User:Sunray Major/EMS Australia

==

Emergency Medical Services in Australia

== Australia has some unique characteristics that make the provision of emergency services problematic. Firstly, the area of Australia is the size of mainland U.S.A. or most of Europe but with the total population of perhaps two majory U.S. or European cities. Secondly, Australia is a first world country and thus the expectation is that Australians will receive emergency care equal to any other first world country.

State Services=

Queensland

The statatory EMS provider is the Queensland Ambulance Service (QAS). It was formally constituted in 19993 to become an autonomous division of the Department of Emergency Services (DES). DES also oversees the Queensland Fire and Rescue Service (QFRS), the Rural Fire Brigade and the State Emergency Service. The latter two organisations are volunteer units.

During combined services operations (e.g. motor vehicle accidents), the Queensland Police Service provide command and control, the QFRS conduct actual rescue operations and the QAS provide medical care. The only exception to this is helicopter "dustoffs" (medical evacuations). In this case, the QAS have specialist crews and paramedics.

The QAS provides the service in the majority of towns that have an ambulance presence. The smallest stations may consist of a single officer. Most stations will have a few "volunteer officers" who work alongside permanent officers.

Other small towns may have one of two options - Hospital based transport. Most communities in Cape York have a Queensland Health clinic with a basic Toyota "troop carrier" ambulance consisting of a single stretcher, oxygen and first aid equipment. The crew consists of one or two Registered Nurses from the local clinic and an indigenous driver. The nursing staff usually stabilise the casualty and evacate them by RFDS if necessary.

Combined QAS/QH Arrangements Some QH hospitals and clinics double as QAS stations. The QAS supplied and maintained vehicles and trained community volunteers as drivers. The Director of Nursing of the clinic is also the QAS Office in Charge. If the driver is called in, Queensland Health pay them as casaul staff.

Changes to the law in the late 1990's made it possible for other organisations to provide "patient transport services" (transporting patients between hospitals or clinics). Red Cross provides this service.

Western Australia

St John Ambulance is the statutory ambulance service in Western Australia. WA is a huge, sparely populated stated. In effect, there is a heavily populated around the Perth-Albury region and there is the rest of WA. The division of the ambulance service reflects this. In the populated area, the ambulance service is staffed by permanent paramedics while the country service is staffed by volunteer officers supported by small number of permanent officers.

Training Structure

In Australia, all vocational training qualifications must be registered through each states Training Recognition Council. Initially this meant that each state ambulance authorit had its own set of qualifications. Movement between states was difficult as the qualifications seldom aligned. There were anecdotal reports of officers having to retrain from scratch in order to gain employment in a different state. However, the Federal Goverment vocational training agenda called for the establishment of "national training packages" which while allowing for flexibility, called for nationally consistant qualificatons. Eventually the Health Training Package included a raft of Ambulance training qualifications in paramedical studies, communications and management.

Today, while, titles may vary from service to service, the qualifications are basically the same.

Patient Transport Officers

Most states and territories have PTO. These officers possess a Certificate III in Patient Transort. Their role is to drive clinic vehicles that transport stable patients from home to hospital or clinics and back.

Ambulance Attendants

In Northern Territory, Queensland, South Australia, Tasmania and Western Australia, the ambulance attendent is usually a volunteer officer and has completed a Certificate IV in Basic Emergency Care. A holder of a Certificate IV level qualifications may provide supervision and may work independently but works under the direction of a profession. Enrolled Nurses/Licenced Practice Nurses would be an equivilent.

Paramedics

The term Paramedic has replaced the traditional term "ambulance officer". Paramedics possess a three year Diploma of Paramedical Studies.

Advanced Care Paramedics

In Queensland, graduated paramedics complete additional training to become ACP's. ACP are able to administer a greater range of drugs. The position of ACP recognised that in a large state like Queensland, the volumoe of work to maintain compentance in advanced skills was not high enough in rural areas.

Intensive Care Paramedics

Also called Mobile Intensive Care Ambulance (MICA Paramedics), ICP respond to any case requiring advanced life support intervention. All metropolian, both capital and region, centres have ICP staffed ambulanced on-duty 24 hours a day. ACP wanting to become ICP must apply for a student positon and ungoing a further 12 months training in order to qualify.

This standardisation of Australian qualifications is now resulting Australian trained paramedics working at level overseas and vice verse.

University Qualification

A number of Australian universities are now offering 3 year full time degrees (Bachelors) as the pre-employment qualifications for future paramedics. The same universities already offer Diploma conversion degree courses, and postgraduate paramedica qualifications from certificate to Masters.

A Future Contraversy?

At present all states are still providing the 3 year apprenticeship style diploma course but both Queensland and Victoria are talking about eventually phasing out the paid student position in favour of university training.

This may prove contraversial as students provide the back bone of ambulance staffing. However the nursing profession successfully made the transition from hospital based to university based education in the 1980 so it would be reasonable to expect the ambulance service to do like wise.

Currently