMS and SAR missions each year across Victoria and Bass Strait.

All AW139s are equipped with a rescue winch allowing MICA paramedics to be lowered into very remote places to rescue patients, including bushland, boats and the ocean. The crew are also equipped with night vision goggles to allow for 24/7 operations.

Chief Pilot and Head of Flying Operations (Onshore), The aircraft perform interhospital transport tasks and infield Captain Tom House, said Babcock’s services include emergency medical responses which can involve landing training and qualifying pilots, aircrew or winch retrieval of injured persons. and engineers to provide a 24/7, In the medical retrieval role, the Babcock’s expertise, 365-days-a-year service within onaircraft can be configured to conduct commitment, and focus on call rapid response times. specialist retrieval of high-acuity adult, safe practices in the most paediatric, and neonatal patients.

“We also provide specialist aeromedical training to Ambulance Victoria’s Mobile Intensive Care Ambulance (MICA) Flight Paramedics, which enables them to conduct HEMS operations,” Captain House said.

“This training includes down-thewire land and water winch rescue operations in addition to their medical duties.

challenging of circumstances has helped saved many lives and 2020 saw more than 2,300 patients transported by HEMS. Captain Tom House,

Captain House said Babcock provides Ambulance Victoria with turnkey helicopter support services to maintain and fly the fleet of specialised medical emergency configured AW139 helicopters.

“This includes early adoption of new technologies, custom configuration of specialised on-board aeromedical equipment, as well as bespoke aircraft cabin designs and fitouts suitable for HEMS and SAR operations,” Captain House said.

Chief Pilot and Head of Flying Operations (Onshore), Babcock Australasia

“Our pilots and aircrew officers work as a close-knit team with the MICA paramedics, which is critical when conducting operations at short notice at all hours of the day and night, often in challenging weather conditions and involving traumatic circumstances.

“As a result, there is a high level of professional respect between the crew members and a close bond forged by shared experiences.”

Operating from bases in Essendon, La Trobe Valley, Bendigo

“Babcock’s expertise, commitment, and focus on safe practices in the most challenging of circumstances has helped saved many lives and 2020 saw more than 2,300 patients transported by HEMS. “Our long-term partnership with Ambulance Victoria and experience with HEMS continues to deliver significant benefit to more than 6.3 million people living in rural, regional and metropolitan Victoria.”

Reaching for the cloud:

stroke telehealth

A

truly unique stroke tele health platform is being rolled-out with region-specific programs starting in Queensland, South Australia and Victoria.

When complete, the nation’s prehospital health workforce will be supported by the Australian Stroke Alliance’s platform, called Zeus, regardless of location.

The first pilot will be completed by early 2023 using a strokecapable road ambulance in a regional setting. According to one of the lead researchers, Professor Mark Parsons: “These stroke capable ambulances will use tele health technology to connect on-site nurses and paramedics to remote stroke clinicians — 24-hours a day”.

Rapid consultations will triage paramedic-suspected strokes and will provide justification for patient retrieval to a comprehensive stroke centre, sometimes bypassing the nearest hospital. On arrival, the patient can be handed over to the stroke team immediately and treated as quickly as possible.

“Indeed, the Zeus network that connects in-field paramedics to specialty clinicians will be widely applicable to many other acute conditions where paramedics are the first contact — other traumas and heart attack, for example,” says Prof Parsons, the new executive director of SPHERE, the Sydney Partnership for Health, Education, Research and Enterprise.

Perfusion imaging specialist, Associate Professor Andrew Bivard, and Professor Parsons have spent six years designing and testing the all-in-one solution for health carers on the frontline.

64

www.caa.net.au

These stroke capable ambulances will use tele health technology to connect on-site nurses and paramedics to remote stroke clinicians — 24-hours a day”.

Prof Mark Parsons, Executive Director, SPHERE

65

There’s an app for that In another first, the platform uses a cloud-based app that ensures accurate diagnosis in real time.

Among its features:

A resilient and consumerresponsive workforce

•

It uses a mobile phone, providing simple clinical data entry and note taking — customised to unique regional requirements

The platform’s optimisation modelling tools will predict the nation’s requirements for prehospital resource allocation. For the first time, digital modelling will help build a demand-responsive and cost-effective allocation of health resources across the nation.

•

It offers easy-to-use video conferencing and image viewing to immediately share observations via the cloud, to the neurologist

Together with the nation’s ambulance partners, including the Royal Flying Doctor Service, we are modelling and testing resource allocation across Australia.

•

Everyone in the care chain is linked in real time. ie: a waiting thrombectomy team is kept up to speed during the patient’s transit

For more information, visit the Australian Stroke Alliance (https:// austrokealliance.org.au/our-story/anational-digital-telestroke-network/)

•

It supports the simple collection of data for clinical trials and the mining of data, generated using machine learning.

Paramedics pre-notify the in-hospital stroke team who then ensure the ED is prepared and that the CT is ready for the patient”.

Andrew Bivard,

Chief Technology Officer, Australian Stroke Alliance

66

www.caa.net.au

PR OGR AM PARTICIPANT

INSTINCT SAVES A LIFE AT VETERANS’ CLUB

“Are you feeling ok?” As she passed through the gaming room, Amy-Leigh Williams overheard one of the guests at Panania Diggers ask this of another.

Recognizing the level of concern in the guest’s voice, Amy-Leigh’s instincts told her to grab the automated external defibrillator (AED) from the reception area.

Amy-Leigh is an employee at Panania Diggers, a Returned Services League club in Panania, Australia.

Luckily, Panania Diggers has an AED on site for such emergencies and, thankfully, Amy-Leigh had the foresight to retrieve it because it ultimately helped save Barry Clarke’s life.

Upon her return, as Barry sat with his wife Lyn, he suddenly went rigid and slipped from his chair to the floor. Amy-Leigh quickly checked for Barry’s pulse and when she couldn’t find one, she immediately began administering cardiopulmonary resuscitation (CPR). Her colleague, Tania Moon, called emergency services and then opened the ZOLL AED Plus®. It appeared Barry was in sudden cardiac arrest (SCA); Amy-Leigh and Tania followed the instructions to connect him to the electrodes. The device analysed his heart rhythm and administered a shock. The AED instructed Amy-Leigh to continue compressions, but she quickly noticed that it was telling her she wasn’t pressing hard enough. “The AED tells you how well you’re doing. Without that [feedback], what I was doing wouldn’t have done [Barry] any good,” Amy-Leigh says. “It was telling me to push harder, so I used my body weight.” The AED feedback indicated that her compressions were then in the target range. She and Tania continued giving compressions and the device delivered two more defibrillating shocks to help Barry's heart regain a normal rhythm.

Copyright © 2021 ZOLL Medical Corporation. All rights reserved. AED Plus and ZOLL are registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners.

The AED tells you how well you’re doing. Without that [feedback], what I was doing wouldn’t have done [Barry] any good.

— Amy-Leigh Williams, lay rescuer

After the third shock, medics were on site. They worked on Barry for 45 minutes and eventually transferred him to the hospital, where he regained consciousness four days later. He was fitted with a pacemaker and defibrillator and was released after three weeks’ time. He has no recollection of the SCA but is immensely grateful for the quick thinking of Amy-Leigh, Tania, and the other attendants at the club that saved his life. If that AED hadn't been readily accessible, his outcome may have been very different.

A timely move Just a week before Barry’s SCA, Amy-Leigh had no idea where the AED was located. Previously kept in an office, management thought that the AED should be stored in Reception so that anyone could access it.

“We were so lucky that they moved it, or we wouldn’t have had the results we did,” she says. Amy-Leigh found the experience confronting. She's only ever held a CPR certification and had no formal medical training. Only managers and supervisors receive basic first aid as part of workplace safety training. She was grateful that the ZOLL® AED did such a great job guiding her and her colleagues to do exactly what Barry needed for a positive outcome, making them unexpected rescuers.

bakeoff

#NationalVolunteerWeek20 #H #ThankAFirstResponder #StJohnDay #bakeoff ene#WomenInAmbulance #HandHyg nDay #bakeoff Our community #lovefromWA #StJohnDay tartaheart #charitygolf PeopleFIRST #People #HandHygiene ronmentDay #stayathome #MeFirst #MeFirst #dogsofambulanc #bakeoff

People First

#ThankAFirstResponder

#bakeoff

#bakeoff

#MeFirst

#inthistogether #ThankAFirstResponder

#ThankAFirstResponder

#inthistogether #bakeoff

#charitygolf

#charitygolf

Hygiene

#ThankAFirstResponder #WomenInAmbulance

#MeFirst

#PeopleFIRST

GoodSAM #MeFirst ve #MeFirst Recruitment Dri

#PeopleFIRST

Laura Wirth from Ambulance l Victoria spent time at her loca#PeopleFIRST g uitin recr ntly rece ital hosp #bakeoff GoodSAM responders.

#PeopleFIRST

#PeopleFIRST

#HandHygiene

#lovefromWA opleFIRST #charitygolf

ambulance

#stayathome

#PeopleFIRST

#ThankAFirstResponder #stayathome #stayathome

#stayathome

#StJohnDay

#WomenInAmbulance

#restartahe

#ThankAFirstResponder

#MeFirst #PeopleFIRST

WomenInAmbulance #WorldEnvironmentDay #StJohnDay

#stayathome

#M

#SustainableAmbulance

#WomenInAmbulance

#restartaheart

Hans arriv e

#bakeoff

s in Coop

#charitygol #restartaheart #sta

#WomenInAmbulance

#StJohnDay

#MeFirst

#restartaheart

#

#StJohnDay #MeFirst #charitygo thistogether #MeFirst #charitygolf #stayathome #MeFirst

eFirst

#MeFirst

When glit

er Pedy

ter and Coob#stayathome er Pedy, th sequins arrived in #MeFirst e local SA team #MeFirsta

mbulance got to h Internatio ave a bit of fun. nal star, H ans, rolled town! into #StJohnDay

#StJohnDay

#Th

#restartaheart

#stayathome me # k20 #bakeoff #lovefromWA #MeFirst lance #dogsofambulance yathome #bakeoff #StJohnDay #WomenInAmbulance

#WorldEnvironmentDay #NationalVolunteerWeek20

#NationalVolunteerW

#bakeoff

#NationalVolunteerWeek20 s joining the team ic ed m #StJohnDay ra pa hort ew N eir most recent co ania welcomed th e sm Ta elv ce tw l lan Al t. bu Am rth-wes the south and no te of paramedics in ning from intersta joi e ar s dic me -thera g in #restartaheart in iv ce re #bakeoff ad experienced pa ro They are on the s. tie, ice Ka rv , se am ce Ad lan – Ambu back row Left to right from ca, Alexandra, an # Bi s, cu field mentoring. ar M , Brooke, Vanessa Harrison, Leigh, atilda #NationalVolunteerWeek #ThankAFirstResponder Toby, Holy and M #ThankAFirstResponder

#N #inthistogether #restart WA #StJohnDay #charitygolf #ThankAFirstRes dHygiene #charitygolf #stayathome nableAmbulance #NationalVolunteerWeek20

#bakeoff

bakeoff

er

mbulance

#ThankAFirstResponder #restartaheart Laidley #WomenInAmbulance #StJohnDay #MeFirst Under 8’s Day in #MeFirst at the nd #stayathome ou It was smiles all-ar #MeFirst #stayathome ey, QLD idl La #stayathome in y Da 8's Under#WomenInAmbulance from the #StJohnDay

lance

#dogsofambulance

#ThankAFirstResponder #StJohnDay #dogsofambulance #NationalVolunteerWeek20 #restartaheart #WomenInAmbulance #NationalVolunteerWeek20

#WorldEnvironmentDay #dogsofambulance #MeFirst #restartaheart #StJohnDay

eoff

#MeFirst

#dogsofambulance

PeopleFIRST #restartaheart

Queensland Emergency Services Expo

nder

nts last week! Stude lebrated ce#WomenInAmbulance ol ho Sc te Sta al loc , with Paul#WorldEnvir y Da 8's r #stayathome de their Un ey idl La at ge Officer in Char n. Looked Ambulance Statio # all! for y da t like a grea

#lovefromWA

#WomenInAmbulance

#stayathome

#stayathome

#WomenInAmbulance

#StJohnDay

#SustainableAmbulan

#re

#ThankAFirstResponder

#ThankAFirstResponder #restartaheart #stayathome #dogsofambulance

#

#ThankAFirstResponder

#inthistogether

#WorldEnvironmentDay #stayathome

#Wom

Day #inthistogether #stayathome #sta #MeFirst #WomenInAmbulance #MeFirst #dogsofambula rldEnvironmentDay #WomenInAmbulance #M The#stayathome re was a fantastic turn out at the Sunshine Coast Emergency Serv ices Expo. Many of the community joined in the fun to get hands on refreshi ng their CPR skills, checking out Queensl and Ambulance services daily offic e spaces, and testing their stretchers.

#MeFirst

#ThankAFirstResponder #ThankAFirstResponder

#WomenInAmbulance

#restartaheart

FIRST #SustainableAmbulance

stResponder

tayathome

68

#WomenInAmbulance

#sta

#WorldEnvironmentDay

#ThankAFirstResponder

#ThankAFirstResponder

#T

# #WorldEnvironmentDa #WorldEnvironmentDay

#ThankAFirstResponder

www.caa.net.au

#restartah #inthistogether #ThankAFir

HandHygiene #PeopleFIRST

#HandHygiene #SustainableAmbulance #ThankAFirstRespo #lovefromWA #bakeoff #bakeoff #bakeoff #lovefromWA #charitygolf #WomenInAmbulan est T E PP #inthistogether #dogsofambulance mite #MeFirst Vege #bakeoff #MeFirst #WomenInAmbulanc #lovefromWA #lovefromWA

giene

#bakeoff

#WomenInAmbulance

te on gemi r Ve avo and u o r refe mashed ant. The uch p es illi We m ith som is just br b centre w u s #stayathome toast e, but thi odridge s in ing a #HandHygiene s o r e t e t W ng s h e e c #HandHygiene t h t a l t #stayathome team a en their by showcansdi doff l tak #MeFirst na eve have to next l it is to do egemite d t t #bakeoff v n h e a g h i t r id an n mpo rrectly. T odily flu ross i w b ho co yg PPE itate prett . o im t looks #StJohnDay your sed t#MeFirst ob j i e u h was minants ality of t #bakeoff e a cont at's the r h t t bu

#StJohnDay #MeFirst

eFIRST

ce

#bakeoff

#HandHygiene #ThankAFirstResponder #bakeoff

#stayathome

#Sustain #Sust

#Nationa

#SustainableAmbulance MeFirst #WomenInAmbulance #HandHygiene #stayathome #ThankAFirst #stayathome #NationalVolunteerWeek20 eart #NationalVolunteerWeek20 #WomenInAmbulance

#Nationa

#ThankAFirst

ort for nerous local supp #ThankAFirstResponder Ge ee Ambulance Wellington Fr#WomenInAmbulance

#ThankAFirstR

pport ns continue to su Mana Lio#ThankAFirstResponder ce raising lan bu Am Wellington Free nual Eat, an eir th th wi $12,000 y fair! The family Drink and be Craft #WomenInAmbulance brings together friendly occasion , ally-made crafts loc of st the very be an in s nt me sh fre re artisan food and ve ng. Mana Lions ha idyllic rural setti gton in ell W ted or pp #StJohnDay09. generously su #SustainableAmbulance $80,000 since 20 Free raising over #restartaheart

lf #ThankAFirstResponder yathome

#StJohnDay

#stayathome #WomenInAmbulance #ThankAFirstResponder

olf

#stayathome #restartaheart #MeFirst #Sustaina

#dogsofambulance

hankAFirstResponder

#StJohnDay

#bakeoff

#MeFirst

#restartaheart

#StJohnDay #SustainableAmbulance #WomenInAmbulance

#MeFirst #StJohnDay

#Nati

#MeFirst

#Natio

#StJohnDay

#NationalVolunteerW

#bakeoff #StJohnDay #charityg #ThankAFirstResponder #StJohnDay NationalVolunteerWeek20 #MeFirst #WomenInAmbulance #restartaheart #PeopleFIRST taheart #MeFirst sponder #StJohnDay#dogsofambulance #restartaheart #WomenInAmbulance

#StJohnDay #WorldEnvironmentDay

#restartaheart #WomenInAmbulance

Week20

#NationalVolunteerWeek20

#NationalVolunteerWeek20

#WomenInAmbulance

#ThankAFirstResponder apa

#bakeoff

irar

Jono and Julia take the lead in Wa

k20

#restartaheart lington Free Ambulance#MeFirst Wel ased ity-b mun com A #MeFirst need for a Pop-Up event in 2019 identified a l Wairarapa. With rura in team ip dedicated leadersh #NationalVolunteerWeek20 the two new shift significant changes on the horizon, #WorldEnvir , will focus on Julia and #stayathome Jono ics med para managers, to team ing exist the g #WorldEnvironmentDay #WorldEnvironme ortin staff wellbeing and supp #MeFirst ice to their rural serv ce ulan amb s #bakeoff -clas first a er #WorldEnvironmentDay deliv

#MeFirst

#stayathome

#bakeoff

#MeFirst

#stayathome

#bakeoff

#NationalVoluntee

#bakeoff

#restartaheart

#restartaheart

#WorldEnvironme

#restartaheart

#stayathome

#restartaheart

#MeFirst

community.

ronmentDay #bakeoff

#bakeoff

#bakeoff

#WomenInAmbulance

#NationalVolunteerWeek2

#bakeoff

#bakeoff

#MeFirst

#charitygolf #NationalVolunteerWeek20 #MeFirst #MeFirst nce #PeopleFIRST #restartaheart #st #ThankAFirstResponder #charitygolf #restartaheart

StJohnDay

#WorldEnvironmentDay

#restartaheart

#stayathome

#MeFirst

#restartaheart

#stayathome

estartaheart #StJohnDay

menInAmbulance #MeFirst

#MeFirst

#restartaheart

#StJohnDay

ood

ices Bl Emergency Serv Challenge Launch

ayathome

ayathome

ance MeFirst

#restartaheart

and er David Dutton puty Commission De#WorldEnvironmentDay rt in the pa ok #stayathome to a an as av Jonathan Tunh ge at ices Blood Challen Emergency Serv s will be up ice rv se y ergenc a Parramatta. All em od te blo and plasm er to dona#WorldEnvironmentDay against each oth g initiative in az am An . ge allen for the annual ch e challenge. t categories in th with five differen Most plasma Most new donors, Most donations, growth. ar ye on ar ye ghest donations and Hi

#ThankAFirstResponder

#WorldEnvironmentDay

#stayathome

#stayathome

#charitygolf

#stayathome

#restartaheart

#MeFirst

#MeFirst #MeFirst

#WorldEnviro

#MeFirst #MeFirst

#MeFirst

#Sustainab #stayathome

#restartaheart

#restartaheart #ThankAF #WorldEnvironmentDay #WorldEnvironment ThankAFirstResponder #bakeoff #MeFirst #WomenInAmbulance #restartaheart #NationalVolunteerWeek20 69 #MeFirst #stayathome #bakeoff ay #bakeoff

#ThankAFirstResponder

#restartaheart

#WomenInAmbulance #NationalVolunteerWeek20

#restartaheart

#MeFirst

Tactical Medical Degrees Learn to deal with acute trauma situations and be uniquely qualified to respond in resource limited, dynamic and high threat environments with a qualification in Tactical Medicine from CQUniversity.

These online, highly flexible courses are ideal for paramedics and first-responders whose personal safety may be compromised. Gain the critical skills needed to assess, plan, prepare and implement strategies for successful operations and patient management within a tactical environment. www.cqu.edu.au

Ambulance, emergency, rescue and height safety products

Non-Emergency Patient Transport (NEPT) Planning Known for our work for EMS providers, ORH also support NEPT providers. While there are clear parallels with EMS service planning, NEPT providers face their own unique challenges and opportunities for improved efficiency. Through a data-led consultancy and modelling approach ORH has helped NEPT providers in Australia and the UK tackle these issues. www.orhltd.com

Real-time communication across healthcare entities www.pulsara.com/w

www.ferno.com.au

Code River Studio

Alpha State

www.coderiverstudio.net

www.alphastate.com.au

High Performance Websites

Advertising & Design Services

Australasian College of Paramedicine

Peak professional body representing and supporting Paramedics www.paramedics.org

70

www.caa.net.au

Automated External Defibrillators

Power-PRO XT & Power-LOAD

With access to the right equipment and support, everyone can help save a life. Philips AED solutions with Life Guidance act as your personal coach to guide you through a cardiac emergency with a simple, step-by-step process.

Stryker’s Power-PRO XT powered ambulance stretcher system utilizes a battery-powered hydraulic system to effectively raise and lower patients at the touch of a button. When used with Stryker’s Power-LOAD system, it offers operator and patient safety by supporting the stretcher throughout the loading and unloading process.

https://www.philips.com.au/healthcare

https://www.stryker.com/au/en/

MEDUVENT Standard Emergency Transport Ventilator WEINMANN offers the emergency transport ventilators for emergency service vehicles, helicopters, and airplanes. The functions of the devices are perfectly compatible with one another and they can be used with portable systems in almost any combination. The result is portable ventilation that is specially tailored to the respective application. https://www.neann.com.au/

Visit The Directory on the CAA website

71

Wellness First

a t i l l Ca ! g n i l e e F t Gu "All disease begins in the gut”.

Hippocrates said this more

Second: Your gut is a major

than 2,000 years ago, however,

part of your immune system. It

we are only now coming to

serves as your body’s reception

understand how right he was.

area, ushering in the good

Your gut plays a huge role

guys (all the nutrients and

in your overall health and

micronutrients in your foods)

wellbeing, with the likes of our

– and working hard to keep out

mood, behaviour, skin issues,

intruders (pathogens, bacteria,

autoimmunity, liver health,

and more). It does both these

hormone imbalances and more

jobs thanks to a permeable lining

being linked to aspects of our

called “gut associated lymphoid

gut health.

tissue” or GALT. When your

You’ve heard these sayings

gut microbes are in balance and

before, for good reason:

your GALT is working well, your

• “Listen to your gut.”

• “Butterflies in your stomach.”

• “Gut instinct.”

For centuries, we've known that our gut and our well-being are connected, and science today is

Mitch Mullooly Health and Wellness Strategist Specialising in the wellbeing of first responders, Mitch is the Chair of the Australasian College of Paramedicine, Aotearoa New Zealand; Council member of Te Kaunihera Manapou, New Zealand Paramedic Council; Advisory Committee member for Te Kiwi Maia, The Courageous Kiwi; and proud CAA2020 Women in Ambulance honour recipient.

Mitch is also a published author, speaker and feature columnist for several sector related magazines, blogs, webinars, and podcasts.

72

uncovering just how linked they really are.

gut will recognise a bad guy and attack it.

But… when your gut microbes are out of balance, those bad guys can start to push their way through the reception area, into the “inner sanctum” of your body – invading and growing. This can cause all sorts

First: your gut (aka digestive

of problems, from digestive

system) and the amazing

upset to chronic inflammation

trillions of microorganisms that

and immune system issues. If

live inside it, breaking down

your gut has ever been out of

everything you eat. This gives

balance, you know exactly how

your body:

uncomfortable this can be!

• The fuel it needs to function.

• The components of all the numerous hormones, enzymes and compounds that power your body’s processes.

Over time, having an out-ofwhack gut can raise real havoc with your energy, mood, and overall health.

• The building blocks it needs to repair and recover.

www.caa.net.au

Your Gut Reaction What can cause a gut imbalance? This is a huge area of study right now, but major players include our modern diet and environment, with its added toxins, stress levels and processed foods, have impacted our microbiome in a significant way. Our digestive tract is now lacking in the diversity and numbers of bacteria that support us living with optimal health. We then find ourselves in trouble, as our beneficial bacteria and

Sugar is another major culprit in the modern diet.

Follow Your Gut to Better Health

Non-beneficial bacteria feed on sugar and a diet high

Simply put, a healthy gut starts with a healthy lifestyle

in sugar allows pathogen strains of yeast to overgrow.

– getting enough restorative sleep, reducing your stress

non-beneficial bacteria are out of balance.

Antibiotics definitely play a vital role to our health

load, and exercising right for you.

in the right circumstance; however, they also play a

In addition, one of the most important factors involves

part in impacting our microbiome. This is because

what you FEED your gut! It begins with cleaning out

they not only ‘knockout’ non-beneficial bacteria you

the stuff that isn’t serving you: mainly high-sugar, low-

are trying to get rid of when you are unwell, they

fibre, and processed foods. And then it’s about feeding

also reduce the diversity and numbers of beneficial

your microbiome with more of the GOOD stuff.

bacteria living in our intestines. It can take up to four years to restore and rebuild the gut biome following

I'll break it down into two basic parts, which I know

a course of antibiotics.

you’ve heard of before - prebiotics and probiotics.

Prebiotics feed the probiotics in your gut. Prebiotics are made up of indigestible fibres such as inulin.

Mitch’s 10 top essentials for a happy, healthy gut microbiome and a happy, healthy you.

1. Eat what is right for you.

2. Eat wholefoods that are in season.

3. Avoid foods that contain gluten.

4. Eat as many gut-loving foods as you can, including fermented foods.

5. Keep well hydrated.

6. Manage your stress well.

These fibres are tough enough to make it through your stomach and small intestine undigested. They end up in your colon, where the healthy microbes feed on them. This is just one reason why adding fibre to your diet is so especially important – it keeps your gut happier, healthier and in balance.

Probiotics are the “good” microorganisms, such as bacteria and yeasts, that live in your intestines.

7. Do the exercise that

They help digest foods, destroy disease-causing

is right for you.

microorganisms, and create vitamins. Probiotics

8. Get adequate restorative sleep.

9. Breathe the right way.

10. Practice mindfulness.

naturally occur in your gut, but you also can get them from fermented foods and some supplements.

Research is still ongoing into exactly which strains of probiotics are the best since they all do different jobs inside your body.

Check out the EAT|TRAIN|BE – Fit for Duty Gut Health Guide & Recipe Manual for loads of gut-loving recipes to help you nurture great gut health!

Free eBook Download 73

Wellness First

74

www.caa.net.au

NSW Ambulance Medic Fit Program F

indings from the Australian Institute of Health and Welfare suggests that over 50 per cent of Australians are getting less than the recommended amount of exercise.

Following this, NSW Ambulance (NSWA), in partnership with Charles Sturt University, published its own research in 2018 which examined how active its workforce is.

A key finding was that over 70 per cent of paramedics were getting less than the recommended amount of exercise. It was also identified that the main barriers were access to equipment and time to participate in structured exercise.

To help improve the health and fitness of its workforce, NSWA introduced the Medic Fit program.

What is the NSW Ambulance Medic Fit program?

The Medic Fit program provides exercise equipment and guidance for all NSWA employees to participate in targeted exercises in the workplace. The program aims to help foster a positive health and wellbeing culture that supports staff to better manage the physical demands of their role and reduce their risk of injury.

When did the Medic Fit program commence?

In 2017, NSWA ran a successful pilot of the Medic Fit program in ambulance stations across the Central West of NSW. The positive feedback and results from the pilot enabled the program to further develop and be implemented at all ambulance stations and other worksites. There are now 236 NSWA worksites across the state with Medic Fit exercise equipment.

How was the program implemented?

Due to the COVID-19 pandemic and other logistical issues, the implementation of the Medic Fit program was complex. To roll out the program as efficiently as possible, the team ensured they were in constant communication with NSWA managers, key contacts at each worksite, as well as the supplier of the Medic Fit equipment.

NSWA managers across the organisation were consulted to determine the most appropriate location for the exercise equipment at each worksite. It was important for the local site contact to determine the equipment order and storage area because every station has a different layout. This ensured the delivery and installation of the exercise equipment at each worksite was a smooth and efficient experience for all involved.

75

Wellness First

Who can participate in the Medic Fit program?

All NSWA employees are encouraged to participate in the program which has been designed to fit around work demands. A Medic Fit policy and procedure was developed, outlining the mandatory requirements, guidelines, and staff responsibilities when using the exercise equipment. This was important as it allows paramedics to participate in the program at work without impacting on response times. To ensure employees are cleared to use the exercise equipment, an induction process was developed that all employees must complete before using the equipment.

What support is provided to help employees get the most out of the Medic Fit program?

The Medic Fit program is an injury prevention initiative which supports employees to take a pro-active approach to build their physical resilience and reduce their risk of injury. The support and resources include: •

Medic Fit Program Guide: The guide is designed to assist staff when using the equipment to ensure exercises are completed appropriately and safely. It includes a robust pre-exercise screen and induction process to ensure employees are safe to exercise.

The guide includes purposely selected functional exercises designed to prepare paramedics for the inherent requirements of the role. This includes the option to progress and regress the exercises depending on the fitness and functional movement of the paramedic.

•

Injury Prevention Specialist: Accredited Exercise Physiologist specialising in injury prevention and management are available to all NSWA staff. They can provide one on one assessments, exercise programming, and health and fitness coaching to support employees reduce their risk of injury and better manage existing injuries. The Injury Prevention Specialists can provide support face to face or through telehealth, using video conferencing facilities.

About the Medic Fit exercise equipment The exercise equipment selected can be used by employees of all fitness levels, easily stored and maintained. Each worksite is provided a range of exercise equipment including dumbbells, kettlebells, dual adjustable pulley, spin bike, TRX, Swiss balls, and other injury prevention tools and equipment. The range of equipment encourages employees to participate in targeted low-intensity functional exercises focusing on the movements required for the different roles at NSWA and the manual handling tasks within the roles. The focus is on exercises that enhance mobility, stability, core strength, and functional movement. All this is important in helping reduce the risk of physical injuries.

76

www.caa.net.au

•

•

Health Coach: Accredited Practising Dietitian support staff with any lifestyle-related goals such as weight management, nutrition, exercise, and motivation to improve their health. The health coaching uses principles of behaviour change to encourage goal setting and self-management.

The Health Coach can provide sustainable and evidence-based information and tools to support employees to progress with their health goals and reduce their risk of chronic disease.

NSW Ambulance online exercise library and on-demand workouts: Provides all staff with online access to videos of recommended functional exercises and workouts designed to prevent common injuries.

Evaluation of the Medic Fit Program NSWA is partnering with academics to investigate the overall impact the Medic Fit program has had on the health and wellbeing of staff. In the short term, employees have been asked for their feedback and thoughts on the program. The results from the evaluation survey have been very positive and the feedback received has highlighted the positive impact the program is having.

Love having equipment available. We previously had no gym or exercise equipment easily available to us in the town we live and work in. This program has made a HUGE difference to my health and general wellbeing and made it much easier to keep moving while working 8 days on with on call. THANK YOU! Best thing NSW Ambulance ever did. I've lost 3 kg since the beginning of the year, I'm fitter and I feel healthier in both body and mind.

I work at an on-call station and pre the equipment (due to workload) sometimes I would go for days without exercising. Now I have the opportunity at work. This has made a massive positive impact on my mental health and my job satisfaction. Thank you so much.

Have a question regarding Medic Fit? If you have a question regarding the Medic Fit program you can contact the NSWA Health and Fitness team at AMBULANCE-Wellness@health.nsw.gov.au

77

TAPPING INTO CAA’S ONLINE PRESENCE TO ENGAGE AND CONNECT WITH THE AMBULANCE SECTOR When you join The Directory by CAA, you will be included in our fortnightly newsletters, on our social media channels, featured on a dedicated webpage on our site among other opportunities. Choose from three tiers that provide options to fit your requirements.

CONTACT NIKKI MURPHY ON NMURPHY@CAA.NET.AU FOR MORE INFORMATION AND TO GET INVOLVED

www.caa.net.au