LARU Report

LARU skills benefit island-hopping paramedic

QAS paramedic Jamie Paul explains in this special report how his LARU qualifications are benefiting the island jobs he attends in the Southern Moreton Bay Islands (SMBIs). Jamie became the OIC of Macleay Island in January this year following a three-year stint in the country at Injune.

Right

Flashback: QAS paramedic Jamie Paul at Injune in the South

West LASN.

Below

The Kitty Kat allows

QAS officers, such as Jamie, to transport patients to the mainland for further assessment or treatment.

Opposite, top

Jamie loves working on the islands.

Opposite, below

Flashback: Jamie watches on proudly as his daughter,

Holly, competes in an equestrian event at

Injune.

I am LARU qualified and carry out my duties on Macleay, Karragarra and Lamb Islands as a single responding officer. I am also required to assist with responses to Coochiemudlo and Russell Island when needed.

As an Advanced Care Paramedic with extended scope of practice, I can provide care for residents so they do not have to leave the islands which can cause a lot of distress for them due to logistical reasons. The SMBIs do not have any after-hours care available, and if a resident requires further treatment or assessment, they must be transported by us on the Kitty Kat boat (QAS boat) to Redland Bay to hand over to another crew, then be transported to a hospital on the mainland.

This process can be very stressful to island residents, so by being extended scope qualified, it has enabled me to provide extended care to residents especially outside of regular business hours to enable them to stay home. Since working at Macleay, I have been called to residents for skin tears, wound management and suturing. These procedures would normally have needed to be done at a medical facility on the mainland. Recently I sutured wounds with patients who would normally refuse to go to the mainland and wait for Monday to have their wounds treated which would have increased the risk of infection.

One patient was a 70-year-old male I attended on a Friday night. The patient was injured after he cut the top off his left thumb just below the knuckle with a clean kitchen knife when trying to open an ice cream container. Due to the COVID-19 restrictions, and the fact that he was in an at-risk group due to his age and low immunity, he did not want to leave home let alone leave the island. The patient called QAS for wound management.

On arrival, I cleaned the wound and consulted for authorisation to suture or glue the wound. After consulting for authorisation to suture the wound, I was contacted by the Operations Centre and dispatched on another case. After responding to that case and transporting the patient to the mainland via boat, I returned to the initial case. The patient’s wound was again cleaned and assessed as directed by the on-call QAS specialist emergency physician. The patient’s wound was then successfully closed with three sutures.

Another case involved a patient who had accidentally cut the left index finger just above his knuckle with a clean knife late on a Saturday afternoon. On QAS arrival the patient had an obvious deep laceration approximately two to three centimetres across his finger with bleeding controlled. The patient’s wound was irrigated, cleaned and dressed initially whilst I called the consult line to get authorisation for

either suturing or gluing of the wound. Photos of the wound were sent for authorisation to glue or suture, along with details of occurrence and patient medical history. This system means a very senior doctor reviews the patient with me, adding a further safety net into the system.

Authorisation was then given to proceed with suturing of the wound. After the consult I was called away on a Code 1 case. After transporting that patient to the mainland, I then returned to the initial patient irrigated and cleaned the wound again and prepared for suturing after administering subcutaneous lignocaine for local anaesthesia. After successfully suturing the wound, I also used some histoacryl glue to assist with sealing the wound and to make the procedure more effective. Final photos of the outcome were sent to the consult email as requested.

For both suturing jobs, I advised the patients to see a local GP on the Monday for further assessment, antibiotics and tetanus injections. The patients were extremely impressed with the improved care and procedures that QAS can provide due to the LARU program, this includes the opportunity to not have to leave their homes.

The other benefits derived from these outcomes are that it saves time and costs on the greater health system and it prevented any potential spreading of COVID-19 to a high-risk patient. I have been working for the QAS for 21 years and currently live on the Gold Coast with my family. I started as an Honorary Officer at Burleigh Heads, before becoming a communications officer at Southport Operations Centre. I started working as a paramedic in 2007 and was stationed at Burleigh Heads, Coolangatta and Agnes Water, before becoming an OIC at Injune and now Macleay Island. I love many aspects of the job from helping others, both the public and fellow QAS staff, as well as the comradery between QAS staff, and engaging within the community as an OIC.

I really enjoyed my time out in the country, and the challenges that being isolated in a remote rural area brings, whether it was responding to major incidents on my own or driving 160 kilometres to a case as a single officer with limited radio or phone reception.

There are a lot of similarities between my country and island roles. One position was remote due to distance or land, the other is isolated by water. I have only been at Macleay for a short time, but I am really liking the challenges that come with being a single officer response on the islands and hopping on and off the boat between islands to respond to cases.

One of the biggest things I learnt whilst being out west was the importance of our role within communities. It is not just about responding to cases and carrying out our duties, it is important to truly be part of, and engage with the community on a daily basis, and support people socially and during local events. This concept is something I want to bring to the islands, to show residents that as a service we are part of their community not just for emergencies!