Summer 2015–16
Paramedic assaults | Indigenous cadets Schoolies 2015 | Coping with PTSD
Ministerial message With the end of the year upon us, there is no better time to take stock of some of the fantastic achievements of the Queensland Ambulance Service over the past 12 months. It is a badge of pride to wear the title of Minister for Ambulance Services. That is in no small part because I know I represent an ambulance service that is the envy of all other states. Queensland Ambulance Service staff deserve the best, and through the government’s strong investment in frontline health services, we intend to deliver. The Queensland Government injected an extra $44 million into the Queensland Ambulance Service this year, making this year’s budget a record one for the QAS. We committed to funding 155 new and replacement ambulance vehicles this financial year, and I am pleased to say almost 60 of those vehicles are now on our roads serving Queensland communities. We also promised almost $10 million to recruit an extra 75 positions to meet increasing demand for ambulance services and improve supervision and wellbeing of staff. Of these positions, a Metro North High Acuity Response Unit (HARU), a Cairns Low Acuity Response Unit (LARU) and an additional senior operations supervisor for West Moreton are now in place. More positions and units are being finalised. Another HARU has also come online at the Gold Coast. Further expansion of the LARU model is also in the pipeline to help keep our hospital emergency departments moving with patients who need to be there. Plans are also progressing for new ambulance stations at Kenilworth and at Bundaberg. But above all, the QAS is about people – those who it serves and those who serve.
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The QAS response to the event that occurred in Ravenshoe in June 2015 was outstanding. Local Advanced Care Paramedic Darrell Thompson has rightly been recognised for his leadership. On the Gold Coast, Critical Care Paramedic Jaye Newton recently helped save the lives of three children in one day, demonstrating what dedicated paramedics do each and every day. QAS and its local ambulance committees provide the community with the capability and confidence to respond to sudden cardiac arrest through the CPR Awareness Program, which has already trained more than 17,000 people to help save lives. Reintroduction of the patient flow directive this year will also help free up QAS personnel and vehicles to respond faster to more people who need them. To help protect QAS personnel, I have established a taskforce specifically to address the issue of violence against paramedics, which will not be tolerated. I expect this taskforce to report in the first half of 2016. I sincerely thank you all for your dedicated service and for everything you have done and continue to do for Queenslanders as the quiet heroes on health’s frontline. I wish you and your families happiness and peace at Christmas.
Hon Cameron Dick MP Minister for Health Minister for Ambulance Services
From the Commissioner QAS Insight is a new magazine dedicated to showcasing the amazing work undertaken by QAS staff and volunteers across Queensland. A product of our Media and Communications team, QAS Insight will be published as a quarterly PDF flip book, accessible on your desktop and mobile devices. In early 2016 QAS Insight will launch its own dedicated website, allowing a media rich platform for telling and sharing the QAS story. At the centre of this story is you, the staff and volunteers of the Queensland Ambulance Service – your engagement is critical to the success of this organisation. Staff engagement can be seen in workplace culture and the way people think and behave at work. Staff behaviour and workplace culture have been top of mind throughout 2015 and while QAS is generally a good and positive place to work, there are always cultural improvements we can continue to make. One of the ways we measure this is through the Working for Queensland Employee Opinion Survey — an annual, whole-of-government survey used to collect information about workplaces. QAS had a large number of staff participate in the 2015 survey — 40 per cent (or 1,698) of all staff. I’m pleased to report significant improvements to our workplace climate since the 2014 survey: 18 of the 19 sub-categories showed improvement; no category declined. Importantly, this achievement is on the back of a similar result in 2014 which shows whilst we have room for improvement, you’re telling us we are on the right track with improvements recorded year on year. However, survey results like this are meaningless unless we take the opportunity to seek feedback from you in identifying actions we should take to improve in the areas we believe are necessary to strengthen our organisation.
An example of this is the campaign we commenced in May to raise awareness in QAS about sexual harassment and workplace discrimination. The campaign focused on educating and building the capability of our staff to be able to understand and appropriately deal with these unwanted issues at work. This campaign dovetailed into a broader conversation, shifting our focus to build positive workplace cultures with a new campaign, ‘Our Workplace, Our Culture – It’s what you make it’. If we want QAS to be the best we can be, we must define what our culture needs to look like. What are we going to commit to? The objective here is for teams across QAS to come together to define their workplace culture, and the actions and behaviours to support it. Critical to this is everyone being involved in the conversation and gaining a shared commitment to the desired culture, behaviours and actions within your local work areas. I’d like to close by thanking you all for the commitment, effort and dedication you have displayed throughout 2015, as well as a merry Christmas to you, your families and friends. Enjoy QAS Insight, enjoy the holiday, stay safe and Happy New Year.
Russell Bowles ASM QAS Commissioner
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This has got to stop In the 2014-15 financial year QAS recorded 247 incidents of occupational violence against our staff, including 170 deliberate physical attacks and 56 verbal assaults. It’s a serious issue that affects all first responders, health workers and emergency services personnel.
It’s an issue that was thrown into sharp, stark focus late in the evening of Friday 11 December when Advanced Care Paramedic Brad Johnson was assaulted while transporting a patient who went from unconscious to highly agitated in a matter of seconds, striking Brad on the face somewhere between 20 and 40 times, causing bruises and lacerations which required sutures. The public response to Brad’s assault has been overwhelming. With widespread coverage in traditional media – television, radio and print – over the days immediately following the assault, a Facebook post to the QAS page, which included images of Brad’s injuries, reached a recordbreaking 13 million people (and still counting), generating 77,716 likes, 137,795 shares and more than 19,000 comments. This strength of public sentiment in support of paramedics, however, is tempered against the peculiarity of increasing levels of violence against not just paramedics but emergency response workers generally – an increasing trend across Australia. Tony Hucker, Director of Clinical Quality and Patient Safety at QAS, said it’s an odd situation given the fact paramedics repeatedly rank first on lists of most trusted professionals and begs the question: why are people doing this? “Acts of violence committed against paramedics are generally always alcohol or drug related,” said Tony. “The real issue is around alcohol and illicit substances, because the only times we see abnormal behaviour like this is when people are drunk or drug-affected. That’s the real problem for us.” While the current focus of anti-social behaviour is focussing on crystal methamphetamine, or ice, as driving the current wave of anti-social behaviour, including violence against paramedics, Tony said alcohol is by far the biggest driver of violent and aggressive behaviour.
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“Paramedics don’t turn up to work to be bashed – our workplace is everywhere and we can’t control our work environment. But the fact is violence against paramedics does happen,” he said. “It’s sad and frightening and we really need to think about this from a safety perspective.” According to Tony, paramedics traditionally approach a scene thinking about danger, but not danger that comes from patients or bystanders: “Now we have to build this into our thinking, that the hazard at a scene might be interpersonal violence.” All of our paramedics undergo Situational Awareness For Everyday Encounters (SAFE) training as part of their induction into the QAS. The purpose of ‘SAFE’ training is to: • Promote professionalism and the use of good practice. • Identify the need for continuous threat assessment, risk minimisation and situational awareness. • Enhance safety and a safe working environment. • Promote use of tactical communication skills in the safe and effective resolution of workplace issues and conflict incidents. • Identify and promote the need for QAS officers to report incidents of workplace violence and/ or assaultive behaviour. Safety of all QAS staff is a key priority and in 2016 QAS will continue work on further developing safety and situational awareness training for operational staff. Additionally, an occupational violence working group has been formed to work with paramedics, communications officers and stakeholders in a view to reduce occupational violence.
been a paramedic for 36 years and worked in two other states and it’s no different.” Another factor Tony finds alarming in the current context of violence against paramedics and emergency workers is the threat of violence for rural and remote paramedics. “I fear for rural and remote paramedics who are out in the middle of nowhere and, in many cases, operate on their own. While the likelihood of violence is probably lower in rural and remote areas, I’ve actually been on calls where a single paramedic and a two-police officer crew is trying to sedate someone under the influence in the back of a van in the middle of nowhere. That’s my biggest fear,” he said. It’s a fear grounded in reality, especially given the fact deliberate physical attacks against paramedics (such as punching and spitting) increased by 49 per cent from the 2009-10 financial year to 2014-15. Despite increasing public awareness and condemnation of paramedic assaults, its increasing prevalence raises broader questions for society in the long term. In the here and now, however, all we can do is ensure paramedics who are assaulted continue to have access to as many health and wellbeing pathways as possible, such as the Priority One counselling service and peer and employer support more broadly. “I’ve worked in several ambulance organisations across Australia and QAS really does have exceptional employee support, but at the end of the day it’s often at the back of an ambulance after a shift, swapping war stories and chatting with your colleagues is where the best benefit is,” said Tony.
“It’s not our job to control violence at a scene,” continued Tony, “and if there is violence at a scene it’s our job to get out of there, be safe and to contact police and let them deal with it. I’ve
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Procurement gets DG’s nod Procurement’s Sea of Colour was the only QAS entry to win a spot on Director-General, Department of Health, Michael Walsh’s Christmas decoration competition. Entries were viewed by Michael physically and by video with entries from across Queensland, including Charleville and Meadowbrook. The judging criteria included colour, creativity, teamwork and a sense of fun – things he saw sleighs-full of. Ho ho ho. QAS Procurement joins the illustrious Little Reindeer That Could commendation ranks alongside the Healthcare Improvement Unit, the System Planning Branch, Strategy, Policy and Planning Division, the Correspondence Team, Office of the Chief Health Officer and DDG Prevention Division.
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Cream of the crop It’s been a stellar year for our Indigenous paramedics and cadets, with awards and success across the state.
The Cairns and Hinterland and the North West Local Ambulance Service Networks (LASNs) both received highly commended awards for their successful Indigenous Paramedic Cadet Programs in the 2015 Queensland Reconciliation Awards. The program aims to recruit more Aboriginal and Torres Strait Islander people into formal education to become qualified paramedics or first responders and is structured to the individual, moving away from classroom learning to on-the-road mentor training to suit cultural needs and learning styles. The award-winning program is a multi-tiered platform for developing Indigenous paramedics who can build response capacity and health resilience within their own communities.
As part of the program, Indigenous paramedic cadets spend two weeks in Brisbane undergoing an intensive, no-holds-barred training schedule. In late October the recruits were put through their paces at the Queensland Combined Emergency Services Academy at Whyte Island in Brisbane, responding to a simulated road traffic crash scenario. As well as simulated training scenarios, the Indigenous cadets also undertake more formal examinations, with some cadets scooping the pool with the highest marks for any cadets statewide. Doomadgee’s Alisha Peter, for example, scored 95 per cent or higher in all her assessment pieces including basic care, immobilisation techniques, respiratory
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and cardiovascular support, drug administration and pharmacology – skills Alisha will take back and implement in her community. Another standout recruit was Willy Obah, whose leadership potential came to the fore during the twoweek intensive training at Whyte Island. Throughout training, Willy took on additional responsibilities to help guide and culturally support both new and inexperienced members within the program in their skills development.
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Richard Murgah, Mark Whitby and Lavin Kayes.
His impact was highly valued by both his peers and the program facilitators and is a testament to the giving character of our frontline staff.
Dylan Harrigan and Petrina Neller
David Gela and Tyson Kebisu
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Sydney Medical School beckons for Qld paramedic Helping people is in Robert Blackley’s blood. From mental health worker to Mayor of Palm Island to Critical Care Paramedic, this inspiring individual is taking the next step to becoming a doctor of medicine, gaining a place at the prestigious Sydney Medical School. Sydney Medical School at the University of Sydney is Australia’s top medical school and among the top 20 universities for medicine globally. For Robert, it’s the logical next step after a life and career steeped in community service – from councillor, youth worker to paramedic, mayor and now medical student. “I’ve always been a leader in my community, and the move to study medicine is just a progression from what I was doing as a local government councillor, working out community development issues, getting people healthier, getting better standards of living,” Robert said. “Working as a paramedic on Palm Island, you have relationships with individual patients, and you have a short space of time – a window – to give the people you’re caring for opportunistic health messages. “It’s my responsibility to help make incremental changes that lead to real increases in life expectancy.” Similar to other paramedics and health care professionals, Robert shares a sense of empathy and care for others – it’s part of what he finds compelling about paramedicine and medicine generally. “You have to care about other people in order to take on this kind of responsibility, but there’s also an element of bravado and there’s no argument there are egos in medicine,” he said. “You need a degree of self-belief to paralyse someone and cut them open – you wouldn’t do this if you weren’t confident.” Robert will be thrown into the thick of it, working one day a week in the emergency department of the Royal Prince Alfred Hospital, the teaching hospital of the Central Clinical School of the Sydney Medical School at the University of Sydney, the largest hospital in
the Sydney Local Health District and the location of television documentary RPA. “I’m ready to hit the ground running,” continued Robert, “and I’ll be learning from some of the best doctors in the world – it’s a great honour and a privilege to be involved with this.”
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Operation Schoolies As thousands of school leavers arrived on the Gold Coast to celebrate the end of Year 12, QAS called on Schoolies to play it safe, think of mates and call Triple Zero (000) in an emergency.
Annual Schoolies celebrations on the Gold Coast are a rite of passage for many Queensland teenagers finishing high school. But keeping that many teenagers safe isn’t easy. The majority of the non-schoolies arrested related to public nuisance and good order offences. Schoolies might be renowned for drunken teenagers out of control and the predatory antics of lecherous toolies, but this year’s Schoolies event was different. QAS Acting Senior Operations Supervisor, Events Coordination Gold Coast, Justin Payne said 40 per cent of incidents were related to drug or alcohol intoxication. He said a large part of the QAS Schoolies response was to reinforce messages and provide information about what to do if someone’s had too much to drink, overdosed on drugs, or been injured.
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“Our main message was to remind Schoolies if their mates are in trouble and need medical help, to stay with them and call for help by phoning Triple Zero (000),” he said. “If someone is unconscious, make sure they are rolled on their side and their airway is clear so they can breathe properly.” The other top tips communicated by QAS for Schoolies included: • Drink plenty of water. • Don’t mix alcohol and medication. • Be careful crossing the road. • Wear flat, comfortable shoes to avoid tripping and blisters. • Be sun-smart: slip slop slap.
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QAS also provided CPR demonstrations each evening at the Ambulance Treatment Centre on The Esplanade between 5pm and 7pm to equip Schoolies with the basic skills to assist in a cardiac emergency. “What few young people may know is that effective bystander CPR can double a cardiac arrest victim’s chance of a survival. It’s a basic skill we can quickly pass onto Schoolies that may just save their life or their mate’s until medical help arrives,” Justin said. CPR initiative outnumbers triaged Schoolies And as Queensland school leavers dispersed following a week of celebrations in Surfers Paradise, Justin said just two per cent of the 25,000 Schoolies that hit the Gold Coast during the celebrations required medical assistance. “The majority of people we treated were here to have a good time and were appreciative of all the support provided to them. As in previous years, the primary reason for presentation to the Ambulance Treatment Centre was for alcohol and/or drug intoxication,” he said. This year marked the first time QAS has offered CPR Awareness Training during Schoolies Week for school leavers and the broader community within the precinct. Justin said CPR training was well received with close to 1,000 participants over six nights: “For every school leaver we treated, two people walked away with skills in CPR. We hope this initiative gains more support next year and becomes a regular feature during Schoolies Week,” he said.
Gold Coast Schoolies 2015 Summary Patient Assessment Count 2014
2015
Daily Average
76
73
Day 1, Saturday
70
48
Day 2, Sunday
81
68
Day 3, Monday
83
83
Day 4, Tuesday
72
83
Day 5, Wednesday
64
96
Day 6, Thursday
80
70
Day 7, Friday
84
66
Total
534
514
Transported to Hospital Count
12
2015
%
Daily Average
8
11
Day 1, Saturday
8
17
Day 2, Sunday
9
13
Day 3, Monday
5
6
Day 4, Tuesday
8
10
Day 5, Wednesday
9
9
Day 6, Thursday
11
16
Day 7, Friday
5
8
Total
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Airlie Beach breaks world CPR record A new world record and entry in the Guinness Book of World Records was the upshot of the Whitsunday QAS team’s ‘CPR Relay Challenge’, which took place at the Airlie Beach Lagoon carpark during Schoolies. All told, 863 people took part in the CPR Relay, smashing the previous record held by Cambridge University. Congratulations to everyone involved.
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Building resilience in light of stress
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Building resilience in light of stress You remember the jobs. The ones with bite in them ... the ones you wish you could forget but find yourself thinking about when you come across a similar job or when you’re winding down for holidays or when you least expect it. The ones that still send shivers down your spine and sit in the pit of your stomach. By Leanne Thompson, MAPS Psychologist, Priority One Staff Counsellor With high exposure to often life-threatening, inhumane, seemingly senseless injuries, illnesses and experiences, you’re bound to have some jobs ‘rattle your cage’. These jobs may trigger a sense of hyperarousal or angst, or you might find yourself thinking about them more often than other run-of-the-mill jobs. Post-traumatic stress It’s not uncommon for ambulance personnel to experience this type of unsettling stress, which can be termed Post-Traumatic Stress (PTS), and is not to be confused with Post-Traumatic Stress Disorder (PTSD). It can be caused by serious jobs involving someone you know or who resembles someone you know or is close to you in some way, paediatric cases, jobs that overwhelm your senses with offensive smells, sounds or sights, large-scale unusual, prolonged, intensive incidents or disasters, or high-profile incidents that have attracted investigation or significant media coverage. Whether you attend these jobs in person or on the end of the radio, hear call recordings or listen to colleagues’ experiences of such jobs or even read through material about the job to put together the media coverage, it’s clear that ambulance personnel have high exposure to significant stressors in a repetitive and often intensive manner in the course of their regular duties. With all of this potential trauma exposure, does that mean that most of you will go on to develop PTSD? The answer of course is no. On the whole, post-traumatic stress reactions are mostly experienced over a few days or a couple of weeks with minimal impact on functioning at work and home. Most personnel respond with a resilient ‘bouncing back’ to usual functioning.
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Even when PTS is experienced to a heightened and more distressing degree, when this distress is accompanied with adaptive coping and meaning-making strategies, an experience of post-traumatic growth may result (such as appreciating life, your loved ones and living according to your values even more than before the job). Such adaptive coping strategies include: • Reducing hyperarousal with a period of downtime and controlled breathing techniques. • Talking informally with colleagues, crew members or Peer Support Officers (PSOs). • Accessing help and other support networks. • Oscillating between talking/thinking about the job and focussing on other activities that are non-job-related, such as exercise. • Returning to normal routines. • Reframing problematic thoughts such as selfblame. • Accommodating the event within existing beliefs or developing new beliefs that bring greater understanding and meaning to the event.
Post-Traumatic Stress Disorder For a small number of staff, however, the particular nature of some jobs in the context of their reactions, history, personality, workplace environment, coping and supports present such an affront to their world view that making meaning of the traumatic event and adjusting to the experience is significantly challenging. Sometimes these factors result in a persistent experiencing of the reactions of hyperarousal (including irritability, anger, hypervigilance, angst and sleep disturbances), re-experiencing (flashbacks and intrusive memories), negative cognitions (depressed thinking), negative mood (depressed mood), and avoidance (of thoughts, places and things associated with the event) for periods longer than a few weeks. When these experiences have persistent and marked impacts over extended periods on personal functioning, on relationships with family and friends and on functioning at work, clinical PTSD may develop. Support and evidence-based assessment and treatment services specific to PTSD, including trauma-focussed Cognitive Behavioural Therapy (CBT) and/or Eye Movement Desensitisation and Reprocessing (EMDR), are available to all staff via the Priority One staff support counselling services across the state. These treatments are usually teamed with the treating general practitioner or other medical practitioner, who may also consider pharmacological treatments where indicated in addition to psychological interventions. The goal of treatment includes a return to regular occupational functioning. Often, whilst treatment is taking place, an interim period of working in a
position with meaningful modified duties or in some cases taking some leave may be beneficial. Depending on the nature of the exposure/critical incident and the responsiveness to treatment, there is an expectation that most staff can gain benefits from appropriate treatment and either in qor return to the workplace. Remember, despite reports of emergency services workers being at high risk for PTSD, within the Queensland Ambulance Service rates of PTSD are lower than the general population. Peer support officers, external counsellors and/ or internal counsellors are available to provide support, early intervention and counselling that is focussed on maintaining positive mental health and resilience, not just for treatment and support once a problem develops. Taking a proactive approach to maintaining and supporting your mental health wellbeing and resilience is the key to longevity in a career in emergency services. If you’re uncertain or concerned about your reactions or the impact of them on your functioning and on those around you, early access to supportive treatment may make all the difference.
Priority One contacts 24-hour toll-free telephone counselling line: 1800 805 980. PSO and counsellor contacts available on the QAS Portal, in most stations, and from the Priority One office +61 7 3635 3333.
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CT scan showing right occipital extra cranial haematoma and right side frontal intracerebral haemorrhagic contusion plus other small haemorrhages.
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HARU Report Based in Brisbane and the Gold Coast, High Acuity Response Units (HARUs) are staffed by critical care paramedics and provide advanced interventions over and above the standard critical care paramedic (CCP) scope of practice. HARU Report discusses cases critical care cases and includes audit findings and learning points.
By Dr Stephen Rashford, QAS Medical Director A 30-year-old male is struck by a car, lying on the road and extremely agitated. When HARU and CCP units arrive on scene the advanced care paramedic (ACP) crew is in the midst of placing an intravenous line into the highly agitated patient while a Queensland Fire and Emergency Services officer supports his spine. The initial primary survey revealed the following: •
Airway – intact, cervical spine supported by manual midline immobilisation
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Breathing – respiratory rate 28/min, equal expansion, no chest crepitus, no subcutaneous emphysema
•
•
•
Circulation – palpable radial pulse, heart rate 70/ min, soft abdomen, pelvis well-aligned and no significant external blood loss Disability – GCS 9 (M4), significant agitation, boggy haematoma to right occiput, blood from right ear, blood sugar level 7.7 mmol/l and moving all limbs Exposure – open right tibia/fibula fracture with significant exposure of displaced tibia.
The initial plan was to sedate the patient with ketamine to facilitate extrication to the ambulance, where a rapid sequence intubation (RSI – drug assisted intubation) would occur. The CCP undertook procedural sedation, using 10mg aliquots of ketamine to settle the patient. A total of 50mg of ketamine was administered. Following completion of the RSI checklist, a further 100mg ketamine and 100mg Rocuronium (muscle paralysis) was administered and the patient was intubated on first pass.
fully packaged allowing immediate transfer to the CT scan and reducing time to identification of critical injuries. Each officer contributed to excellent team work. A pre-hospital ultrasound was not performed due to the relatively short scene time and haemodynamic stability. It was reinforced that such a scan should still be done, often undertaken whilst other procedures, such as limb splinting is being done. Although it was acknowledged the individual officer workload was intense. Discussion regarding the option of titrated ketamine (10mg) versus a single 0.5mg/kg dose was debated at length in the audit. The HARU officer felt the small titrated dose allowed for observation of the haemodynamic and neurological response. This is especially important in the setting of potential significant blood loss. Despite ketamine usually resulting in a good haemodynamic response, when the patient has profound blood loss this effect is compromised. Learnings Each paramedic contributes to the outcome, no matter what clinical level. Appropriate task allocation working in parallel optimises patient care and scene time. Attempt to think five to 10 minutes ahead, to plan interventions proactively and not be reactive (e.g. ultrasound). Ketamine is a great pre-hospital drug but it even has limitations in certain circumstances.
No hypoxia or hypotension resulted. An orogastric tube was inserted and a heating blanket applied, with the patient then departing scene for hospital. Audit findings The scene flowed well because of of excellent team work by ACP, CCP and HARU officers. The patient arrived in hospital 34 minutes post the Triple Zero (000) call,
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Southport OpCen refurb Refurbishing an office might sound straightforward, but not if it’s one of our OpCens. With a high likelihood of disruption to services and staff members, it was planned that the Southport Operations Centre and its staff would temporarily relocate to Brisbane. In February 2015 planning started with the scope of works including roof and ceiling repairs, a new airconditioning system, fresh paint, new carpets and blinds. Five months later on an evening in July the physical transition of staff and operations took place. Southport staff relocated to Brisbane for one week and were provided with the option of bus transfers to and from Brisbane or accommodation near Kedron with daily transfers to the Brisbane Operations Centre. The Brisbane and Southport staff worked together seamlessly to service the Southeast Queensland public. All staff involved in this transition engaged positively and adapted to the environment with relative ease. This transition also provided Southport Operations Centre with the opportunity to enact its
business continuity plan in the live environment. Overall, the temporary relocation was very successful. This was measured by no impact on our service delivery to the public and our staff being very excited by the results of the refurbished environment.
Government Wireless Network The Department of Science, Information Technology and Innovation (DSITI) and Telstra formed a successful partnership to design and deliver a secure, fully integrated government radio communications network for implementation into Southeast Queensland (SEQ). The Government Wireless Network (GWN) is now being progressively rolled out across almost 30,000 square kilometres in SEQ. DSITI is delivering the digital radio voice and narrow-band data network in collaboration with Queensland Ambulance Service (QAS), Queensland Police Service (QPS) and Queensland Fire and Emergency Services (QFES) to ensure the solution meets operational requirements and fully integrates with agency dispatch systems. The network revolutionises the way front-line ambulance, police and fire personnel communicate, setting a new benchmark in radio coverage and levels of in-building penetration, front-line officer safety and radio encryption. In collaboration with the public safety agencies – QAS, QPS and QFES, the GWN-SEQ Project will facilitate delivery of the GWN by Telstra
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across the SEQ implementation area. The QAS GWN Implementation Program team has worked with key stakeholders in the public private partnership and developed a new concept of operations for QAS in SEQ that takes full advantage of the benefit realisation through key QAS operational benefits (capability and functionality) delivered by the GWN infrastructure, technology and equipment that differs significantly from what is used today in the QAS to include: • • •
•
•
crisp clear voice communication. increased radio coverage, resulting in a reduction in radio black spots. portable and vehicle radio location services, with Global Positioning System tracking systems linked to operations centres. availability of an emergency call (duress) button on portable radios providing QAS officers with the ability to instantly call for emergency assistance. improved building radio frequency signal penetration.
Nurturing the future Grants totalling $30,000 were awarded to QAS officers and paramedic students by the KJ McPherson Education and Research Foundation for research and development projects that will improve care for patients across the state. The KJ McPherson Education and Research Foundation announced recipients of its research and development grants at a presentation ceremony held at Brisbane City Hall in conjunction with its Leadership Symposium in November 2015. Named after Kenneth James (Jim) McPherson, a QAS officer who lost his life in an aerial ambulance crash in 1987, the Foundation is a not-forprofit entity dedicated to delivering better patient care by providing research and professional development opportunities for QAS personnel and paramedic students. Commissioner Russell Bowles said the grant recipients followed in the footsteps of Jim McPherson, who demonstrated a strong commitment to training, education and research. “We have seen enormous advances in clinical skills and training in the field of ambulance services over the past 10 to 15 years. The generous support of the KJ McPherson Foundation in providing professional development opportunities
through its grants program and events such as the symposium has played an important role in enhancing pre-hospital patient care in Queensland. “Research and development fostered by the Foundation gives paramedics the scope and encouragement to think about innovations that can advance the paramedic profession, and these contribute directly to improved outcomes for our patients. We look forward to seeing the fruits of their hard work and big ideas in the form of better service to our community.” 2015 KJ McPherson Education and Research Foundation grant recipients Wayne Loudon – Patron’s Research Grant $15,000 Wayne Loudon of North Lakes Station received the Patron’s Research Grant for his project An investigation of the diagnosis and stratification of ischaemic and haemorrhagic hyper-acute stroke in the pre-hospital environment. Wayne is a Critical Care Paramedic and is currently completing a Masters of Research with likely articulation
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to PhD in early 2016. His topic area is pre-hospital acute stroke diagnosis and care.
ay/Whitsunday area and transferred to Gatton Station in 2008.
Prue Sneddon – Dr Peter Stephenson Overseas Study Grant $3,000 This grant provides an opportunity for a QAS operational officer to undertake an overseas professional development opportunity with information shared with their peers on return. Prue is an Critical Care Paramedic at Ipswich Station and plans to use her grant to attend the Social Media and Critical Care 2016 Conference in Dublin, Ireland.
While working in South West Region Daniel undertook Paramedic and Officer-in-Charge relief at a number of rural and remote locations.
Greg Reaburn – QAS Research and Development Grant $3,000 This year’s grant went to Greg Reaburn for a project which involves researching a combined skill set of a paramedic and physician’s assistant that can straddle three sectors of health care: pre-hospital care, primary care and hospital care. Daniel O’Brien – Paramedics Australasia Professional Development Grant $2,000 Daniel O’Brien will use his grant to attend the annual Australian and New Zealand Association for Health Professional Educators Conference in Perth in 2016. Daniel began as a student paramedic with QAS in 2005 in Mackay. After qualifying as an Advanced Care Paramedic he worked throughout the Mack-
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Mark Costello – QAS Professional Development Grant $1,000 Mark Costello will use his grant to attend the Royal Flying Doctor Service Essential Aspects of Aeromedical Retrieval Workshop. Mark has worked for the QAS for the past 16 years after leaving his role as an emergency nurse with Queensland Health. He has worked at Spring Hill, Roma Street and Kedron Park stations and is now based at the Queensland Government Air Wing at Archerfield as a Critical Care Flight Paramedic. Matthew Cividin – KJM Graduate of the Year Grant $1,000 Matthew started at Kirwan Station as a Graduate Paramedic in his Phase 3. He openly discussed his progress. Matthew continued to shine throughout his Phase 3 attending many challenging cases with mentors. Matthew cheerfully accepted feedback and learned different ways of practising his craft.
New QAS threads in 2016 Hold on to your hats ladies and gents: the first quarter of 2016 is the date set for operational trials of final design pieces of the new QAS uniform. What’s in a new uniform? Quite a lot if you’re an organisation like QAS. Throughout 2015, the QAS Uniform Review has been trialing 720 prototype paramedic and communications officer uniform pieces at 52 diverse locations throughout the state. Design consultancy Symplicit were engaged by QAS to liaise with staff and develop conceptual uniform designs. This involved direct interaction with more than 400 QAS staff through interviews and workshops, as well as feedback and opinions from more than one
third of the QAS workforce. Symplicit gained insight into various QAS work environments to understand people’s behaviour in the workplace, facilitated through day and nightshift observation and operational ride alongs. From observed user experience, Symplicit developed a simplified uniform with a focus on user comfort, fabric qualities, layering, personal storage solutions and role recognition. The final piece of the new uniform puzzle is the Statewide Equipment and Vehicle Committee, which will review the latest round of prototyping being developed using a recently appointed whole-ofgovernment provider.
QAS wins big at state and national health awards
From left: Director-General Michael Walsh, QAS Assistant Commissioner Stephen Gough, QAS Acting Assistant Commissioner Dr Emma Bosley, QAS Acting Deputy Commissioner Dee Taylor-Dutton, QAS Commissioner Russell Bowles, QAS Deputy Commissioner Craig Emery and Minister for Health and Ambulance Services Cameron Dick.
QAS had a successful evening at the Awards for Excellence in Health at Brisbane City Hall in December 2015, winning in the categories of Customer Focus (CPR Awareness – State LASN Operations) and Excellence in Performance (Integrated Real-Time Operational Ambulance Management/iROAM). The awards recognise initiatives, teams and individuals across Queensland Health and QAS that have
demonstrated a commitment to putting the public service values into practice. At the Council of Ambulance Authorities (CAA) Awards held in October, QAS was also awarded in two categories – clinical and technical – for its Digital Clinical Practice Manual, which generates a virtual office environment for paramedics and for the iROAM.
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Lighter, stronger, better Reducing strain and fatigue for paramedics were key factors driving the design of new primary response kits for QAS. It started with groups of paramedics who were tasked to develop design concepts to be prototyped for new primary response kits (PRKs). From these prototypes an initial suite of modular kits were produced for a threemonth trial at 30 locations around Queensland. These PRK prototypes consisted of 50 ACP sets and 20 CCP sets, comprising 300 bags in total. The trial designs weighed considerably less than the PRKs previously used with the ACP kit being nearly 6kg lighter and the CCP kits more than 4.5kg lighter. Consultants Symplicit were engaged to liaise with the workforce in regards to the PRK design to obtain an understanding of the level of staff satisfaction relative to operational experiences when using prototype equipment in the field. Due to pharmacological interventions being utilised in 20 per cent of QAS responses, a dominant pharmacology kit emerged from the statewide trial
Easily locating equipment within the kit was a driving factor in design development in an attempt to produce intuitive user interaction and statewide layout uniformity while most appropriately utilising space. To minimise glass ampoule breakages, hard-sided plastic cases were incorporated into the design, allowing for the visualisation of drug labels without the need to remove ampoules for storage at the beginning and end of shift. process with integral assessment equipment for each ACP and CCP role. Trauma-related equipment was rehoused in ‘grab and go’ disposable modules as opposed to customarily constructed kits. This design approach further reduced weight being carried into each case by an additional kilogram resulting in an overall reduction from original kits of more than 47 per cent for an ACP and 34 per cent for a CCP.
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Minimising the weight of the resuscitation kit has been limited by the oxygen cylinder that it houses, however a reduction of more than 2kg (15 per cent) was still achieved due to a change in kit design which also now accommodates required ACP airway equipment. The final PRK design trial has been ongoing at Ipswich station in West Moreton LASN since the beginning of October 2015.
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Appointments and farewells It’s goodbye, farewell and thank you to some recently retired staff who collectively racked up an impressive 122 years of service for QAS. Paramedic Alan Grant from Nerang retired after 36.6 years, Operational Manager Gregory Skerman from Spring Hill retired with 35.3, Paramedic Darren Stewart from Springwood retired at 29.5 and Lutwyche-based Clinical Educator Sheree Leader called it quits after 21 years. QAS also welcomed Natalie Schutt (right) as Executive Manager, Senior Pharmacist, in Clinical Quality and Patient Safety in September. Originally a registered paediatric nurse, Natalie studied pharmacy at QUT and most recently worked as the Pharmacist Customer Service Manager at Queensland Health.
Supervisory Recruitment Campaign A centralised Supervisory Recruitment Campaign to fill Officer in Charge, Senior Operations Supervisor, Operations Supervisor and Clinical Deployment Supervisors positions across the state was conducted in 2015. The following is a list of permanent appointments. Tony Armstrong, Senior Operations Supervisor, West Moreton Colleen Brownsey, Officer in Charge, Nanango David Cameron, Officer in Charge, Thursday Island Toni Careless, Officer in Charge, Caloundra William Clark, Officer in Charge, Glenden Travis Cramb, Officer in Charge, Kingaroy Anthony Cunneen, Officer in Charge, Ayr Helen Donaldson, Officer in Charge, Hervey Bay Elissa Edie, Officer in Charge, South Townsville Jody Fiegert, Officer in Charge, Doomadgee Adam Flory, Officer in Charge, Ipswich
Recent key appointments and transfers to the Queensland Ambulance Service Executive Team include Dee Taylor-Dutton, who was appointed to the position of Assistant Commissioner, LASN Strategic Operations within the Central Office.
Helen Geddes, Officer in Charge, Sarina
Dee has held a number of operational and managerial roles including her most recent role as Assistant Commissioner, Gold Coast LASN. Dee will continue to act in the role of Deputy Commissioner, Service Planning and Performance, until the return of Deputy Commissioner David Eeles.
Scott Harris, Officer in Charge, Burnett Coast
John Hammond was appointed to the position of Assistant Commissioner, Gold Coast LASN. John commenced with the QAS in 1998 as an Ambulance Officer and has held a number of operational and managerial roles including his most recent roles acting as Director, State Operations Centre and his previous substantive position as Chief Superintendent, West Moreton LASN.
Supervisory Recruitment Appointments Robert Gray, Officer in Charge, Rainbow Beach Paul Hardie, Officer in Charge, Laidley
Nick Haug, Officer in Charge, Petrie Joanne Herbertson, Officer in Charge, South Brisbane John Hodson-Gilmore, Officer in Charge, Calliope Michelle Holsworth, Officer in Charge, Roma Street Lara Jedyn, Officer in Charge, Townsville Brian Jillett, Officer in Charge, Mornington Island Loretta Johnson, Officer in Charge, Central Queensland Nigel Jones, Senior Operations Supervisor, Mackay Scott Kreigher, Officer in Charge, Blackwater
Chris Broomfield has transferred to the position of Assistant Commissioner, Metro North LASN, and Gavin Trembath transferred to a role within QAS Central Office based at Kedron. In October QAS also welcomed three new full-time media and communications staff to its Kedron-based team: Senior Media Officer Krathyn White and Media and Communications Officers Tamani Nair and Emma Mercer.
Michael Low, Senior Operations Supervisor, Wide Bay Andrew Lowndes, Officer in Charge, Stanthorpe Adam Marston, Officer in Charge, Bamaga Russell Moore, Officer in Charge, Fairview Warren Painting, Senior Operations Supervisor, Gold Coast Russell Pavey, Officer in Charge, Boonah
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Jennifer Pearce, Officer in Charge, Bribie Island Neil Pinto, Officer in Charge, Moreton Island Christopher Rendall-Day, Officer in Charge, Mackay Michael Robson, Officer in Charge, Collinsville Adam Russell, Officer in Charge, Maleny Jayney Shearman, Operations Supervisor, Metro South Wayne Slee, Officer in Charge, Longreach Peter Solomon, Officer in Charge, Texas Simon Stevens, Officer in Charge, Taroom Philip Switzer, Officer in Charge, Fraser Island Norm Veal, Officer in Charge, Spring Hill Ross Vickers, Senior Operations Supervisor, Mackay
Did you know? All QAS staff can now access social media sites – including Facebook, Twitter, LinkedIn and Yammer – on their work devices. QAS has official accounts on Facebook, Twitter, Instagram and LinkedIn, so make sure you check them out. Of course, keep in mind that any use of social media accounts on a work device, whether in a work or private capacity, is subject to the Queensland Public Service Code of Conduct and the QAS Social Media Policy. You can find the social media policy on the staff portal under ICT Policies.
Antoinette Woods, Officer in Charge, Caboolture Luke Wyatt, Operations Supervisor, Metro South
New stretchers a lift for staff and patients
facebook.com/qldambulanceservice 72,930 followers
Paramedics generally have one of the highest rates of occupational injuries in Australia with lifting and carrying injuries an ongoing issue. So it was a win-win for paramedics and patients with the start of the statewide rollout of Stryker Power-Pro stretchers. The stretchers are proven to reduce manual handling injuries and make transporting heavy patients easier. Reduced rates of stretcher-related injuries suffered by paramedics during shifts means better health outcomes for them and less workdays lost for the ambulance service. Importantly, it also means patients can get into the ambulance and off to hospital more quickly.
@QldAmbulance 8,510 followers
@QldAmbulance 3,644 followers
@QldAmbulance 1,146 followers
youtube.com/AmbulanceQld 88,738 views
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Why are we on social media? Social media. Those two words can mean many things to many different people. Some see this internet phenomenon as vacuous and a forum for the selfish and self aggrandising. Some see it as a tool for trolls, bullies and sexual predators. Others see it as an endless stream of mind-numbing whinges and vents about poor customer service, rude people, bad days at the office and health issues. Then there are the marketers – sometimes subtly and sometimes not-so-subtly pushing their company’s products; and the ‘influencers’ – who are often being paid by marketers to recommend their products. And of course, there are the cats. Many, many cats. And while the above all seem like very good reasons to completely avoid social media, it does have an upside. At the most basic level, QAS exists to help the community. And that community is using social media every day to communicate, to complain, to have fun, to experiment, and to an extent, to learn. That’s why we need to be on there too. Facebook, Twitter, Instagram and their ilk have long attracted criticism as contributing to the decline of in-person conversation and communication skills, nuanced political debate and even grammar and language skills. But, as with any communication tool or web-based platform, it’s really how you use it that matters. Emergency services and health agencies have shown in recent years that social media platforms can be very useful tools for communicating with a variety of audiences – including their own staff. The inherent beauty of social media platforms – paid or sponsored content aside – is that the audience ‘opts-in’ to receive your news or information. They want to hear from you. Consider the fact that there are roughly 4,500 people working for QAS, yet we have more than 72,000 Facebook followers and 8,500 Twitter followers. That’s a lot of people who care about what we do – and it’s not just our mums, dads, sisters and grandmas that are watching.
It’s not just ‘social’ Emergency management agencies are now using social media platforms such as Twitter and Facebook to gather intelligence on unfolding events. Defence and law enforcement agencies monitor it closely during mass shootings or terror attacks; while emergency services are using social media intelligence to help build a more comprehensive ‘picture’ of flooding impacts or structural damage during and following natural disaster events. QAS uses Twitter as a key publishing tool to let media outlets and the public know what is happening ‘right now’ in Queensland. We Tweet about a variety of QAS operations, including our response to road traffic crashes, assaults, snake bites, drownings, workplace accidents, fires and hazardous materials incidents, as well as issuing safety advice during heat waves, severe storms and cultural festivals. It’s a simple and cost-effective way to service the information needs of journalists, while at the same time helping to provide the community with a snapshot the breadth, frequency and seriousness of the incidents that paramedics and emergency medical dispatchers deal with every day. As part of our Twitter strategy, we’ve also set up accounts for all of our Local Ambulance Service Network managers. As the local ‘leader’ of the ambulance service, they are in a prime position to act as key community influencers, whether during natural disasters or commenting on local issues. Our Deputy Commissioners Craig Emery and Dee Taylor-Dutton, as well as Medical Director Dr Stephen Rashford, are also on Twitter, so if you’re an active user, make sure you are following all of these QAS-related accounts.
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QAS receives messages of thanks from members of the public every day. In each edition of QAS Insight we’ll publish a selection.
Thanks for looking after Sofia From Tony Meliambro, 12 December 2015 Last night my daughter Sofia broke her arm on the jumping castle at the Christmas Carols at Caboolture. It was a very scary experience but made easier thanks to the warmth and compassion from the ambulance officers that picked her up and transferred her to Caboolture hospital. The little knitted bear that she was given was absolutely lovely. It kept her happy and entertained while she was at the hospital and will be cherished forever. Thank you very much for taking such good care of her.
You make a difference From Nina Atkin, 9 August 2015 My name is Nina and I am a 38 year old former heroin addict. During the height of my addiction I was attended to a number of times after overdosing at the place I was living. I have wanted to send this message for years but now that I’m writing it I know why it has taken so long. It really is difficult to articulate to virtual strangers the depth of my gratefulness for the acts of people who were literally just doing their job (and if I recall correctly were a little upset at me for being called out a number of times to revive me – I would be too). It’s hard to remember that time – everything was so hazy, and muted, but I vividly recall the faces over me as I woke up from the shot of what I assume was something like Narcan. I remember a gentleman – who I was beginning to recognise after a couple of visits – telling me I needed to go to rehab. I told him, ‘No really, this is the last time’. I really wish it was, but it wasn’t. But eventually I got there.
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Since I got clean (it took another couple of years, but with the support of my incredible friends and family I eventually got there and stayed there), I went back to university and did a dual degree, (achieving first class honours too – apparently my brain still works) and then went on to work for the Federal Government in Brisbane and Canberra. I’m now back at uni on a full scholarship doing a PhD looking at family violence in immigrant communities in Australia with a view to implementing culturally appropriate support services. I’m so thankful that you saved my life, and save the lives of others. I know you have to deal with so much awfulness in your jobs so I just wanted to tell you that what you do makes a difference. And in the same way I hope that my PhD can translate into something useful too. Paying it forward, I guess. Anyways, keep trucking on y’all.
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Helping others – a good way to start your day From Valmor Morais, 13 December 2015 I had an amazing experience this morning. After having a delicious Amazonian açai in South Bank, Duilio and I were driving back home when I saw a little white-haired lady throwing up in the kerb, being helped out by two other ladies. I immediately jumped from the car and ran towards them whilst Duilio parked the car. I advised the ladies that I would call the ambulance and they accepted my help whilst they continued helping the lady who had to lie down on the cold and almost wet concrete. It was a cloudy and wet Brisbane morning and it was not really a good place to be lying down. This little old lady was feeling really sick from the side effects from her chemotherapy treatment. Anyway, I called the ambulance and provided them with all the details and they sent an ambulance to assist us. Whilst we were waiting for the ambulance to come, several people stopped to assist this lady: A gentleman assisted the ladies to calm down; a girl who was supposed to open her convenience store at 8.00am but stopped to help them clean the lady of her vomit; another lady went and paid for the sick lady’s breakfast in the restaurant where she was eating with a friend; another lady paid for the water and other materials to assist this lady who was feeling sick. There was even a doctor lady who was jogging and she stopped by just to see if everything was under control. It was really amazing to witness this human, Aussie spirit. I am glad to be one of those people who were there in this lady’s moment of
need. Once the paramedics came these anonymous people disappeared in the same way as they showed up when their presences were required. I am a great fan of super heroes including X-Men and Justice League, but what I saw that morning was much more amazing than all of the comics that I have read and the movies that I have ever watched. Well done anonymous beings.
QAS Insight is published quarterly by the Queensland Ambulance Service Media and Communications Unit. Editorial and photographic contributions are welcomed. Contact us at qas.media@ambulance.qld.gov.au or +61 7 3635 3900. Front cover image courtesy of Ian ‘Diaz’ Whittleson. Back cover image courtesy of Carmen Jensen.
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The public often hears about tricky rescues in national parks but they rarely get a look behind the scenes – unless they’re unfortunate enough to be involved. This dramatic rescue at Cedar Creek Falls on Tamborine Mountain in August 2015 shows the reality of what emergency services personnel go through. Six paramedics, police and a helicopter rescue crew all played a role in treating and transporting a 19-year-old female to Gold Coast University Hospital with neck and hip injuries after a 10-metre fall.
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