QAS Insight Magazine - Autumn 2019 edition

EVEREST FUNDRAISER • GERMAN HEMS • WINE MAKER PARAMEDIC • PRIORITY ONE

Autumn 2019

united response Also inside Valé, Craig

Australian first

Autumn 2019

ACP’s Iraq tour

Queensland fires

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Contents – Autumn 2019

Features

Regulars Minister’s message

2

Commissioner’s message

2

Briefs 4 OpCen Reports

11

Thank yous

26

Priority One

30

HARU 35

QAS MOURNS LOSS

INTERPRETER ACP

LARU 37

6

8

MEDICAL MILESTONE

ACP’S IRAQ TOUR

12

18

FLOODS RESPONSE

WINEMAKER PARAMEDIC

22

28

GERMAN HEMS

STATION PROFILE

32

38

Happenings 42 Movers and shakers

44

QAS INSIGHT is published quarterly by the QAS Media Unit, GPO Box 1425, Brisbane QLD 4001.

Editorial and photograhic contributions are welcome and can be submitted to: Joanne.Hales@ambulance.qld.gov.au Want to contribute? If you know of a QAS ‘quiet achiever’ or an event or program with a story worth sharing with our colleagues, please get in touch with INSIGHT editor Jo Hales by email (above) or phone 3635 3900.

Autumn 2019 edition contributors: Jo Hales, Michael Augustus, Andrew Kos, Emma O’Connor, Jo Mitchell, Melissa Mangan, Matt Stirling, Steve Turner, Kent Jackson and Emily Mildred.

Designed by: Masthead Design & Creative Winter 2019 edition key dates: • 3 May 2019: advertiser bookings • 17 May 2019: supplied artwork received • 26 June 2019: scheduled release

Front cover: The QAS and Australian Defence Force (ADF) joined forces to provide a united response effort in early February when devastating floods inundated north Queensland. The ADF assisted paramedics to respond to challenging areas in the Townsville region that were quickly inundated with flooding.

Read more on the flood response and the QAS bushfire response in late 2018 on pages 22-25.

Front cover photos by QAS staff and Department of Defence; photographer: Private Brodie Cross.

Autumn 2019

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Minister

Commissioner

January was a tragic time for the QAS and Mackay community following the death of paramedic Craig McCulloch.

North Queensland has borne the brunt of natural disasters of late as a result of cyclones and monsoonal weather.

I felt honoured to be able to attend his funeral and pass on my heartfelt condolences to his family and colleagues.

Heavy rain has resulted in an unprecedented weather event impacting on towns with floodwaters inundating and cutting off communities.

The service was an outpouring of love for a man dedicated to his family and to his job. It was also humbling to see so many members of the Mackay community attend Craig’s memorial service to pay their respects. My thoughts and prayers are with his family and loved ones. Valé, Craig.

The QAS deployed additional crews to affected areas to ensure the health and well-being of residents cut off by floodwaters.

Events such as these are unifying with emergency services partnering together to assist affected residents. In particular, the QAS teamed up with ADF personnel and travelled in the Bushmaster Ambulance Varient to assist with patient transports and reaching inundated areas.

The recent floods in the northern parts of Queensland have further reinforced the QAS’s resilience as a service and that our officers are willing to take on any challenge to look after fellow Queenslanders.

Emergency services joined forces and QAS partnered with the Australian Army proving we are stronger when we work together, especially in times where communities are cut off by rising water levels.

I would like to thank the paramedics, EMDs and QAS personnel who went above and beyond for the people of North Queensland.

Particularly those who, despite being personally affected by the floods, continued to turn up for work to care for others.

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Demand for the vital services Queensland ambos deliver continues to be at an all-time high. Despite this increase in demand, QAS continues to maintain its high-performance levels. The recent Report on Government Services 2019 showed the QAS responded to more than one million incidents, the most of any state or territory.

Whilst in the midst of these natural disasters, the QAS was grieving the loss of paramedic Craig McCulloch. Sadly, Craig died in a traffic crash along Mackay Eungella Road in January, as he was making his way to a patient.

His death has ricocheted throughout the service. I was humbled to attend his funeral on the Tweed Coast and to hear of his character, his love for his family and his dedication to his children and speak with his loved ones. Craig’s memory will live on as we promise to remember him and honour his service. Valé, Craig.

Lastly, on 7 March, the first of four workforce forums took place, with operational and public service employees from around the state coming together in Brisbane to discuss the key issues related to the QAS employee responses to the 2018 Working for Queensland Survey.

The QAS had faster Triple Zero (000) answering times, an improved cardiac arrest survival rate with paramedic intervention, and overwhelming patient satisfaction.

I enjoyed the opportunity to engage with members of our workforce directly, to understand the issues they’re facing in their environment and to also understand what we’re doing right as an organisation, to better shape the future of the QAS.

We know our paramedics are among the hardest working in the nation and the level of care they show towards patients complements that, with 98 per cent of patients saying they were satisfied with the level of care provided by officers.

I appreciated the comments and suggestions that were raised at the forum and look forward to future opportunities to share the progress we are making.

Thanks for all your hard work and dedication, both clinical and non-clinical, to helping those Queenslanders in need.

Steven Miles MP Minister for Health and Minister for Ambulance Services

Autumn 2019

Russell Bowles ASM QAS Commissioner

QAS news round-up

QAS Legacy fundraising Everest trek 2019 Local Ambulance Committee (LAC) State Conference Every two years, QAS LACs from across the state send delegates from their committee to attend a state LAC conference.

The purpose of this conference is to discuss statewide issues of mutual concern for both the QAS and LACs, to address community issues and to continue to build on and enhance the partnership between the QAS and LACs. This conference also provides LAC members with the opportunity to learn more about the QAS and engage with staff and other committee members.

The 2019 LAC State Conference is being hosted by the Toowoomba LAC from 6 to 8 September 2019 at the Picnic Point Function Centre in Toowoomba.

An enthusiastic group of our QAS paramedics and their Queensland Health staff friends are rugging up to take part in the fundraising trek of a lifetime to Everest South Base Camp in April.

This prestigious honour is acknowledgement of John’s highlevel leadership across senior management roles within the QAS. Organised by expedition company Earth Trails and led by Chermside ACP Rhys Greedy, the trek is raising funds and awareness for QAS Legacy Scheme Incorporated (QAS Legacy).

The group’s 18-day adventure begins and finishes in Brisbane and they will pass through Kathmandu and Lukla, before arriving at the Base Camp at an altitude of more than 5300 metres.

He said there had been an occasional group training session in the lead-up to the trek, but most people had been training solo.

The group aims to raise $20,000 for QAS Legacy. Stay tuned as there will be an update on this amazing adventure in INSIGHT’s Winter 2019 edition. To donate to this worthwhile cause visit: www.qaslegacy.org/t4p-fundraising

It is in recognition of John’s dedication to maintaining ambulance services to the Gold Coast community during the Gold Coast 2018 Commonwealth Games and establishing collaborative relationships with key allied health services to ensure the health, safety and wellbeing of staff and the community.

Background

■ Lukla Airport’s short (523 metre) and steep (11.7 per cent upward gradient) runway at an elevation of 2,845 metres, carved between a precipitous cliff at one end and steeply-rising terrain at the other, is for many the Nepalese starting point of the Everest Base Camp Trail, but South Base Camp itself is still at least a week’s trek away — and another 2,500 metres higher.

Good luck to the intrepid trekkers!

Photo: Wikipedia / Reinhard Kraasch

If you have any queries about the upcoming conference, please contact the COC at toowoombalac@gmail.com.

Congratulations to Assistant Commissioner John Hammond who was announced as an Ambulance Service Medal (ASM) recipient in the Australia Day 2019 Honours List in January.

The ASM recognises distinguished service by the men and women of Australia’s ambulance organisations.

Rhys, a veteran fundraiser for QAS Legacy, is no stranger to adventurous climbing, with the cancer survivor having undertaken six fundraising treks and mountain climbs over five years.

Registration packs have been circulated to LACs to register their attendance at the conference. To ensure the early bird registration rate is applied, registration forms are required to be submitted to the Conference Organising Committee (COC) by 30 June 2019.

ASM announcement

Autumn 2019

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Briefs Kuranda paramedic award Thumbs up to Kuranda paramedic Jeff Hodgetts who was honoured by his local community in January for the exemplary way he serves the region.

As a sign of appreciation, local Sandy Ryan (also a former patient of Jeff) presented the well-respected officer with a Paul Harris Fellow Medal on behalf of the Rotary Foundation.

Sandy said the ACP’s professional skills, calm and kind demeanor, and caring approach to his patients inspired confidence in those that found themselves in his care.

4 BMX crash reunite Metro North paramedics Jean Lloyd and Nadine Warmerdam were all smiles when they reunited with young patient Samuel following his nasty crash on mountain bike tracks at Mount Coot-tha in October. Sam (second from left) suffered a serious leg fracture from the incident and the paramedics needed to negotiate a very steep incline to assist him.

Autumn 2019

At the reunite, which was attended by members of Sam’s family, the paramedics were delighted — and relieved — to see the teenager walking, mobile and in good spirits.

BRIEFS • Autumn 2019

Innovative new 500 Club Winton Ambulance Station OIC John O’Shea is determined to prove that practise makes perfect when it comes to saving lives in the Central West LASN. John is the brains behind a new initiative dubbed the 500 Club, designed to improve the resuscitation skills of paramedics in his LASN. Central West LASN has 20 officers at five stations and the aim is that each paramedic, under the watchful eye of another officer, performs CPR training on a manikin once a fortnight to reach a total of 500 for the year.

The initiative kicked off on 1 January and each station reports their monthly totals to CW LASN Clinical Support Officer Steve Robertson, with the total CPR training sessions already numbering more than 120.

“I am really excited with how well this initiative has been received and hopefully it will catch on in other LASNs,” John said.

John said the great thing about the initiative is that the CPR training does not take long and it can be done when there is only one officer at a station or on shift, thanks to the Microsoft Teams application.

“At one of my training sessions recently I was on my own at the station but an officer at Barcaldine was able to watch me in real time and give me feedback.”

John said the more times officers practised their skills, the more confident and competent they will become at CPR and airway management and achieving ROSC with a cardiac arrest patient.

5 Spotlight on BRT Celebrations were in full swing when the Brisbane BRT celebrated its first birthday in February.

Since rolling out on the Gold Coast in November 2017, both our BRT units have been doing fantastic work, with their quick response times contributing to positive patient care and outcomes.

Meanwhile, the BRT captured the media’s attention when it raised the handle bars in lycra bike fashion at the unveiling of the unit’s new outfits, livery and safety equipment on the Gold Coast in December 2018.

Autumn 2019

Death touches our QAS families It was with an extremely heavy heart that the QAS sadly farewelled one of our own following the sudden passing of much-loved and popular Advanced Care Paramedic (ACP) Craig McCulloch on 28 January 2019.

Craig, 32, who lived on the Gold Coast and worked in the Mackay LASN, tragically lost his life while responding to an emergency case when the ambulance he was travelling in was involved in a crash.

The following week, an extremely moving public memorial service to honour Craig’s life was held on 14 February in Mackay at another Catholic church, also named St Joseph’s.

Commissioner Russell Bowles flew to Mackay to offer support to staff following Craig’s untimely death and summed up the sentiment many were feeling in a QAS message on the day of his passing.

At the Mackay memorial service Acting Deputy Commissioner Gerard Lawler’s tribute mentioned that ‘when we lost Craig, we didn’t just lose a paramedic, we lost a family member — a brother, a son and colleague’.

“The loss of one of our colleagues whilst working on the job is heartbreaking and the entire QAS family is deeply saddened by this tragic event,” Russell said.

Following a break in service to work as a paramedic in the United Kingdom and then in the private sector, he recommenced with the QAS in June 2018.

Craig leaves behind two children, Ida and Clyde, both 2, partner Heather and her son Dominic, 14, as well as his mother Mary, father Cliff and partner Kim, sister Sarah and partner Matt and his aunt and uncle Marg and Tim. Craig is the 35th officer in Queensland to have died while on active service.

QAS Legacy Scheme Incorporated is coordinating fundraising activities for Craig’s children, with more than $61,000 having been raised at the time this edition of INSIGHT went to print.

“On behalf of the QAS I extend my deepest sympathy to Craig’s family, friends and colleagues.”

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Craig commenced with the QAS in 2009, working in a number of LASNs until 2013 as both a Student Paramedic and ACP

As everyone tried to come to terms with Craig’s sudden passing, there was an outpouring of love and support from hundreds of people, including QAS staff, who attended his private funeral at St Joseph’s Catholic Church at Tweed Heads on 8 February.

Anyone needing support during this difficult time is encouraged to contact Priority One on 1800 805 980. The service is available to all QAS members and immediate family.

“His death resonated not only in Mackay, but across the state, along with colleagues from other jurisdictions within Australia and overseas, as the QAS joined as one in mourning,” Gerard said.

He also thanked and acknowledged the operations centre team who coordinated the call and the paramedics who responded to such a challenging incident attending one of their own. The efforts of everyone were very much appreciated by the family.

Gerard also made a heartfelt gesture to Craig’s family on his passing and emphasised his contribution as a paramedic and to QAS and the communities he served, adding, ‘rest assured, we will remember Craig and continue to honour his service’.

Autumn 2019

Valé, Craig McCulloch

ACP Warren Herlt delivered a touching eulogy at Craig’s funeral and he later spoke with Jo Hales about the ‘loveable larrikin’ and ‘devoted dad’ he was proud to call a great mate.

Gold Coast BRT paramedic Warren Herlt is still trying to come to terms with the death of his close mate Craig McCulloch.

“Everyone enjoyed watching Craig slowly self-destruct on the golf course as he tried in earnest to improve his game,’’ he said.

Warren had just returned from a short trip to Japan and was due to catch up with Craig on his next set of days off when he discovered his friend had passed away.

On a more serious note, Warren said Craig — ‘who started out as an ACP at Ipswich before transferring to the Gold Coast LASN’ — was a loyal and caring paramedic who loved helping people and going the extra mile with his patients.

Warren was initially introduced to Craig 10 years ago after he joined the QAS — “Craig was a first-year student and I was assigned to mentor him for three months.

During that time, we became good friends,” Warren said.

Despite his grief, Warren was determined to honour his mate at his funeral and delivered an uplifting, and at times funny, eulogy that emphasised how Craig was a family man, a father, a friend and ‘someone you could always count on’.

Warren’s final words during the eulogy captured the grief people are feeling at the tragic loss of Craig, as well as the lasting impression the late officer made on many lives.

“Craig was devoted to his family — he absolutely loved his kids Ida and Clyde and had a new outlook on life once they were born,” Warren said.

“He was also very close to his partner Heather’s son, Dominic, and shared a very special bond with him and loved him as though he were his own.”

There was also a lighter side to Craig, who Warren described as being highly intelligent, as well as a larrikin and a prankster.

Warren said he and a group of mates would catch up with Craig every time he returned from his days off from the Mackay LASN; whether it be for a game of golf, a barbecue or a card game, and there were always guaranteed to be plenty of laughs.

“When we played poker, you couldn’t help but laugh at Craig’s expressions. His poker face was legendary. Everyone on the table knew when he had the winning hand.”

“I know everyone here today is hurting, especially Craig’s family and friends,’’ Warren said at the funeral. “Personally, I take comfort in the pain I feel because it reflects just how important Craig was to each and everyone one of us.

“He is greatly missed but never forgotten.”

RIP, Craig.

Service photos: Michael Augustus

Meanwhile, Warren said, golf matches, mainly at Parkwood Village Golf Course, were always hilarious.

Donations for Craig’s children can be made to the following account: Craig McCulloch Fund QBANK to QBANK BSB Acct

704052 1024555 S1.2

Other bank to QBANK BSB Acct

704052 100 190 219

Westpac over the counter deposit BSB Acct

034838 266292

Note: the appeal officially closes on 19 April.

Autumn 2019

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Meet Paul: a truly inspiring story born from one man’s pursuit to communicate with his children.

Mel Mangan recently caught up with Paul Bermingham on his journey from Auslan interpreter to QAS paramedic.

“You’re standing on the wrong side of the stretcher,” are the words that were etched in Paul Bermingham’s mind, a comment that would lead him to where he is today.

The comment made back in 2012 motivated the Auslan interpreter for the Deaf to study paramedicine, with Paul becoming an Advanced Care Paramedic, based at Springfield Station in the West Moreton LASN, just over a year ago.

Paul’s journey from Auslan interpreter to paramedic began in 2001 when his first-born son, Jordan, was diagnosed with non-verbal autism at age two, followed by the diagnosis of his second-born son, Xander, with the same condition in 2004.

In 2002, Paul studied a Diploma of Auslan and an Advanced Diploma in Interpreting, becoming fully accredited in 2006 and commenced interpreting as a full-time job.

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Paul’s sons were not deaf but it was suggested to him, with their young age, to try ‘Makaton’, a form of baby sign language. When this showed signs of success, Paul decided he would use Auslan to communicate with his sons.

Autumn 2019

Photo: Mel Mangan

Uphill battles spell success for Paul

Throughout his time as an interpreter, Paul found his passion and niche in medical signing and quite often found himself at doctors’ surgeries, hospitals, and with paramedics, assisting his clients to communicate their medical concerns.

Paul explained that for an interpreter to communicate effectively with the Deaf, both parties need to be in full view of each other, as expressions and gestures play a huge role in understanding the tone of the conversation.

One memorable moment as an interpreter came while at a hospital with his client on a stretcher and paramedics nearby. Paul didn’t have full sight of his Deaf client and needed to change his position to get a broader view.

He said to the paramedics, “I’m on the wrong side of the stretcher.” The paramedics mistook Paul’s meaning of this and replied, “Yes, you are on the wrong side of the stretcher: you should be over here with us. You would make a fantastic paramedic.”

Paul was referring to being better situated to communicate with his client, but, for some reason, those words never quite left him, planting a seed for what was to come.

But none of it would come easy. In 2010, Paul was diagnosed with Non-Hodgkin Lymphoma, a type of blood cancer, affecting the lymph nodes. After years of treatment with little success and further diagnosis of the cancer spreading, early in 2011 Paul’s prognosis became terminal.

Later that year, the decision was made to have a bone marrow transplant as a final form of treatment and, miraculously, it worked, with Paul now seven years in remission and living a healthy life.

With his health back on track and strength improving every day, in 2015 Paul commenced the study of paramedicine, aged 41. On completion of his study, he was fortunate to get a graduate position with the QAS at Springfield Station, where late last year he celebrated his one-year anniversary as a qualified paramedic.

Paul recently transferred to Bribie Island Station to be closer to his three sons, Jordan, 20, Xander, 18, now high functioning autistics, and Declan, 16.

He is loving the island life and is ramping up training ahead of his climb to Everest South Base Camp in April, one of 20 paramedics and Queensland Health staff raising funds for the QAS Legacy Scheme.

Above left

■ A stricken Paul in hospital facing the uphill battle of his life-saving bone marrow treatment.

Left

■ Same Paul, different uphill battle: training for the climbing trek to Everest South Base Camp in April 2019.

Photos: Paul Bermingham

Autumn 2019

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… it’s for the birds.

If you visit the Cairns Operations Centre, you will be greeted by some unusual wildlife, writes Emily Mildred: the ospreys nesting atop the communications tower are a sight to see.

A pair of ospreys built their original nest on top of the communications tower but, perhaps unsurprisingly, this was found to be interfering with QAS signals.

Above

■ Cairns OpCen Manager Brina Keating and her team watch over the Tropical North.

Photos: QAS except as noted.

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The communications tower had previously been ‘attacked’ by a flock of sulphur-crested cockatoos, which chewed through cables and damaged antennae, requiring extensive and expensive repairs.

As the ospreys were in residence at the time, expert advice was sought on the best way to proceed, without infringing their protected status. Rather than try to evict them, Cairns staff noted at the time, ‘we waited for them, and their chicks, to fly away for their annual leave.’

Continuing around down below, if you keep your eyes peeled you’ll find the remnants of a snake skin which belongs to the large resident python that has also become accustomed to the hospitality of staff at the Cairns OpCen. The Centre was initially located on Grafton Street at the original Cairns Ambulance Station which was built in 1927. In 1995 it was moved to a new site on Anderson Street, Manunda, which was also the first combined QAS and QFES communications facility in Queensland.

The Cairns OpCen takes emergency Triple Zero (000) calls from Tully to the south, north to the Torres Strait and west to Weipa and Georgetown.

During their absence, a new grid-dish aerial was added to a small extension to the tower and the ospreys’ nest was carefully relocated and reinstalled, local paramedics undertaking the gentle handling of the nest into the crane’s sling basket.

‘They now have a better view,’ staff wryly noted of the magnificent birds, although the mooted plan to use them as back-up message carriers is yet to bear fruit.

Above

■ The OpCen was initially sited in the original 1927 station premises, until 1995.

Right

■ A more contemporary view of the 21st Century Centre.

Background

There was a flutter of trepidation as Spring dawned the following year but the ospreys — one of which was nicknamed ‘Oscar’ — did indeed return, and they have continued to return every year to nest and rear their young.

The birds are not the only ‘protected’ part of Cairns OpCen, however: locals know that the car park, within a certain radius of the tower, is not the best place to park vehicles …

■ ‘Oscar the osprey’ comes in to land on the original nest atop the communications tower in 2015, before the ‘domestic renovations’ were made by the QAS.

Photo: Marc McCormack, Cairns Post

Autumn 2019

The most common calls in 2018 were for chest pain, falls and breathing problems but, due to the vast and disparate area covered, the staff do get some unusual calls, including marine stings. These generally require the assistance of rescue helicopters to retrieve patients from reefs and islands.

Cairns OpCen currently has 37 full-time staff who last year received 52,323 Triple Zero (000) calls – an average of 4360 per month, or more than 145 every day!

Photo: Adobe Stock / tera

Cairns OpCen

Operations Centre Reports

OpCen Reports Our dedicated staff at Operations Centres around the state provide vital help and assistance to people in their time of need. INSIGHT’s debut OpCen Report showcases examples of outstanding responses to Triple Zero (000) calls.

Toowoomba OpCen EMD Karyn Gartner took a call for a patient found in a car who was unconscious and not breathing.

After initially being told that no defibrillator was available, the caller then stated that the first aid officer had gone to get it.

The caller and bystanders were reluctant to commence CPR prior to the first aid officer returning, but through reassurance and clear instructions, Karyn was able to instruct them to move the patient out of the vehicle and commence CPR instructions prior to the defibrillator being present.

Once the defibrillator was with the patient, Karyn supported the caller through its use and, when no shock was advised, further support and instruction were provided so CPR could recommence prior to QAS arriving on scene.

Karyn was also involved in a call where a baby was birthed prior to QAS arriving, in which the father was given wonderful support and clarification to safely assist in the birth of his son.

Karyn continued to remain calm and caring throughout and provided reassurance when the father became anxious or was unsure of how to proceed.

At one point the call dropped out just when the baby started crowning, Karyn called back immediately and by that time the head had been birthed.

Karyn continued to provide reassurance and repetitive persistence to ensure the safe delivery of the baby. Initially the baby cried then became quiet again. Through active listening, Karyn asked after the welfare of the baby and provided instructions to clear the airway.

The joyous sound of him crying was then heard and further instructions about cord and baby care were provided.

Brisbane OpCen EMD Kate Burrows managed a call for two patients who had fallen inside their house at Victoria Point.

Sadly, the caller’s husband had passed away after collapsing and the caller, who had also fallen, couldn’t get up, but managed to drag themselves to the phone to make contact with QAS. Kate built a good caller rapport and supported the caller whilst remaining on the line until QAS/QFES could gain access to the house. Kate also asked focused questions to obtain useful information for the dispatcher and responders.

When the caller stated ‘I think I’ve lost my Husband’, Kate refocused the caller on the efforts they had gone to, in order to get assistance to both of them.

Call lessons This call is an example of good holistic customer service and support. Kate demonstrated compassion and caring, that has left a lasting impression when providing support for the caller and her husband in their time of need.

Call lessons Karyn demonstrated many of the key attributes that make a great EMD. In the first call, Karyn needed to be assertive to encourage the bystanders to commence CPR. She was able to apply repetitive persistence techniques effectively to get reluctant bystanders to follow her instructions.

The second call required Karyn to provide support, encouragement and persistence to assist the father in delivering his own son. Karyn then demonstrated excellent active listening skills to identify that the child’s breathing was compromised.

Karyn was then able to rapidly and effectively navigate ProQA to provide lifesaving Pre-Arrival Instructions to assist Dad in clearing baby’s airway.

EMD Angiela Taylor took a call for a 74-year-old with a serious nose bleed.

The caller had a hearing impairment and the patient was located leaning back in a lounge chair which was affecting the patient’s breathing.

Upon providing nose bleed control instructions, the patient became distressed and agitated that the ambulance was still en route and the instructions weren’t helping. Through repetitive persistence and reassurance, effective instructions were provided and the patient had improved breathing and became calmer.

Call lessons Angie recognised the caller’s distress, able to identify his concerns through active listening.

Angie provided reassurance which included explaining her actions.

This calmed the patient and enabled him to follow her instructions, resulting in a change to the patient’s posture which allowed him to breathe more effectively.

Toowoomba OpCen EMD Catherine McNeice took a call for a one-year-old with significant burns to their under arm and chest from boiled water.

Cat was on the call for approximately 40 minutes while the crew responded from Roma. During this time Cat calmed and reassured the mother whilst providing burn cooling instructions.

During the call Cat became aware the patient was still in a significant amount of distress, even after the cooling had commenced. Showing awareness for the weather and locality of the incident, Cat enquired as to the temperature of the water coming out of the cold water tap.

It was found that the water was too hot to provide relief for the patient so, in liaison with the OCS, Cat amended instructions to provide cooling instructions using a towel and some cool water from the fridge. This relieved the patient’s distress significantly and Cat continued to provide instructions and reassurance until the crew arrived.

Call lessons This call is a great example that MPDS is not always ‘one size fits all’. Cat’s ability to think outside the box has resulted in the unconventional but effective delivery of first aid and has alleviated some of the suffering of a one-year-old child.

Autumn 2019

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“This will be the last time Jo Hales reports on a milestone clinical case and talks to the extremely grateful patient: the first person in Australia to survive a pre-hospital resuscitative thoracotomy.

Matt celebrated his 49th birthday on 1 March 2019 with his partner Sandra who he is preparing to marry next year, but neither event would have been possible if not for the remarkable work of the QAS team — Dr Stephen Rashford and paramedics Mikayla Grant, Jacob Wegener, Benjamin Lu and James Wylie — who saved his life last year.

The QAS officers worked tirelessly on Matt in August 2018, successfully bringing him back to life with a pre-hospital resuscitative thoracotomy after he stabbed himself twice in the chest during a psychotic episode in his high-rise Brisbane apartment.

The incident occurred after Matt consumed a cocktail of prescription drugs and alcohol.

Whilst he has no recollection of the incident, let alone the hours leading up to it, Matt is eternally grateful to the QAS treating team for giving him a second chance at life.

“It’s hard to put into words how appreciative I am to the QAS staff who saved my life,’’ Matt said.

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“It is pretty incredible to think of what they have done … I am very humbled by what has occurred … What they did is nothing short of inspirational.”

Autumn 2019

Matt, a recovering alcoholic, said he is still struggling to come to terms with his actions that fateful night.

“It is hard to comprehend what I did to myself.

I am not like that… and suicide has never crossed my mind. I have been a positive person most of my life, so looking back at what happened has been quite difficult.”

However, Matt, who has worked as an executive in the transport industry for almost 30 years, explains at the time of the incident he had become increasingly depressed, anxious and stressed over growing financial pressures.

“I had my own transport business, but just leading up to the incident, I lost my major client,’’ he said. “I was struggling to pay the mortgage on my unit … I had the bank and the body corporate chasing me for money.”

Matt said that, as a way to deal with the stress from the growing bills, he turned to the bottle.

At his worst Matt was drinking up to two bottles of vodka a day plus six bottles of wine.

It would later emerge that the drugs and alcohol caused him to hallucinate the night he stabbed himself.

Lifesaving medical milestone

you see him breathing…”

Partner Sandra, who has been a tower of strength for Matt throughout his ordeal and the recovery process, remembers that evening well.

Sandra said EMD Michelle Kelly was amazing and helped keep her calm, talking her through what to do. This included watching Matt’s breaths and counting them.

“The night Matt stabbed himself he had been really happy, we had spent the earlier part of the evening listening to songs we wanted to play at our wedding,” Sandra said.

Unfortunately, Matt was deteriorating fast.

When the colour in his face started to turn grey Sandra said she ‘knew he was dying’.

Both Sandra and Matt had retired to the bedroom when Matt said he was going into the kitchen to get some cold water to drink.

“Next thing I heard Matt yelling ‘baby!’…

I could tell by the tone of his voice something was really wrong,” Sandra said.

She rushed out of the bedroom to be met by the confronting scene of Matt with a steak knife in his chest.

“I went and bashed on the bathroom door and yelled out to our flatmate who was having a shower and then I ran into the bedroom to get my mobile phone.

“When I came back Matt started collapsing into my arms as I was calling Triple Zero (000).”

“I put him in the recovery position and put a shirt around the knife which was still in his heart.”

When Dr Rashford arrived on scene, he and the paramedics moved Matt from the kitchen to the hallway near the lifts where there was more space to work on him.

With police watching, Dr Rashford, assisted by the paramedics, performed the pre-hospital resuscitative thoracotomy.

Matt was subsequently rushed Code 1 to the Royal Brisbane and Women’s Hospital where he underwent more surgery until early the next morning.

“As Matt was taken to the ambulance,” Sandra recalled, “Dr Rashford told me to say goodbye.

He said, ‘this will be the last time you see him breathing’.”

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Thankfully, that was not to be the case.

Dr Rashford said Matt’s survival was ‘an amazing testament to the commitment to a class one trauma system and the professionalism of our paramedics’.

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“Whilst I had a similar survivor when working in London, Matt’s case is all the more special because he is the first to survive after receiving this procedure in cardiac arrest in Australia.”

Clinical notes by Dr Rashford A resuscitative thoracotomy involves making an incision from one armpit, across the anterior chest to the other armpit.

The skin and layers are incised, all the way down through the intercostal muscles. The sternum is cut horizontally, with the entire chest opening up like a ‘clam’ to reveal all the structures within that cavity.

This is why the procedure is also known as a ‘clam shell thoracotomy’. This procedure is only successful if undertaken within 10 minutes of cardiac arrest, therefore, almost all patients who suffer cardiac arrest in this scenario die unless they are arriving at, or are very near to, a trauma hospital.

With Matt, it became immediately apparent that the knife had penetrated the heart, resulting in a haemopericardium and cardiac arrest.

The pericardium was excised, with release of the blood. The heart started to beat again.

The wound in the right ventricle was bleeding profusely with each contraction.

The left ventricular wound was not bleeding, so I closed the right ventricle wound using intermittent staples.

Matt’s heart went into ventricular fibrillation after a short period. This required four defibrillation shocks, with internal cardiac massage in between, before cardiac output was re-established.

I then tied off both internal mammary arteries, which had begun to bleed once cardiac output started up.

HARU CCP James Wylie and I then undertook a rapid sequence induction in the ambulance after Matt had been extricated from the upper floor of his building.

Further information: www.ambulance.qld.gov.au/docs/clinical/cpp/CPP_Thoracotomy.pdf

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Lifesaving medical milestone

Fast forward more than half a year later and Matt, who is taking small steps each day, said he was speaking to INSIGHT in the hope his story would give other people hope.

“I still do get stressed due to my financial hardship. But thankfully, I have Sandra here by my side and we are working through solutions together.”

“I am giving this interview because I know there are a lot of people with anxiety and depression,” Matt said.

Matt said compiling positive lists of things to do was also helping him.

“If you are experiencing problems or struggling, make sure you talk to someone or a counsellor.

Don’t give up hope.

“I kept it in for so long and was scared to seek help — but I finally realised I needed to do something as the path I was on was going to eventually land me six feet under.”

And Matt is taking control of his body, eating three meals a day with lots of vegetables and even porridge for breakfast with yoghurt.

“It may sound simple and standard, but this healthy eating regime is something I haven’t done for years,” he said.

*Matt and Sandra did not want to be identified but were agreeable to use of first names in this story.

Photos: Jo Hales and QAS

Matt said he decided to take control of his life in January. “I enrolled in a detox program and I have been receiving counselling,” he said.

“I am feeling a lot better and the brain is a lot calmer.

He has started reading inspirational books, taking walks, spending time outdoors and actively looking for employment.

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Out of Hospital Cardiac Arrest survival rates more than double for our patients Earlier in the year, all staff received a copy of the report Survival Trends: Out of Hospital Cardiac Arrest in Queensland 2000-2016, which provided invaluable insights into the outcomes of this critically ill patient cohort.

QAS Medical Director Dr Stephen Rashford described these outcomes as a reflection of the commitment and dedication of all personnel, whether they are stationed in city, regional or rural LASNs. “The results of this report demonstrate the benefit that timely and effective CPR has on patient survival — whether we’re called to a case in Caloundra or Cunnamulla,” Dr Rashford said. “These outstanding results are a credit to the continual high performance of our frontline staff in the often challenging and high stress environment that OHCA cases present.

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More than 69,000 Out of Hospital Cardiac Arrest (OHCA) cases from 2000-2016 were analysed, and the report’s findings have reinforced our service’s position as one of the nation’s best performing when it comes to acute cardiovascular care.

The extensive study of the Information Support, Research and Evaluation (ISRE) Unit’s Cardiac Arrest Data Base (CADB) detailed throughout the report highlighted several important survival outcomes, including: Where the cardiac arrest is witnessed, bystander CPR attempted, and resuscitation

by QAS paramedics performed, ROSC at hospital has increased from 18% in 2000, to 36% in 2016.

Patients with an initial shockable rhythm have seen great improvement in pre-hospital outcomes, with ROSC at hospital doubling from 24% in 2000, to 48% in 2016.

In Queensland, survival to hospital discharge has increased from 9% in 2000, to 16% in 2016.

The QAS has delivered CPR Awareness and skills to 57,572 Queenslanders as at the end of 2016.

“Through the early recognition of OHCA by Operations Centre staff, leading to the rapid dispatch of paramedics who are well trained and equipped to manage such incidents, we have seen greatly improved outcomes for patients in this cohort since 2000, when the program began.

“The recognition of the paramedic workforce becoming the 16th Australian registered health profession reflects the highly advanced level of clinical skills paramedics possess, particularly in OHCA, and our transition from vocational beginnings to a tertiary model.”

The report was developed by staff at the ISRE Unit, headed by Director Dr Emma Bosley. With a staffing establishment of ten and experience and qualifications spanning • pre-hospital and public health research • statistical analysis and data linkage methodologies • paramedicine • pharmacology • health economics • nursing and population health, the ISRE Unit ensures the service is advised of the latest evidence base to inform service delivery and decision-making.

Autumn 2019

Dr Bosley said the report was the first of its kind to be produced in the Australian pre-hospital sector examining 17 years of data, and greatly added to the evidence base on best practice management of the OHCA patient cohort.

“Compiling this report has involved complex analysis of all OHCA-related data and began with collating eARF (including ECG strips), DCARF and CAD data sources in accordance with the Utstein template,” Dr Bosley said.

“This task was extensive and involved thousands of hours in scrutinising, entering and auditing cardiac records, and ensuring the current paper-based documents were filed in accordance with clinical record keeping protocols.

“Keeping abreast of technology and testing its efficiency to reduce the burden of paperwork for operational personnel is an area we are focused on and hope to introduce new procedures to simplify these processes in the near future.”

Dr Bosley acknowledged Dr Rashford for his clinical oversight of the report and joined him in thanking all areas of the service which contributed to its development. “From the diligence of paramedics in providing high quality care to our patients and accurately completing their case notes, to the Operations Centre staff providing immediate telephone assistance to Triple Zero (000) callers, while coordinating immediate resource allocation— all efforts have been commendable,’’ she said.

“Subsequently, the QAS ISRE Unit will be issuing annual reports on the survival outcomes for our OHCA patients, along with participating in ongoing collaborative research opportunities. I look forward to updating everyone on the exciting work being undertaken in this area.”

ISRE report: OHCA survival outcomes

“The successful insertion of an airway adjunct, such as an endotracheal tube (ET) or supraglottic airway device (SGA), is a key intervention in the management of patients that have experienced an out of hospital cardiac arrest (OHCA).

There is currently much conjecture regarding which of these devices is associated with superior patient outcomes.”

Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest – A Randomized Clinical Trial The primary objective of this study by Wang et al. 2018, published in the Journal of the American Medical Association, was to determine the survival outcomes (as measured 72 hours after OHCA) of patients that were randomly assigned to receive one of two advanced airway adjuncts. The secondary outcomes explored within this study were the return of spontaneous circulation (ROSC) on hospital arrival, survival to hospital discharge and presence of a favourable neurological outcome (denoted as a Modified Rankin Scale Score <3).

Designed as a multicentre pragmatic cluster-crossover randomized trial, this study recruited 3,004 patients from 27 different emergency medical services (EMS) throughout the United States. In this design, a sequence of interventions is assigned to a ‘cluster’ of individuals (e.g. patients presenting to a single EMS agency), and each cluster receives each intervention in a separate period of time.

Pragmatic trials test the effectiveness of an intervention in the context of routine practice, they are not as robust as randomized controlled trials but are practical in the pre-hospital setting.

Patients were included if they were aged 18 years or older, had experienced an OHCA of suspected non-traumatic aetiology and required ventilatory support or advanced airway management. The trial randomized EMS agencies to provide one of two airway management strategies: laryngeal tube (LT) insertion or endotracheal intubation (ETI).

A laryngeal tube is a commonlyused SGA with a single-lumen tube consisting of an aperture with two low pressure cuffs and is inserted in a similar manner as a laryngeal mask airway.

EMS personnel involved in this study followed the clinical protocols of their respective agencies for confirmation of airway placement and overall management of OHCA, no additional training in the devices was provided.

Survival measured at 72 hours was found to be higher in patients that received a LT by comparison with an ETI (18.3% vs. 15.4%; adjusted difference 2.9% [95% CI, 0.2%-5.6%], p = 0.04). Secondary outcomes of this study found LT was associated with higher rates of ROSC (27.9% vs. 23.4%; adjusted difference, 3.6% [95%CI, 0.3%-6.8%]; p = 0.03), hospital survival to discharge (10.8% vs 8.1%; adjusted difference, 2.7% [95% CI, 0.6%4.8%], p = 0.01), and favourable neurological status at discharge (7.1% vs 5.0%; adjusted difference, 2.1% [95% CI, 0.3%3.8%], p = 0.02).

It should be noted that there are several potential confounders and limitations that must be considered when appraising the results of this study. Most notably, the initial (first-pass) success rates of the adjuncts were significantly higher in LT (90.3%) in comparison with ETI (51.6%). Additionally, the time duration from EMS arrival on scene to successful insertion of airway device was shorter for LT (9.8 vs. 12.5 minutes). Finally, the quality of CPR and broader resuscitation management was not assessed across the trial.

Wang HE, Schmicker RH, Daya MR, Stephens SW, Idris AH. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest – A Randomized Clinical Trial. JAMA. 2018; 320 (8). doi: 10.1001/jama.2018.7044

Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome – The AIRWAYS-2 Randomized Clinical Trial Published in the Journal of the American Medical Association (Benger et al. 2018), this study aimed to determine if the insertion of a SGA for advanced airway management during OHCA resulted in a better functional outcome in comparison with ETI. Functional outcomes were measured using a Modified Rankin Scale Score, which is a six-point measure of disability with scores 0-3 representing no to moderate residual deficits (‘good outcome’) and 4-6 denoting significant disability (‘poor outcome’).

This study included a total of 9,296 patients from 4 different ambulance services in England, using a multicentre, cluster randomized trial design.

Similar to the research by Wang et al (2018) this pragmatic trial included patients aged 18 years or older who had experienced an OHCA of suspected non-traumatic causes, and received a subsequent resuscitation attempt by paramedics. As the randomization of patients at the point of care in the pre-hospital environment was considered impractical, paramedics were randomized to use one of the two advanced airway management strategies for patients they attended across the entire study period.

Paramedics were randomized in a 1:1 ratio using computer generated allocation to either SGA with a soft noninflatable cuff (i-Gel©) or ETI. Paramedics received additional training in how to perform their allocated intervention following randomization, to ensure competence and familiarity was homogenous across paramedics.

There was no statistically significant difference in the presence of a favourable neurological outcome, as measured using the Modified Rankin Scale Score, between SGA (6.4%) and ETI (6.8%) (adjusted risk difference, -0.6% [95% CI -1.6% -0.4%], p = 0.24).

However, use of a supraglottic airway device achieved initial ventilation success more often; 87.4% in the SGA group compared with 79.0% in the TI group (adjusted RD, 8.3% [95% CI, 6.3% to 10.2%]).

Additionally, the number of patients that achieved ROSC at hospital with SGA was significantly higher than ETI (30.6% vs 28.4%; adjusted risk difference 2.2 [95% CI 0.3 – 4.2%], p = 0.03).

Benger JR, Kirby K, Black S, Brett SJ, Clout M. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome – The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018; 320 (8). doi: 10.1001/ jama.2018.11597

“There remains only limited evidence available regarding optimal pre-hospital airway management, and it remains the source of much debate. Two recently published studies, focused on out of hospital cardiac arrest, also do not conclusively show a benefit of advanced airway techniques over basic techniques. The study by Wang et al. (2018) from the United States suggested improved 72 hour survival using supraglottic airway devices compared to tracheal intubation. However, a similar study in England failed to demonstrate superiority of supraglottic airway devices when compared with tracheal intubation [Benger et al. 2018].

The pragmatic design of these studies given the complexities of conducting controlled research in the pre-hospital emergency environment, and the consequent inability to adjust for confounders such as the quality of CPR and other resuscitation management aspects, is recognised. The findings of these studies serve to advocate for the importance of undertaking further research in this field.”

Medical Director’s comments The two studies do provide some indication that advanced airway management in the initial management of non-traumatic cardiac arrest in an adult population is not associated with improved outcomes. The primary aim of the initial management is good quality chest compressions with minimal interruptions and prompt defibrillation when indicated. It is likely a supraglottic device results in less chest compression interruption, thus why the QAS advocates this as the initial airway option. It is likely that endotracheal intubation is more appropriate as part of post ROSC care or certain circumstances where it is the most appropriate intervention. It will be interesting to see how ILCOR deals with the recent large pre-hospital studies surrounding cardiac arrest management strategies.

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Combat paramedic’s Iraq deployment INSIGHT editor Jo Hales spoke to Metro North ACP and Army Reservist Lance-Corporal Lawrence Odlin about his first deployment overseas as an Australian Defence Force (ADF) combat paramedic. The ACP’s six-month tour involved training Iraqi soldiers to rejoin the front line against ISIS (Daesh).

Lawrence Odlin, 42, is settling back into family life and his ACP role at Roma Street Ambulance Station after his six-month deployment to Iraq from May until November 2018.

The combat paramedic was part of the Task Group Taji-7 training team responsible for training hundreds of Iraqi soldiers at the Taji Military Complex.

Above

■ ACP Lawrence Odlin on a more relaxed ‘posting’ visit to Kedron Park Headquarters.

Photo: Jo Hales

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Below

■ Lance-Corporal Lawrence Odlin (R) with Iraqi Army Trainer ‘Corporal J’ chat during an Officers and Junior Leaders Training Course at Taji Military Complex.

Photo: Department of Defence, Corporal David Said

The complex is located northwest of Iraq’s capital, Baghdad, and Lawrence’s main roles at the facility included teaching the soldiers basic combat lifesaving skills, such as the application of tourniquets and emergency trauma bandages for gunshot wounds and blast injuries.

“The soldiers were also taught vital skills such as weapons handling, marksmanship and field craft and undertook live fire range training to ensure their accuracy,” Lawrence said.

“This basic training was designed to further refine their skills and make them more capable in a combat environment, giving them the best chance of survival during a battle against the Daesh.’’

Lawrence trained three brigades, each for 10-week stints and, on completion of their training, the Iraqi soldiers were to be re-deployed on security operations around the country.

“The soldiers were very appreciative of the training and I was even invited to a celebration dance after one of the brigades successfully completed its final exams,” he said.

Lawrence, who has been in the Army Reserve for 11 years, said he was excited at being called up for his first deployment.

“It was an amazing experience and it was a privilege to work alongside Australian soldiers from 6RAR in Brisbane,’’ he said. “They were fantastic. They were so professional. I had the utmost confidence that, if there was an incident, we were in the safest hands.”

Autumn 2019

Lawrence trained as a combat medic after the specialised ADF role was introduced around seven years ago. He said his Defence Force and paramedic roles complemented each other.

“In the army I have been able to capitalise on the skills and experience I have as an Advanced Care Paramedic providing pre-hospital care to patients,” he said.

“My deployment to Iraq allowed me to use my paramedic skills in another environment — and it also gave me an appreciation of what it is like to respond in high-threat environments,” he said.

Lawrence said some of the challenging aspects of the deployment were the harsh, hot conditions, with the temperatures ranging from 40 to 50 degrees Celsius.

Meanwhile, to address any language barriers, Lawrence was given a quick course in Arabic before heading to the Middle East.

“I was taught the basic greetings and common words,” he said. “Then, when we were over in Iraq, we were assigned interpreters to assist us with the translations and the lessons and instructions.”

However, the toughest part of the tour was ‘being away from his family’.

“Thankfully, I was able to have regular contact and Facetime (when it worked) with my wife Shannan and son, Eli, 5,” Lawrence said.

“But it was hard not being home to celebrate Eli’s birthday with him.”

Lawrence has been based at Roma Street Ambulance Station since becoming an ACP 10 years ago.

He had always wanted to be an ambulance officer and said his decision to study paramedicine was reaffirmed by the care and treatment he received following a serious car incident at Jindalee in 1995.

Combat paramedic Lawrence Odlin

Lawrence, who was in his late teens at the time, was in the front passenger seat of the car which went into a power pole.

He suffered significant injuries including a broken pelvis and arms and a collapsed lung, and credits the ambulance officers who treated him with saving his life.

“I spent four months in hospital in traction due to my pelvis and right humerus injuries,” Lawrence said. “But the care I received from the officers on scene was one of the reasons I am a paramedic today.

“It made me want to assist people in their time of need and give them that same level of care and compassion that I was given.”

Note: Around 300 Australians and 100 New Zealanders were deployed on Task Group Taji-7.

Above

■ Gazing through binoculars, Lawrence observes live-fire training by soldiers of the Iraqi 41st Brigade.

Main image

■ Lawrence stands watch by a Bushmaster Protected Mobility Vehicle Ambulance of Task Group Taji-7 at the Taji Military Complex.

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Photos: Department of Defence,

Corporal David Said

Below

■ Map of the Baghdad region, showing the Taji Complex northwest of the city.

Masthead Design & Creative

TAJI 0 km 5

Ri

Ti gr

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BAGHDAD

‫دادغب‬

Green Zone

Baghdad Airport

Autumn 2019

Quiet Achievers Story: QASEC

Meet the teams supporting QAS careers The Queensland Ambulance Service Education Centre (QASEC) has two main sites: Vanda Street in Woolloongabba and a permanent satellite campus at the Queensland Combined Emergency Services Academy at Whyte Island.

QASEC also operates from the Queensland Police Service Academy at Oxley as required.

The next edition is due to be released in the new financial year and in the future there will be a new edition each year documenting the significant scope of education and training priorities for QAS staff, as well as providing all staff with information about education pathways to support their personal career development.

QASEC Acting Director Drew Hebbron said that, “over the past two years in particular, our education system has been on a journey of change with the main goal of contemporising our approach to staff education and development in a way that makes training enjoyable, relevant and easily accessible to all staff.

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With around 60 staff at both principal sites, QASEC’s dedicated teams of talented individuals provide services to the QAS such as: Tier 1 Training Packages New employee induction programs, including EMDs, PTOs, Graduate and Qualified Paramedics Graphic design, animation, videography, multi-media, production and online creative services Learning Management System (LMS) and QASCLO administration Study and Research Assistance Scheme Administration (SARAS) Student Placement Online Tool (SPOT) administration and coordination University sector interface to discuss student placements

“Education needs to grab your attention and captivate you – you need to want to do it,” Drew said. “We consult extensively across the organisation and regularly engage with staff in the LASNs. This keeps our education topical and in keeping with the current operational environment, helping ensure we grow capacity and capability.

Critical Care Paramedic Program (CCPP)

“Our content developers feature subject matter experts including paramedics, PTOs and EMDs with currency of practice in their respective areas, ensuring our outputs are targeted and relevant.

Indigenous Paramedic Program (IPP) and Culturally and Linguistically Diverse Paramedic Program (CALDPP)

Coordination of the Bicycle Response Team (BRT) course with Queensland Police Flight Paramedic Program (FPP) Local Area Assessment and Referral Unit (LARU) Program

As well as recently completing a refresh of PCi/Lysis training, other major QASEC projects underway include:

“We also have an extremely talented design and production team producing high-quality publications, animations, videos and multi-media experiences in support of education and QAS business units more broadly,” Drew added.

Scoping to incorporate Virtual and Augmented Reality mediums into education delivery in an ongoing and sustainable way

“We have also been pushing the boundaries of our ICT environment to deliver new and innovative ways of delivering content across the state.”

Reviewing the Graduate Paramedic Internship Program (GPIP)

“Virtually all QAS staff will have crossed paths with QASEC at some point,” Drew observed, “but many may be unaware of the extensive scope of our work behind the scenes supporting career paths right across the organisation.”

Autumn 2019

Delivering the 2019-20 Education Plan

QASEC forms part of the QAS Service Planning and Performance portfolio under the leadership of Deputy Commissioner Dee Taylor-Dutton.

All photos: Philippe Vipathkun, QASEC

The Centre’s primary goal is to provide leadership and strategic direction across our statewide education system.

In January 2019 the QAS Education Plan was released by Commissioner Russell Bowles.

Quiet Achievers Story: QASEC

RAMS TEAM

CONTINUING EDUCATION UNIT

Mel Bernas

INDUCTION PROG

QAS service: 20 years

Rebecca Taylor

Acting Executive Manager Continuing Education

QAS service: 16 years

Acting Executive Manager – Induction Programs, QASEC

Career snapshot: ACP, CCP, CSO, CCFP, Townsville, Mackay and North West LASNs

Career snapshot: Paramedic, CSO, OIC, Manager Clinical Education

“Working amongst a team of enthusiastic people that are committed to innovation and quality education outcomes is really stimulating. Making a positive difference in the lives of our frontline officers and supporting them with engaging and relevant education that is both innovative and empowering is truly rewarding.”

“Working with the new graduates is really satisfying and helping them take their first steps to developing their own professional pathways draws on my own memories of commencing with the QAS, and constantly renews my commitment to providing high-quality education services.”

Drew Hebbron

QAS service: 17 years

Acting Director – QAS Education Centre (Current substantive appointment: Director, West Moreton LASN)

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Career snapshot: Communications Officer (NT), Paramedic (QLD and NT), Senior Clinical Educator, Commissioner’s Office “In my substantive role as West Moreton LASN Manager, I would hear a lot of feedback from our people that they wanted access to more relevant and quality education that more realistically reflected their clinical practice. Acting as Director for Education has given me the chance to effect real change to our statewide education system through pushing boundaries of our ICT environment, looking to the future to implement a more strategic approach to education for all staff.”

QAS service: 9 years

Career snapshot: Department of Foreign Affairs and Trade, AUSAID, Commissioner’s Office, LAC and Volunteer Support “The Educational Support and Systems team is effectively a shared service provider to QASEC teams and to all of QAS. I really like the diversity of tasks our team is involved in, and the challenge of solving problems and supporting the delivery of high-quality outcomes. It is a pleasure to work with such a creative team.”

EDUCATION

AL SUPPOR T & SYSTEM S

Lisa O’Mahoney

QAS service: 20 years

Manager, Communications Education Career snapshot: CSO, EMD, OpCens, Quality Assurance “Most important is my wonderful team and the dynamic but rewarding diversity of our work environment: we fully appreciate our critical role in training and renewing competencies for our frontline Triple Zero (000) call takers and are always refining and enhancing our Certificate III and IV education packages.”

Autumn 2019 COMMUNICATION STUDIES UNIT

Photo: Adobe Stock / Dschwen

Teresa Jurgensen

Executive Manager, Educational Support & Systems, QASEC

TSV

The QAS’s disaster effort was activated in late November when regions across Queensland were scorched by savage bushfires. In February, north Queensland was under threat, when unprecedented floods ravaged the region. Over the next four pages, INSIGHT editor Jo Hales and ACP Kent Jackson, who was deployed to Townsville, report on our presence at these extraordinary events.

The QAS floods response When devastating floods inundated north Queensland in early February, the unprecedented event caused mass destruction and displacement, with thousands of homes going underwater and many lives placed at risk.

However, out of the devastation came an uplifting story about the united response effort between the QAS and the Australian Defence Force (ADF).

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Assistant Commissioner Townsville LASN Robbie Medlin said ‘the QAS had the good fortune of being able to activate the local ADF early in the piece to help paramedics respond in areas that were very quickly inundated and proved quite challenging to our troops at the height of the floods.

“On activation of the ADF, they had a presence within our Local Ambulance Coordination Centre (LACC) on a 24-hour basis,” Robbie said. “Initially, we had access to four ADF vehicles.

Having access to these vehicles proved invaluable, especially during the nights of 2–5 February, the ADF assisting us to gain access to places we otherwise would not have been able to reach.”

Robbie said that, prior to February, the LASN had been involved in events with the ADF in Townsville but the floods allowed their connection to flourish.

“Some of the benefits achieved included providing the ADF with a very thorough understanding of the QAS disaster management framework and how that interlocks with local and district disaster management arrangements,’’ he said.

“Our staff were able to quickly adapt to policies and procedures within the ADF environment and act on them.

Going forward, the ADF has indicated a willingness to participate in joint training opportunities.”

Robbie said his heart went out to those who were directly impacted or affected in some way during the floods.

“My condolences go to those who sustained property damage.

Sadly, we had some staff who lost everything,’’ he said.

“The ADF was able to witness a LACC from within for the first time. Until this event, we had very little interaction at a local level in times of a disaster, the interaction had been more through a district disaster coordination centre.

“We were also able to familiarise them with our equipment, vehicles and undertake some scenario training in patient care, considering all the ADF units dispatched to us were from a health battalion.

Robbie said there were also multiple benefits derived for the QAS. “Our involvement with the ADF enabled us to understand more fully their response, what their capabilities, their roles and responsibilities are and for us to be very much engaged with them in that area,’’ he said.

Autumn 2019

“In terms of our response and functioning throughout this disaster, I would like to extend my sincerest appreciation to all the Townsville staff and the 62 staff from around the state who deployed to the LASN to assist with the flood response.

“I cannot speak highly enough of the comradeship, teamwork, the respect and courtesy shown to and by our staff.

“It has certainly been my privilege as a LASN leader to witness examples of extreme hardship and then to see like-minded people rally around their mates and provide assistance.”

Regarding the united approach undertaken with the army, Robbie said that there was a number of long-lasting friendships forged across the state with ADF personnel.

QUEENSLAND FLOODS AND FIRES

Student’s placement QUT student paramedic Max King, 21, was given an amazing insight into the life of a paramedic when he undertook a placement during the university break.

A dual degree paramedic and nursing student, Max was assigned to help his mentors John Cooper and Michael Fischer with the flood effort in Townsville.

It was an eye-opening experience for the second-year QUT student whose roles included stocking supplies in the ambulance and heading out in to the community to help with the clean-up effort. “It was sad to see all the devastation, but I was so glad to be given the opportunity to go to Townsville and assist.

Background

■ AC Townsville LASN Robbie Medlin and Army Liaison Officer Captain Craig Smith take a moment to pause for a warm handshake.

Army connections Captain Craig Smith, 2IC of 2 Close Health Company, a unit of 1 Close Health Battalion, spoke to INSIGHT about Joint Task Force 635.

Craig, who was Liaison Officer to the Townsville LACC, said the ADF utilised four PMVAs (Protected Mobility Vehicle Ambulances) in support of the joint task force.

Each vehicle had either two or three ADF personnel and a paramedic.

Fourteen military medical staff assisted the QAS during the floods and Craig said a number of drivers and co-drivers from Three Brigade, 1RER, CTC and 4 Regiment, supported the joint operation.

“The key things my teams were able to get out of this was the clinical exposure in extreme conditions,” Craig said. “They were able to treat patients they generally wouldn’t be exposed to in normal exercise conditions. This will really set them up for success when they go on operational tours and operations.”

Craig said the relationship between the QAS and the defence community had always been very strong in Townsville.

“There always has been a connection during disasters such as this, Yasi and the 1998 floods, in which we’ve always been able to supplement.

“Our drivers and co-drivers were able to navigate and drive through very hazardous conditions and all those people performed exceptionally well in fulfilling those duties,” he said.

During Joint Task Force 635, ADF and the QAS responded to 67 medical taskings as well as 26 administrative taskings which included route reconnaissance, personnel and equipment movement.

“It was great to see first-hand just how the emergency services response effort was run,’’ Max said.

Max said when he initially learned he would be assisting the Townsville community, he hoped to gain knowledge, extra practice and to ‘just soak up as much as I could’. He said the experience had equipped him with the skills if he is ever called on to assist in a disaster effort in the future.

“If I come across a situation like this again, it’s rewarding to know that I have had some experience and will feel a bit more comfortable about getting involved,” he said.

“It is great that we can complement the emergency services during these difficult times and provide our assets that are able to meet the demands that are not normally expected of civilian vehicles.”

Max said the Townsville placement also reaffirmed his decision to ultimately become a paramedic.

“My involvement with the Townsville floods made me realise that I have definitely made the right career choice,’’ he said. “I am really looking forward to getting the clinical experience and attending medical jobs and traumas.”

Autumn 2019

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Paramedic Kent Jackson’s deployment Brisbane-based ACP Kent Jackson was one of more than 60 staff deployed to north Queensland to assist with the response effort. Kent, who is also an operational media liaison officer in the QAS Media Unit, flew into Townsville on Sunday 3 February – just hours before the city was inundated with water.

“One case that particularly affected me was a family with a baby around the same age as my daughter Adeline,’’ Kent said. “The family was brought to the North Shore Evacuation Centre after being rescued from their flooded home by the army.”

Kent said they had been trapped in their house all night and hadn’t slept.

“As I flew into Townsville, the Ross River was peaking due to the ongoing torrential rain … Just hours later the airport was closed due to the rising water levels,” Kent said.

“When they arrived, they were just so exhausted, and the mum was trying to settle the baby and get him to sleep, but it was impossible with all the noise,” he said.

While Kent was being briefed at Townsville Ambulance Station, an emergency text was issued directing people to move away from the Ross River as flash flooding would occur in the coming hours.

Several hours later, as Kent walked into his CBD hotel lobby, another emergency text advised flash flooding had occurred and for people to make their way to high ground.

He also undertook shifts in an ambulance and recalls a job with Gold Coast officer Brett Fournier.

“When we arrived at the patient’s house it was raining heavily, and the water levels were rising,” Kent said. “By the time we had assessed the patient and were ready to leave, the street had flooded. Luckily, the water wasn’t high, and we were able to safely drive to Townsville Hospital.”

“I knew I would be okay as I was staying on the third floor of the hotel, but at the same time it was a bit unnerving as I was unfamiliar with the area,” he said.

One of his tasks during his six-day deployment involved travelling in Protected Mobility Vehicle Ambulances (PMVAs) with members of the ADF to assess and treat patients.

It was while travelling from community to community in the PMVAs that Kent witnessed the rescues of many locals from their flooded homes or vehicles.

Kent said while it was rewarding and a privilege to assist with the flood effort in north Queensland he was glad to return home to give lots of hugs to wife Carly and Adeline.

Canadian-born Kent has been a paramedic for six years, three of which he has served with the QAS. The other three years were served with Superior North EMS. He moved to Australia in 2011 to be with Australianborn Carly who is a nurse.

Kent is working in the QAS Media Unit for 12 months and he said his interest in the media stemmed from an unexpected stint on TV in 2015.

However, Kent said many staff from the hotel found themselves stranded and unable to return to their homes.

Kent was deployed to the region for the dual role of media liaison officer and operational officer.

At the centres, Kent and the other paramedics were kept busy organising the many donations that were streaming in.

“We would organise the items into categories including personal hygiene, blankets, shoes and clothes, before the Red Cross arrived to distribute them,” he said.

“In 2015, I entered a competition being run

by The Project on Network Ten and ended up winning. The prize was the opportunity to co-host the show for a night.”

Most of Kent’s time was spent at the evacuation centres in Townsville and the surrounding areas assessing patients and giving out general advice about food and water. “The paramedics were also kept busy with many people presenting with chronic health conditions who had not had access to medications for various reasons.”

Kent went on to be given whirlwind training and mentoring by presenter Carrie Bickmore and rub shoulders with co-hosts Peter Helliar and Waleed Aly. “It was an amazing experience and from that moment on I had an interest in media,” Kent said.

Kent said working at the evacuation centres, which contained people of all ages and from all walks of life was an eye-opening experience. “It was sad seeing so many people distressed by this flooding and the situation they had found themselves in,” he said. “They were worried about their homes, their belongings and pets left behind.

Photo: QAS / Matt Baker

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TSV

Autumn 2019

QUEENSLAND FLOODS AND FIRES

Previously in Queensland …

ACPs Gabrielle (Gabby) Tickle and Karina Bahnisch experienced the unpredictability of the bushfire crisis that ravaged Central Queensland in late 2018.

Gabby said the pair communicated to the LACC ‘any potential patients that would need to be airlifted should their health deteriorate, or the situation escalate’.

Gabby, from South Mackay, and Karina, from Rockhampton, were on standby at a location in Eungella when they were informed a fire was advancing in their direction, so they needed to move to a community hall.

“Thankfully, there were no patients, and everybody stayed calm and pitched in and we cleared the area near the hall and doused the walls with water,” she said.

After relocating to the hall with around 30 people including locals, reporters and other emergency service workers, the QAS officers were informed the wind had changed and a fierce fire front was approaching them.

Throughout the incident, Deputy Commissioner Dee Taylor-Dutton maintained contact via mobile phone from the State Incident Management Room (SIMR).

“Dee was amazing, providing encouragement and keeping us informed on the latest developments about the fire and emergency response to the situation,” Gabby said.

To everyone’s relief, the fire was eventually contained 100 metres from the hall.

“It was a very intense time, as it was nothing I had ever experienced,” Gabby recalled.

Above

■ Late-night reunite for Gabby and mum Leanne.

There were lots of hugs when Gabrielle’s mum, Leanne Tickle, a firefighter who had been responding to the bushfire crisis from Walkerston Fire Station, about an hour’s drive from Eungella, visited the pair that night!

Left

Gabby said the pair would always be grateful for the tight-knit Eungella community’s ‘tireless efforts throughout the heightened experience’.

Bottom

■ Eungella preparations.

Main background

■ View looking west of the fires burning on the Eungella escarpment west of Mackay.

■ Fires also burnt through the Deepwater district north of Bundaberg.

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All photos in this feature are from QAS staff, QAS Media and the Department of Defence, reproduced by permission.

Autumn 2019

THANK YOU :) 4 December, I thought I would never be Everyone has different levels of success. ForOn me, success Hi there, I just wanted to say a big totospeak to my dad again as he into can never be achieved unless you have theable desire Justwent want to say a big thank you to the ladies thank you to the two paramedics Cardiac Arrest just before going out on a ride initiate it. The amazing work and commitment from staff (Corinne Wilkes, Kate Olive and Candice (Carly McManus and Steve Whitfield) with we hisreceive mates. I was absolutely devastated. that continuously results in appreciation letters Boileau) that came to my house thiswho morning Commissioner’s thanks attended my son after he had a I love my dad so much.

But, thanks to his mates from members of the public, makes me constantly aware of (July 19) for my little girl and the dispatch guy fall in the pool at a holiday apartment The continual increase in the who did CPR, and the absolute professionalism, what accomplishments we have made as an organisation.

(Jamaine Prieditis) who helped me complex stay very in Burleigh Heads. They were number of emails/letters of thanks care and quick response of QAS staff who used the Queensland Ambulance Service so kind and caring and looked after him calm.

They do an amazing job and I really This month has seen an influx of thank youthe letters, with defibrillator, anaesthetised and intubated receives shows that you are so well. My eldest son hopped in the appreciated them being so fantastic.

304 letters received this year to date and 609 letters and dad at the scene, Dad is doing so well. contributing positively towards ambulance with them as my youngest emails of thanks sent to staff members. excellent patient care.

Incredibly, no damage to the heartKristie, muscle was was on the stretcher, he could not get Morningside Although Dad is super fit and rides There was a 27.3 cent increase I cannot thank youper enough for all your harddetected. work. over how compassionate and caring in the number of appreciations 90km, four times a week and lives a healthy they were. Thank you. received in 2018 compared with

lifestyle, he had two 80% blockages in his LAD Abir, Stathfield, Sydney Artery, and underwent Bypass surgery on 17 December. Dad is like a ‘caged Ilion’ thea quick thank you to the compared with the same period last want (as to send year (1 January to 28 February). surgeon calls him) and is already doing 1.9 (Chantal km paramedics Greaney and Melissa of walking twice a day, only one week Thank you for continuing to put Dajic) after who assessed my son and took him surgery, but can’t wait to get backtoon his bike your patients and community first. hospital on Wednesday night (July 12). It I would like to take the time to express our thanks when he is fully recovered.

Russell Bowles asm Russell Bowles ASM 2017 and so far this year there has QAS Commissioner been a 42.2 per cent increase

was the first time I have ever had to call the to various QAS officers for their attendance QAS Commissioner The family is so very grateful to allambulance of you and I was quite nervous in doing so and assistance at our unplanned home birth

for helping Dad and for restoring him back to – worried I was overreacting and wasting the his much-loved place in our family. We were (Julie Ricardo) for her efficiency and ability to able to pass our sincere thanks onparamedics to two time. The two ladies who attended ourand homeCaitlin were so calm and reassuring. They reassure us that help was on the way and clear ambulance officers Aaron Kingsford quickly assessed instructions in the meantime. Tammy (Olsson) Bayles, who transported Dad and kindly came my son and took us to Lady Cilento, all arrived on scene approximately 5 minutes to visit him in CCU, RBWH while picking upthe while distracting my son with another thanks Wiggles videos and calming a nervous and following the birth of our son Woody and I would patient, but please pass our on into the others (including Rory Jackson firstThank you for such excellent panicked –mum. like to commend her professionalism, calm Matthew service and care!!! I don't believe this service the situation and ability to treat me as aofficer fellow on scene – Scott Gardiner and Meister) who attended the scene gets around the recognition it deserves for all the work being rather than just a patient. She was caring, 4:15am, outside a coffee shop in North Lakes. on 4/9/2017. I commend the Triple Zero officer

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your paramedics do.

compassionate and efficient. I appreciate Tammy

Dad is so very lucky to be alive. We cannot thank you enough for all that youAmanda, did. Wellington Point

arranging for our transfer through to Hervey Bay Hospital. I believe Arto (Hirsimaki) and another

Anna, Milton officer (Andrew Rach) assisted with my transfer from Hunters Hut through to Hervey Bay and I found Arto to be very attentive to my needs at this time considering I was having much

Just want to give a shout out to the LARU officer

difficulty. I hope our message can reach the

who attended my home on Monday (August

I would just like to thank the Gladstone staff (Jack Aubrey, Mark 21). His name was Steve (Kliese) and we are O’Donoghue, Kayleigh King and in the Ipswich area. He was prompt, caring, Aleisha Mills) who were working on compassionate, empathetic, funny and the list the morning of 16 January 2019, goes on. He had me reassured within minutes. as they saved my life.

individual officers involved. Thank you to QAS for the important work you do I know we certainly needed the service on this day! Our little man Woody is doing great settling in at home with his

If my thanks could be passed to his OIC that

older sister Anna, feeding and sleeping well.

would be appreciated.

Darren and Kate, Lakeside Des, Silkstone

36 QAS Insight

SPRING 2017

QAS_Insight_Magazine_SPRING_2017_DRAFT3.indd 36

Thanks to you guys! I rang for assistance when my 81 years young mother was having chest pains at 4am.

I hung up at 4.07am and paramedics (Marcus Clemenkowff and Timothy Smolders) were in the house and doing an ECG by 4.22am …

Awesome.

Turns out it wasn’t a heart attack but pericarditis and after a few nights in hospital, she is home and doing well … SO thank you, thank you, thank you.

Bronwyn, Winwill

Autumn 2019

I found out that day that I’m allergic to wasp stings and had an anaphylactic shock which nearly killed me and would have if it wasn’t for your excellent staff.

They were only young men and women as far as I remember as I was in and out of a conscious state.

11/10/17 8:43 pm

But I’m very grateful to your service with such polite staff and courteous and swift working guys and girls who saved my life.

Thank you and may God bless every single one of you.

Vaughan, Port City Christian Church, South Gladstone

THANK YOU Hi guys, I wanted to sincerely thank the paramedics and everything they do for the community on a daily basis. I specifically wanted to send the highest praise to the duo that were sent to assist us with an inter-hospital transfer on 6 February.

Iâ&#x20AC;&#x2122;m an Intensive Care Registrar at Logan Hospital and was charged with transferring a patient to the Princess Alexandra Hospital ICU for specialist management.

The paramedic duo sent for the transfer were Chloe (Dunkley) and Craig (Truesdale), who I believe are one of the IHT teams. During the transfer, the patient unfortunately went into Cardiac Arrest en route, and ALS had to be commenced in the back of the ambulance.

Craig was seated in the back with me and the ICU nurse and he leapt straight to duty, starting CPR immediately while the ICU nurse and I worked the other parts of the ALS algorithm. Chloe ensured throughout the tenuous drive that we remained safe and continued en route as required, ensuring we arrived safely and promptly at the Princess Alexandra Hospital. The patient got ROSC and is in a stable condition and has had a positive outcome to date.

We would like to say a big thank you to Fumi (Burnett) and Carley (Carney) and their student for attending a BMX club on Tuesday night (22 January) when my son Koby broke his arm. They were very kind and caring and made us feel comfortable and calm. Kind regards and many thanks.

Jessy, Redland Bay

Getting in touch Messages collated on these pages are derived from a range of QAS contact points, including: via Facebook facebook.com/qldambulanceservice by email QAS.Media@ambulance.qld.gov.au by post QAS Media Unit, GPO Box 1425 Brisbane QLD 4001

Unfortunately, in the flurry of the PAH Emergency Department, Craig and Chloe managed to exit before my ICU nurse or I could sincerely thank them for the tremendous job they did in ensuring the survival of this patient. We are incredibly grateful for their brilliant work.

I would greatly appreciate if you could send our heartfelt thanks to them, as it was truly earned on this transfer. Kind regards.

Dr Myranda Shooter, ICU Registrar, Logan Hospital

Hi QAS, two lovely paramedics (Miriam Friesen and Catherine Muir and USQ student Kurt Harmer) came out to my baby on Australia Day. They were from the North Lakes station. We just wanted to thank them for giving Harrison his favourite toys ever. Picks these every time over all his other new and fancy things. You guys are legends!

Courtney, Kallangur

27

Thank you to QAS paramedics John (Strasser) and Jemma (Lenarduzzi) from Springfield Station today (15 January) in caring for my little girl Elsie after what appeared to resemble a febrile convulsion.

She was transferred safely and happily to QCH where we are staying overnight for observation.

Pia, Springfield Lakes

Autumn 2019

Wine maker paramedic Gold Coast LASN Operations Supervisor Allan Windsor has mastered the science of wine making. Jo Hales caught up with the long-serving officer who works as a vintage wine maker when he is on leave from the QAS. For the last 11 years, Allan Windsor has been honing his wine making skills at the boutique Witches Falls winery on Tamborine Mountain.

Allan takes two months leave from the QAS between February and April each year to work at the winery where he is involved in every facet of the wine making process from crushing, pressing and fermenting the grapes to bottling, capping and labelling the product.

During the eight-week production process, there is little down time for Allan, who would not have it any another way.

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Various techniques are involved in the production process, but Allan said once the grapes arrive at the winery from the Granite Belt they are de-stemmed in machines before the primary fermentation can begin.

“The fermentation process for red grapes occurs with the skins, this gives the wine its colour and additional tannins,’’ he said.

“Meanwhile, the white grapes are pressed in machines to extract the juice, and the skins are removed.”

Before the red wine goes into barrels and start malolactic fermentation, (a process in which the bitter-tasting malic acid is converted to softertasting lactic acid) it settles out in a stainless-steel tank for a few days.

Despite his role being at times physically demanding and the long hours at play, the vintner thrives on creating the right elements to produce the perfect drop of red or white wine by the end of the season.

While the wine is ageing in the barrels, Allan said he undertakes laboratory analysis to make sure the PH levels are correct to ensure the ‘wine doesn’t spoil through bacteria’.

“It is so rewarding being able to produce something that people enjoy,” Allan said.

“Everybody has a different palate, so as long as the person tasting the wine is enjoying the experience, that is all that matters.”

“The wine then stays in barrels for 10 months to two years depending on the variety before it is ready to be bottled,” he said. Allan’s interest in wine making had its beginning back in his late 20s when he and a friend would analyse the wines they were drinking and discuss the different smells and tastes.

Autumn 2019

Allan went on to complete a Bachelor of Wine Science at Charles Sturt University in Wagga Wagga. After completing his degree, he spent his QAS leave working at a winery in Stanthorpe before transitioning to the Tamborine Mountain winery in 2009 when it was just five years old.

Wine maker paramedic

“We are a smaller company here, not like some of the big ones down south. We have a great team, and everyone is so passionate about the wine making process,” Allan said.

When INSIGHT caught up with him, he had worked every day of the past two weeks, one shift lasting more than 14 hours.

Even when he returns to his QAS role in April, Allan will spend most of his days off at the winery until around July.

“During this time we need to do wine maintenance which means going through all the wines and tasting and smelling them to see how they are developing and to make sure the wine is free from bacteria.”

“We had 60 bins of grapes needing to be processed. It was bucketing down but we had to get it all done otherwise the grapes would have been ruined through disease,’’ Allan said.

“I looked like a drowned rat by the end of it and I was so exhausted, but thankfully we got the job done.”

Allan joined the QAS in 1991 after completing work experience at Beenleigh Ambulance Station.

He followed in the footsteps of his father Allan, a QATB officer from 1960 to 1971 on the Gold Coast. Like many others, Allan said he initially wanted to become an ambulance officer from a desire to help people.

And while it may seem his two jobs are poles apart, Allan said there are similarities, including having to work at times in ‘trying’ weather conditions.

This was never more evident than when Cyclone Debbie unleashed her fury on Queensland in 2017.

When Allan finishes the production process at the winery, he is expecting to receive some bemused reactions when he comes across members of the public on the Coast. “My hands generally get stained from handling the dark grapes and it can take a while for the marks to fade, so I tend to get some puzzled looks …”

All photos: Jo Hales

“When we have different white grape varieties come in on the same day we can’t process them all at once, we must wait for the press cycle, which takes about 90 minutes, before we can process the next variety,” he said.

“As a paramedic, there are times when you respond to jobs, such as road traffic crashes where it is raining, and you get soaked — it is no different at the winery, if it is pouring outside you still need to work outdoors to get the job done.”

Autumn 2019

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When a person dies Grief and bereavement are natural and normal responses to the experience of loss, writes Priority One Staff Counsellor Terri-ann Spence. Losses can take many forms, the most powerful and deeply felt loss experience being that of the death of a loved one.

Above

■ Priority One Staff Counsellor Terri-ann Spence.

The nature of grief

What helps

We experience a devastating disruption to our sense of who we are in the world and question how we will now continue our life without this person, with whom we are so deeply and emotionally connected.

We cannot bring the person back, but we can be comforted, and over time reorientate life.

What is a distressing, confusing time can be made more overwhelming when the death is that of a child or younger person, is unexpected, traumatic, or involves multiple, simultaneous or recent deaths.

Ways of expressing grief

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The grieving process may initially involve disbelief, followed by wishing the person to still be alive and playing over the ‘what ifs’ in one’s mind. The loss of someone who we love invokes a process of fluctuating and overlapping experiences of shock, longing, disorientation, and reorganisation of our thoughts and reorientation to life.

This process varies in length of time, from person to person and within different contexts of loss, as we strive and struggle to adjust to life without the physical presence of our loved one. This fluctuation involves oscillating between focusing on the loss, sadness, distress and reflecting on the person who died, and reorientating to the practicalities of daily life, work, home, and social pursuits.

During grief, particularly early on, we can sometimes get fixated on blaming something or someone (including ourselves or the deceased person) for the death, and have strong feelings of anger, guilt and regret.

These powerful feelings can be about trying to make sense of what has happened and may also be an attempt to not feel the deep, painful sadness of the loss that seems too difficult to bear.

Autumn 2019

What helps is different for everyone. Part of what happens is we feel our way through what we need to do, step by step. However, there are processes that are more commonly helpful: • Natural reaching-out to friends and family for support can provide comfort and a semblance of normality. Practical support like help with shopping, meals and everyday tasks can really assist to get through the foggy days, weeks and months.

• We may not have any choice in experiencing a loss, but we can choose what tasks we do and pathways to take during the active grieving process of bereavement. We make meaning of our suffering by participating in our own healing.

This can happen by reflecting on and talking about our loved one who died, what they were like, our relationship with them, the moments of their death, and by deciding how we will now honour them and have a continued connection to them.

• Two common ways of expressing grief are intuitively (feeling) and instrumentally (doing). Intuitive grievers experience grief as strong emotional reactions and their expression of grief reflects that. If they are sad, they cry; if they are angry, they look and sound angry. What helps intuitive grievers is to be able to express and explore these strong emotions. Instrumental grievers, on the other hand, experience grief in a cognitive and physical way.

Priority One

They may think about the person who died in a more factual sense and be pragmatic in getting things done. What helps instrumental grievers is to think about what now needs to be done and to get on with doing it. Most people will experience grief in a combination of feeling and doing ways but will often have a preference for one or the other.

• Be with your emotions. Powerful emotions are often difficult to be with.

Emotions are not only symptoms of grief but have the very important function of informing us of the state and process of our meaning-making.

Emotions are a part of helping us to transition through the destabilising implications of the loss on our current and future life.

Continuing bonds One very important aspect of grieving is the transformation of our relationship with the deceased. Relationships do not end with death; they continue in a different but meaningful and enduring way.

A healthy continued connection to the person who died develops slowly over time and can happen in many different ways.

This may include the creation of rituals, remembering birthdays and anniversaries, wondering what they would say or advise, speaking to them, creating art, having mementos, and through our dreams.

Additional support There are times when, even though your pain and grief are normal, it may be helpful to reach out for some extra support. This could be with a support group, minister or chaplain, GP, counsellor or psychologist, or other mental health professional.

The reasons why and decision to reach out for additional support lies with each individual person who is grieving. Professional support can be vital if you are experiencing:

Where do I find help?

24-hour telephone counselling  1800 805 980

• substantial guilt • suicidal thoughts

QAS Priority One Manager  0419 707 397

• extreme hopelessness

• depression lasting many months

QAS Staff Counsellors  0408 191 215 or 0417 079 679 or 0409 056 983

• persistent impairment in everyday living tasks

QAS Priority One State Office  3635 3333

• uncontrolled anger

LGBTIQ+ support service  3830 5888

• prolonged agitation

• persistent numbness … or if find you are drinking alcohol heavily or taking drugs to cope.

There is often a humbling paradox in bereavement. In our grief we can feel overwhelmed in our suffering and vulnerability and yet grief can also be, over time, a powerful and healing process that often leads us to a deeper sense of our values, strengths, compassion and humanity.

Chaplaincy service  3835 9923 Local Priority One Peer Support Officers or Counsellors  See list in each QAS Station or on QASPortal

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Photo: Adobe Stock / Sergei Dvornikov

Giving support If you are supporting someone through bereavement, it is important to know that there is no ‘perfectly getting it right’.

There is only being there in the moment, as your authentic self, willing to hear their story and share their suffering. Allow compassion to lead you through the process of ‘being with’.

When offering instrumental support, be specific about how you can help as people who are grieving may find it impossible to know what to ask for.

It is unhelpful to give advice, offer platitudes like ‘time will heal’ or make judgements about their personal way of grieving.

Autumn 2019

Luftrettung

hubschrauber

Gold Coast LASN CCP Jan Muhlenberg writes about a recent trip to Germany in which he had an opportunity to spend a couple of days with one of the country’s Helicopter Emergency Medical System (HEMS) teams based in Hamburg. Despite treating just two patients, Jan reports the overall experience was fantastic and gave him an insight into what working in an Anglo-German-style EMS system is like.

Hamburg is located in Northwest Germany, with a population of around 1.8 million and a reputation as a party city. It has a large fleet of EMS providers that are dispatched from one central communications centre.

The providers include the city’s fire department, a couple of Non-Government Organisations (NGOs), as well as the military, which in the case of Hamburg also provides the HEMS service.

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Being a physician-based system, most cases that require any pharmacological or procedural intervention will have a physician attached to them. This means that during a normal day around 18 doctors are available to respond via sedan, on a truck and also via helicopter. In most cases they are working with a ‘Notfallsanitaeter’ — equivalent to our paramedic in their level of training but not authorised to treat independently due to local rules and regulations.

On my first night in the city, I attended their clinical update night, usually held every three months. I learnt the city has one of the highest rates of traumatic injuries in the country, well above the national average, with many instances of penetrating trauma.

Our LARU and BRT responses were concepts which met with particular interest, as of course was HARU and the current trials underway.

■ Dawn breaks over Hamburg as ‘Christoph 29’ ascends above the sprawling City-State flanking the banks of the Elbe River.

Background

■ The ‘Luftrettung hubschrauber’ (Air Rescue helicopter) Eurocopter EC135 T2+ [msn 0648] D-HZSP is operated by the Federal Ministry of the Interior, and is seen here in a typically German suburban setting.

Radio callsigns of Luftrettung helicopters throughout Germany are prefixed ‘Christoph’ in the same way we use ‘Rescue’ identifiers.

The reason is the risk of acidosis with large volume replacement and saline’s non-balanced profile, thought to worsen the condition of many critically-ill patients.

The coverage is provided by a combination of private and government providers. The most common aeromedical platform is the EC135, flying with a crew comprising pilot, doctor and paramedic/HEMS crew member.

My first day at the HEMS base began early. I had been requested to give a small presentation to the local EMS and hospital staff about the QAS and how we do business.

Facing some similar challenges with regard to workload and case types as we do in southeast Queensland, the group was very keen to hear how things are done ‘Down Under’.

There are no specific clinical indications for the dispatch of the helicopter, other than where it is anticipated or requested that a doctor should attend, and the helicopter is considered closest.

This means the machine will frequently fly four to six responses per day, with the aim of being airborne within 90 seconds from receipt of the case.

Photos: Jan Muhlenberg unless otherwise noted

Listening to the presenter run through a couple of case reviews, I found many parallels to the care patients would have experienced in Queensland, but there was also one notable difference — the complete absence of Normal Saline 0.9% crystalloid for use as volume replacement. Instead, local treatment guidelines recommend use of Ringers Acetate in cases where we would use saline.

In discussion with the other attendees, I was given a long list of reasons why saline has long been superseded and is not found in any local resus rooms.

Autumn 2019

When the sun began to rise and shift change was complete, I was taken over to be inducted to the helicopter, call sign ‘Christoph 29’. Part of the briefing process was to provide me with a quick overview of the crew configuration, tasking process and type of cases likely to respond to, all of which differs significantly from aeromedical responses in Queensland. To my amazement, almost the entire country has HEMS coverage.

Time flies for Jan with German HEMS

Following a quick assessment of the patient, it appeared she may have experienced a neurological event leaving her with a decreased GCS, however, she was maintaining her airway and her vitals were stable.

Although the doctor briefly considered intubating the patient, he opted to transport instead with the ground crew, as is usually the case. The rest of the case passed uneventful and we reunited at the hospital and returned to base.

■ ‘Amazing’ HEMS coverage of Germany, by the federal government (magenta), ADAC (yellow) and the non-profit DRF (cyan), each circle an operational radius of 50-70 kilometres within which aeromedical response can often be faster than by road.

Map: ADAC (German Automobile Association)

It is possible to do this, for no flight plan has to be filed as long as the helicopter remains below 500 feet AGL (above ground), which can make for some pretty spectacular flying — navigating around power lines and wind turbines. Logistics are well organised: the response is integrated with a police response that meets the crew on landing and takes the team to the case address if required.

Response times are often no more than five to 10 minutes and landing can be literally anywhere such as on top of a shopping centre carpark, in a local school ground or a paddock.

After a couple of cancelled cases, we were tasked to an unconscious female, possibly a cardiac arrest. As the address given was on the outskirts of the city, a quick paddock landing around the corner of the house had us arrive at the same time as the road crew.

A couple more turnouts with mid-flight cancellations then occurred. In between cases, I was able to check out some of the impressive equipment that was available on most vehicles, including the different ventilators (usually Hamilton T1 or Oxylog 3000) and also the LUCAS2 cardiac compression device.

Apparently, this has had a huge impact on the cardiac arrest management and outcomes, with management now focusing on transporting directly to PCI capable facility as soon as the LUCAS2 has been applied and the airway has been secured.

Defibrillation and drug protocols are unchanged and continue en route to the hospital. With multiple PCI capable facilities within a very short radius, transport is usually less than 15 minutes and the patient is taken directly to the cath lab and extracorporeal membrane oxygenation (ECMO) is applied if required.

Should the patient later require transfer, the service also boasts a purpose-built ICU transfer vehicle that has an unbelievable set up, with three different ventilators, multiple infusion pumps, fully-stocked drug cupboard and dedicated space for an ECMO machine.

An hour into my second day we were tasked to assist a crew attending an 80-year-old patient who had been found on the floor with a suspected hip dislocation.

No different to here, it appears patients requiring lifting are usually located on an upper floor and in confined space.

A crew was already on scene and had requested the doctor to assist with analgesia. The drug of choice was ‘Ketanest’ and a small dose of midazolam, which seemed to work wonders for the patient. Wondering if this was simply the local version of Ketamine, I found out that it is in fact an isomer (a molecular mirror image) of ketamine with twice the potency and less associated psychiatric/ hallucinogenic episodes.

■ Jan has one last photo with the crew before heading off, with the special moment giving him a chance to express his gratitude for the opportunity to spend time with the Hamburg-based HEMS team.

After a quick bit of research, I found out that unfortunately ketanest is available only in Europe, so any thoughts of preparing a pitch to introduce to our practice quickly evaporated.

A few more cancelled cases and some quiet hours at the base saw my time with Hamburg HEMS quickly come to an end.

Although I didn’t quite get to see the team in action with any real challenging cases, it was still a great experience seeing another EMS at work with their own tips and tricks.

Autumn 2019

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Flu season 2019 With the late influenza A season in 2018 continuing throughout the summer of 2018–19, Clinical Nurse Consultant Infection Prevention Leah Mason says it is timely to revise what can be done to prevent the flu.

When and where will the QAS 2019 staff flu vaccines be available?

How to protect yourself, your patients and your family from the flu:

From late April 2019 at the following locations:

y Wear a mask and eye protection (standard plus droplet

precautions) when transferring patients with

respiratory symptoms.

» QAS Nurse Immuniser Flu Vax Expansion Program The pilot project in southeast Queensland LASNs was highly successful in 2018. This program will be expanded in 2019 with QAS nurse immunisers providing free flu vaccines whilst working out of SEQ, Cairns, Central QLD, Darling Downs, Mackay and Townsville LASNs.

» HHS Vaccination clinics

y Keep up five moments hand hygiene (use friction

when washing/rubbing hands). y During flu season regularly clinelle common areas

of the station — ensure tissues and cutan are available

and bins are emptied regularly. y Apply cough etiquette by turning away

and always sneeze into the crook of your arm. y Get your annual flu vax.

» Medimobile Flu vax clinic Medimobile will be available in selected locations again this year. Obtaining a flu vaccine through the clinics is free but appointments must be pre-booked.

y Do not come to work sick — stay home until well

(seek early GP review and request testing).

» Guild Pharmacies QAS staff may present to Guild pharmacies for a free flu shot. There is no out of pocket cost with the QAS being directly billed for this service.

» Preferred personal GP or non-Guild pharmacy The option to visit your preferred GP or non-Guild pharmacist for a flu vaccine and be reimbursed

by QAS.

Further information www.health.qld.gov.au/news-alerts/news/flu-vaccine www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/influenza

Autumn 2019

Photo: Adobe Stock / vectorfusionart

34

Paramedics can obtain a free flu vaccine at most HHS hospital staff flu vax clinics that may be operating through the staff health clinic or roving outreach flu vaccine stations.

y Clinelle highly touched surfaces in vehicles and patient

equipment before the first transport, in between cases

and after concluding the last transport.

High Acuity Response Unit Report

CASE Intracardiac arrest fibrinolysis A 60-year-old male requested an ambulance following the onset of acute chest pain and diaphoresis. An ACP crew attended, requesting early back-up from a CCP as the patient was suffering an acute inferior STEMI. Shortly after arrival of the CCP, the patient suffered a VF arrest. Immediate BLS and ACLS was commenced.

After 10 minutes the patient remained in VF despite being treated with an LMA, high-quality cardiac compressions, sequential defibrillation in addition to intravenous adrenaline and amiodarone.

Given the patient had a proven STEMI and was now refractory to standard cares, the CCP called the on-call QAS specialist emergency physician via the 24/7 Clinical Consultation Line. The request was for consideration of intra-cardiac arrest fibrinolysis.

The patient was approximately 15 minutes from a pPCI hospital, and at least 45 minutes from an offending culprit lesion being treated by pPCI. On this basis, the QAS on-call doctor approved TNK and heparin. At that point the cardiac rhythm had degenerated to a narrow complex bradycardic rhythm unresponsive to adrenaline. TNK and heparin were rapidly administered.

Approximately three minutes later the patient reverted to sinus tachycardia with cardiac output and began to breathe up. HARU arrived a short time later and a rapid sequence induction was performed without complication. The patient was then transported to the pPCI centre.

QAS Medical Director Dr Stephen Rashford

Following a brief assessment in the emergency department, the patient was transferred to the cardiac catheter laboratory. A significant stenosis was present in the right coronary artery. It appeared the artery had been re-opened during the resuscitation, resulting in ROSC. A cardiac stent was inserted. The patient made an excellent recovery and was discharged approximately one week after admission.

1. Cardiac arrest management algorithms are designed for broad cohorts of patients.

There is room for nuanced care, but it must be carefully assessed prior to institution.

AUDIT learnings

2. There is no role for routine intra-arrest thrombolysis. The studies have not supported this approach.

3. Fibrinolysis may be considered in patients where a STEMI has been diagnosed and the patient suffers a cardiac arrest that is refractory to standard management. The request to the consult line should occur no later than 10 minutes after the cardiac arrest starts.

4. The use of TNK in this scenario is off standard indications and can only be approved by the QAS on-call specialist emergency physician. This use is approved infrequently. Every administration is thoroughly audited, with the indications for use assessed in detail.

5.

The QAS is currently reviewing all aspects of cardiac arrest management, including our role in the identification of patients who may potentially benefit from direct transfer to the cardiac catheter laboratory in cardiac arrest or the institution of emergency department Extra Corporeal Membrane Oxygenation (ECMO). Amongst this cohort, a small number of patients will still potentially benefit from field fibrinolysis during cardiac arrest. The selective deployment of cardiac compression devices will be required.

6. The QAS has also thrombolysed a number of patients during cardiac arrest due to high risk for pulmonary embolism who have survived (diagnosis proven). The same approach to nuanced care applies, with early consultation with the on-call QAS specialist emergency physician.

Autumn 2019

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Grateful teens’ heartfelt reunion A night out for three high school friends drastically changed their lives forever after they were electrocuted on the Gold Coast. Emma O’Connor met with the trio to see how they are recovering as they move forward with their lives and thank the QAS staff who saved them.

Tragedy struck Gold Coast friends Rex, Jake and Sheldon as they were sitting on an overpass near the Pimpama rail corridor.

A powerline arced with 25,000 volts of electricity, entering Rex’s foot, travelling through his body and then arcing across into Jake.

Rex and Jake subsequently caught on fire, resulting in the pair sustaining critical injuries.

36

Sheldon used his bare hands to put out the flames before calling Triple Zero (000) for help. “I had to do whatever I could to keep them alive,” he said.

Jake recalled he couldn’t move his lower body. “It was all on fire,” he said.

Trains were suspended and power was shut down as multiple QAS units rushed to the scene providing lifesaving treatment to Rex and Jake, who were subsequently transported Code 1 in critical conditions to the Royal Brisbane and Women’s Hospital where they were placed in induced comas.

Sheldon was transported stable to Gold Coast University Hospital.

Today, the trio is out of hospital and on the path to recovery, but it will be a long journey both physically and mentally, with Rex and Jake needing to wear pressure garments for 12 months.

“Sheldon definitely saved my life,” Rex added. “If not for him, I’d be dead.

It could have been a whole lot worse; I could have had my whole face burnt.”

Autumn 2019

Part of their rehabilitation saw the trio recently meet the QAS staff who rushed to their aid, including Operations Supervisor Allan Windsor, ACP Belinda Donkers and Emergency Medical Dispatcher Greg Riley.

Belinda remembers the night clearly and treated Rex while en route to the RBWH. “It was good to see them out of hospital and on their way to recovery,” Belinda said.

Rex, Jake and Sheldon are united in their gratitude for the QAS staff who saved their lives and cherished the opportunity to say a heartfelt thank you in person after they feared they would die.

“Just a big thank you,” Rex said.

“Queensland Ambulance did an unbelieve job that night,” Jake echoed.

Photo: Emma O’Connor

The date of 6 September 2018 will forever be etched in the minds of three childhood mates after a Thursday night get-together went horribly wrong.

Local Area Assessment and Referral Unit report

Back pain: low acuity is high risk Back pain is a common complaint, with about one in six Australians — or approximately 3.7 million people — reporting back problems in 2014–15, writes LARU officer Mitch Ridgway.

“It is estimated that 70 to 90 per cent of people will suffer from lower back pain in some form at some point in their lives. Approximately 85 per cent of patients presenting with acute lower back pain will be given the diagnosis of non-specific lower back pain. For the remaining 15 per cent of patients they may present with medical or surgical emergencies requiring immediate intervention to prevent permanent disability or death,” Mitch said.

Mitch’s case A 2A had dropped in on iRoam and was immediately dispatched to an acute crew. The case information indicated a 45-year-old male had bent over to pick up a towel and hurt his back. After a quick evaluation of the case nature, age and close proximity of the patient, it was decided that this job could be suitable for LARU. The dispatcher was notified, and the acute crew was stood down, with the case now reassigned to LARU. While travelling to the job there were a number of factors requiring consideration for a case like this: what day of the week, the time of day (what referral options are available), age, mobility, means of transport, family/friends support, risk factors and co-morbidities.

Back pain is a condition that presents a high risk in itself. It requires an extremely thorough and detailed assessment.

Upon arrival I was met by the patient’s wife who was very apologetic for calling Triple Zero (000). She gave a brief history, stating that the patient was doing laundry at home, had bent over to pick up a towel and ‘twinged’ his back, then an obligatory joke about men and laundry was had. On entering the house, the patient was lying on his back in the bedroom and he confirmed the story already conveyed, stating he had moderate aching pain which slightly increased with movement.

A thorough history and physical exam was conducted on the patient and nil concerning clinical signs, risk factors or red flags were identified. While the patient was lying supine, a full set of vital signs including 12-lead ECG, temperature and BSL was conducted, all without abnormal findings. The patient was then assessed in a prone position with nil abnormalities on inspection or palpation.

A full systems review was conducted; nil abnormality detected. An abdominal exam was performed with no abnormal findings. Nil bowel or bladder dysfunction was noted. Lower extremities neurological exam showed normal tone, strength, gait and sensation and no neurological deficits identified.

The patient had nil past medical history, nil surgical history, nil allergies and nil family history of cancer or CVD. He maintained a healthy and active lifestyle, was a non-smoker, had no history of illicit drug use, nil immunosuppression, nil history of infection or infective symptoms and had been well recently.

Having now completed the history and physical exam with nil red flags or concerning signs or symptoms, a decision was made with patient and family member involvement to consult the patient’s normal treating GP to see if a referral to them was appropriate. Contact was made directly with the patient’s GP and a thorough verbal handover was conducted, after which the GP accepted the referral.

1

There was a vacant appointment and the patient was able to be seen immediately. He was able to independently mobilise without significant distress to the vehicle. Transport was arranged to the GP clinic and the patient was subsequently assessed and managed in a timely manner and received the diagnosis of non-specific lower back pain.

2

■ LARU officer Mitch Ridgway.

Later that day contact was made with both the patient and GP to ensure the correct provisional diagnosis was made and the referral was clinically appropriate.

Both parties were very thankful with the outcome and happy a trip to the hospital was avoided.

A number of medical and surgical emergencies are associated with lower back pain and it is imperative to identify patients at risk and ensure timely assessment, management and transport to a dedicated hospital emergency department which is able to manage spinal cases if required.

3

4Red flags

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• Fever or systemic symptoms • History of cancer • Unexplained weight loss • Severe pain when supine and/or at night • Age <16 or >50 years • History of significant trauma • Vertebral tenderness • Intravenous drug abuse • Recent bacterial infection or fever • Immune suppression (HIV, transplant, corticosteroids) • Saddle anaesthesia • Bladder dysfunction (urinary retention, incontinence or UTI) • Bowel dysfunction (faecal incontinence) • Neurological deficit in either or both lower limbs (especially if progressive) • Persistent symptoms for >4 weeks (recurrent presentations, worsening pain) • Pregnancy • Re-presentation

References Wheeler, L. P., Karran, E. L., & Harvie, D. S. (2018). Low back pain: Can we mitigate the inadvertent psycho-behavioural harms of spinal imaging? Australian journal of general practice, 47(9), 610.

Bardin, L. D., King, P., & Maher, C. G. (2017). Diagnostic triage for low back pain: a practical approach for primary care.

Medical Journal of Australia, 206(6), 268-273. www.aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/clinical-tools/orthopaedic-and-musculoskeletal/ acute-low-back-pain/acute-low-back-pain---assessment

Autumn 2019

Station Profile: Nambour Nestled at the foot of the Blackall Range and home to one of two public hospitals in the Sunshine Coast heartland, the town of Nambour provides a solid base for QAS staff to service the hinterland, writes Matthew Stirling.

The team hailing from Nambour Station plies its trade across a large swathe of the Sunshine Coast, but the majority of responses are to cases anywhere from Maroochydore inland to Yandina and Bli Bli. To the west, the station is encircled by numerous national parks in the rugged terrain of the Blackall Range; a fact that results in some complex retrievals for crews.

Nambour has benefited from a long affinity with ambulance services, after an application was approved by the City Ambulance Transport Brigade (CATB) in 1899 to establish an honorary centre in the town. Having officially opened in 2001, the present station on Rigby Street provides a much more modern platform for the Nambour team to deliver daily operational duties within the community.

Each incident requires a unique extrication strategy, whether managing injuries sustained by rock-climbing and mountain-biking enthusiasts to tourists slipping while hiking or jumping from rocks at popular spots such as Wappa Falls and Kondalilla Falls.

The traffic-crash toll stemming from the Bruce Highway is a daunting prospect for any first responder, and Officer in Charge (OIC) Joy Reitze stated that the station’s proximity to the highway resulted in frequent call-outs to road trauma.

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Equivalently, crews also encounter many mental health episodes due to nearby Nambour Hospital’s role as a primary mental health facility on the Sunshine Coast.

NAMBOUR: FAST FACTS Location

27 Rigby Street, Nambour.

Officially opened on 20 October 2001.

Staff moved to their current home across the Petrie Creek, which splits the town, from the previous station on William Street. In use for 43 years prior to 2001, this building has now been refurbished into a creative centre for the region and is aptly named ‘The Old Ambulance Station’.

Nambour Station is one of 19 permanent stations in the Sunshine Coast LASN which is managed

by Assistant Commissioner Tim Eva.

Three of Nambour’s current long-serving stalwarts were around for the move, with officers Scott Bradford, Tyrone Kleeman and Julie Kleeman having served the local region for more than 20 years.

Complement

Above

LASN: Sunshine Coast

Total 40 permanent staff: • OIC: Joy Reitze • 18 paramedics • 18 PTS Acute • 3 PTO

■ A cheery welcome from some of the Nambour Station crew.

Below

■ Scott Bradford is one of the trio of 20-year Nambour veterans.

Vehicles

12 Vehicles in total: • 3 x Mercedes Sprinter 319 Van Acute / single stretcher • 2 x Mercedes Sprinter 519 Long Wheel Base van Patient Transport Service / dual stretcher • 1 x Mercedes Sprinter 519 Modular Patient Transfer Service / dual stretcher • 2 x Mercedes Sprinter 519 Modular Acute/Patient Transfer Service / dual stretcher • 3 x Mercedes Sprinter 518/519 Modular Inter Facility Transfer / dual stretcher • 1x Hyundai Santa Fe Emergency Response Vehicle

Autumn 2019

Station Profile: Nambour

Nambour LAC Nambour Ambulance Station can attribute part of its efficiency to the Nambour Local Ambulance Committee (LAC), which in early February celebrated its 20-year anniversary in true LAC style by holding CPR awareness sessions, vehicle tours and kid-friendly activities at the Nambour Station.

A genuine sense of community has developed over this time, with Scott organising and conducting CPR awareness and first aid training for residents in his neighbourhood of nearby Montville, Mapleton and surrounds. Married couple Julie and Tyrone both joined the service on the same day over two decades ago, evidenced through their QAS medal numbers ending in 71 and 72 respectively.

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The LAC’s support to its local paramedics includes a staggering $400,000 raised over the life of the committee, utilised by QAS through essential equipment in the form of vehicles, defibrillators and training gear.

In contrast, the station welcomed its newest staff member Francis Witt when she qualified as an Advanced Care Paramedic in late February this year.

Alongside the vital fundraising, the LAC also directly benefits the community through countless hours of education, including first aid, CPR Awareness and teaching primary school children the basics of dialling Triple Zero (000) and explaining an emergency to an EMD.

Top

■ Nambour OIC Joy Reitze reviews essential gear provided by the tireless efforts of the LAC.

Photo: Adobe Stock / Mike

Above

■ LAC stalwarts (L to R) Geoff Brown, Greg Biggs and Gary Langford were acknowledged for their sterling service.

Top right

■ Gary’s daughter Eloise seemed rather bemused by the vintage ambulance on display during the 20-year LAC anniversary events…

Right

■ … but the Arrol Johnston ambulance was a popular attraction for all ages.

Main background

■ View north from Montville towards Nambour.

Autumn 2019

advertorial

Health check for your health insurance So you’ve just been told you’ll be paying more for your health insurance from 1 April and it’s no April Fool’s joke. What can you do about it? Make sure you’re getting the best bang for your buck.

We know that’s easier said than done. Between exclusions, excesses and co-payments on hospital cover, plus benefit limits and sub-limits when it comes to Extras, there’s a lot of complexity to wade through in order to understand just what you’re paying for. The ‘too-hard basket’ is surely full of people’s intentions to reassess their private health insurance.

But there are some real, tangible advantages to reviewing your cover – both financial and medical – and now’s the best time of the year to do it. So let’s get you started.

1. Look beyond the price (for now), focus on the cover.

We’re conditioned to get ‘quotes’ when researching health insurance, but focusing on price gives us just part (if that) of the picture. The real value comes from reviewing benefits alongside the premium price. Focus your research first on understanding what is and isn’t covered, and to what extent.

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2. Do the math If you’re forking out good money every time you visit your dentist or physio, or buy glasses, perhaps your Extras cover isn’t meeting your needs. The amount a health fund product will pay back on Extras services varies dramatically. Have you considered you may be better off paying for higher quality insurance so you spend less at the provider’s counter and are covered for the unforeseen?

3. Don’t get caught out by T&Cs Comparing hospital cover isn’t about predicting what health services you may require, but feeling confident you’ll be covered if and when you need it. The most common causes of dissatisfied consumers are exclusions and restrictions. Keep this top of mind when you’re reviewing your cover. Trust us, it’s better to check off on these now than be hit with more bad news when you’re already faced with a trip to hospital.

4. Pay attention to the ‘other stuff’ It may sound silly, but do you trust that your health insurer will look after you when you need them? Ask yourself: » Are you happy with their customer service? Can you talk to a real person without waiting on hold forever? » Do they have a good reputation? Are current members satisfied or are there a stack of complaints sitting with the ombudsman? » Is it easy to make a claim? » Are you free to visit the provider of your choice? » Are there any benefits that really set them apart? (Do they have a rollover benefit? Is Ambulance cover included?)

5. Take a shortcut Health insurance staff are poised and ready to provide ‘benefit comparisons’ for you. It’s their job, make use of it. Having a real person help you compare covers has a lot of advantages over using comparison websites that often only sort based on price and basic details. So once you’ve narrowed down a list of potential insurers, ask each to do a benefit comparison with the other insurers on your list. Refer to steps 1-4 when you review the information they give you.

Autumn 2019

One to add to your shortlist…

If you’re reading this, chances are you’re eligible to join Emergency Services Health. It’s a restricted access private health insurer, but if you’re part of the Queensland Ambulance Service network then you and your family will meet the eligibility criteria needed to join.

Here’s why that’s such good news; » VALUE FOR MONEY: When you compare apples with apples, Emergency Services Health’s premiums are usually lower than those of other insurers.% » GENEROUS BENEFITS: Emergency Services Health pay 80% of the service fee on most Extras claims.* » NO EXCLUSIONS, EXCESS OR CO-PAYMENTS ON HOSPITAL COVER: Emergency Services Health’s cover is simple, so you won’t get caught out.* » KEEP UNUSED BENEFITS: The funds that are part of the Police Health Group, including Emergency Services Health and Police Health, are the only funds in Australia to provide a Rollover Benefit. This means that for many Extras services, any unused Annual Maximum benefit not claimed during one calendar year can be rolled over to the following year.* » CHOOSE WHO TREATS YOU AND WHERE: Emergency Services Health gives you the freedom to choose your preferred hospital, doctor and any other service provider.^ » 100% AMBULANCE COVER INCLUDED AS STANDARD: for emergency transport, clinically required non-emergency transport and treatment not requiring transport.* » HASSLE-FREE CLAIMING: Emergency Services Health members can easily make claims using a mobile app, or by swiping their membership card at most providers. » NOT-FOR-PROFIT & MEMBERS OWN: Members are the top priority, there’s no shareholders or overseas owners. % Contact us and we’ll help you do a benefit comparison. * Waiting periods and other conditions apply ^ Provided they are recognised by us

For a benefit comparison against your current provider or other insurers you’re considering, give Emergency Services Health a call on 1300 703 703 or email enquiries@eshealth.com.au

Intoducing some new faces

Daniel weathers health challenges It has been a stressful time for popular Townsville EMD Daniel Ryland who was diagnosed with Hodgkin’s Lymphoma on 14 December 2018.

The 27-year-old needed to stop work immediately to focus on his health and prepare for chemotherapy.

Then, just weeks after starting his treatment, Dan and his family were delivered another blow when his mum’s house, where he was staying during treatment, was inundated with water during the Townsville floods. The house was deemed unliveable and needed to be rebuilt.

“I am currently critically neutropenic, so I am extremely susceptible to infection (and with the added risk of melioidosis, I have to take additional precautions to ensure my health and safety).

“This means it is essential I am not around anyone with a cold or flu or those showing signs and symptoms of a cold or flu.”

Thankfully, there has been some silver lining with Dan’s spirts bolstered in mid-February with the ‘incredibly exciting’ news he was in remission.

Despite the positive news to date, Dan still has a tough time ahead over the coming months.

Dan said making his situation more bearable has been the love and support from his QAS colleagues.

Work mates wasted no time rallying around Dan when he was diagnosed, holding raffles and fundraising activities to raise funds to help alleviate some of the financial pressures he may face.

A highlight of the initiatives was a shave-off which resulted in multiple colleagues, including Dan’s OCM Lara Jedyn, losing their locks.

Thanks to the generosity of people, more than $5000 was raised in cash donations and fundraising activities, including meat tray raffles and sausage sizzles, and over $8000 was pledged on Dan’s Go Fund Me page.

The funds will enable Dan to cover his costs while he is not working and allow him to focus on his health and recovery.

Dan said he has been incredibly humbled by the outpouring of love and support for him.

“I would like to thank everyone for their ongoing support through this horrible time,” he said.

For updates on Dan’s progress, visit www.gofundme.com/fundraising-for-daniel-ryland

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HARU adds to the team A warm welcome to Emergency Physicians Dr Andrew Davidson and Dr Sarah Collins, who commenced with the High Acuity Response Unit based at Kedron Headquarters in February.

They have been working with both HARU and CCP officers to provide high level pre-hospital interventions to the most critically ill and injured patients in Southeast Queensland.

Both Andrew and Sarah will also undertake regular shifts with LARU officers and participate in initiatives and professional development programs within the Operations Centres.

Andrew, who hails from the Royal Brisbane and Women’s Hospital and Sarah, from the Princess Alexandra Hospital, have broad experience in adult and paediatric emergency medicine, critical care and pre-hospital and retrieval medicine.

Autumn 2019

Happenings Chinchilla Melon Festival Our paramedics were on hand to help keep everyone safe at the Chinchilla Melon Festival in February. The much-anticipated event included a record- breaking giant watermelon at 100.5 kg!

Chinchilla, known as the Melon Capital of Australia, sees its population triple in size for the event which is held biennally.

John Austin and his wife Gay were delighted with the opportunity to meet the QAS officers who assisted him when he suffered an unexpected near-fatal heart attack.

Abseiling feat Metro North ACP Rhys Greedy had no qualms abseiling down between two buildings at a construction site in Fortitude Valley on 28 February to assess a patient who had fallen approximately eight metres into a narrow void space.

60-year-old John was moving furniture with his brother at their mother’s house when he started experiencing chest pain. John’s brother called Triple Zero (000) and EMD Siobhan Moore quickly sent paramedics Hamed Moqaddasi, Kelsey Williams and CCP Josh Kearney to help John.

The patient was subsequently transported stable to Royal Brisbane and Women’s Hospital.

The father-of-three was transported to Rockhampton Hospital and then onto Brisbane later that day.

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Welcomes to the world Paramedics Ashlea Shelly, James Laing and their student Olivia were more than happy to assist in the delivery of one of 2019’s newest Queenslanders – baby Arlo (left) on 2 January.

Meanwhile, EMD Corinne McCall couldn’t resist a cuddle when she met this cute, little bundle of joy named Benaiah at a Sunshine Coast reunite on 1 February.

Corinne guided Beniaiah’s parents Jonathan and Alexandra through the speedy delivery of their son at the family’s Buderim home in late January.

Autumn 2019

HAPPENINGS • Autumn 2019

Helicopter transport Mareeba paramedic Matthew Ewing captured the moment the Queensland Government Air Cairns 510 Rescue team prepared to land on a small stretch of road in Southedge to collect one of two motorcyclists the QAS had treated following a crash.

QGAIR Cairns subsequently airlifted the patient to Cairns Hospital, while the other patient was transported by road to Mareeba Hospital.

International Women’s Day In March, QAS staff from around the state took part in events to mark International Women’s Day. Staff at Rockhampton Ambulance Station celebrated the occasion with a much-anticipated morning tea, and their Wide Bay colleagues were also among many across the state demonstrating their support.

Samford First Responders farewell In February, the QAS farewelled two pillars of the Samford community: first responders Shane O’Mara and Steve Parry.

The pair has almost 20 years of combined service, with Shane volunteering two years of his time to the community and Steve dedicating no less than 17 years of service.

Thank you, Shane and Steve, for your selfless contributions to the Samford community and to the QAS.

Warwick Emergency Services Day Acting Officer in Charge Jamie Taylor and his team went the extra mile to ensure the Warwick Emergency Services Day in February was a resounding success.

The event attracted many people, with the Warwick Ambulance Station officers helping enthusiastic members of the community to learn lifesaving CPR skills and become familiar with all things ambulance.

Autumn 2019

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Appointments

Farewells

Movers and Shakers

44

Years of Service

NAME

Position Title

Edward (Ted) Hayton

Patient Transport Officer

41

Gold Coast LASN

Stephen Burns

Senior Operations Supervisor

39

Gold Coast LASN

David Dennett

Patient Transport Officer

36

Metro South LASN

Kenneth Casey

Patient Transport Officer

35

Metro South LASN

Colin Romeo

Patient Transport Officer

33

Gold Coast LASN

Clive Moore

Paramedic

32

Cairns & Hinterland LASN

Timothy Mellor

Paramedic

30

Metro North LASN

Kathryn McIver

Professional Development Officer

21

State Operations Centre Toowoomba

NAME

Position Title

Notes

Mary-Anne Head

Officer in Charge

Appointments made during the period from 1 October 2018 to 28 January 2019.

Mchael Atkinson

Program/Project Manager

22-Oct-18

Head Office Kedron

Karen Spiteri

Senior HR Consultant

1-Nov-18

Head Office Kedron

Nicholas Groves

Clinical Support Officer

5-Nov-18

QAS Spring Hill

Craig Sankey

Clinical Support Officer

19-Nov-18

Gold Coast LASN Clinical Education Unit

Paul Boyd

Operations Supervisor

29-Nov-18

Caloundra Ambulance Station

Claire Minett

Senior Human Resources Consultant

3-Dec-18

Head Office Kedron

Annika Smith

Snr Employee Relations Advisor

3-Dec-18

Head Office Kedron

Marco Polino

Officer in Charge

3-Dec-18

Cleveland Ambulance Station

James Andrews

Senior Operations Supervisor

3-Dec-18

Cairns and Hinterland LASN Headquarters

Benjamin Phipps

Officer in Charge

5-Dec-18

Cooroy Ambulance Station

Jason Kluver

Exec Manager Metrics and Reporting

7-Dec-18

Head Office Kedron

Kylie Babarovich

Exec Manager Recruit & HR Adm

7-Dec-18

Head Office Kedron

James Forman

Officer in Charge

10-Dec-18

Cairns Ambulance Station

Patrick Lasalo

Officer in Charge

10-Dec-18

Yarrabah Ambulance Station

Daniel Perrin

Info & Comm Tech Officer

17-Dec-18

Cairns Ambulance Station

Jon Day

Operations Coordinator

17-Dec-18

Head Office Kedron

Mistey Curran

Clinical Support Officer

17-Dec-18

Darling Downs LASN Headquarters

Penney Lang

Officer in Charge

17-Dec-18

Stanthorpe Ambulance Station

Tom Kelsey

Clinical Support Officer

19-Dec-18

QAS Spring Hill

Paige Harris

Officer in Charge

23-Dec-18

Mount Isa Ambulance Station

Kevin Morgan

Senior Operations Supervisor

24-Dec-18

West Moreton LASN Headquarters

Nathan Gemmell

Officer in Charge

24-Dec-18

Springwood Ambulance Station

Anna Colquhoun

Officer in Charge

31-Dec-18

Maryborough Ambulance Station

Shayne Goodwin

Clinical Deployment Supervisor

7-Jan-19

Brisbane

David Martin

Clinical Deployment Supervisor

7-Jan-19

Southport

Simon McInnes

Clinical Deployment Supervisor

7-Jan-19

Brisbane

Daniel Nicoll

Clinical Deployment Supervisor

7-Jan-19

Brisbane

Nathan Pattle

Clinical Deployment Supervisor

7-Jan-19

Brisbane

Paul Vennells

Clinical Deployment Supervisor

7-Jan-19

Brisbane

Kaylee Woodbine

Clinical Deployment Supervisor

7-Jan-19

Southport

Bradley Bischoff

Clinical Deployment Supervisor

7-Jan-19

Maroochydore Ambulance Station

Lucille Farrant

Clinical Deployment Supervisor

7-Jan-19

Maroochydore Ambulance Station

James Mayfield

Clinical Deployment Supervisor

7-Jan-19

Maroochydore Ambulance Station

Lee Walsh

Clinical Deployment Supervisor

7-Jan-19

Maroochydore Ambulance Station

Peter Caffery

Clinical Deployment Supervisor

7-Jan-19

Southport Ambulance Station

Michael Freeman

Clinical Deployment Supervisor

7-Jan-19

Southport Ambulance Station

Philip Gadd

Clinical Deployment Supervisor

7-Jan-19

Southport Ambulance Station

Craig Warner

Clinical Deployment Supervisor

7-Jan-19

Southport Ambulance Station

Russell Larkin

Officer in Charge

9-Jan-19

Charleville Ambulance Station

Sati Aslan

Prin Town Plan & Property Off

14-Jan-19

Head Office Kedron

Ingrid Wulff

Clinical Deployment Supervisor

14-Jan-19

Brisbane

Zaheer Suleman

Clinical Deployment Supervisor

14-Jan-19

Southport Ambulance Station

Gavin Becker

Clinical Support Officer

14-Jan-19

Bundaberg Ambulance Station

Kate Rowan

Manager Frontline Srvs-Comms

21-Jan-19

Head Office Kedron

Patrick Lafferty

Clinical Deployment Supervisor

21-Jan-19

Brisbane

Jodie Rogers

Officer in Charge

21-Jan-19

Birtinya Ambulance Station

James Thompson

Operations Supervisor

21-Jan-19

QAS Spring Hill

Carolyn Emerson

Officer in Charge

28-Jan-19

Pinjarra Hills Ambulance Station

Matthew Steer

Officer in Charge

28-Jan-19

Bundaberg Helicopter

Helen Donaldson

Officer in Charge

28-Jan-19

Buderim Ambulance Station

Robert Stark

Clinical Support Officer

28-Jan-19

Darling Downs LASN Headquarters

Notes Reflects activities during the period from 24 November 2018 to 28 February 2019.

Autumn 2019

Appointed date 1-Oct-18

Division / Location

Location Gold Coast LASN Headquarters

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Below

■ QAS officer Michael Fisher and Corporal Sarah-Jane Seaton from the 1st Close Health Battalion conducting welfare patrols during the floods.

■ Sergeant James Gummow accepts a plaque as a token of gratitude and appreciation for the ADF’s assistance in helping QAS staff reach flood-affected communities in north Queensland. Also pictured are QAS Acting Assistant Commissioner for Townsville Amanda Harper, Scott Stewart MP, Member for Townsville (left) and Aaron Harper MP, Member for Thuringowa.

Photo: Department of Defence, Private Brodie Cross

Photo: QAS, Emma O’Connor

3014QAS_MDC

Above