PARAMEDIC REGISTRATIONS • INTRODUCING ISRE • TOOLS FOR STAFF • IAED AWARDS
Summer 2018–19
Also inside Aaron’s award
Steve’s journey
Summer 2018–19
G-Wizz! Wagon
APEC volunteers
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CONTENTS • Summer 2018–19
Features
Regulars Minister’s message
2
Commissioner’s message
2
Briefs 4 Paramedic registration Mental Health
8 18
LARU 29
QAS NEWS ROUND-UP
SCHOOLIES 2018
3
7
IN THE EYE OF THE STORM
EMERGENCY CALL
10
12
Designed by: Masthead Design & Creative
ROYAL VISIT
G-WIZZ NEW 4WD
Autumn 2019 edition key dates: • Friday, 15 Feb: advertiser bookings • Friday, 22 Feb: supplied artwork received • Friday, 29 Mar: scheduled release
22
28
MACKAY REMEMBERS
QAS STAFF FORUMS
32
38
HARU 33 Priority One
34
Thank yous
40
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. SUMMER 2018–19 edition contributors: Jo Hales, Michael Augustus, Andrew Kos, Emma O’Connor, Jo Mitchell and Melissa Mangan.
Front cover: The Duke and Duchess of Sussex were introduced to the QAS’ Hervey Bay Patient Transport Officer Danielle Kellam and Advanced Care Paramedic Graeme Cooper during the Royal visit to Fraser Island in October 2018, thanks to the warm interest and support of Premier Annastacia Palaszczuk and her office. Photo: Jo Hales Read more: pages 22–25
Summer 2018–19
1
Minister
Commissioner
It’s hard to sum up one year in a few short paragraphs, particularly when we have achieved so much.
Christmas is just a few days away which always leads me to reflect on the year that was and our achievements as an organisation.
From a successful Commonwealth Games response to tonnes of new station openings and the delivery of additional staff and record funding, my first full year as your Minister has been a memorable one. What I like most about my position is getting around the state speaking to as many of you as I can to get a genuine understanding of your jobs — the day-to-day intricacies, the technical aspects, the enriching parts and the challenges. I recently travelled to Thursday Island to visit the hardworking officers there and inspect their new station. It was fantastic to see how this great investment is benefiting the local community. It ensures they are receiving the highest level of care, regardless of where they live in Queensland.
2
During my visit I learnt all paramedics based there are flight-trained for the rescue helicopter and in the event of a search and rescue incident can respond as far south as Weipa. It struck me how the officers at Thursday Island — and particularly the Indigenous Paramedic Cadets — are helping build the foundations for the future of emergency and pre-hospital care in the region. Just like the rest of you right across the state. The things I’m most proud of this year are the well-overdue pay rise delivered to the hardworking staff of the QAS and making sure paramedicine becomes a nationally regulated profession and the title ‘paramedic’ is protected by law. 2018 was also another year of innovation for the service. In November I was fortunate enough to test-drive the new G Wagon 4WD module ambulance before it was sent across the state for operational testing. It is exciting to see how a vehicle like this will deliver improved patient and officer safety in some of Queensland’s most rugged and challenging environments. With the festive season now in full swing I’d like to thank all the staff who are giving up time with their families in order to serve the community. Your dedication is much appreciated. I wish you all a happy, healthy and safe holiday season.
It has been a busy year and I would like to extend my gratitude to you for your dedication and positive attitude. It is not an easy job, I recognise that, and your commitment to the QAS and our patients is highly valued. One of our key focuses this year has been paramedic registration. The process has now closed, and I would like to thank you for taking the time to submit your registration applications. The impacts of registration will be broad and beneficial to those who register, their colleagues, and the broader public. The Paramedicine Board of Australia has adopted a series of Professional Capabilities for Registered Paramedics which identify the knowledge, skills and attributes required for safe and competent practice of paramedicine in Australia. These guidelines, along with the Registration Standards, will assist to strengthen our profession and drive accountability for all health care professionals. I would also like to thank everyone who participated in the Working for Queensland Survey. Sixty-five per cent completed the survey, making it the highest response rate the QAS has achieved since the survey commenced in 2013. At this stage we have received preliminary results, which highlight the positive changes across most areas of the survey, with only some minor reductions across a couple of areas. I am very proud to see positive changes particularly regarding Workload and Health, Flexible Work Arrangements, Learning and Development, and Agency Engagement. These areas have been key themes discussed at the QAS Workforce Forums. We will continue to engage with you via the QAS Workforce Forums during 2019 to further understand your views as we continue to shape and redesign our future workforce to meet your needs and deliver on our vision of Excellence in Ambulance Services. Christmas is a joyous time of the year. I trust you will be safe over the Christmas and New Year period, take care of yourself and keep an eye on those who are vulnerable. Wishing you a safe and happy festive season.
Steven Miles MP Minister for Health and Minister for Ambulance Services
Summer 2018–19
Russell Bowles ASM QAS Commissioner
QAS news round-up
42 for 42 endurance challenge QAS staff smashed their fundraising target of $1200, raising more than $1700 for not-for-profit organisation 42 for 42 after taking part in an endurance challenge at Suncorp Stadium in November. 42 for 42 was set up to raise funds for a memorial to be built outside Suncorp Stadium for Australian soldiers who lost their lives in the Afghanistan War during 2001—2014.
Hannah Gaulke award Congratulations to QAS Critical Care Flight Paramedic Hannah Gaulke, who was recognised at an award presentation in Innisfail in November, along with members of five other services, for their involvement in the search and rescue of a female who was missing on Mount Tyson near Tully for more than five days in June. Amazingly, the patient was found safe and well with only minor injuries after two days of searching.
Former solider-turned-paramedic Tom Kelsey rallied the QAS contingent at the 42-hour endurance event which commenced in Suncorp Stadium on Friday 9 November and finished on Remembrance Day. Other QAS staff who joined in the challenge were Deputy Commissioner Michael Metcalfe, Troy Aspinall, Sandy Thornton Ruddiman, Carlie Whiteley, Wayne Loudon, Barrie Barker, Torrin Nelson and Rhys Greedy.
3
Emergency Services cricket carnival Howzat! Wickets fell, runs were made and, most importantly, money was raised for charity at an Emergency Services cricket carnival in Townsville in October.
QFES and the Army also rolled the arm over to raise awareness and funds for the Townsville Hospital and Health Service Dementia Unit.
The QAS ladies team defeated their QPS counterparts but, unfortunately, our men’s team was bowled over by the boys in blue.
Kirwan A/OIC Steve Willdin and the Kirwan Local Ambulance Committee achieved 149 Community CPR participants as well.
Summer 2018–19
Briefs GC2018 presentation Assistant Commissioner Gerard Lawler and the team that worked with him on the Gold Coast Commonwealth Games (GC2018) were presented with a framed tribute of memorabilia at the KJ McPherson Education and Research Foundation’s annual awards and symposium in Brisbane on 23 October. Two framed collections were made and will be put on display at the QAS Wynnum and Charters Towers museums as enduring commemorations of the professional and valuable contribution made by QAS and its staff to the GC2018.
4 Sebastian’s reunite Young Sebastian was the centre of attention when he and his extremely grateful mum attended a recent special reunite with the QAS officers who helped save his life on Australia Day this year. The toddler was snacking on grapes when he began choking and became unresponsive. Bystanders quickly leapt into action by calling Triple Zero (000) and commencing CPR. Within minutes of arriving on scene, Dr Stephen Rashford, Critical Care Paramedic Paul Gray and Advanced Care Paramedics Shane Mattingley and Sarah Dunk were able to clear Sebastian’s airway and assist his breathing. He was then transported to Queensland Children’s Hospital for further treatment.
Summer 2018–19
BRIEFS • Summer 2018—19
Priority One awarded – again! It was a very proud moment for the QAS when our Staff Support Service Priority One was awarded the Open Minds 2018 Queensland Mental Health Week, Large Workplace Award for the second year in a row in October. Priority One Director, Staff Support Services, Todd Wehr said the award was recognition of the many QAS staff and executives who had placed the health and wellbeing of personnel on the top of the organisation’s agenda through the ‘Priority One’ staff support program.
“The award acknowledges the hard work being undertaken by all involved in Priority One, including counsellors and volunteer peer support officers,” Todd said. “This is a program that is actually up there in terms of a gold standard and is an indication of how Priority One has evolved over time and maintained current best practice.” Priority One has been in place for more than 25 years and each year the program has around 3,500 contacts from staff and their families seeking support.
5 Leadership in Townsville The QAS hosted the Department of Health Women’s Network ‘Position Yourself’ Workshop in Townsville on 10 October. The interactive one-day workshop was delivered by Executive Coach, Facilitator and Consultant Jenny Brice and provided attendees with the knowledge and practical tools to assist them in developing their confidence in the workplace. A highlight of the program was when Assistant Commissioner Michelle Baxter shared her leadership journey with the crowd during her inspirational keynote address.
Summer 2018–19
Frontline recruitment Recruitment of the right people into our frontline positions is critical to achieve our goals and deliver patient-focused services for the Queensland community.
Above ■ Core HR recruitment team members (front row) Brierley Richardson, Kate McCoist, Kristine Bates, with (behind) Stacie Ramanah and Alicha Edwards. Absent this image: Rikki Scriven and Shaylee Cunington.
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On average, more than 3500 applications are processed annually by our small recruitment team within the Human Resources branch of Corporate Services. The recruitment team manages all aspects of the application process for a number of campaigns including Graduate and Qualified Paramedics, Emergency Medical Dispatchers (EMDs), Patient Transport Officers (PTOs), Critical Care Paramedic Interns, Indigenous Cadets and Supervisory Recruitment. As well, the team coordinates all voluntary and compassionate transfer requests. Over the last five years QAS Recruitment, in consultation with key stakeholders, has undertaken several reviews of our operational recruitment processes. These reviews have allowed the team to implement significant improvements and efficiencies to our processes and has created a new, holistic and more inclusive way of recruiting through an assessment centre model.
Feedback is sought anonymously from new starters and all QAS personnel who have helped with the process to gain insight on potential improvements and to ascertain what works effectively in our current structure. Our team actively participates in Workforce Forums, the Classified Officers’ Development Program (CODP), KJM, ride-alongs with operational supervisors, tours of facilities including OpCens and any other developmental opportunities that may assist with continually extending our operational knowledge of the business.
Many of our recruitment campaigns now include an assessment centre and involve clinical and technical experts from the LASNs and QASEC to assist with shortlisting, assessment and selection of candidates. Below ■ An example scenario assessment is played out and carefully reviewed.
To further extend and evolve our processes, we have recently implemented post-campaign feedback which is currently being piloted through the EMD campaigns. Above ■ Panel members CCP Jack Williams and SOS Kristy McAlister review notes following an assessment.
Understanding the role of each division/unit in the organisation is critical in order to achieve our goals. Our team has worked extremely hard to understand the needs of each LASN and the candidates when recruiting. We pride ourselves on the relationships we have built and continue to maintain with key stakeholders. Our ongoing reviews, improvements and fostering of effective working relationships have successfully increased the calibre and professionalism of our recruits and contributed to the significant statewide attrition reduction.
Summer 2018–19
DepartmentSchoolies title / section Week/ topic 2018
SEILOOHCS
Schoolies 2018 kicked off in Surfers Paradise on Saturday 17 November with almost 21,000 teens officially recorded as wrist-banded Queensland school-leavers. Gold Coast Senior Operations Supervisor, Major Events and Planning Rachel Latimer, who was the Forward Commander and official QAS spokesperson for the event, said that throughout the week there was a large number of drug overdoses and drug and alcohol combination presentations at the Ambulance Treatment Centre (ATC) requiring assistance from QAS and Queensland Health staff.
“As per most years, there are always people who do silly things, but there were also a lot of Schoolies who were well-behaved and doing the right thing,’’ Rachel said. She also praised the QAS Schoolies response team: “We had a great bunch of officers working very hard over the Schoolies response period. They demonstrated patience and flexibility in a challenging environment: I can’t thank them enough for their efforts.” DATE
Transports to hospital From ATC Bypass ATC
Male
Female
Schoolies
Others
TOTAL
Sat. 17th
14
36
46
4
50
3
Sun. 18th
28
62
87
3
90
2
0
Mon. 19th
35
63
58
40
98
2
5
Tue. 20th
21
27
31
17
48
2
0
Wed. 21st
35
53
81
7
88
5
4
Thu. 22nd
49
52
94
7
101
1
3
Fri. 23rd
44
41
80
5
85
3
5
TOTAL
226
334
477
83
560
18
18
Summer 2018–19
7
1
7
Paramedic registration: National Paramedic Registration update
Article title
Q+As
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Q Now that I am registered, what ongoing professional development should I undertake?
Q How long will my paramedic registration last and when will I need to renew my registration?
Q Do I need to comply with other standards once I am registered as a paramedic?
A You will need to build a portfolio of educational activities completed in the 12 months following your registration commencement. This is known as Continuing Professional Development (CPD).
A Registration generally lasts for 12 months, meaning that your registration will be due for renewal by 30 November 2019.
A
Yes. In relation to your registration you have ongoing responsibilities to ensure you maintain professional indemnity insurance (PII) that complies with the Paramedicine Board of Australia’s requirements, that you maintain currency (Recency of Practice Standard) and you comply with the Code of Conduct and other codes and guidelines applying to the profession.
Genuine learning occurs when you apply what you have learned in your professional practice. Research indicates that CPD may be more effective when it involves planning and reflection.
Reflection means thinking carefully about your CPD, what you learned and how you might use it to improve your practice as a paramedic.
Your CPD should include elements of tier training and interprofessional learning, planning and reflection.
QAS training will qualify towards your CPD.
Renewal is a similar online process to your original application for registration and will require you to be compliant with the Paramedicine Board of Australia’s National Standards.
You will not have to provide your qualification details or education and English language skills information again.
This information can be found on the Paramedicine Board of Australia’s website at:
There will also be some questions on your working profile that will be used by AHPRA to build the paramedicine/ paramedic demographic in Australia, like that of the other registered health professions.
www.paramedicineboard.gov.au
There are also standards, codes, policies and procedures that continue to apply in respect of your employment with the QAS.
You must comply with these as well as those set by the Paramedicine Board of Australia.
Summer 2018–19
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Summer Spring2018–19 2018
In the
ye of the storm …
While most people would seek safety during a natural disaster, QAS Critical Care Paramedic Gavin Cousens has on more than one occasion risked his own life to help those in need or in danger when catastrophe strikes. Jo Hales writes about the officer who recently received a Queensland Police Service (QPS) bravery medal for his heroic efforts during Cyclone Debbie. Gavin Cousens will never forget Tuesday 28 March 2017, the day Cyclone Debbie unleashed her almighty fury on the Whitsundays and tore through the town of Proserpine where he lived and worked. Gavin, who was the OIC of Proserpine Station at the time, was on duty at the station while gale-force winds lashed the area. “At around 11am, I looked outside the window to see the house opposite the station being destroyed,’’ Gavin said. “The roof was coming off, the walls were falling apart. I did not know it at that time but there was actually someone in the house. Thankfully, they were unharmed.
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“My house was about 400 metres down the road on the same side of the street so I was also wondering how it was holding up,’’ Gavin said. As Gavin was filming the unfolding carnage on his mobile phone, he received a call from the Local Ambulance Coordination Centre (LACC). “I was informed a patient had sustained significant injuries after he had been hit by flying debris from a neighbour’s roof that breached the walls of his adjacent property,’’ he said. And while Gavin desperately wanted to get into an ambulance and drive 800 metres to assist the patient and his wife, he had to endure an agonising wait due to the intensity of the storm.
Summer 2018–19
“It was a really tough period knowing that someone needed my help but I was unable to get to them.” Gavin was advised by the Clinical Deployment Supervisor and LACC that he had permission to head out and attempt to save the man’s life during the eye of the cyclone. “There was a coordinated effort through the LACC and the local QPS team that, when the eye passed over Proserpine, I would liaise with the police by phone and when we saw our chance we would head out to the patient,” Gavin said. His window of opportunity came while he was watching the cyclone live on television, thanks to the station’s generator. “I witnessed the eye of the storm pass through Airlie Beach and I was hoping it would come Proserpine’s way as well and, thankfully, it did,” Gavin recalled. He and two QPS officers — Sergeant Mark Flynn and Constable Gary Lee from the Proserpine Police Station — then made their way to the scene and they were met by Peta, the very relieved wife of the patient. She had been caring for her now critically-injured husband Fred for three hours. “Fred was very seriously injured. He had a deep laceration to his upper arm that went into his thoracic cavity,’’ Gavin said.
QPS Bravery Medal for QAS CCP
After treating and stabilising Fred, Gavin drove him to the hospital, but his intense shift did not end there. “When I hopped back in the ambulance to go back to the station, the coordination centre asked me if I could do a couple of Code Twos relating to the cyclone, so I also went and picked up a man with a fractured humerus and another man with an ankle injury.” In October 2018, Gavin, along with the two police officers, received QPS Bravery Medals for their contributions in the Cyclone Debbie disaster of 2017. Making the award even more special for Gavin is that he is the first person outside the QPS to receive this Bravery Medal. Gavin said it was an honour to be recognised by the QPS for his efforts that extraordinary day and that ‘it was a very humbling experience’. He also paid tribute to his wife, Jenni Cousens, as she was the one ‘who made it possible’ for him to work that day thus allowing him to be in the right position at the right time. “The only reason I could be at Proserpine Station that day was because my wife, who is also a paramedic, took our three children out of the area to be safe,” he said. “I also feel strongly that I accept the award on behalf of all the QAS staff who assisted the community during Cyclone Debbie. “From everyone in the communication centre that relayed first aid information to the patient’s family, to the other paramedics manning their stations and to all the personnel that came to the region from all over the state to assist before and after the event, I sincerely say ‘thank you’,” Gavin said.
Above left
Gavin is no stranger to brave rescues during natural disasters. In 2010, when he was working in Rockhampton, a bushfire ravaged the town and he sprinted towards the flames to save the life of a woman who was trapped in her house. She had fallen down and was unable to escape the flames which were advancing.
■ Gavin strides into the inferno in Rockhampton in 2010.
Photo courtesy The Rockhampton Morning Bulletin
Gavin, who received burns to his face, reached the lady when the flames were just one metre away from her. “It all happened so quickly so it was a bit of blur, but I just quickly hauled her out of there.” Following the heroic gesture, Gavin was presented with a QAS Meritorious Service Award by former Commissioner David Melville.
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In June 2018, Gavin, Jenni and their children Cody, 7, Chloe, 5, and Charlotte, 2, moved back to Rockhampton — more than four-and-a-half years after they left. He is currently working as a casual paramedic at Rockhampton Station due to an opportunity arising to take a full-time position at Central Queensland University as a Paramedical Science lecturer. Meanwhile, Jenni, the main carer of their young children, is working part-time at Rockhampton Station with the aim of one day resuming her full-time OIC role there. As Gavin reflects on his 15-year career with the QAS, the former Royal Australian Army medic said it has certainly been an amazing experience.
Above
■ Poignant Proserpine reunite with the wife of the injured man, before the boarded-up facade of the damaged home. Left
■ A deservedly-proud Gavin, following the presentation of the QPS Bravery Medal.
“I love being a paramedic and I feel extremely fortunate about being a part of the QAS as the service has afforded me so many great opportunities and memories,” he said.
Summer 2018–19
A handful of Emergency Medical Dispatchers (EMDs) got a chance to experience life on the small screen when featured in a new national television series taking a behind-the-scenes look at our Triple Zero (000) call-takers, as Andrew Kos reports.
Right ■ EMD Tori Mathison’s face is a picture of intense focus on a call in this still from the series.
Australia’s Emergency Call was filmed by the Seven Network over five weeks at the end of 2017 when a three-person film crew embedded themselves in the Brisbane Operations Centre following several of our EMDs throughout their shift. The aim was to capture the essence of the work undertaken by EMDs in a unique documentary-style look into the heart of emergency services around Australia. The program focused on Triple Zero (000) call centres in Brisbane and Melbourne and the staff who answer calls, providing the first contact with the public during their emergency.
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Background ■ Despite the intense scrutiny of the television cameras, EMD Louise Curtis continued to concentrate on her duties.
The six-episode series began airing on Channel 7 in a prime-time 7:30pm timeslot in October and proved to be compelling viewing, with the show rating well.
Summer 2018–19
Four of our Brisbane EMDs were featured in the series with many more providing cameos. Tori Mathison was one and wanted to give the public an insight into what EMDs do. She found working with the film crew an interesting experience. “It was often a bit awkward having someone following me and sometimes I wouldn’t realise I was likely doing something ridiculous until I turned around and saw the cameras pointed at me,” Tori said.
EMDs featured in EMERGENCY CALL
Another of the EMDs featured in the program, Emily Mildred, explained that viewers would have definitely gained a full insight to the job. “I’ve had a few people ask, ‘is that really what you have to do every day?’” Emily said. “Explaining the role and responsibilities is always a big eye-opener — the highs, the lows, the frustrations. People are certainly learning it’s not an easy job and it can take its toll emotionally some days. It’s not a job that everyone can do.” All sorts of calls were featured in the show, including a baby birth, a gas explosion and a nightclub stabbing, creating enough heartstopping, realistic moments that may see the show return for a second season. “We spent quite a lot of time together and it was interesting to bond with them and show them the ins and outs of the job to allow them to better portray what it is that we do.”
13 Header
■ EMD Emily Mildred at work in a still from the series.
Below
■ Emily being interviewed to camera at Kedron Park.
Louise Curtis had been an EMD for only a number of months before she found herself popping up in promos for the show. “The strangest part has actually been when I’ve been at work, and there’s a Channel 7 ad playing on the large monitor and my face is staring down at me — I don’t think anyone is comfortable seeing themselves on the big screen!” Louise said. “I really hope that viewers can appreciate how important their role is in making a call to emergency services. Their cooperation and information is paramount to us being able to do a good job for the patient until our incredible paramedics arrive to take over.”
Summer 2018–19
Outstanding first-time award nominations It was a defining moment for the QAS when four of our finest EMDs were recently nominated for the International Academies of Emergency Dispatch (IAED) Dispatcher of the Year Award.
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Rhonda Connors, Tracey Dodd and Michelle Kelly from the Brisbane Operations Centre, and Trista Buckley from the Townsville Operations Centre, flew to Sydney mid-November where they were acknowledged at the Australasian Navigator conference.
The award recognises individuals who have made the most significant contributions to further the values and missions of the Academies through personal action.
Acting Manager Clinical Education Jo Mulvaney said that while the EMDs were not selected as the Dispatcher of the Year, all State Operations Centres staff were extremely proud of their accomplishments.
• compliance with Medical Priority Dispatch System (MPDS) protocols
“This is the first time we have had our staff nominated for this award and having four meet the criteria for entry is a huge plus for the QAS and the community of Queensland and an incredible individual achievement,” Jo said.
Nominees must consistently demonstrate the following qualities:
• a commitment to teamwork • initiative to further professionalism and education
In addition, each of the EMDs’ submissions to the Academies required supporting audio of a Triple ZERO (000) call involving either: a difficult caller, extraordinary circumstance or a positive outcome. Rhonda’s called involved her providing CPR instructions to the wife of a 56 year-old man in cardiac arrest. Tracey calmly instructed a young man to successfully perform the Heimlich manoeuvre on his choking father.
• the ability to function well under highly stressful situations.
Michelle provided CPR instructions and support to the family of a 15 yearold girl whom had hanged herself.
“All four QAS nominees prove their commitment to our callers and patients by continually demonstrating these qualities,’’ Jo said.
Trista’s call was a child birth in which the lady delivered her baby on her own, with the newborn’s father sleeping through the birth.
Summer 2018–19
IAED Dispatcher of the Year Awards 2018
Submissions required an explanation of why the EMD was deserving of the award:
Rhonda Connors
Tracey Dodd
“A quiet achiever, Rhonda always engages with callers in a professional, compassionate and conversational manner. She always strives to deliver personalised care and ensures that all appropriate protocol questions and instructions are provided.”
“Regardless of the situation, Tracey’s ability to communicate enables her to gather the information she needs yet always deliver the service and support our callers have the right to expect. Seemingly with ease, Tracey has the ability to make even the most distressed of callers feel confident that they are in safe hands.”
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Michelle Kelly
Trista Buckley
“Michelle engages with callers in a professional and conversational manner. She balances this nicely with personalising the service provided to the caller and ensuring that all appropriate protocol questions and instructions are provided.”
“To further promote team unity, Trista has arranged a number of OpCen Team events which have included ‘Hit the Hill’ and ‘Biggest Morning Tea’. Trista has a calm demeanour which helps her manage stressful situations. This relaxed approach has seen her develop into a respected and well-liked EMD by both her peers and on-road staff.”
Background image
■ The International Academies of Emergency Dispatch trophy. presented at the EuroNavigator event.
Photo: Pam Stewart, Chair, IAED Board Certification
Opposite page
■ The four proud QAS EMDs who were acclaimed at the IAED Australasian Navigator Conference in Sydney.
Summer 2018–19
Holidaying paramedic’s hands-on help QAS paramedic Aaron McNeill recently received a civilian’s award from the NSW Ambulance Service for assisting at the scene of an horrific car crash on Boxing Day 2017 that ultimately claimed the lives of five people, including former Home and Away actress Jessica Falkholt. Jo Hales talked with the humble Metro South officer who was the first medic on scene. On Boxing Day 2017, Advanced Care Paramedic Aaron McNeill and partner Tasia Nita were making their way to Sydney airport to catch a flight to Perth after enjoying a fun-filled Christmas with extended family in Narrawallee when their holiday took an unexpected turn. “We had a great time catching up with my family for Christmas and we were also excited to be heading to Perth to meet Tasia’s newborn niece,’’ Aaron said.
16 Above
■ Aaron McNeill at his regular day job with the QAS.
Background image
As he came around the corner, Aaron was confronted with a devastating sight. Two cars had collided head-on; both were in flames.
“At the last minute we decided to leave Narrawallee early so that we could visit Tasia’s cousin on the way to Sydney airport.’’
About eight metres away from the cars were two females lying on the ground. They were both breathing — but they were not in a good way. Bystanders had bravely pulled them out of one of the burning cars.
As fate had it, Aaron and Tasia never made it to the cousin’s place; instead they came across the horrific fatal car crash on the NSW south coast near Bendalong.
Aaron would later discover that the 29-year-old female was former Home and Away star Jessica Falkholt. The younger patient was her sister Annabelle, 21.
Little did Aaron know at the time he would be the first medic on scene and play a crucial role in assessing and treating two patients who survived the fiery crash.
Their parents, Lars and Vivian, were killed instantly in the crash. The driver of the other car, 50-year-old Craig Whitall, was also dead.
“As we were approaching the Bendalong exit travelling north, the traffic started to slow down,’’ Aaron said.
■ View north from the southbound lane of the Princes Highway, 400m from the Bendalong Road turn-off. This April 2018 image shows the central crash barrier which was installed after the fatal events of 26 December.
“I couldn’t see what was going on as there was a bend in the road, but I thought there might have been a vehicle broken down. Then there was a huge plume of smoke, so I just got out of my car and started running towards it.”
Photo: Google Street View
Summer 2018–19
After surveying the scene, Aaron knew there was a risk the cars could explode, so he and other bystanders rallied people to grab blankets from their cars so they could carefully move the two patients another 10 metres down the road behind a police car which had just pulled up.
Holidaying paramedic’s hands-on help
Aaron then quickly got to work assessing the patients. Both Jessica and Annabelle were critically injured, suffering multiple injuries. When the first ambulance arrived on scene, Aaron continued to play an integral role in treating and stabilising the sisters. He assisted with the clinical care, supporting the road paramedics and flight crews. Meanwhile, Tasia played an integral role at the scene supporting Aaron in his care, as well as comforting bystanders. Sadly, despite all the efforts from everyone at the scene that day, including an off-duty doctor and the emergency crews who responded to the incident, both siblings later died. Before leaving the deadly crash scene several hours after he had sprung into action, Aaron handed his details to police and the on-scene commander. “It was a surreal moment as I was driving away because I was thinking ‘if we had had just left my family’s place a few minutes earlier that could have been us’,” Aaron said. “And while I felt a deep sense of sadness, at the same time I was so glad that I had been able to assist.” When Aaron rang the hospital in the days following the crash to check on the conditions of the sisters, he was put into contact with a relative, who continued to keep him updated on their conditions.
And while he was honoured to accept the award from NSW Ambulance Commissioner Dominic Morgan, Aaron said the event, which was also attended by NSW Premier Gladys Berejiklian, also gave him some closure as he was able to chat with emergency crews who had attended the incident. “I caught up with the Intensive Care Paramedic, Ian Watson, who was the first on-duty paramedic at the scene, and a flight crew. “It was great as it allowed us to debrief about the crash. We didn’t have the opportunity to do it on the day.” Aaron joined the QAS in 2013 after working in the hospitality industry as a restaurant consultant. It was no surprise he eventually became a paramedic as his interest and admiration for the profession stemmed from a traumatic childhood incident he witnessed. “When I was 10 my dad collapsed in front of me and I couldn’t wake him,’’ he said. Aaron’s dad, who at the time had undiagnosed pneumonia and a pulmonary embolism, went into respiratory arrest. Thankfully, he survived and it is the image of the ambulance officers ‘treating my dad with care and compassion and giving him a second chance at life that stuck with me,’ Aaron said. “It is a large part of why I eventually became a paramedic. I love being able to help people.”
Above
■ Aaron receives his award from NSW Ambulance Commissioner Dominic Morgan.
Below
■ Floral tributes by the side of the Princes Highway a reminder of that deadly Boxing Day 2017.
Photo: Google Street View
Photo: Google Street View
Nine months after the tragic crash, Aaron was surprised to learn he had been invited to a ceremony at Bankstown Super Ambulance Station where he would be presented with a civilian’s courage award for his courageous efforts that day. “I didn’t expect to receive an award or recognition,’’ Aaron said. “For me it was just another day in the life of an off-duty paramedic. I‘m sure anyone with my background would have done the same thing.”
Summer 2018–19
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Steve’s journey back is brimming with support When ACP Steve Turner — or ‘Stevie T’ as he is affectionately called by his mates — started to feel unwell after attending jobs, he had no idea his mental health had been compromised. Jo Hales reports on an all-round nice bloke and dedicated paramedic who is getting his life back on track after succumbing to a stress-related disorder. Chermside paramedic Steve Turner has always been the dependable one. The strong partner, mate and colleague who helps and protects others and makes them feel safe, so when he found himself out of sorts at work in late December 2017, he initially brushed it off. Steve, 30, didn’t know it at the time, but jobs he had been attending were beginning to affect his mental health and he would eventually be diagnosed with Adjustment Disorder, sometimes referred to as situational depression. Triggered by a stressful situation or event, Adjustment Disorder symptoms can include sadness, trembling, twitching, physical complaints, withdrawal and anxiety.
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Ten months after he initially sought help for his symptoms, Steve, who is currently working in the Media Unit whilst he is receiving treatment and therapy, is sharing his personal struggles with his QAS family in the hope it helps at least one person who may be experiencing the same symptoms, as well as those who may be worried about speaking up for fear of losing their job. “Although I didn’t realise it at the time, my symptoms started surfacing shortly after Christmas when I attended a number of serious cases in a short time — including two cardiac arrests on the same night,” Steve said. “One of the patients was a 50 year-old male who had collapsed at his home; unfortunately, he was unable to be revived. The other was a man who went into cardiac arrest after having a seizure.”
Summer 2018–19
Family members were present at both cases and both scenes were emotionally-charged; however, looking back, Steve said it was the second job that affected him. “The patient was a husband, father and a grandfather and all three generations of the family were at the home following Christmas,’’ he said. “When my partner and I arrived on scene we took over the compressions from his son and worked on him for 45 minutes. During this time, we managed to get Return of Spontaneous Circulation (ROSC) several times.” In between giving compressions, Steve, who was assisting with case management, would update the anxious family on the patient’s condition. “Going back and forth and giving the family the mix of good and bad news wore me out,’’ Steve said. “One minute there was hope, then there was despair, it was very distressing for them.” As well, the case started to make Steve think of his family and how he would feel if he was in the same situation. “Here was this upset wife, and I was just thinking ‘wow this family reminds me of my own, what if that had been my mum or if that was my dad who was in cardiac arrest’,” he said. After the third ROSC the patient was transported lights and sirens to hospital. Sadly, Steve was later informed the patient died in hospital.
MENTAL HEALTH FEATURE
“At the time I didn’t realise I was stressed or affected by this case, I just thought things would sort themselves out after a couple of days off.” But that was not to be.
However, Steve felt no better when he came back from his days off and after attending a standard Code One left work sick and headed straight to a GP.
It was New Year’s Eve and Steve was working his second night shift following his days off, when he found himself out of sorts following another case — a teenage patient who was the victim of a suspected sexual assault. Steve and his partner treated and transported the girl who had extensive bruising to her neck, arms and hips and could barely recall the alleged incident.
“When the GP asked me what was wrong I just broke down and started crying. There was a big sense of sadness and shame,” Steve said.
On the following days off Steve started to feel physically unwell and have interrupted sleep. “I had never been one to have problems sleeping or to have reflux or an upset stomach but they were becoming my constant companions. The fatigue hit me hard too.” In addition, there was no slowing down on the intense cases. In the following week Steve attended yet another cardiac arrest. On this occasion, a middle-aged man had gassed himself in his vehicle. Steve and his partner got ROSC, but the man later died in hospital. “For the next month my physical symptoms — including the reflux, upset stomach and decrease in energy levels — continued, but I still didn’t realise I was stressed. I just thought I was physically unwell. I didn’t put two and two together,” Steve said. It was after another shift when Steve assisted in the management of a critically unwell infant that he also started experiencing mental health symptoms. “Even though the baby improved in the ambulance I was incredibly anxious after the job and I had never been an anxious person. After pushing through the next eight hours I ended up finishing my shift 45 minutes early as I couldn’t bring myself to attend another case.”
“Up until then I had always been the solid one. The one who had been dependable — not the sick one or the one who needed to be looked after.” Steve was prescribed medication as part of his treatment to help him relax. He then had four weeks off and started regular sessions with a Priority One counsellor. After a psychiatrist diagnosed Steve with Adjustment Disorder with traits of Post-Traumatic Stress Disorder, he was informed he would need to be off the road for at least six months. Steve started out on light duties at the station but felt he could do more to contribute to QAS, which is when Chermside OIC Doug Buchanan met with Assistant Commissioner Chris Broomfield to discuss the best work strategy for him. AC Broomfield then approached QAS Media Director Michael Augustus to see if he would offer Steve a paramedic placement in the Media Unit. And the rest, as they say, is history for Steve, who became a paramedic in 2010. “Working in the Media Unit has given me a sense of purpose, I feel like I am contributing to the organisation,’’ Steve said. “Just because someone cannot fill the role of a paramedic, it doesn’t mean that they can’t assist in operations centres, clinical education or other areas of the QAS.”
Opposite page
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■ No bars to seeking help: ACP Steve Turner’s message to colleagues.
■ Steve involved in CPR demonstrations at the Brisbane EKKA.
Photo: Jo Hales
Photo: Studio Deco Photography
Summer 2018–19
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Above
Above
■ Steve ‘the strong one’ supporting mobile blood donations.
■ Steve regaining his strength, supported by ‘amazing’ girlfriend Amy.
He is also learning new skills and is now an old hand at starring in newspaper stories and television bulletins when he represents the QAS at media opportunities.
“I am definitely not back to my former self, but I am slowly getting there,” he said.
Although Steve is enjoying his time in the Media Unit, his goal is to ultimately get back on the road full-time. He has recently started working one to two shifts each week as a LARU officer and is revelling in the chance to connect with patients and provide advice and treatment. “I am still a bit worried about my job. I know there will always be a role in the QAS for me, but I still don’t know what area that lies in. However, it is reassuring to know that there is a permanent position for me.” Steve, who at his worst had thoughts of self-harm, said it is rewarding to finally be getting his life back on track. Aiding his recovery has been a positive mind frame, therapy, medication and a ‘great support network’.
Summer 2018–19
“I’m pretty lucky to have an amazing girlfriend. Amy has been invaluable in my road to recovery, as has my family, friends and my QAS colleagues and managers including work partner Laura Kirby and OIC Doug.” Steve strongly encouraged anyone who is feeling out of sorts, sad or displaying unusual physical symptoms to seek help or advice immediately — whether it be Priority One, a GP or a friend or family member. “Taking that first step can be hard but, trust me, once you do, it really does take the weight off your shoulders.” Background
■ ACPs Daniel Wilson and Steve Turner with the LARU Hyundai iLoad.
Photo: Jo Hales
MENTAL HEALTH FEATURE
Assistant Commissioner Peter Warrener said the QAS has many initiatives aimed at reintegrating staff with ‘mental health injuries’ back into the workforce. “When they start their shift they just have to sign out their drugs and do their vehicle check list.
“If you have any concerns for a colleague talk to them about it and ask them if they are okay.”
The most recent program has been operating for 18 months and aims to instil positive confidence back in an officer when they are attempting to return to work.
“Meantime, the positive reinforcement supplied by staff to the officer with a mental illness makes the officer still feel they can make a difference and this is important for their health, progression and recovery.”
Peter also urged staff to have mental health check-ups, which are just as important as a normal health check-up.
“We tailor the program to each individual and what their medical officer advises, but one of the tasks we have had success with is getting an officer to detail and restock ambulances for crews who are on night shifts,’’ he said. “There has been such a positive reaction to this. As Metro South paramedics are quite busy, colleagues love having their ambulance operationally ready to go.
Peter said it is important that all QAS staff continue to have conversations in the workplace about mental health. “Mental health is not something to be ashamed of, rather it is something that we should be talking about openly,” he said. “It is also important that staff look out for one another each shift.
“Remember it is okay to get a check-up from the neck up,” he said. “I would encourage everyone to get a mental health check-up with a Priority One psychologist once a year — even if you don’t feel there is anything wrong with you.”
Photo: Adobe Stock / Helmut Singer
“When someone has a musculoskeletal injury, we do everything we can to rehabilitate them through various resilience programs and get them back to what they were doing prior to the injury — it is the same for our staff who have experienced a psychological illness or injury,” Peter said.
Peter has been trialling mental health resilience programs in the Metro South LASN for some years
Summer 2018–19
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Royal recognition for the QAS On 22 October 2018, QAS officers Danielle Kellam and Graeme Cooper experienced a once-in-a-lifetime opportunity when they met their Royal Highnesses the Duke and Duchess of Sussex on Fraser Island. Hervey Bay Patient Transport Officer Danielle Kellam and Advanced Care Paramedic Graeme Cooper’s meet and greet with Harry and Meghan capped off what has been an incredible year for the two officers.
Above
■ INSIGHT editor Jo Hales accompanied Danielle and Graeme to Fraser Island, and reports on their amazing opportunity and the fantastic efforts by all Emergency Management Unit and operational staff to ensure the QAS response during the Royal visit was a great success.
22 Background
■ An excited crowd greets the Duke and Duchess of Sussex as they walk along the jetty at Fraser Island.
All photos this feature by Jo Hales
They first gained worldwide attention in November 2017, when a photograph taken of the moment they showed compassion and care towards a palliative patient they were transporting was shared on the QAS Facebook page, resulting in millions of views and significant media interest worldwide. Fast-forward almost 12 months and the pair was once again in the spotlight — and attracting attention from media all around the world — when they were invited by Premier Annastacia Palaszczuk to an invitation-only lunch at Fraser Island; which could potentially include a meet and greet with the Royals. The Royal visit to Fraser Island on 22 October was the newlyweds’ first official visit to the Sunshine State and the only Queensland destination on their tour of Commonwealth countries, focussing on youth leadership, environmental and conservation efforts.
Summer 2018–19
Danielle and Graeme’ s brush with Royalty occurred after the lunch with Premier Palaszczuk at Kingfisher Bay Resort. Before boarding the Premier’s mini-bus for a short journey to the jetty to await the Royals’ arrival, the officers and a handful of lucky others, were lined up for potential meet and greets. Security was strong while hundreds of media, most of whom were behind barricades, eagerly watched for a glimpse of Harry and, hopefully, Meghan. At that stage it was unclear if Meghan would be taking part in the public walk, however, as with everything else that day, everything fell into place and when the boat carrying the Royal entourage docked at the jetty, the pregnant Princess emerged. “It was a fabulous surprise to see Meghan on the jetty,’’ Danielle said. “I had felt a bit disappointed by earlier reports that she may not be attending so it was like ‘wow, she really is here’.” Danielle is currently undertaking a paramedic science degree and has worked in various roles with QAS since joining in 2013.
FEATURE • Royal visit to Fraser Island
She said she felt calm in the lead-up to the event but, as she watched the Royals approach, her nerves started to kick in and her heart started to race. Graeme said he felt the same way too. And then came the coveted moment Danielle and Graeme had been waiting and hoping for — the Premier introduced the Duke and Duchess to the two QAS officers.
“I couldn’t wipe the smile from my face,’’ Graeme said. “It was just so wonderful to meet Harry and Meghan and then, to a have a photo taken with them — words can’t describe how amazing that was… It was such a surreal experience. This amazing day will stay with me forever.” The photo opportunity came about after the two officers presented the Royal couple with two QAS teddy bears. “As the conversation was wrapping up I asked Prince Harry and Meghan if they would mind having a group photo,’’ Graeme said. “My sister is battling cancer at the moment and I told them she would dearly love a photo of us to place on her loungeroom wall. It was such a thrill when they readily agreed.”
“We were lucky to be recognised individually, but it was also great for the QAS to receive positive coverage on behalf of all staff. We recognise that a lot of other people in this organisation and the healthcare professions go the extra mile, often doing something special for patients.” Graeme, who has been serving with the QAS for almost 30 years, said the Royal encounter was definitely the pinnacle of his career.
But their work was not done yet, the following morning, the officers, still on a high after the event, had to rise and shine early for live crosses with the Today and Sunrise TV shows. As Danielle and Graeme reflect on their aweinspiring journey, both officers praised their passionate and loyal OIC Helen Donaldson — who has been behind them all the way. It was Helen who sent the photo Danielle took of Graeme with the palliative patient to the Media Unit in late 2017 requesting that it be posted on the QAS Facebook page.
23 Above
■ Double thumbs-up from deservedly-thrilled Danielle and Graeme, who were still beaming as they spoke with the media and, later, paused for a photo with their OIC Helen Donaldson.
Photo: Adobe Stock / Dschwen
“It was such an honour and a privilege to meet them,” Danielle said. “The Premier had briefed Harry and Meghan about us and when they were talking to us they both took a genuine interest; asking questions too. It was just amazing.
Following the meet and greet, multiple media lined up to interview Danielle and Graeme about their brush with royalty, with images of the two officers once again beamed around the world.
Summer 2018–19
Official Emergency Management Unit appointment Monica Farrow was officially appointed EMU Director Operations on 10 September 2018.
“It went really well. We wanted our operational presence to be behind the scenes and for the most part it wasn’t obvious we had a presence there,’’ Monica said.
“I am really enjoying it. I have been working in the unit since 2015 so I am very familiar with the team,” she said. Formerly the Executive Manager Operations, Monica’s appointment came on the back of her almost three-year commitment to the QAS’s biggest ever operational response, GC2018. For now, Monica said she is concentrating on refocusing the Geebung-based unit. “We are taking the learnings from GC2018 and other events and exercises and mapping out two to three years of moving forward to create better capability in frontline supervisors and paramedics across all LASNS.” Monica has been a paramedic for 26 years, six of which she has spent educating other officers and she said her aim is to increase capability across all levels of the QAS’s education, programs and curriculum.
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EMU Director Operations Monica Farrow said Prince Harry and Meghan’s visit to Fraser Island was a ‘huge success’ from a QAS operational perspective.
Monica said Emergency Management, which is responsible for ensuring appropriate risk mitigation planning to lessen the potential impact on the ability of QAS to deliver services to the community and to support other agencies in delivering safe and secure events, was ‘officially’ engaged by the Department of the Premier and Cabinet (DPC) on 25 September 2018. However, the EMU had been planning for the Royals’ visit well before that time. “Our team had started planning for the event months before. This included liaising with QAS executives and supervisors in the Wide Bay LASN and also ensuring an event plan was drafted,” Monica said. “The meeting with the DPC allowed us to establish exactly what our requirements would be for the Royal visit to Fraser Island on 22 and 23 October and for the security contingent.” Prior to the meeting, Monica and her team had very little details on the Royals planned movements on Fraser Island.
“I love capability building … I get so much enjoyment out of seeing people develop and become better operators. It is also so rewarding to be able to contribute to their understanding,” she said.
“In order to allow us to execute our job, at the meeting, the DPC revealed the Royals’ movements to us on a need-to-know basis,’’ she said.
“For me, it is very intrinsically fulfilling to come into work and support others in serving our community through preparedness, planning, response and recovery activities.”
“We were not allowed to disclose the information. The details were also given to us on paper, as the information was not allowed to be sent electronically.”
When not at work, Monica and husband Gareth, a Metro South paramedic, love spending time with their four children, aged between 10 and 14 years.
At the meeting it was also established that throughout the Royal visit, five additional paramedics would be required to be on Fraser Island and dedicated to the Royal party.
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■ Monica with members of the EMU team which is based at Geebung.
Summer 2018–19
■ The Fraser Island crew included (L to R) Darrell Searle, Phil Switzer, Warren Kellett and Alex Meredith.
FEATURE • Royal visit to Fraser Island
The EMU took the intelligence received at a State level and liaised with Wide Bay LASN to ensure they had all the information available for appropriate planning. Monica said the working relationship with LASNs is very important to ensure assumptions are reviewed with local knowledge of geography, response capacity, operations and relationships. After liaising with the LASN it was determined the medical contingent would have exclusive access to three Landcruiser Troop-carrier 4WD ambulance vehicles specifically designed for use on Fraser Island and one Ford Ranger ERV. This resourcing was in addition to the business-as-usual paramedic and Landcruiser 4WD vehicle located at Happy Valley. Monica said the Royal visit required the EMU to work closely with not only QAS staff but also with multiple external agencies and stakeholders. “We spent lot of time liaising with the Dignitary Protection Team and Public Safety Response Team to devise the best way to provide support for police as well as the VIPs. “We also worked with the Queensland Health Disaster Management Unit and Retrieval Services Queensland, should extrication need to be facilitated via helicopter,” she said. As a result, Rescue 522 (Bundaberg) was deployed to Happy Valley with a Flight CCP for the event. Following several meetings with all stakeholders final resourcing was confirmed with five paramedics, a Director, Senior Operations Supervisor and one emergency physician, with Rescue 522 on standby. “When the Royal visit unfolded on 22 October, all our work had been done so we were able to watch all the glam and glitter as it unfolded live on the TV,” Monica said. Thankfully, no patients required treatment or transport during the Royal event.
Left
■ Warren Kellett and Darrell Searle sit down for a run-through of the operational plans for the Royal visit to the island.
Operational staff for the Royals’ visit to Fraser Island EMU team members involved in the Royal visit to Fraser Island included Danny Murphy, Emma McKenzie, Jeremy Wickham, and the Forward Command Unit on Fraser Island was led by Incident Controller Acting Chief Superintendent Warren Kellett and Forward Commander SOS Nigel Jones. Meanwhile, a crew consisting of CCP Cassandra Taylor and ACP Andrew Eason was deployed to follow the Royal Party around the island. Another crew with Fraser Island OIC Phil Switzer and ACP Alex Meredith remained on standby at Pile Valley for the unveiling of the Queen’s Commonwealth Canopy Plaque. The crew was to respond to calls for service by the community at the event which was being attended by many Indigenous Elders. Another ambulance unit with CCP Darrell Searle remained on standby at Kingfisher Bay Resort to assist the emergency physician Doctor Peter Logan. Other QAS staff heavily involved in the event were Manager of Operations Rick Tenthy, the event’s Ambulance Supervisor SOS Martin Kelly and Hervey Bay OIC Helen Donaldson. Below
■ A warm embrace for Graeme from Premier Annastacia Palaszczuk.
Summer 2018–19
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Introducing ISRE The Information Support, Research and Evaluation (ISRE) unit’s role within the QAS is to provide an evidence base for QAS clinical practice and operations, and to facilitate interaction between industry, paramedics and academics to develop the paramedic profession and the evidence base for pre-hospital care. Emma has more than 15 years’ experience conducting a wide range of pre-hospital research projects and is experienced in the linkage and analysis of ambulance and hospital data. ISRE manages a large array of studies that cover clinical, operational and service planning topics, including several longitudinal research projects. Above
■ Dr Emma Bosley
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The ISRE unit is headed by Dr Emma Bosley PhD, an Adjunct Associate Professor in the School of Clinical Science at QUT.
Two principal projects are maintaining and evaluating the QAS data on all out-ofhospital cardiac arrest (OHCA) incidents and the statewide pre-hospital reperfusion program for patients with ST-segment elevation myocardial infarction (STEMI).
These are fundamental to the unit, which is informed by both organisational requirements, and national and international trends in pre-hospital practice.
Practical placements are provided in ISRE for paramedics undertaking further studies as part of their university curriculum.
ISRE is the central management point for advice and the management of access to QAS personnel and data for the purpose of research. Our staff provides expert knowledge of the QAS collection, including guidance and data governance. Staff are also actively involved as co-investigators in a range of studies with external partners. Mentorship and supervision is provided by the ISRE unit for paramedics undertaking research projects, either independently or as part of tertiary studies.
In addition, ISRE staff spend significant amounts of time supporting KJM applicants, from the development of their idea to a research question through to completion of a successful research project. Results from the mentorship program have assisted paramedics to develop projects that have led to changes to QAS practice.
The ISRE unit is currently establishing a Paramedic Research Participant Database for QAS staff who may be interested in participating in upcoming research projects. For more information on the research participation database, current projects or to view completed projects, please visit: https://qas.psba.qld.gov.au/research/evaluation/Pages/default.aspx On the opposite page, ISRE profiles two recently published journal articles, with a brief commentary of the key findings, accompanied by comments from QAS Medical Director Dr Stephen Rashford. Space limitations preclude the reproduction of the Adrenaline article’s Study Population infographic but that for the POLAR study is reproduced below.
Summer 2018–19
Introducing ISRE and the unit’s work
Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury (POLAR)
The induction of prophylactic hypothermia following severe traumatic brain injury has been thought to potentially provide a neuroprotective benefit and improve long-term neurological outcomes. The QAS was a contributing site to the recently published Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury (POLAR) study (Cooper, Nichol, Bailey et al., 2018). The aim of this multisite, international research was to examine the effect of early induced prophylactic hypothermia on long term neurologic outcomes for patients with a traumatic brain injury. Designed as a randomised controlled trial, the POLAR study recruited 511 patients attended by ambulance services and emergency departments across six countries (A total of 54 patients was recruited to the study by QAS High Acuity Response Unit (HARU) paramedics). Patients were eligible for inclusion if they presented with an obvious head injury, had an estimated age between 18 and 60 years, a Glasgow Coma Scale score of less than 9, and received or were likely to receive endotracheal intubation. Patients were excluded if significant bleeding was suspected indicated through systolic hypotension (<90 mm Hg) or sustained tachycardia (> 120/minute), suspected pregnancy or a Glasgow Coma Scale score of 3 and unreactive pupils. Eligible patients were randomly assigned 1:1 to either (a) the intervention group that were inducted into a state of hypothermia, or (b) the control group with maintained normothermia.
Patients that were randomised to the prophylactic hypothermia group received an intravenous bolus of up to 2,000mL ice-cold (4°C) saline and surface-cooling wraps. A targeted temperature of 33°C-35°C was sustained for a minimum 72 hours, and up to a period of seven days if raised intracranial pressure was observed. The control group patients received no intervention and maintained a temperature of normothermia (37°C). The primary outcome of a favourable neurological outcome was measured six months following injury using the Glasgow Outcome Scale-Extended (GOS-E) score. GOS-E is a global measure that is primarily used in research trials with TBI survivors; a score in the range of 5-8 (lower end of moderate disability – upper end of good recovery) is classified as a positive outcome. A favourable outcome was seen in 117 patients (48.8%) randomised to the hypothermia group and 111 patients in the normothermia group (49.1%). The percentage difference in patients with positive long term outcomes between the intervention and control groups was 0.4% (95% CI, -9.4% to 8.7%).Thereby, the relative risk, or ratio of the probability of the measure outcome (a GOS-E score of 5-8) in the intervention group to the probability of the outcome in the control group, was 0.99 [95% CI, 0.82-1.19] (P = 0.94). These findings suggest that inducing early prophylactic hypothermia via bolus IV fluids does not improve neurological outcomes in TBI. Cooper DJ, Nichol AD, Bailey M, et al. Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury The POLAR Randomized Clinical Trial. JAMA. Published online October 24, 2018. doi:10.1001/ jama.2018.17075
Medical Director comment: This was a large, prospective well-designed trial that the QAS contributed to significantly. This result may finally put to bed the notion that acute cooling with large volume 4C fluid is not the way to go. Perhaps in time alternative cooling techniques may arise and this hypothesis can be reviewed. Until that time, pre-hospital cooling is not supported.
A Randomised Trial of Epinephrine (Adrenaline) in Out of Hospital Cardiac Arrest (PARAMEDIC2 Trial)
The efficacy and subsequent benefits of adrenaline administration in the cardiac arrest setting has been the source of continual conjecture and debate. The highly-anticipated results of the A Randomised Trial of Epinephrine (Adrenaline) in Out of Hospital Cardiac Arrest (PARAMEDIC2) trial were published in the New England Journal of Medicine in July 2018 (Perkins, Deakin et al., 2018). PARAMEDIC2 was a randomised, double blind trial that recruited 8,014 out of hospital cardiac arrest (OHCA) patients in the United Kingdom. The primary aim of this study was to determine if the administration of parenteral adrenaline, in comparison with saline placebo, improved the likelihood of 30-day survival. The secondary aim was to determine the rate of survival until hospital discharge with a favourable neurological outcome using the modified Rankin scale, a measure of dependency or disability due to neurological impairment, that is commonly used in research involving stroke patients. Patients were excluded from this study if pregnancy was suspected, the arrest was secondary to suspected anaphylaxis or asthma-related aetiology, or if the patient was aged less than 16 years.
The median time to administration of trial agent was 21.5 minutes for the adrenaline group, or 21.1 minutes for patients receiving the placebo. Overall survival to hospital discharge was low (adrenaline = 3.2%; placebo = 2.3%). Return of spontaneous circulation was found to be higher in adrenaline patients in comparison with those that received placebo (36.3% vs 11.7%), and there was a small but statistically significant difference in survival to 30-days in the adrenaline group (130 patients, 3.2%) compared to placebo (94 patients, 2.4%). Patients in the adrenaline group were 1.39 times more likely to survive to 30-days than patients administered the placebo (unadjusted odds ratio; 95% CI 1.06 to 1.82; P = 0.002). However, there was no evidence of a statistically significant difference in the proportion of patients who survived until hospital discharge with a favourable neurologic outcome (87 of 4007 patients [2.2%] vs. 74 of 3994 patients [1.9%]; unadjusted odds ratio, 1.18; 95% CI, 0.86 to 1.61). Perkins GD, Ji C, Deakin CD, et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. The New England journal of medicine. 2018. PMID: 30021076
Eligible patients were resuscitated according to protocols outlined by the European Resuscitation Council. If preliminary attempts (CPR and defibrillation) were unsuccessful, patients were randomly assigned (ratio of 1:1) to receive either 1mg of adrenaline, via an intravenous or intraosseous route, or 0.9% normal saline, every 3 to 5 minutes.
Medical Director comment: This was a large trial attempting to address an important question regarding cardiac arrest management. It was real world – the adrenaline was prioritised to be administered after proven interventions associated with survival had been undertaken. At QAS, our median adrenaline administration is at approximately 12 minutes. Adrenaline does improve ROSC but does it improve quality survival? – we still do not know the answer. It will be interesting to see how this study and others are treated by ILCOR. Perhaps earlier novel administration of adrenaline in cardiac arrest – watch this space!
Summer 2018–19
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G-WIZZ: new 4wd SENSATION! It’s big, brash, bold and touring LASNs for testing. The Mercedes G Wagon 4WD module ambulance prototype is on the road and, as Andrew Kos reports, the future looks bright. Turbocharged with enhanced terrain capability and weight-carrying capacity, the Mercedes G Wagon 4WD might just be the right fit when it comes to replacing the QAS’ 250 strong fleet of off-roaders.
After being officially launched at the start of November, the G Wagon is now undergoing local testing before making its way to LASNs across the state in a six-month testing period. It will be trialled in areas including Cairns, Rockhampton, Longreach, Kilcoy, Boonah and sand environments such as Moreton Island.
Having entered the Australian market in the last few years, the G Wagon was picked up by the Australian Defence Force to renew its fleet — and caught the attention of the QAS as well. The team at Fleet and Equipment Operations has spent almost two years diligently working with the State Equipment and Vehicle Committee (SEVC) developing and refining the specification for the G Wagon to become a state-of-the-art ambulance capable of responding to patients and incidents in difficult areas across the state. Fleet and Equipment Operations Director Ian Tarr said the increased base vehicle 4WD capability and the customised fit-out is geared around improved patient and paramedic safety and comfort.
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Feedback from operational staff on the G Wagon’s performance and fit-out will be evaluated and required modifications made before replacing the current 4WD fleet. Key features of the G Wagon include: Above
■ Graeme Hodges with F&EOps Director Ian Tarr at the G Wagon’s media unveiling. Below left and right
■ Preview of the integral Stryker stair chair, loader and stretcher in the patient care module.
“The big benefit of this vehicle over our current Landcruiser 4WD platforms is its increased weight capability, allowing us the ability to fit the powered Stryker stretcher and loader as well as a Stryker stair chair,” Ian said. “The vehicle also comes standard with three differential locks and all-round coil springs, giving it enhanced 4WD capabilities.
Photo: Premier’s Media Team / Jack Tran
“The vehicle’s patient care module has been designed to provide ample room for paramedics to provide a wide range of patient care activity within a safe environment. It is also slightly lower, narrower and shorter than the current module platform which will provide further enhanced off-road suitability.”
Summer 2018–19
•
A 3.0 litre V6 turbo diesel engine and seven-speed automatic transmission with high/low range and three differential locks for enhanced terrain capability.
• Improved weight-carrying capacity of approximately 600 kg. • The latest electronic screens for the operation of both vehicle and patient care features. • Grab-and-go equipment store.
Local Assessment and Referral Unit report
Alarmed vacuum unit an easy re-set for LARU A call was made to the QAS about an 81 year-old male whose vacuum wound dressing machine had been sounding an alarm for the past hour, writes LARU officer Rohan Smith.
The machine in question was a KCI ActiV.A.C vacuum wound dressing unit. It has been designed as a portable Negative Pressure Wound Therapy (NPWT) unit for patients who are suitable to continue their wound treatment in the comfort of home. The patient was living at home with his elderly wife but neither was comfortable with how the machine operated — nor how to rectify common issues that may arise. The patient’s wound had developed after a large amount of tissue was removed from his right axilla some weeks earlier after a skin cancer diagnosis. The patient was deemed fit to be treated as an outpatient, with his treatment continuing in home. Many different companies manufacture NPWT units, but they all function in a similar way. The advancement of NPWT — and in particular portable units —has revolutionised the management of chronic wounds. These systems provide a negative pressure environment (that is, pressure lower than the surrounding atmosphere) that promotes a far more efficient healing process, speeding up the duration of healing while decreasing time spent in hospital and, with regular follow-up appointments, able to be conducted through community health care. The units consist of a sterile open pore medical foam that is packed into the wound. Over the top of the foam a clear Opsite-like material is placed, adhering to healthy, intact skin.
Apart from improving the quality of life for patients with chronic wounds with extended healing time, significant funding is saved by not having the patient remain in hospital for treatment. An interesting statistic is that approximately only three per cent of wound management costs relate to dressings; the rest is associated with nursing time and hospital costs. In this case, due to the wound being in an awkward position, the Opsite had been pulled and rolled as the patient moved his arm. This caused a loss in suction and negative pressure which made the unit alarm.
Above
■ Rohan Smith
Having only a couple of weeks prior completed the QAS LARU Wound Management course, I was comfortable in troubleshooting and rectifying the issue. There is also a manufacturer helpline number attached and I was able to speak with a technician, who was able to walk me through the resetting of the machine and to continue normal optimal function.
Below
■ A typical ActiV.A.C unit – representative of the different versions used by hospitals.
The patient was given a thorough assessment. There were no signs of infection or being systemically unwell. The end result was that the patient avoided an emergency department presentation and was able to stay in the comfort of his home with his wife.
A small hole is cut into the centre and the suction tubing is then applied; this returns to a detachable cannister that can be emptied from exudate and is connected to the suction unit which has a display and soft touch buttons. This particular unit is quite small (about the size of a lunch box) and weighs a little over one kilogram.
Summer 2018–19
29
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ECLIPSE: take charge with this CPD tool
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ECLIPSE provides a platform to participate in such CPD activities as:
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Evaluating Clinical Improvement and Patient Safety (ECLIPSE), the new QAS clinical governance application, provides paramedics with a tool to govern their own clinical improvement and a self-directed approach to patient safety while obtaining registration Continuing Professional Development (CPD) hours.
Guided Case Reflection
System Audit
•
Eclipse provides the QAS with a platform to meet its obligation for analysis, through audit and review, its clinical practice to ensure continual improvement while maintaining patient safety.
A Guided Case Reflection provides a formal process of self-analysis by an individual paramedic, allowing individuals to take ownership, reflecting on potential improvements in care and adverse events as well as considering potential implications of their actions with support from peers.
Reflective Peer Review •
Officers share their personal guided reflection of a case with a trusted peer, providing clinical improvement through sharing personal experience, knowledge and expertise.
•
These activities remain with the individual paramedic and can be viewed only by invitation of the user, when potentially seeking third party review or validation.
In-Field Quality and Safety Coaching •
Real-time coaching of live clinical cases with access to immediate advice and feedback and in field coaching record on ECLIPSE.
ECLIPSE CPD activities are not utilised to audit paramedics.
Patient Safety Reporting •
Through ECLIPSE, paramedics will have a direct link into the Office of the Medical Director for self-identified or peer notification of potential patient safety risks.
Summer 2018–19
•
Case reviews on high risk triggers will be undertaken by experienced clinicians in a state-level approach to clinical review. These reviews will focus on systems and trends promoting clinical improvement and excellence while helping to inform clinical incident management processes. Exemplary care will be immediately fed back to the treating paramedics.
Those cases needing further review will be moderated before any feedback, to ensure consistency and constructive follow-up when required.
TOOLS • Handy things to know about
New payroll system coming for QAS The HRIS Payroll Replacement Project is on track to deliver a new payroll system to QAS in March 2019. The system, called ‘Aurion’, will include Employee Self Service functions that allow staff to update their personal information such as their address and bank account details, access their Pay Advice online, and view their leave balances through the Aurion portal. Operational staff will continue to use the eTimesheet application to capture their hours although public service staff will continue to complete their timesheets and apply for leave through the online system as is done in many other public-sector agencies. Deputy Commissioner, Corporate Services, Michael Metcalfe said the move to a contemporary payroll system with online Employee Self Service will future-proof our payroll system, allowing the QAS to move off the aged Lattice system as well as bring some great benefits to staff. “The change experienced by most of our workforce will be minimal and given our staff are agile and used to interacting with online systems as part of their day-to-day work, we expect that this will help achieve a smooth transition for end users,” Michael said. The Department of Housing and Public Works (DHPW) is responsible for coordinating the roll-out of the Aurion payroll system across several Queensland Government departments and agencies. QAS representatives, led by Deputy Commissioner Metcalfe, have been working closely with DHPW and others to scope, plan and configure the system.
A number of QAS staff have been and continue to be involved in this process, including operational and corporate office representatives, to ensure the end product is fit-for-purpose and suited to the QAS environment. “We have been working with the team in DHPW, PSBA and Queensland Shared Services to ensure that the move to Aurion will be as smooth as possible for our workforce,’’ Michael said. “A number of testing processes have been undertaken, and will continue over the coming months, along with the appropriate due diligence to ensure the system is configured to meet our needs and that QAS staff are ready for the system. “The final decision to proceed to go live in March 2019 will rest with the relevant Ministers.” LASN and Branch HR staff have started receiving training in Aurion, one of the first steps in preparing the QAS for the new system. More information will be rolled-out over the coming months to all managers and staff. All QAS staff are encouraged to keep an eye on their email for important information about the implementation process. Any questions or queries can be sent to: QAS.HRIS@ambulance.qld.gov.au
New CPR Awareness vehicle rolled-out In November, the QAS Media Unit rolled out its new CPR Awareness vehicle – a fully-restored retired Mercedes Benz 319 Sprinter ambulance. The promotional vehicle, which is used by the Media Unit and paramedics in different regions to promote CPR awareness at events and interactive displays, has been fitted out with the latest LAERDAL Australia educational manikins and the new QCPR Race.
3131 Vehicle colours reflect the QAS with the artwork promoting CPR awareness and the Emergency+App. Fleet managed the fit-out including rewiring the unit and adding a siren — a feature not included in the previous promotional vehicle. The siren has reduced volume and is designed to appeal to youngsters who are walking through the van when it is on display. However, unlike operational ambulances, the siren can be engaged only when the handbrake is on.
Summer 2018–19
Mackay remembers ‘one of our own’ On 17 October, the Queensland Ambulance Service and CQ Rescue gathered at St Joseph’s Catholic Church to commemorate the three men who lost their lives in an aviation tragedy in 2003. This year marked the 15th anniversary of the crash which claimed the lives of paramedic Craig Liddington, pilot Andrew Carpenter and crewman Stewart Eva. They were aboard the CQ Rescue Bell 407 helicopter VH-HTD heading to Hamilton Island for a medical evacuation when it crashed into the ocean off Cape Hillsborough.
Above
■ Tracey Eastwick greets Craig’s parents, Denise and Brian, at the service.
2018, 15 year memorial
I answered the phone, My heart began to pound, Someone just told me, The chopper’s hit the ground. A million feelings came rushing in, I did not know where to begin.
Manager of Operations in Mackay Tracey Eastwick said when she was notified of the crash she felt a sense of disbelief.
Could you imagine a pain so deep inside, That it cannot be summarized into words that you can simply write.
“We as paramedics respond to significant incidents every day, exposed to families’ tragedies, but this was different,” Tracey said.
A pain that starts at your toes and reaches the ceiling, You cannot eat, You cannot sleep, That is the pain I am feeling.
“It was one of our own, it was one of our colleagues we worked with for some time and got to know and love.”
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In Memory Of Craig
For 15 years have passed, This number so high, Yet we still remember just too well, This day that changed our lives. But we know now you’re in a better place, And we are all still so proud to call you our best mate. We will hold dear the memories of our time together, A time of love and laughter that we will cherish forever.
Above
We gather today, To honour your name and the sacrifice you gave.
■ Commissioner Russell Bowles was joined by fellow QAS officers at the service.
Craig we hope that you can now rest, As we all know God only takes the best.
Summer 2018–19
~ by Analise Cunington
High Acuity Response Unit Report
Upon arrival of the Advanced Care Paramedic (ACP) crew, the patient appeared pale, breathless and profusely diaphoretic. The patient was rapidly placed on oxygen and extricated to a stretcher near the dwelling. The first observations were: SpO2 85% RA RR 32/min BP 60/40 HR 130/min A – Intact, short sentences B – Reduced expansion left chest with associated wheeze. Surgical emphysema left axilla C – Clinically shocked. Poor peripheral perfusion with reduced capillary return D – GCS 14, drowsy
The Critical Care Paramedic (CCP) and HARU CCP arrived a few minutes later. As intravenous access was achieved, a rapid ultrasound was undertaken. There was no cardiac tamponade and no intra-abdominal bleeding found. A large left sided haemothorax was apparent on ultrasound. The patient was rapidly transported to the major trauma service with a titrated blood transfusion commenced along with tranexamic acid. Upon arrival, the patient was less diaphoretic with clinically improved perfusion, albeit still shocked.
r-old a e y 0 2 a o t d calle e r e t. w s s e c i h c d e t f m e l a e h Par t nd to u o w b a t s a h t male wi nts Chest X-ray comme
E – 2cm linear incision left axilla
CASE
all: e left chest w ema along th t. ys es ph ch e em th al g ic lpatin Note the surg ous when pa this was obvi ht to the rig ue compared ars more opaq t but it was pe en ap es pr ax g or in ith The left hem emothorax be ha a whole lung e to th e ss du – this is spreads acro it so , fluid level m s/ fil a supine ng a meniscu vi ha . an th er rath t film is done when an erec present mothorax is oderate pneu evident is ng lu ft A small to m le tline of the ou r orax. pe ith m up e he th – the left at the top of ift of the some mild sh There may be es away ur ct ru st mediastinal injury. of from the site
LOOKEEL F LEARNINGS LISTEN
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QAS Medical Director Dr Stephen Rashford
1. All penetrating wounds to the torso, particularly those between the sternal notch and umbilicus (anterior and posterior) present a very high-risk presentation. The size of the stab wound and the physiological status is irrelevant. 2. Always look for other wounds – this is called a ‘stab check’. This includes removing all clothing and especially looking at the groin, buttocks and the axillae. More is missed by not looking than not knowing. 3. Have a system in your head to exclude major injury. Do it in this order and you will not miss anything: >> cardiac tamponade >> tension haemo or pneumothorax >> haemothorax >> and then intra-abdominal bleeding. Remember, you can have injuries above and below the diaphragm at the same time. 4. Not all reduced air entry is a tension pneumothorax. Look at the work of breathing and breathing pattern. Reduced expansion is not a tension pneumothorax. Needle decompression does nothing for pulmonary contusion or haemothorax, except introduce another potential complication. 5. Examine the patient properly – don’t just listen to the chest … in general, this will not give you the diagnosis but LOOKING and FEELING will, well before listening – LOOK, FEEL then LISTEN. 6. This patient had already developed acute coagulopathy of trauma. In the future, pre-hospital fibrinogen will be administered to combat this condition (the treatment will be discussed in the next edition of INSIGHT!).
Summer 2018–19
Priority One Where is my optimism? The word or idea of optimism can stir a lot of different emotions and thoughts for people writes Acting Staff Counsellor and Advanced Care Paramedic Jodie Brown. Some see it as their normal way of living, others might feel a little uncomfortable with the idea, some may be indifferent. But regardless of how you may currently feel about optimism it is important to recognise and reflect on our thinking patterns and how these have served us in the past, and continue to do so. Above
■ ACP Jodie Brown
So, what does optimism look like? Optimism is being able to look at a situation and tending to see the positive side, and then also expecting a favourable or helpful outcome. It might look like going into unknown situations hopeful for a positive outcome, but irrespective of the outcome being able to also find a silver lining from that experience.
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The research shows that having this mental attitude has many physical and psychological benefits. Optimistic people are more likely to promote and have a healthy living and lifestyle, which the research shows is beneficial for the body and the mind. Optimism also helps with creating and maintaining adaptive behaviours and cognitive responses, helps with mental flexibility, finding helpful coping strategies, and being able to process negative information. Being optimistic has not only an indirect influence on our quality of life, but also a positive impact on the people we engage with and can even have a positive therapeutic impact on patient outcomes. Optimism brings with it a sense of efficacy and hope, energy and determination, especially around solving problems. But to understand optimism, we also should understand pessimism; having a negative outlook or being more inclined to expect a negative or poor outcome. This might look like expecting to fail at something or thinking that a result is never good enough.
Summer 2018–19
Having this mental attitude can be quite effortless at times, as our brains are hardwired for survival and maybe on the lookout for trouble or danger. So, the more we perceive the world around us as troubling or having a pessimistic outlook, this enhances and reinforces these neural pathways in the brain, making the links stronger and more readily accessible. If we continue to think like this, building these pathways in our brains, this outlook can dictate our behavioural responses, coping strategies, ability to effectively solve problems, and we start to anticipate more negative outcomes for the future. Knowing this, then, it seems like we are set for failure. But how would an optimist look at the situation? It may be as simple as recognising the pattern of thinking, and reflecting ‘how will this mental attitude serve me in this moment?’ Perhaps we have developed these thinking patterns as they have served us well in the past. Often in times which challenge us we will default to ways of being and habits which our brain thinks may (or may not) have been useful in the past. Even within the continuum which is optimism and pessimism, leaning too heavily on one side can also be problematic. Extreme optimism can lead to risky behaviours with negative impacts or impulsive behaviours, or may be an opportunity to avoid the situation and responsibility. Too much pessimism can lead to excessive worrying about potential dangers, avoidance behaviours, apathy as well as increasing the risk for chronic illnesses. Don’t be too optimistic, but also don’t be too pessimistic, right? Again, it’s about reflecting on which mental attitudes we use, and then finding the right balance on the continuum and leaning towards having a realistic optimism.
Priority One
Where do I find help? 24-hour telephone counselling 1800 805 980 QAS Priority One Manager 0419 707 397 QAS Staff Counsellors 0408 191 215 or 0417 079 679 or 0409 056 983 QAS Priority One State Office 3635 3333 LGBTIQ+ support service 3830 5888 Chaplaincy service 3835 9923 Local Priority One Peer Support Officers or Counsellors See list in each QAS Station or on QASPortal
A realistic optimist can look at a situation, take an accurate assessment and imagine probable outcomes. They can see there could be negative outcomes, but don’t worry or dwell on these, and focus more on the positive outcome and finding solutions. Most importantly, a realistic optimist believes in the capacity and ability for growth, which allows them to really expand their potential. But having an optimistic outlook can be challenging work. It is a discipline which needs to be practised, as the neural pathways sometimes need to be rewired to ensure we create new healthy neurological links. Bringing awareness and reflecting on our mental attitude is the first step. If you have a realistic optimism and believe you can succeed, this will continue to encourage your ability to try. Respectively, when you know and expect some situations will need hard work to complete, this will again encourage you to apply a persistent and engaged effort with the belief that a positive solution is not far away. Along with acknowledging the hard work required, having a growth mindset is also important. A growth mindset is about believing that improvement is possible, learning from mistakes, acknowledging that all feedback is important for progress, and recognising that failures are signs that better strategies or more effort is required.
This growth mindset may also look like seeing mistakes that you make as potential opportunities for growth in the future, but also what may be able to be avoided next time that situation arises. A person with a growth mindset might still see the mistake as a failure or inadequacy, but it is only a temporary one, and something that can be corrected. So, the focus is not on the mistake or failure, the focus is about how and what is needed to jump over the hurdle and then maybe the next one. It is also about looking back at what you have learnt from that experience, and how that can make a positive impact and change for future experiences. Sometimes, however, these hurdles may need the help of others along with the awareness of how you cope in challenging times. So, do not be discouraged if you find your positivity and optimism waning in a situation, as it can be difficult to create new patterns of thinking and new links within the brain. Knowing who you can lean on or use to help you get through the hurdles will be important. Having adaptive and helpful coping habits and strategies has consistently shown to be very important in developing resilience and post-traumatic growth, both important elements of building and maintaining optimism.
Summer 2018–19
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KJM’s 30th anniversary grants awarded The enhancement of patient care across Queensland continues to improve following the announcement of $39,000 worth of grants to QAS paramedics and personnel, writes Emma O’Connor. The KJ McPherson Education and Research (KJM) Foundation’s annual Symposium was held on 23 October 2018 at Brisbane City Hall, coinciding with its 30th anniversary. Named after Kenneth James (Jim) McPherson, a Queensland ambulance officer who lost his life in an aerial ambulance crash in Bundaberg in 1987, the KJM Foundation is a not-for-profit entity dedicated to improving patient care by providing research and professional development opportunities for uniformed personnel. QAS Commissioner Russell Bowles congratulated the grant recipients as they use the funds to assist in conducting research, or to fund research and education projects into pre-hospital care.
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“Among other things, this year’s grant winners will be undertaking research into paramedicine in extreme environments, quality assurance and quality improvement in emergency call-taking, and mental health,” Commissioner Bowles said.
KJM Foundation This year the KJ McPherson Education and Research Foundation celebrated its 30th anniversary.
Since 1988, more than $350,000 worth of grants has been distributed across 156 awards to 194 QAS recipients.
Since 1988, the Foundation has continuously invested in the future of the QAS through the announcement of grants to enhance patient care.
Among the innovations of past grant recipients is the application of a five-electrode EEG device to better inform the pre-hospital care of acute stroke patients.
The QAS has had a long and direct involvement with the McPherson family, and continues to work in conjunction with Jim’s daughters Katrina and Karla.
Top
■ The KJM Foundation’s Patron, Major-General Professor John Pearn ao, addresses the gathering.
Summer 2018–19
30th anniversary of KJM Grants • 2018
KJ McPherson Education and Research Foundation Grant Recipients 2018 Grant
Recipient/s
Patron’s Research Grant sponsored by Stryker Australia ($15,000)
► Alanah Morrison – Metro North LASN ($7,500) ► Peter Drew – Metro South LASN ($7,500)
Dr Peter Stephenson Overseas Study Grant sponsored by Dr Peter Stephenson ($5,500)
► Steve Whitfield – Gold Coast LASN
Bundaberg LAC State Operations Grant sponsored by Bundaberg Local Ambulance Committee ($5,000)
► Catherine Duncan – State Operations Centre
Earl Duus Priority-One Services Grant sponsored by Priority-One Services ($4,000)
► Melanie Burns – Metro South LASN
QAS Research & Development Grant sponsored by Spectrum Data Systems International ($3,000)
► Kate Cowan – State Operations Centre
Paramedics Australasia Professional Development Grant sponsored by Paramedics Australasia ($2,000)
► Craig Sankey – Darling Downs LASN
QAS Professional Development Grant sponsored by Laerdal ($1,500)
► Leigh Terrey – Mackay LASN
United Voice Graduate of the Year Grant sponsored by United Voice ($1,000)
► Jodie McCallum – South West LASN
37 Best Paper ($600) ► Shian Watson, Griffith University “The use of prehospital continuous positive airway pressure in adults with respiratory distress: A narrative review”
Paramedics Australasia Scientific Student Grants sponsored by Paramedics Australasia
Runner-up Best Paper ($400) ► Lachlan McIntyre, Central Queensland University “Activated charcoal: A pre-hospital treatment strategy of paracetamol toxicity”
Best Poster ($600) ► Isabella Winstanely, Jeffrey Moate, Mahli Burgin, Ryan Edwards, University of Southern Queensland “Paramedic Identification & Management of Sepsis”
Runner-up Best Poster ($400) ► Andrew Watkins, Central Queensland University “Adenosine”
Summer 2018–19
■ Participants at the Townsville Forum held on 11–12 October.
QAS STAFF FORUMS
Building a Strong Safety Network: on 16 and 17 October, members of the QAS Health and Safety Network from across the state attended Brisbane’s first QAS Health, Safety and Injury Management Forum, following a QAS Workforce Forum in Townsville a week earlier which focused on staff health and wellbeing. The primary aim of the Brisbane Forum was to ‘strengthen our network through building capability, co-designing innovative, evidence informed practices and establishing strong relationships.’ Highlights of the Brisbane Forum were presentations from Craig Emery (Deputy Commissioner, State LASN Operations), Nathan Williamson (Director, Corporate Strategy) and Michelle Baxter (Acting Assistant Commissioner, Metro North LASN).
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Their presentations provided Forum participants with invaluable insight into the vision senior management has for safety and wellness, and guidance on how to meet our safety goals. A clear message taken away from these sessions was the QAS’s strong commitment to the safety and wellbeing of staff, and staff responsibility to keep themselves safe.
Presentations from internal and external stakeholders representing QAS Infection Control, Priority One, Fleet and Equipment, QASEC, Legal Services, WorkCover Queensland, QSuper and the PSBA SHE Administration team, gave participants an understanding into the services provided by these groups and how they contribute to the safety of QAS staff. A key activity was breaking into groups to workshop, consult, plan and review the QAS Safety Management System. This ‘meeting of minds’ provided invaluable insight and direction that will ensure our safety system is practicable and applicable to operational staff. The opportunity for our Safety Network to meet face-to-face was appreciated by all and provided an opportunity to build strong partnerships towards influencing positive change. Early feedback indicates the Forum met all intended targets and was a great success.
The QAS Legacy Scheme is now registered with Containers for Change. To donate, take your containers to an over-the-counter depot, drop off, reverse vending machine, mobile or pop-up site and use scheme ID C10006933 to donate your refund to the QAS Legacy Scheme. The Scheme will receive the 10 cent refund per container. Visit www.containersforchange.com.au/how-it-works for more information.
Zoe Finch is a legatee of the QAS Legacy Scheme: her mother Tania was a well-respected Patient Transport Officer from Metro South. The Scheme currently supports 10 legatees from six QAS families. Queensland Ambulance Service Legacy Incorporated is a charitable organisation that provides a range of services to the families of QAS uniformed officers who have passed.
Several QAS Stations across the state have already started collecting containers – speak to your OIC about setting up a donation bin at your Station. Summer 2018–19
For updates on QAS Legacy Scheme Inc activities or to join, please visit our website www.qaslegacy.org or find us on Facebook at www.facebook.com/QASLegacy
APEC 2018 • QAS Port Moresby deployment
St John Ambulance – Papua New Guinea (SJA–PNG) was tasked to provide pre-hospital health care service at the Asia-Pacific Economic Cooperation (APEC) Economic Leaders’ Week (AELW). Held in Port Moresby from 12 to 18 November, the event brought together leaders, ministers and senior officials from 21 APEC member economies. Beenleigh OIC Chris Draper was appointed QAS Planning Officer to support the SJA–PNG team in preparing and ensuring motorcade operations were delivered smoothly during the AELW. He reports about the deployment and the more than 20 QAS staff who travelled to PNG to work at the event in a voluntary capacity. On my arrival in PNG on 5 November, I was embedded with the St John Ambulance planning team to support and complete the planning of the motorcade response during AELW, including finalising operational plans documentation and reviewing event plans. My role during the event was to manage operations, in particular the motorcade operations. This included briefing crews, managing real-time operations and liaising with internal and external agencies to manage the motorcade operations. The Queensland voluntary paramedics arrived a few days before the start of Leaders’ Week. They were to work with PNG Reserve Ambulance Officers (RAOs) staffing the motorcade ambulances and venues. The RAOs were tasked to drive, navigate and help with communication if there were any language barriers. On arrival at their hotel, the Queensland volunteers were welcomed by traditional dancers who put on a great show.
Because of the security arrangements, to ensure the paramedics’ safety, they were restricted to the accommodation compound prior to AELW. However, our staff were keen to help with other tasks, so they were allocated to projects to build rosters, develop transport plans, and complete logistic tasks; ensuring vehicles, equipment and kits were ready for AELW. When the motorcade tasking commenced, paramedics worked odd shifts, starting and finishing all hours of the night, coinciding with the leaders arriving and departing PNG. There were 21 motorcades that were allocated an ambulance. The ambulance was required to stay with the motorcade 24/7. Paramedics were rostered for 12-hour shifts, but due to the security restrictions, access issues and transport difficulties, they often worked up to 15-hour days. In addition, it was amazing watching the Queensland paramedics bond with the RAOs they were working with.
They forged inspirational relationships which I believe will stay long after APEC 2018. PNG and its people have an effect that touches you personally. I observed this a number of times watching the interactions between people. Thankfully, AELW went along with minimal issues; the St John Ambulance Service delivered on its mission to deliver a first-class ambulance service at the event. The paramedics supporting the ROAs ensured this was achieved. Highlights of the deployment included a personal meeting with the Australian High Commissioner, where all the paramedics attended his residence to be greeted by His Excellency. He thanked the paramedics for supporting PNG ambulance service and the paramedics enjoyed a lovely sunset and a few drinks.
IN PNG The QAS donated 15 stretchers, 10 drug kits, 10 response kits, 38 Lifepaks, 12 defibrillators and patient care stores including 50 boxes of gloves, 40 Endotracheal Tubes and 65 intravenous fluid administration sets. IN CAIRNS Six QAS officers were deployed to support Cairns and Hinterland LASN rosters, while Cairns paramedics provided service to five areas of operations including APEC Operations Centre and Cairns and Hinterland LACC, Dignitary Protection Motorcade support, accommodation support at the Hilton Hotel and a QPS specialist unit support crew. IN BRISBANE The QAS State Incident Management Room (SIMR) was at “Lean Forward’ from 15 November 2018 for the duration of the visit to Cairns by the Vice-President of the United States’ during APEC week in PNG. For me, this was a deeply moving occasion as my grandfather served in PNG during World War II. It was wonderful to meet and work with the PNG nationals and experience how they live their lives and deliver patient care to their community. It also made me very proud to see our QAS paramedics volunteering to work in an environment very different to what they are used to, without complaint, while also giving up their holidays and family time.
A personal highlight was attending the Remembrance Day ceremony along with paramedics and armed forces from multiple countries.
Summer 2018–19
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n
Thank you to QAS officer Scott Hunter and back up SES/RFS guys who helped out with my neighbour Len on Russell Island on Monday night (1 October). Job well done. Cheers.
THANK YOU :)
Steve, Russell Island Everyone has different levels of success. For me, success can never be achieved unless you have the desire to Just want to say a big thank you to the ladies an Wilkes, Kate Olive and Candice initiate it. The amazing work and commitmentHey from guys, staff just wanted to share (Corinne absolutely my that continuously results in appreciation letters we receive outstanding experience Very happy with your service and Boileau) that came to my house this morning Commissioner’s thanks partner encountered with your officers from members of the public, makes me constantly aware of support (July 19) for my little girl and the dispatch guy as I use Queensland (13 October) when they attended So far this year,we there what accomplishments havehas made as an organisation. ambulances regularly due to health (Jamaine Prieditis) who helped me stay very to my partner, Sarah at around 3am been an increase of more than circumstances. today whilst she was in intense pain 28 per cent in the number of calm. They do an amazing job and I really This month has seen an influx of thank you letters, with appreciations received by the from kidney stones. Would like to especially thank the appreciated them being so fantastic. 304 letters received this year to date and 609 letters and Queensland Ambulance Service, Mackay district. Your staff were nothing short of emails thanks sent to staff members. withof 502 appreciations received outstanding at every turn. On topMorningside Kristie, from 1 January to 31 October 2018, Joanne, Mackay of this, Sarah received news as the compared with 392for forall the I cannot thank you enough your hard work. officers (Samuel Brown and Sharianne same period in 2017. Turner) arrived that her cousin in the Russell Bowles ASM Not only is it pleasing to see UK had only just committed suicide. QAS Commissioner
the gratitude we receive from the It’s been a very tough day made much community increasing, but also that I want to send a quick thank you to the I would like to send a heartfelt thanks to I’ve been able to send 1,083 emails better by the fine officers who were on paramedics (Chantal Greaney and Melissa the responders who attended my wife this to our valued staff passing on hand. I can’t even begin to describe Dajic) who assessed my son and took him (25 September). the kind words received. evening how much it meant to Sarah, myself to hospital on Wednesday night (July 12). It I would like to take the time to express our and thanksSarah’s three young children. The positive impressions Despite my panic, the calm and was the first time I have ever had to call the to various QAS officersmaking for their attendanceIf you could please pass on my you are continually eternal professionalism that was shown by all the greatlyatappreciated. ambulance in doing so (Brooke Curley, Frances Watt, andare assistance our unplanned home birth thanks to the officers we would all and I was quite nervousQAS officers
very much appreciate it. We–know worried I was overreacting and wasting on 4/9/2017. the Triple Zero officer RussellI commend Bowles asm Shanethe Herbert and Casey Robinson) your staff sometimes have to handle QAS Commissioner astounded paramedics time. The two ladies who attended me. (Julie Ricardo) for her efficiency and ability to a lot of pressure but without them we
our home were so calm and reassuring. FromThey the bottom of my heart you all quickly assessed my son and took us to Lady a pat on the back and a pay rise. deserve Thank you so very much again from 502 appreciations, emails 5 minutes the bottom of my heart! you again. Cilento, all the while distracting myThank son with arrived on scene1083 approximately
reassure us that help was on the way and clear would have been helpless. instructions the meantime. 1 January to 31 in October 2018 –Tammy (Olsson)
Wiggles videos and calming a nervous and Morayfield John,
following theOctober birth of our son -Woody and I David, would 1 January to 31 2017 Nerang 392like appreciations, 965professionalism, emails to commend her calm in
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panicked mum. Thank you for such excellent
the situation and ability to treat me as a fellow
service and care!!! I don't believe this service
being rather than just a patient. She was caring,
gets the recognition it deserves for all the work your paramedics do. ■ Kyle sent in these gorgeous pictures on 31 October and Amanda, Wellington Point said ‘this was them [Jordyn and her little brother Jesse, 10 months] yesterday.
compassionate and efficient. I appreciate Tammy arranging for our transfer through to Hervey Bay Hospital. I believe Arto (Hirsimaki) and another 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 difficulty. I hope our message can reach the individual officers involved. Thank you to QAS for
Hey guys, I had lovely QAS officers (Timothy Abbott and Cassondra Stevens) attend our property last night (10 October) around 9.30pm after my daughter Jordyn, 2, burned the palm of her left hand.
“Jordyn’s hand is looking great and I put it down to Just wanted to say thank you again. Just wantfrom to give a shout out to the LARU officer the fast response QAS They did well and were very lovely medics! so thank you guys so much who attended my home on Monday (August again”. Little Miss is back up to her same old tricks 21). His name was Steve (Kliese) and we are
this morning like nothing happened with her tools in hand – that chair was her compassionate, empathetic, funny and the list accomplice last night too! in the Ipswich area. He was prompt, caring,
the important work you do I know we certainly needed the service on this day! Our little man
goes on. He had me reassured within minutes.
Woody is doing great settling in at home with his
Her little brother trying ever so hard to join in!
If my thanks could be passed to his OIC that
older sister Anna, feeding and sleeping well.
would be appreciated. Darren and Kate, Lakeside
Kylie, Loganholme
Des, Silkstone
I would like to thank the two paramedics (Samuel Clough and Paul Macaulay) who attended 36 QAS Insight SPRING 2017 home to pick Helen up and transport her to Bundaberg Base QAS_Insight_Magazine_SPRING_2017_DRAFT3.indd 36 Hospital. They were the most nice and informative officers I have witnessed in such a long time. At the end of their shift several hours later, the two paramedics came to her bedside to see how she was going. They did not have to do that but they did. Bravo. Tony, Isis Central
Summer 2018–19
11/10/17 8:43 pm
THANK YOUs • Summer 2018–19
Hi, yesterday (18 October) I fell and was taken by ambulance from Adelaide Street in Brisbane City by Teresa (Clausen) and Emma (Farrelly) and Chris who was being trained by the two girls.
Getting in touch Messages collated on these pages are derived from a range of QAS contact points, including:
They did a great job and took me to St Andrews for a fractured ankle. Please pass on my thanks as the three were fantastic.
via Facebook facebook.com/qldambulanceservice by email QAS.Media@ambulance.qld.gov.au
Professional, knowledgeable, compassionate and resilient. No doubt underpaid for the role they do, so please send my thanks and kudos.
by post QAS Media Unit, GPO Box 1425 Brisbane QLD 4001
Regards Judi, Greenslopes (and my wonderful boss!)
I just wanted to say a massive thank you. Two lots of ambulance crews (Jack Dawson, Sally Lucas, Paul Gray and Rachael Lucas) arrived to my house (29 August) after I made a Triple Zero (000) call as my eight-month-old daughter Athena had stopped breathing. I was a mess when I phoned and spoke to the lady (Michelle Van den Broek) on Triple Zero (000). Not long after I called I had two ambulance officers arrive in a 4WD. They took quick action to make sure my daughter was okay and then reassured me she was okay. Then the second lot of officers arrived to take us to the Logan Hospital. Being an ambulance officer and EMD wouldn’t be an easy job, although between the five of them, they had me calm and my daughter was responding better. I don’t think you all get thanked enough for what you do. I was hoping you could please pass on how very thankful I am for their quick and professional response.
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Hi, my name is Tracy. I’m a student paramedic at Central Queensland University. I want to pass on my thanks and I want the powers that be to know of my two amazing mentors (Amanda Kuhn and Sam Manley) on my recent placement at Coomera station. This is a thank you cake I made for them on my final day of placement and I would love for them to be acknowledged by QAS for the guidance and support they showed me. Tracy, Coomera
From the bottom of my heart thank you so much. Sarah, Slacks Creek
Summer 2018–19
Happenings Queensland Mental Health Week provided an opportune platform for our staff to reflect on their own personal wellbeing, as well as that of coworkers. QAS events included morning teas to raise awareness of stigmatised mental health issues and advocate the support options available to staff.
Our Brisbane-based Health and Safety Advisers were kept busy visiting staff in October as part of Safe Work Month.
Maleny retrieval
The advisers delivered education and gained valuable insight on subjects such as mental health, injury prevention and the importance of nutrition.
In late October our crews assisted with the tricky retrieval of a patient who had fallen awkwardly nearly 10 metres into the waters of Gardners Falls.
This included visits to hospitals, stations and even riding along with night shift crews to get the best opportunities to speak to our frontline staff on safe work practices, and to listen to any feedback.
Other agencies involved in the job included QFES, QPS, the Maleny SES and LifeFlight.
42 Everton Hills Kindergarten visit Our paramedics enjoyed a visit with littlies at the Prince of Peace Kindergarten at Everton Hills, Brisbane in October. It was a great opportunity for the kids to have an up-close and personal look at an ambulance and have a chat with paramedics
In October, a group of Gold Coast indigenous students from Southport State High School met with operational staff from our QAS Indigenous Paramedic Program for an informative chat about first aid, CPR and career opportunities.
Summer 2018â&#x20AC;&#x201C;19
HAPPENINGS • Summer 2018–19
Restart a Heart Day Paramedics conducted free CPR and AED sessions with members of the public in community hubs in Cairns, Brisbane and the Gold Coast on 16 October in support of Restart A Heart Day and the crucial advice it advocates in case of sudden cardiac arrest.
Metro North staff took part in a mass casualty exercise in late September designed to test the effectiveness of their response and interoperability with key stakeholders. During the exercise, paramedics practised casualty management and triaged more than 40 patients who were subsequently transported to a simulated emergency department.
43 Trip down memory lane In October, a collection of historical vehicles had a starring role in the 150-year celebrations of the small mining town of Ravenswood, located 88 km east of Charters Towers. The vehicles are from the Charters Towers Ambulance museum and they are similar to vehicles that would have been used in the area over the past century.
The QAS had a dedicated team on hand when the GC600 revved into action on the Gold Coast’s Glitter Strip in October. The event also provided an unexpected reunite for Critical Care Paramedic Luke Adams and former patient Peter. Both Luke and Peter happened to be providing medical response at the GC600 when they ran into and recognised each other. In December last year Peter, a nurse, suffered an out-of-hospital cardiac arrest. Peter’s wife called Triple Zero (000) and commenced CPR and Luke was one of the first responders who eventually took over and helped resuscitate him.
Summer 2018–19
Movers and Shakers
Farewells Years of Service
Division / Location
Assistant Commissioner
43
Darling Downs LASN
Kevin Wendt
Paramedic
32
Darling Downs LASN
Robert Marsden
Paramedic
31
Gold Coast LASN
Gordon Brown
Operations Coordinator
28
State Operations Centre
Anthony Windle
Paramedic
28
Darling Downs LASN
Ken Duncan
Manager Clinical Education
26
West Moreton
Melissa White
Staff Officer
22
State Operations Centre
Catherine Austin
Communication Support Officer â&#x20AC;&#x201D; (CQI)
20
State LASN Operations
NAME
Position Title
Rod Sheather
Notes Reflects activities during the period from 31 August to 23 November 2018.
Appointments 44 Notes Appointments made during the period from 1 September to 31 October 2018.
NAME
Position Title
Appointed date
Location
Stacie Ramanah
Principal HR Consultant
10-Aug-18
Head Office Kedron
Kylie Babarovich
Manager Metrics and Reporting
10-Aug-18
Head Office Kedron
Tony Armstrong
Director Operations
3-Sep-18
Caloundra Ambulance Station
Matthew Green
Director Operations
3-Sep-18
QAS Spring Hill
Kelsie Pelka
Manager Workforce Planning
5-Sep-18
QAS Spring Hill
Anne Winlaw
Operations Coordinator
6-Sep-18
Head Office Kedron
Monica Farrow
Director Ops Emergency Management
10-Sep-18
Emergency and Fleet Management Precinct
Mark Burgess
Operations Coordinator
17-Sep-18
Head Office Kedron
Claine Underwood
Officer In Charge Field Office
8-Oct-18
Cooktown Ambulance Station
Danielle Williams
Manager OpCen
8-Oct-18
West Moreton LASN Headquarters
David Hill
Director Workforce Governance Safety & Capability
22-Oct-18
Head Office Kedron
Wendy Lowes
Director Human Resource Services
22-Oct-18
Head Office Kedron
Todd Wehr
Director Staff Support Services
22-Oct-18
Head Office Kedron
Melissa Mangan
Media Coordinator
22-Oct-18
Head Office Kedron
Summer 2018â&#x20AC;&#x201C;19
16
19
17
11
9
23
14
10
22
13
18
8
15
12
20
Thanks to Santa for making time during his visit to the Myer Centre in Brisbane to catch up with some QAS staff â&#x20AC;&#x201C; among them Rebecca Pham, Peta Thompson, Daniel Wilson, Solomon Lee Wen and Ben Todd â&#x20AC;&#x201C; and for agreeing to a quick health check-up with BRT officers Madeline Shield and Russell Brodie before he got underway on his busiest time of the year. Best wishes for a safe Festive Season and a Happy New Year to all our INSIGHT readers! Arrangements and photography by Jo Hales; Advent calendar styling by Masthead Design & Creative.
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