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Capital – Canberra
Land Size – 7,682,300 sq km
Population – 21,515,754
Language(s) – English 78.5%, Chinese 2.5%, Italian 1.6%, Greek 1.3%, Arabic 1.2%, Vietnamese 1%, other 8.2%, unspecified 5.7% (2006 Census)

  • Anglo-American model
  • Provincially administered

History

  • 1885 – Civil Ambulance and Transport Brigade (Sydney)

EMS System Model

  • New South Wales (NSW)
    • Dual-role ambulances, typically, though single-role is being implemented “to enable a higher percentage of overall vehicles to be staffed by a paramedic” (Trevithick, 165)
    • Ambulance Service of NSW (ASNSW) – primary prehospital provider
      • Gov’t funded; by law, only organization allowed to provide prehospital road ambulance emergency services
        • Private agencies allowed to provide services at major sporting events
        • Motorcycles and four-wheel drive vehicles are also employed
  • Victoria

Lead Agency

  • Provincial DOH

Levels of Care

  • New South Wales (NSW)
    • Paramedic
      • Intubation (post-intubation sedation only)
      • DefibrillationIV fluid admin
      • Needle thoracostomy
      • Adrenaline, Atropine, Calcium Chloride, Glucose, Frusemide, Glucagon, Glyceryl Trinitrate, Lignocaine, Metoclopramide, MS, Midazolam, Naloxone, Salbutamol, Sodium Bicarb, ASA, inhalational Methoxyflurane.
    • Advanced Life Support Officer
      • Less developed ALS scope
    • Patient Transport Officer
      • BLS
  • Victoria
    • Mobile Intensive Care Ambulance (MICA)
      • Equivalent of Paramedic
    • Advanced Life Support Officer
      • Less developed ALS scope
      • As of 2008, Basic ALS Officers’ scope is being upgraded
      • Broader range of ALS skills and meds

Education and Training

  • “Pre paramedic training is carried out over a 3 year period and involves a combination of classroom theory, hospital attachments and probationary road period” (Trevithick, 165)
  • “Progression to paramedic level is based upon merit” (Trevithick, 165)
  • Specialized training achieved by selection – e.g., high angle or water rescue

Medical Direction

  • Medical oversight provided by Chief Medical Officer and Medical Advisory Committee
    • Includes treatment and hospital bypass protocols

Specialty Services

  • ASNSW
    • Aeromedical Services
      • Fixed-wing transport w/flight RNs
      • HEMS w/ MD/RN; MD/Paramedic; or Paramedic-only
    • Medical Retrieval Unit
  • Royal Flying Doctor Service (RFDS)
    • Established as charity organization to assist with limited medical services in Australian Outback
    • Funding comes from gov’t, donations and fundraising
  • NRMA CareFlight
    • Helicopter medical services through ASNSW
  • Sydney Aeromedical Retrieval Services

Dispatch

  • 000 – Nationwide
  • ASNSW – 5 call centers to where all emergency calls are directed
    • Use of Computer Aided Dispatch (CAD) and vehicles equipped with Mobile Data Terminals (MDT) for messaging and Automatic Vehicle Location
    • Recent introduction of Medical Priority Dispatch System (MPDS)

Emergency Medicine

  • Australasian College for Emergency Medicine (ACEM) – primary training institution for specialist EM MDs in Australia & New Zealand.
  • The Royal Australasian College of Physicians (RACP) – training and accreditation of pediatric EM MDs.
    • “The supply of emergency physicians throughout Australia and New Zealand currently cannot meet demand, and is not expected to do so within at least five years” (Trevithick, 169)
  • EDs in NSW are rated on a 6-level scale
    • Level 6 – Full Trauma Center with 24/7 access to EM MDs, Neurosurgery and Cardiothoracic surgery.
      • 10 Level-6 EDs in NSW (2 are pediatric)

Disaster

  • HEALTHPLAN – NSW DOH major medical incident management plan
  • NSW Health Counter Disaster Unit – responsible for policy, planning and preparedness training
    • “Planning involves purchase, storage and distribution of personal protective equipment, antidotes to Chemical and Biological agents, rapid identification of such agents and training of key personnel” (Trevithick, 169)

References

  • https://www.cia.gov/library/publications/the-world-factbook/geos/as.html
  • Boyle MJ, Smith EC, Archer FL: “Trauma incidents attended by emergency medical services in Victoria, Australia.” Prehospital and Disaster Medicine 2008;23(1):20-8.
  • Trevithick S, Flabouris A, Tall G, Webber CF: “International EMS systems: New South Wales, Australia.” Resuscitation 2003;59:165-70.

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