Briefs

USAR training

Four QAS officers became official members of the Queensland Disaster Assistance Response Team (AUS Taskforce 1) in September after completing four weeks of Urban Search and Rescue (USAR) Category 2 training at the Queensland Combined Emergency Services Academy at Whyte Island.

The course culminated in a 48-hour exercise simulating a city block extensively damaged by an earthquake. The activity was designed to test the officers’ endurance in extreme conditions to locate, treat and rescue multiple trapped patients.

QAS USAR facilitator Mark Zimmermann said the QFES sponsored course ensured our newest USAR members–paramedics Aleasha Stenhouse, Luke Adams, Charlotte Hood and Jacinta Nicholas–were now highly skilled and specialised in a wide variety of disaster response situations including all aspects of rescuing trapped and injured victims from building collapses, as well as damage assessment for natural or man-made disasters. It was the first time in almost two years QAS officers had undertaken USAR Category 2 training at Whyte Island.

The QAS currently has more than 20 active USAR officers available to deploy with as little as two hours’ notice to domestic and international disaster zones to help locate, extricate and provide medical assistance to victims trapped in structural collapses. Our paramedics are also responsible for looking after the health and welfare of their USAR team members on scene.

International incidents that our QAS USAR paramedics have been deployed to include the Samoa earthquake and tsunami in 2009 and earthquakes in Indonesia (2009) and Christchurch (2011). Domestic incidents include the 2019 Townsville Floods and Australian bushfire event, as well as Tropical Cyclones Larry (2006), Yasi (2011), Marcia (2015) and Debbie (2017).

ASM presentation

Photo courtesy of Government House

It has been a remarkable year for humble Rathdowney couple and long-serving QAS volunteers Lyn and Ian Richter, who were presented with Ambulance Service Medals by His Excellency the Honourable Paul de Jersey AC, Governor of Queensland at a special ceremony at Government House in September. This followed their announcement as ASM recipients in the Queen’s Birthday Honour list in June.

A beaming Lyn said it was amazing being announced as an ASM recipient and the ceremony at Government House was surreal and ‘one of life’s amazing moments’. “From a life point of view this was extremely special,” Lyn said. “It was lovely to be awarded and presented our medals together. We will never forget that moment.”

The ASM is a deserving acknowledgement for the couple who have clocked up more than 60 years combined service volunteering for the QAS.

CCP graduation

After completing their 12-month internship, our latest batch of Critical Care Paramedics were more than eager to hit the road to care for some of our state’s most vulnerable patients. The new CCPs and their nearest and dearest attended a Graduation Ceremony at Kedron’s Emergency Services Headquarters on 17 September where they received their new gold epaulettes and Certificates of Achievement.

More than 600 people in Australia, New Zealand, the United Kingdom and Europe took part in an inaugural High Acuity Response Unit (HARU) webinar facilitated by the QAS Metro North Clinical Education Unit on 14 September.

The event highlighted the team and system approach to the management of severe trauma in Queensland and was a continuing professional development (CPD) collaboration between the Australasian College of Paramedicine and the United Kingdom’s College of Paramedics.

Panellists included QAS Medical Director Dr Stephen Rashford, HARU CCP Matthew Meister and Christian Wiggins, a Critical Care Paramedic with the Great Western Air Ambulance. Christian was awarded a Winston Churchill Fellowship in 2019 to travel to Australia and New Zealand and investigate critical care teams–giving great insight into various models of care.

The webinar gave viewers the opportunity to ask questions about the structure of the QAS trauma system and HARU. Discussions focussed on the clinical skill mix, procedural training and competency, governance and auditing and potential future developments in prehospital critical care. Congratulations Craig Cameron, Andrew Rochecouste and Brooke Curley (Metro North LASN), Paul Boustead, Grace Cormick and Andrew Morris (Metro South LASN), Patrick Forrestal (Cairns and Hinterland LASN), Samantha Berg (Darling Downs LASN), Cameron Gulliford and Daniel Gundersen (Gold Coast LASN), Harry Werner (Sunshine Coast LASN), Brodie Rollason (Townsville LASN), Sergio Gomes (West Moreton LASN) and Tristen Meacham-Day (Wide Bay LASN). Group 28 we wish you all the best as you embark on this exciting new chapter in your career!

Critical Care Teams – HARU Webinar

The discussion was then brought together with insights from Christian across various models of care in Australasia, as well as ongoing work to develop advanced practitioners in critical care. This model would see senior practitioners from various backgrounds (paramedicine, nursing and medicine) trained to the same high standard to deliver prehospital critical care.

The webinar was an exciting first step toward ongoing international collaboration and learning that will benefit paramedic professional development and ultimately the patients that rely on our care.

Stoic Mick’s Return to Work after life-changing leg amputation

Beaudesert OIC Mick Mahoney’s life was turned upside down at the start of the year after his left leg was amputated following a buggy rollover on his property. Insight Editor Jo Hales reports on the courageous Metro South officer who was back at work in no time, determined to not let the incident, and the loss of a limb, hold him or his career down.

Above

Despite having his left leg amputated in late February, Mick returned to work in record time in June.

Photo: Jo Hales

Opposite

Mick said the support he has received from the QAS, including his staff and work colleagues, was instrumental to his speedy recovery.

Photo: Peter Wallis, The Courier Mail Mick, 48, had just finished his shift on a rainy day on 31 January and was looking forward to two weeks leave when his life drastically changed forever.

“My girls Elyse and Annabelle (who were 8 and 5 at the time), wanted to go down to the river to see how much water was in there,’’ Mick said.

“We got on the side-by-side buggy and drove down there. We had done this a thousand times.’’

However, on this occasion, the buggy tipped over and Mick’s foot got caught underneath it.

“The foot was crushed quite badly. Thankfully though, my girls were fine and had no injuries,” he said.

“I tried walking up to the house but that didn’t work, so I called my friend to drive me to the hospital but when he arrived and saw the injury, he said ‘No way, we are calling for an ambulance’.”

Mick said when the first paramedic, Jimboomba ACP Emma Hooper, arrived on scene, he was happy to see her as by then he was ‘in quite a bit of pain’.

Once Mick was in the back of the truck, the single responding officer was able to begin assessing and treating him, with Woodridge CCP Patrick Amadeu and ACP Laura Meadows arriving shortly after.

It was a confronting scene for the three responding officers–all of whom knew Mick very well.

Emma said when she found out she was attending Mick’s case–she instinctively knew it was going to be a big job.

“The case details were very minimal, and it stated that Mick had hurt his foot, but knowing him, and how stoic he is, he would not have called for anything minor,” Emma said.

Patrick, who works out of Woodridge Station and on the Logan Pod, said when he saw Mick in the truck, it was obvious his injuries were very serious.

“Not only did he have multiple fractures, but significant soft tissue injuries,” Patrick said.

“There was also a lot of dirt and grass in the soft tissue.”

After medicating Mick and irrigating and cleaning the wounds, a dressing was applied and Mick was transported Code 1 to the Princess Alexandra Hospital.

Despite the severity of the incident, Mick, who has been a paramedic for more than 20 years, and the OIC of Beaudesert for eight years, lightheartedly describes his first time as a patient as an ‘epic failure’.

“I had never been badly injured before and I found it difficult being the patient,” Mick recalled with a cheeky grin.

“I kept saying I will just lay here and not do anything but then I would start trying to tell them what to do. I really was the worst patient. That was until the ketamine and fentanyl took effect.”

Mick said one of the things that stands out in his mind on the way to hospital–even with the effects of the drugs that had been administered–was the ‘simple gesture’ of Emma holding his hand.

“That’s what I remember more than anything. It is very clear in my memory. It made me feel safe and was comforting,’’ Mick said.

“I can genuinely say that from the moment the call was made to the Southport Operations Centre, to the time I was delivered to the hospital, my experience was gold standard.”

Mick spent just over a month in the Princess Alexandra Hospital where he endured more than ten operations in a bid to repair his ‘mangled foot’.

It was while he was having consultations with specialists that the future of his foot was decided.

“The best advice I was given was that it would have needed at least a year of operations and rehabilitation, and there were no guarantees my foot would be saved. I was also told there would be limitations on its use. It would need to be elevated at night and I would also experience ongoing pain,’’ Mick said.

“Knowing myself and the person I am, and the way I want to live my life, I sought more advice.”

Mick spoke to someone from the prosthetics department who went ‘through all the possibilities and probabilities around cutting my leg off and what I could expect from the time I became an amputee to the point I left this earth’.

“I quickly decided amputation was the direction I was going to take,” he said.

However, before he made his final decision, there was one important phone call Mick wanted to make to QAS Medical Director Stephen Rashford.

“When I contacted Steve I said, ‘Can I still be a paramedic if I am missing a leg?’ to which he quickly replied, ‘Of course you can’.

“That was very reassuring to me at that moment in my life and it made it really easy for me to make my decision,” Mick said.

Mick said he did not know what he would have done if Steve had said no.

“I could never see myself doing anything else. I love being a paramedic and helping people,’’ he said.

“When you get down to tin tacks, there is a real satisfaction in what we do. It is a very privileged position we hold within the community.”

Mick said he has always been that person who ‘rightly or wrongly once I make a decision I follow it’.

So, when an orthopaedic surgeon asked when he would like the surgery, Mick said, ‘Well if you are not busy, can we do it after lunch?’ She replied with, ‘Maybe not after lunch, but we will get you in as soon as we can!’

Mick was so motivated to get moving after his surgery on 24 February, that he was out of hospital and heading for home on 29 February.

He was also eager to return to work, donning his teal uniform for the first time after the amputation in June.

“When I came back, I was helping the Acting OIC with drug audits and basic stuff, but this return to work was integral to my recovery,’’ Mick said.

“We are creatures of habit and to come back and see my other family and receive the level of support I had on my return, meant I never felt alone.”

On the subject of support, Mick said his teal angels and the QAS in general, played a crucial role in his speedy recovery and subsequent return to work.

“Every day I was in hospital someone came to see me and that has played on my mind a lot,’’ he said.

“I have always tried to be there for my mates, but if someone is going through difficult times or is injured, I will make more of an effort to be there for them now as I know what a difference it made to me.

“When you are lying in a hospital bed wondering about the rest of your life, a couple of people showing up really lifts you.

“I don’t think I can ever repay everyone who came to see me, and I don’t think they understand how much it means, but it made such a difference, that is what helped me get out of hospital so quickly.”

In fact, the large number of visitors led to one of the nurses joking about ‘charging admittance to Mick’s room’ to which he replied, ‘I’ll go you halves. Charge away’.

Mick said the same people who visited him in hospital turned up at his property to ‘mow my lawn and clean my house’.

Meanwhile, officers from his station ensured he never went hungry with Mick having ‘more food and meals than I could possibly eat’.

“Some of the girls even helped me shop for my youngest daughter’s birthday, as pushing a trolley with crutches and one leg carries a high degree of difficulty,’’ he said.

Mick said if he had to write down everything people had done for him ‘it would take over a week’.

“There were really kind gestures and it wasn’t just the teal angels; it was the people in the community too,’’ he said.

Mick would like to ‘acknowledge the messages and phone calls of support from folks he has worked with over the years in various roles’ and to reiterate ‘just how much he appreciates the support’.

“Folks would take me shopping. All the locals were supportive and wanted to contribute, which is hard to come to terms with when you are someone who has been very independent and never accepted help.

“For me, it really shows the quality and the fabric of the people I work with and the community I live in.”

Mick said when he was cleared to return to operational duties in late October, it was a milestone, not only physically but psychologically.

“After 20 years as a paramedic, I still have a strong attachment to treating patients. I love what I do, and it is important for me as an OIC that I am leading by example. If I am out there treating patients and doing it well, the people around me do it well too.”

Mick recently caught up with the three work colleagues who attended his case back in January.

Patrick, who has known Mick for 11 years, said he was not surprised by the OIC’s speedy return to work.

“It is fantastic to have him back. Mick is not someone who gives up. He is the kind of person you can throw things at and he will pull through,’’ Patrick said.

Patrick summed up the sentiment of many when he said Mick was an amazing and integral person to have on the team.

“Mick is someone who has your back 100 per cent, no matter what. He has the guts to stand up and say no when something goes against his own philosophy which I think is very rare these days,” he said.

“He also takes responsibility for what he does. I just love working with him as you know when he is around that you don’t have to worry about anything because everything that can be done will be done.”

QAS officer’s ‘Phantastic’ career as a comic book artist

When Bundaberg Patient Transport Officer (PTO) Shane Foley is not on the job, he is in his art studio–aka man cave–pencilling his latest comic book illustrations. Insight Editor Jo Hales reports on the talented 63-year-old whose artistic flair has snared him coveted recurring roles illustrating one of the world’s longest running comic book characters–The Phantom.

Opposite

A 2018 Phantom cover by Shane.

Left

Some of Shane’s captivating artwork.

Below

The Saga of

Shakah‑Rune.

Shane said when he was first asked to illustrate a cover of the renowned Phantom series in 2016, it was a dream come true.

“I have loved the Phantom comic books since I was a kid,” Shane said.

“When I was seven, I found a Phantom comic in a caravan on a holiday. That’s when a light bulb went off in my head and I realised I loved the action-oriented story telling approach. It is where my love for comic books started.”

Fast forward five decades and Shane’s dream of sketching Lee Falk’s fictional, tight-skinned purple costumed crime fighter became reality after he contacted the publisher of the Australian Phantom series, Frew Publications. Based in Sydney, the company mostly reprints The Phantom series from Scandinavia and America but incorporates its own cover.

“When I picked up one of the comics on a news stand one day, I noticed that The Phantom image on the cover was a panel from the story inside the magazine. It had been enlarged on a photocopier and had lost all its definition and clarity,’’ Shane said.

“It got me thinking, ‘I can do way better than that’, so I got to work redoing the cover using the same layout and I sent my sketch to the publishing company.

“They wrote back and said they liked my sketch, but they didn’t have enough money to pay me.” The editor kept Shane’s work on file and when the publisher changed hands sometime later, he was asked to illustrate a cover.

Since then Shane has undertaken ten Phantom covers and he has also been commissioned to write stories and sketch comics inside the magazines from time to time.

The Phantom may be Shane’s biggest job in terms of ‘prominence’, however, he is no stranger to comic book work.

In the early 1990s, Shane’s illustrations were published in Australian publications Southern Aurora Comics Presents Dark Nebula and Australian War Stories. Between 2004 and 2006, in conjunction with his colourist friend ‘Sarge’ in Ohio, he also produced a monthly fourpage series in the popular children’s publication Krash Magazine called The Saga of Shakah‑Rune. His artwork has also been published in church newsletters and children’s stories.

Shane, who was born in Victoria, but grew up in Maroochydore on the Sunshine Coast, said he has been sketching ‘forever’.

“I don’t remember when I started drawing because I have always done it. It has always been a part of my life. It is in my blood,” he said.

“I still vaguely remember the day I realised that most other people didn’t draw for fun like I did, and that it didn’t come as easily to them. Drawing was always something both my brother Gerry and I did. He was marvellous at drawing complicated battles scenes–but hasn’t kept it up like I did.

“Mum noticed all our drawing, and when we were still in primary school, she arranged for us to do oil painting classes. The tutor convinced Mum to paint as well, rather than just sit and wait. Gerry and I both went back to just drawing, but Mum kept it up and got so good that in her 60s she had some exhibitions of her own.”

The artistic family tradition also passed on to Shane’s sons, Pete and Brendan, both of whom are making a living out of art.

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Shane and wife Helen have a wonderful partnership and provide unconditional love and support for each other.

Left

Shane’s artwork can be very labour intensive.

Right

Flashback: Wide Bay LASN Chief

Superintendent Russell Cooke with

Shane when he was presented with a 25‑year service medal in 2017.

“Pete is an animator in Sydney and Bren is a graphic designer in New Zealand. They both draw extremely well,” Shane said.

Meanwhile, Shane and wife Helen work as a team when it comes to designing artwork on greeting cards for family and friends.

“Helen has a flair for decorating and she always has amazing ideas for the illustration on the card, which I then sketch,’’ he said.

Shane lists his favourite subjects as science fiction characters, as well as trees, rocks and animals and while he dabbles in colour, his preference is black and white.

“I don’t do much colour. I use pencil and ink most of the time. I find some of the most powerful images are black and white,” he said.

Shane said a great deal of patience is needed when undertaking comic book artwork as it is extremely labour intensive.

“If a page has four or five panels, that is four or five decent pictures you need to do. If a panel of art doesn’t take your eye to the next panel and tell the story simply, it doesn’t work,” he said.

“Comic book story telling is really different from other art. Also, apart from the actual drawing, you are doing the work of a movie director, trying to work out how a scene will work and why. It is important to make it readable.”

However, Shane said the intense process is worth it–especially considering the reaction the artwork receives.

“When people witness the comic book drawings, they seem to find them a bit magical. They can appreciate the illustrations, even if they have no desire to read the book,” he said.

Shane held his first full-size solo art exhibition, mostly black and white, comic book style-pieces, in the Bundaberg Regional Art Gallery in 2016. Over the years, his artwork has been commissioned by facilities such as Bundaberg Council. He also has a mural in the Emergency Department of Bundaberg Hospital. The actionpacked mural in the paediatric area, featuring fairies, a robot and a range of animals, provides comfort to young children and takes their mind off what is happening.

He also uses his art to bring a smile to the faces of others in his community in his free time.

Most Fridays, Shane works alongside a local with a disability. The 35-yearold man loves Marvel Comics and they spend quality time escaping into a world of fun.

“I meet up with him for an hour and a half and draw with him. He likes Manga and Marvel, cutting out pictures of characters and says, ‘I would like this body with this suit’, so then I draw a character for him,” Shane said.

“His imagination is amazing and relentless–we have a great time!”

Just like Shane’s artwork brings joy to others, it also provides stability and grounds him when life gets tough.

“When there is heavy stuff going on, I put myself into a story. I usually find then that the problems in the real world are put into perspective and I am not obsessing over something. It is a really good way of dealing with stress, a healthy way,’’ Shane said.

“I am not ignoring issues. I am just managing them and letting the dust settle.”

The artwork has also helped Shane remain calm when he and Helen have experienced ongoing health issues over the years.

In 2017, Shane was diagnosed with prostate cancer, then in 2019, kidney cancer was found.

“It was found by accident–it was while I was getting a scan for a prostate check-up,’’ Shane said.

Shane, whose Dad Bert died from prostate cancer in 1982, said ‘they were checking to see if the prostate was enlarged on a scan, when the urologist’s assistant–filling in for my urologist while he was overseas–noticed the lump on my kidney’.

Left

Shane’s colourful mural in Bundaberg

Hospital helps comfort youngsters and takes their mind off what is happening.

Right

The Phantom in action.

“When the urologist returned, I was immediately booked in for surgery at the Wesley Hospital. Due to the location of the lump and the size of it, he advised that removing the whole kidney was the best solution.”

Thankfully, the cancer had not spread, and Shane has had no problems since. So far, he also has the all clear with his prostate cancer.

Shane joined the service in 1991, after the newly formed QAS placed an ad in the newspaper seeking Ambulance Officers.

“I had been a funeral director for a while and was living in Ipswich with Helen and the two boys who were very young at the time,’’ Shane said.

“I was one of three who was selected for Bundaberg Station.”

Shane said he put Bundaberg as his first preference as Helen’s parents lived there at the time.

The couple moved to Bundaberg in September 1991, where Shane has been based most of his career.

In 2008, after more than 16 years in the service, Shane resigned.

Around the same time, he noticed he was struggling with things and was not coping well.

When his new job didn’t work out, things got worse. “I had been out of the ambulance service for six months by that time and I felt terrible,’’ Shane said.

“Ever since leaving, I’d be able to hear an ambulance siren coming long before anyone else could. And I simply couldn’t make any decisions. Helen asked me to do the Beyond Blue online questionnaire and my score confirmed her belief that I needed help. So, we arranged a doctor’s appointment.”

Shane was diagnosed with depression and once again it was his artwork which helped him through.

“Helen felt I needed time away and organised for us to go to Poatina in central Tasmania–where a friend worked in a Christian run village that helps disengaged youth,’’ he said.

“Every day I used to go walking in the forest, often with my little sketch book in my hand, drawing nature in black and white, talking to virtually no one for weeks. This really helped me. Helen volunteered in the village and I slowly began to socialise again.”

In 2009, back in Bundaberg, when Shane started looking for work again, things still weren’t easy.

“I despised looking for work and found it so hard, still feeling like I was on the edge of depression. But one day, by chance, I met some paramedics I knew in town. “They told me that PTO work was available. It had been about 10 months since I left the service–and I thought that maybe, if I wasn’t doing acute work, I might be able to give it a go.”

“I approached management in Bundaberg, and they were keen for me to return at a PTO Certificate 3 level. It worked well for both of us–I’ve been a PTO for almost 12 years now.”

Shane works four days a week, taking Friday off to unwind and pursue his art.

He has no plans of slowing down on the artwork as there is nothing more rewarding than seeing it come to life.

“It is always exciting when the artwork is done and you take a step back to see what you have achieved,’’ he said.

As for the Phantom, Shane said he is keeping his fingers crossed the character’s old-style comic book imagery will not become obsolete in the future.

“It is great that the Phantom hasn’t really modified much over the years, like other characters, such as Batman, who seems to have grown nastier and darker. I really hope this doesn’t change!”

Visit Shane’s website to view more of his amazing artwork.

A close look behind the scenes of the Professional Standards Unit

Tucked away in the Medical Director’s Office, the Professional Standards Unit undertakes a unique responsibility within the background of our organisation. It’s a team most paramedics are happy not to hear from, in fact, Crystal Nelson admits she didn’t have a full awareness of the unit until she joined over a year ago. Matt Stirling recently sat down with Crystal to delve into her role.

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Crystal has just completed a Bachelor of Laws and she loves how her Professional

Standards Unit role allows her to use her clinical and legal education.

Opposite

When the FIPN QAS

RESPECT Induction

Workshop was held in

Brisbane in October,

Crystal delivered a presentation on the Professional

Standards Unit’s work.

Photos: Jo Hales A paramedic makes countless decisions every day; clinically, professionally, ethically. In the world of patient care, filled with high-pressure enigmas, raised emotions, and a real person’s wellbeing on the line, these decisions have serious ramifications. And as is human, sometimes we get it wrong.

Formerly known as Clinical Quality and Patient Safety, Crystal and her colleague, currently Brendan Schultz, have been operating under the Professional Standards banner for 12 months.

“We work directly to the QAS Medical Director to oversight professional performance and conduct,” Crystal said.

“In our role we primarily deal with external parties that receive complaints about paramedics employed by the

QAS. This includes the Office of the

Health Ombudsman (OHO), Australian Health Practitioner Regulation Agency (Ahpra) and the Coroners Court of Queensland.”

Almost all staff fully engage with these processes to ensure a matter is resolved quickly.

“A small number of cases involve significant aberrancies in conduct and practice, which result in elevated regulatory inquiry and intervention. Non-engagement by clinicians significantly escalates this scenario, often complicating a resolution. Fortunately, this behaviour is rare,” Crystal said.

Their time is evenly split between dealing with complaints through the OHO and Ahpra and the other half spent assisting the Coroner’s Office when a death is under investigation. The Professional Standards team also oversees the ECLIPSE project, which aims to run quality assurance upon reviewing of triggered cases.

Crystal commenced her role in June 2019 and was drawn to the legislatively heavy work as she was studying her Bachelor of Laws, which she has just completed.

“I undertook my last two exams recently for law and this is quite a legal area too,” she said.

“It was good to come into a spot where I can use a clinical and legal brain together.”

After nine years on-road, including stints at regional stations such as Woorabinda and Boyne Island, Crystal said she didn’t fully comprehend the breadth of the service behind the frontline until she attended a workplace forum in Brisbane.

“I was blown away by how big our service is. At the time I didn’t understand the organisation’s structure or what each Deputy Commissioner’s portfolio entailed,” she said.

Now in a position to witness the safeguards in place first-hand, Crystal is reassured that measures are being undertaken to maintain the integrity and safety of our staff.

“I’m in a position where I can see something being done, and not just with QAS,” she said.

“As a result, the public is safer and so are our paramedics.”

Ahpra/OHO

Ahpra is a national regulator of Australia’s registered health practitioners and primarily deals with professional performance and impairment issues. Meanwhile, Queensland is the only state with an OHO, a body that decides what Ahpra can investigate while focusing itself more so on behavioural misconduct than clinical errors or impairments that impact on a practitioner’s ability.

On a day-to-day basis, Crystal oversees what the QAS escalates to the OHO while managing incoming complaints the OHO has received externally. Last year saw a nearly even split between issues raised proactively by the QAS and cases submitted by the OHO.

“Very few of the cases are quite serious and most involve employee conduct,” she said.

Professional Standards recently began presenting at Graduate Paramedic Program inductions and is reaching out to universities to educate paramedics early on practical steps to mitigate the chances of an investigation and warn of the consequences.

“I think the biggest qualities we need to hone down on people is to be honest and have integrity,” Crystal said.

“I’ve seen countless paramedics be supported through clinical mistakes, whether through education or performance plans.

“Conduct or misconduct is different and relies more on the individual to make changes.”

Patient documentation is one area the governing bodies monitor stringently.

“The worst thing we find with documentation, and this will go to OHO and Ahpra, is when people make up or falsify things in it because it’s a legal record,” she said.

“Sometimes people will absentmindedly put in a false blood pressure to fill a blank out of complacency and habit.

“Only a small portion of people purposefully try and deceive, but they’ll often get found out.”

It’s not all doom and gloom at Professional Standards however, as the team use virtual monthly LASN catchups to highlight well run cases or honourable acts of conduct and to connect with the regional/rural LASNs in the state.

“We’re trying to say–who has a job that went well, share that with us. Why did that go well?”

Coroners Court of Queensland

When a death involving QAS attendance is referred to the Coroners Court of Queensland, the Professional Standards Unit works intensively to supply information to assist in an investigation.

A case will sit among four tiers within the Coroner’s Office, and if a person is unable to receive a death certificate and the cause of death is unknown, it will progress to the highest tier–a coronial inquest. During an inquest, the Professional Standards Unit supports witnesses throughout the process to ensure they are well supported and prepared for the upcoming proceeding.

On a typical day, Crystal has a case load of around six coronial cases being investigated alongside one ongoing or upcoming inquest at a time.

Sometimes spanning over four years, a coronial inquest isn’t taken lightly. And the result can have ramifications for the QAS if the Coroner’s recommendations find clinical care was inadequate or could be improved. However, QAS will often proactively launch an internal investigation before a case proceeds to a coronial inquest.

“The best practice is to identify an adverse event occurred, be transparent and honest, and work on changes to clinical policy if any are required, before the Coroner has the opportunity to recommend them,” Crystal said.

“This occurs frequently where we discover an issue because a Coroner has requested information about a QAS attendance. We’re fortunate to have a close working team in the Medical Director’s Office where we can easily access the key people needed to make important change.”

One thing Crystal has found important to learn is professional empathy when assisting inquests.

“It’s extremely unfair to judge another health practitioner if you aren’t in the moment. It’s easy to sit back and reflect on something four years ago, but we were all different paramedics four years ago at different scopes,” she said.

Good patient documentation also proves essential in this area of Crystal’s work, especially for a paramedic who may be called as a witness to a case they attended four years prior.

“Documentation is your requirement as a practitioner and the patient has a right to good, fulsome factual documentation. But beyond anything, it’s a gift to yourself,” she said.

“Four years later you won’t remember the intricacies of the care you provided.”

Despite the rarity and drawn out process of a coronial inquest, Crystal says it’s the most intriguing aspect of her position in Professional Standards.

“They want to investigate in court, not just hear arguments and decide,” she said.

“I like that it’s about giving answers to the family of the deceased, even if it’s a delayed process.”

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Eighteen Corpuls

CPR MCCDs have been rolled out on emergency response vehicles in Metro

North, Metro South and Gold Coast

LASNs. NOTE: This picture is a training scenario.

Above

Around 120 CCPs have already been trained and assessed in the use of the Corpuls

CPR. NOTE: This picture is a training scenario.

New CPR device delivers high quality chest compressions

Stage one deployment of the Corpuls CPR Mechanical Chest Compression Device (MCCD) is now complete with the successful rollout of 18 MCCDs on emergency response vehicles in Metro North, Metro South and Gold Coast LASNs.

As of November 2020, around 120 Critical Care Paramedics (CCPs) had been trained and assessed in the use of the Corpuls CPR MCCD. QAS Statewide Reperfusion Coordinator Brett Rogers said clinicians had high praise for these ‘extra set of hands’ and they have already applied them in several out of hospital cardiac arrest incidents.

“Four hours of face-to-face training and assessment has been delivered to paramedics to ensure that they are well prepared and confident in using these new devices,’’ Brett said. “The Corpuls CPR MCCD provides continuous, high quality chest compressions from the scene, during ambulance transport, and into the emergency department,” he said.

“Our first out of hospital cardiac arrest involving the use of the MCCD as a bridge to Extracorporeal Membrane Oxygenation (ECMO) at hospital and quickly into the cardiac catheterisation lab, has already demonstrated the importance of providing continuous chest compressions during transport into the emergency department, and we anticipate this patient will make a very good recovery.” The case is detailed in the HARU Report on the opposite page and Brett said the attending paramedics and treating doctors praised the high quality of chest compressions provided by the device from arrival at scene through to transport into the emergency department and onto ECMO, after which the patient went quickly into the cardiac catheterisation lab and the Intensive Care Unit.

“This case highlights the importance of the training and simulation exercises that have been delivered in the roll out of the Corpuls CPR MCCDs,’’ he said.

“Without each link in the chain of survival working seamlessly and quickly, including the application of the mechanical chest compression device, the outcome would almost certainly have been very different for this patient.

“I want to thank the Clinical Support Officers and paramedics for their enthusiasm and positive attitude in embracing this important new piece of equipment.”

Stage two of the Corpuls MCCD roll out is planned to begin early in 2021, with more devices set to be deployed across the Cairns, Townsville, Mackay, Sunshine Coast, West Moreton and Darling Downs LASNs.