saascene april 2015 edition

SAASceneAPRIL 2015

A DAY OUT

WITH SAAS

CALENDAR

146

4

APRIL/MAY

3-6 APRIL Easter weekend

4-6 APRILOakbank Racing Festival

15-19 APRILBarossa Vintage Festival

26 APRILAnzac Day

1-8 MAYKangaroo Island Feastival

11-17 MAYNational Volunteer Week

15-17 MAYClare Valley Gourmet Weekend

VOLUNTEER RECRUITMENTCENTRAL SOUTH EAST – Lucindale, Padthaway

FLINDERS – Hawker, Leigh Creek, Quorn, Yunta

Getting you There and Back Again2 An EMD's Tale

National Safety and Quality Health Service Standards4 Seeking Accreditation

Driver Awareness6 What to report?

Commendations8 Special thanks to our staff

On the Job 14 When everything falls into place

Gang Green16 Meet Amy, Rebecca, Emma and Renae

A Moment with Mazur18 Oxygen in patient management

Pulse20 General news

CONTENTS

Editor Alexi Tuckey

Graphic Design Svelte Studios

Writers Marise Kalika Leda Kalleske Lisa MorrisonSimon NankivellBirgitt OlsenAdele Pitman-JonesAlexi Tuckey

SAAScene is the official internal magazine of SA Ambulance Service. The publication is produced bi-monthly by the Corporate Communications team.

Find the latest edition of SAAScene, as well as all back issues, on SAASnet.

Contributions, including articles and photographs, are welcome from all SAAS staff. Please ensure you have received approval from your line manager before submitting.

Front Cover: Bianca Hillier and Mel Beer trackside at Clipsal.

GPO Box 3, Adelaide SA 5001

Telephone 8274 0413 Facsimile 8272 9232 [email protected]

© SA Ambulance Service 2015

Material from this publication may be reproduced with the approval of the Editor providing appropriate acknowledgment for all photographs and articles.

SAAScene and Pulse are printed on 100% carbon neutral paper.

mailto:saasnews%40health.sa.gov.au?subject=

SAAScene APRIL 2015 | 1

FROM THE CEO

By my departure date (24 April), I would have been with SAAS almost two years. During this time, I have visited every SAAS location across the state at least twice, and some up to 10 times, except Cleve (my apologies to Matthew and Trish Leonard, and the rest of the team). I will also take this quick opportunity to thank Trish for her years of service as a SAASVHAC Member.

During my time here, I have travelled approximately 45,000 kilometres around SA. I have enjoyed not only the beauty and sheer diversity of this great state, but more importantly, I have enjoyed meeting many of you. If you haven’t done so already, I encourage everyone at SAAS to get out and see your state and meet your colleagues.

I will miss my time with SAAS and look forward to reading how SAAS progresses on its journey, in particular with Transforming Health.

SAAS faces significant challenges in the next financial year, however SAAS is a resilient organisation with a fantastic workforce and competent leadership, whom will no doubt be able to steer the organisation successfully through the difficult economic times ahead.

As you have probably seen from previous SAAScene columns and communications from me, I continue to be humbled by the selfless dedication of our volunteer staff members.

I’d like to acknowledge and thank these volunteers (with over 10 years’ service) who recently resigned: Paul Bleasby (Kingston), Suzanne Gregory (Kadina), Judy Holmes (Kapunda), Valma Clift (Maitland), Michelle Flowers (Port Broughton), Cindy Miller (Wallaroo), Deb Cooper (Bordertown), Justin Croser (Tintinara) and Karen Freeman (Orroroo).

Michael Geisler (25 years) and Helen

Saligari (26 years) recently retired from their career roles. Thank you for your excellent service over these decades.

I would also like to pay tribute to four amazing people – Pat Kakoschke, who recently celebrated a career of 50 years’ service with SAAS (see page 23), Norm Hill who sadly passed away in March having serviced a career for 40 years and 77 days across the state (see page 29), Jock Craig who recently retired after 43 years with SAAS, and Graeme Aistrope who also retired after 40 years.

People of this calibre have earned our respect, many times over. In many ways, they are the thread that ties this organisation together. Not to mention, their families who have supported their commitment to SAAS throughout all these years.

Pat – thank you for your tireless commitment to the Mallala community. The support you have provided, during these past 50 years is very much appreciated. Here’s to another 50!

Norm – may you now rest in peace, knowing you are a well loved and respected gentleman of SAAS. Your legacy will not be forgotten, and your commitment is admired by all.

Jock – thank you for your many years of service as a paramedic, rostering officer and with ESS. You saw an incredible amount of change during your career and took this all in your stride. Congratulations on your retirement!

Graeme – a 40-year long career as a paramedic is no easy feat; the northern suburbs will miss you. You are well respected and will be remembered for your Rotary Club collaboration to produce a fridge magnet that lists the homeowner’s medications. Congratulations!

I also wish to recognise Dave Taylor from Wudinna, who sadly passed away

in February. Dave was a volunteer for 14 years and will always be remembered by his team and the community as a loveable larrikin and excellent clinical role model. There will be a tribute article on Dave in the June edition of SAAscene.

I have had the good fortune of having the support of many people across SAAS. There are too many to mention individually, however I want to single out my executive assistants, Barb Keller and Carissa Tucker (née Harford). They have been my eyes and ears throughout these past two years, and I appreciate and value their support and assistance.

In particular, I want to thank and acknowledge my Executive Management Team whom have put up with my jokes, ramblings and rants. They took it all well! I also want to thank our Senior Management Committee, our Ministerially appointed members of SAASVHAC, and the Clinical Education Team who put in so much effort to de-program me as an Irish Advanced Paramedic (a tough ask) and re-program me as an SA Intensive Care Paramedic.

I also want to thank the Country Regional Response Team whom welcomed me into the team, allowed me to join in on their Thursday night training activities, and allowed me to be a team member without having to be the CEO.

To Megan Cree and the Corporate Communications team, who have effectively been my voice over the past two years, thank you and well done. They did a great job on the translation from Gaeilge to English!

Finally, to each and every one of the 100s and 1000s of staff members I have had the good fortune to engage with face to face across the state – thank you for your courtesy, respect and candour!

I have had the good fortune to visit every state and territory across Australia; this place and its people will always be special for me. However, for the immediate future, I must return to Ireland to support those whom spent their young lives supporting me as parents.

In due course, I will share my new work contact details with SAAS. Please do not hesitate to contact me.

Slán go fóill!

Robert Morton Chief Executive Officer

Welcome to my final SAAScene CEO Column. As I approach my date of departure, I have taken time to reflect upon my time with SAAS and think about those whom have supported me during my tenure. It’s not easy to pen a farewell note, particularly for an organisation that I have grown to respect and admire.

2 | SAAScene APRIL 2015

Getting you

there and

back again

An EMD's Tale

1

Last SAAScene we spent half a day listening to emergency medical dispatch support officers manage triple zero (000) calls. This edition, we’ll see what the emergency medical dispatchers (EMDs) do.

“Basically it’s a chess game, you move the pieces where you need them,” Chris tells us.

A priority 2 flashes up on one of EMD Chris Cameron’s many computer screens. Then another, and another. Calmly and meticulously Chris inspects each event, glances at the Automatic Vehicle Location (AVL) on another screen and almost instantaneously evaluates whether or not it’s worth him sending a SPRINT car. Chris is currently on the SPRINT desk and is responsible for not only SPRINT cars, but also extended care paramedics (ECPs), clinical support officers (CSOs) and managers across the entire metropolitan area.

“Basically it’s a chess game, you move the pieces where you need them,” Chris tells us.

While this is definitely an understated, modest view of the work he does, it is the crux of the EMD role. Chris spent two years as an emergency medical dispatcher support officer (EMDSO) before beginning as an EMD, a role which he’s been in for about a year.

“I generally try and do one or two shifts a month with SPRINT to see if there are any issues from the dispatch side and what’s a good distance to make them beneficial when you’re sending them to cases (i.e. how far away they are from an event and how much further the crew is).”

Chris explains there are a number of things to consider when using single responders:

• Will they get there before a crew?

• If they get there first, will it be by very long (i.e. is it worthwhile to send them)?

• Will the patient likely require transportation to hospital (i.e. is the caller a doctor at a medical centre)?

• Does it sound like the job might be dangerous (i.e. violence at scene)?

• Can they be deployed to help manage cribs and maintain area coverage?

Motor vehicle crashes are SPRINT’s bread and butter, Chris explains, as it can easily save tying up a crew if the patients don’t require hospitalisation.

“It’s all about awareness – of crews and jobs – if you read the notes and see what might be needed, as well as think ahead to whether the patient will need a carry or not then everything can run pretty smoothly,” he says.

“It’s good to have little wins like that,” Chris says after cancelling a crew who were attending a nursing home patient and instead dispatching an ECP to perform a catheter reinsertion.

In the same area as Chris there are three other dispatchers – one responsible for metro south/east, one for north/west and the other assists them all by answering phone calls, covering breaks and providing any other support they need.

With events dropping onto computer screens left, right and centre it feels like the overall setting should be in some way chaotic. In actuality, it’s an extremely calm environment and the entire space operates like a well-oiled machine. Then we remember – this is what EMDs do every day and every night, and it definitely shows.

Chris says welfare checks for crews are one of the most important functions of an EMD and that the role requires him to constantly have an eye on where his crews are on AVL

and what’s happening with their case.

“We really need to keep them safe, especially the single responders, and at night time.”

Around the corner from the metro EMDs we find Matt Dehaas who’s currently looking after the crews in region south (country).

Matt’s been an EMD for five years and spent a couple of years working as an EMDSO prior to that. Matt explains the main differences between country and metro dispatching are how often the phone rings and the sheer distance between ambulance resources.

“Managing both volunteer and career crews is a pretty unique part of the job.

“Lots of crews call in for one reason or another and every time we dispatch a volunteer crew that’s usually two phone calls that come in.

“Having knowledge of the area is really beneficial because it helps to be aware of intricacies of different patches, so you can make sure the patients are always receiving the best care possible.”


EMD positions in the Emergency Operations Centre:

• Region north• Region south• Royal Flying Doctor Service

(including AusHeli, SAAS MedSTAR and Special Operations Team resources)

• Metro south/east• Metro north/west• SPRINT• Metro support• Emergency Support Services• Patient Transfer Services

2

1. The metro dispatch hub.

2. EMD Matt Dehaas works on the region south dispatch desk.


SAAS is about to embark on an exciting journey over the next four years – seeking accreditation in the National Safety and Quality Health Service (NSQHS) Standards – and every staff member (career and volunteer) will be involved to some degree, so it’s important we keep you up-to-date.

We will provide you with as much information as possible about the project, as it will involve and affect us all. The project will demonstrate that SAAS is dedicated to finding ways and means to ensure all members of the community receive the highest quality care and safety possible.

WHAT ARE THE NSQHS STANDARDS AND WHY DOES SAAS NEED TO BE ACCREDITED?

The NSQHS Standards:

• were developed by the Australian Commission on Safety and Quality in Health Care to drive the implementation of safety and

quality systems and improve the quality of health care in Australia. The Commission developed them following extensive public and stakeholder consultation.

• provide a nationally consistent statement about the level of care consumers can expect from health service organisations.

• are a critical component of the Australian Health Services Safety and Quality Accreditation Scheme, endorsed by the Australian Health Ministers.

• focus on evidence-based improvement strategies to deal with

gaps between current and best practice outcomes that affect a large number of patients.

All States and Territories have agreed that hospitals and day procedure services would be accredited to the NSQHS Standards from January 2013.

The SAAS Executive Management Team has given its in-principle approval for the organisation to seek national accreditation for the Ten Standards. SAAS would be the first ambulance service in Australia to gain accreditation.

Accreditation will take four years to achieve. During 2015 SAAS will undertake a planning and

NATIONAL SAFETY & QUALITY HEALTH SERVICE STANDARDS


implementation process ready for audit. From 2016 to 2018, an external provider will audit SAAS in a number of ways. This will include survey visits during 2017 to various metropolitan

and country stations. The intent is for SAAS to be nationally accredited by the end of 2018.

The Ten Standards address these areas:

WHO ARE THE PEOPLE OVERSEEING THIS PROJECT FOR SAAS? Keith Driscoll, Executive Director Clinical Performance and Patient Safety, is the Project Sponsor.

Richard Larsen, Operations Manager Patient Safety and Quality, is

responsible for the overall management of the project.

Julie Cathro, Senior Project Coordinator Clinical Effectiveness and Patient Safety, has been seconded for six months to project manage the initiation and planning stages of the project.

All members of the Patient Safety and Quality team are working hard behind the scenes to support Keith, Richard and Julie on this important project. Special thanks to the NSQHS Standards working party: Mel Thorrowgood, Peter Hayball, Caroline Gafney, Paula Hales and Dan Martin.

Julie Cathro

Project Manager SAAS NSQHS Standards Accreditation ProgramRichard LarsenKeith Driscoll Julie Cathro

WOULD YOU LIKE TO KNOW MORE?

SAASNET > CLINICAL > PATIENT SAFETY AND QUALITY > NSQHS

STANDARDS

You feedback is important to us.

To provide any feedback, please email Health.

SAASPatientSafety&[email protected].

NATIONAL SAFETY & QUALITY HEALTH SERVICE STANDARDS


In this final article for the SAAS Driver Awareness Campaign we will discuss the events that should be reported (in relation to our day to day driving activities), and some of the things that get reported to us.

NEAR MISSES While driving in such a broad range of circumstances staff may encounter an issue that is considered a ‘near miss’. Reporting near misses is important. We have a WHS obligation to report, which helps to identify trends and ensures change can be made before it becomes a bigger issue. For example, you may attend a new building and nearly hit a post that you consider is in a dangerous or awkward spot. You go back on station and it comes up in conversation that others have experienced the same issue. If no one reports it formally, then the power to make a change is lost, and we continue to expose our colleagues to potential injury or damage to SAAS or third party property.

Please talk to your WHS reps in relation to reporting a near miss incident.

CAUSAL FACTOR CRASHES From time to time, when SAAS crews are driving using emergency provisions they may witness a crash between other road users. By the presence of your vehicle on the road, you are likely to be a causal factor in the crash therefore you are ‘involved’. The correct process is to stop, give assistance if required, and the SAAS driver must give their “required particulars” as required by law and outlined in the Emergency Driving Procedure (PRO-055). Giving the required particulars is not something we are exempt from under the Australian Road Rules. For more detailed information look up:

Australian Road Rule 287 Duties of a driver involved in a crash

Road Traffic Act 961: Rule 43—Duty to stop, give assistance and present to police where person killed or Injured

If you are a causal factor you need to ensure all persons involved are safe and uninjured. You may then be able to leave the scene to attend to the case you were originally tasked. If you have not given your required particulars to any driver involved in the crash and to the owner of any property that has been damaged, there is a legal requirement to provide those details to the police as soon as practically possible, but no later than 24 hours after the incident. If someone has been injured you must report within 90 minutes.

If you are physically involved in the crash you must not leave the scene, until the police have completed their investigations and you have given all the required information.

In the event of you being physically involved in a crash you must:

• call the State Duty Manager (SDM) to get an incident number, and then

• fill in the Incident Report and Quick Assessment (IRQA) form, and then

• fill in the insurance form for vehicles (regardless of cost of damage), and

• if there have been any personal injuries, fill in the Injury Claim Form for each member of staff injured

In the event of a causal factor crash happening due to the presence of your vehicle on the road you must:

• call the SDM to get an incident number, and then

• fill in the IRQA form

There will be additional reporting if the incident involves a patient that was in the ambulance.

We need all this information to provide to SAPOL and insurance companies

(should they request it). Without these reports we cannot give the correct information. This, however, is not about appropriating blame on the SAAS driver.

REQUESTS FOR INFORMATION Occasionally, staff receive requests for information from insurance companies. Any staff member who is contacted by a third party, insurance company or any other company, in relation to SAAS staff witnessing a crash, should not complete the paperwork. Immediately return it to the company concerned and advise them requests for information must go to the SA Ambulance Service Client Relations Unit at:

Administration Officer – Legal Client Relations Unit 216 Greenhill Road Eastwood SA 5063 [email protected] 08 8274 0450

The unit will gather information for the insurance company, and provide advice to the person concerned (with their line manager).

COMMUNITY VIEWS SAPOL often receive Traffic Watch Reports from members of the public, about a driving issue. SAPOL will issue a letter to the owner of the vehicle stating that, while no legal action will be taken, their driving behaviour is not considered safe. If they are witnessed by police doing it again, it may constitute a breach of the road rules.

SAAS also receive such complaints. Recent reports to SAAS relate to “driving erratically”, “driving on the wrong side of the road with no lights on”, “driving with their flashing lights on but no siren”, “driving their own

Driver Awareness Campaign

What to Report?


Causal factor crash?

Report to State Duty Manager

Up to date polices and procedures can be found on the SAAS intranet.

NON injury accidents

must be reported to the

Police as soon as possible

but within 24 hours

Injury accidents must

be reported to the Police

within 90 minutes

car (in uniform) while talking on a hand held mobile phone” and “texting on the phone in the ambulance whilst in a 100kph zone”.

We drive very recognisable vehicles and all SAAS staff are representatives of the organisation. The actions of each person have an impact on the confidence the community has in SAAS. To maximise this confidence, staff must comply with the Code of Ethics for the SA Public Sector at all times and all applicable road rules. We have some exemptions available to us but we are never exempt from driving with due care or attention.

By reporting near misses, damage and crashes, you are behaving responsibly, complying with the Code of Ethics, and acting in a professional manner.

Please note: in some cases the public can report a minor crash to SAPOL online. This is not an option for SAAS as we drive government vehicles.

If you have any questions relating to driving matters please talk to one of the SAAS driving instructors or send an email to [email protected].

Drive Safe. Drive Smart.

Andy Hillier

SPRINT Paramedic Driver Development Unit Instructor

LOOK OUT FOR DRIVER AWARENESS CAMPAIGN POSTERS IN A STATION GARAGE NEAR YOU!


COMMENDATIONSMETRO

Please pass on sincere thanks for professionalism and prompt attendance. They were very impressed and remain grateful for the care, concern and reassurance during a frightening experience. Alison Christie (EMDSO), Leanne Read (West C), Sharni Sattler (Casual), Emma Perry (CTL NW 8 Hr Team)

Sincere thanks and appreciation for the excellent and professional service provided. They were calm, reassuring and their care prevented further damage to the patient. Madeline Paech (EMDSO), Christine Dale (SPRINT), Joseph Schar (West A), Maud Bennett-Hol (South C), Margaux Kuhlmann (South B), Marianne Soulsby (South C)

Sincere thanks for the support, understanding and professional manner in which you provided treatment to her mother, who was rather shaken by the incident. John McInyre, Shanra Kessell (East B)

Sincere thanks for your kindness and support, and for the time spent with palliative patient. Phil Knight, Andrew Noble (ECPs), Robert Turner, Jenny Whittenbury (Barossa), Stephen Brown, Trudy Borgas (North B)

Thank you for the care, support, understanding and professional manner in which you provided treatment to her very distressed son. You were wonderful. Nick Kaye, Joshua Cox (SE 8hr Team)

Please pass on thanks for the professional, considerate and terrific service they received. Martin Chessell, Jacqueline Harley (Casual PTS)

Thanks for your professionalism, care and concern. They appreciated the outstanding service they received. Stephen Thorpe (EMDSO), Debbie Harrop (SOT), Caon (NW 8hr Team)

Grateful thanks and appreciation for the wonderful service and care he received.Jessica Sala, Stephen Hambling (West D)

Grateful thanks on behalf of the family for your attempts to save the life of their mother. Your professionalism, effort and kindness were greatly appreciated.Harrison Barolo (Ashford PIDT), Justin Cowan (East D), Shane Kuhlmann (SPRINT), Kathryn Mason (East PT)

Sincere thanks on behalf of the family for the care you provided to their father, who did sadly pass away. Your kindness and heartfelt respect were greatly appreciated. Stuart Elliott, Sebastian Lesnicki (Fulham PIDT)

Thank you for your professionalism, clear explanations of treatment and exceptional service. Darrell Bockman, Kevin Franklin (West C)

Thanks for your care, patience and empathy. She understands she was not a cooperative patient and apologises for her behaviour. Richard Giles, Kevin Franklin (West C)

Grateful thanks for your support, understanding and professional manner in which you provided treatment to her mother, who had a fall. Your assistance to her father was also greatly appreciated. Douglas Whiting (ESS C), Christopher Atkinson (ESS B), Phil Knight (ECP)

Thanks to you for your service, knowledge, professionalism and attitude. You did a wonderful job caring for her husband. Sally Njoroge (East B), Thomas Njoroge (ECP)

Sincere thanks for assisting her through child labour. It would have been difficult for her to cope without you there. Your care, support and reassurance were appreciated. Catherine Brown, Ray Saxon (West A)

Sincere thanks for your support, understanding and professional manner in which you provided treatment to her grandmother. To everyone’s amazement she not only survived the incident but has no residual effects of being without oxygen for suspected ten minutes or more. Doctors advised it was your efforts and treatment that provided this outcome. Grant Gallagher (North B), Tim Wakeling (Murray Bridge RMTS)


COMMENDATIONS

Sincere thanks for your professionalism and the wonderful treatment her husband received. Melissa Turner, Renate Flaherty (North D)

Thank you for helping to save their father. Unfortunately, he did not survive, but the family wanted you to be thanked and recognised for your efforts. Kim Nguyen, Josie Davies (NW 8Hr Team), Keith Summers, Gerard Clingly (SPRINT), Hilding Hanna (ACTL West C)

Thank you for your exceptional professionalism, kindness and support of her elderly mother. Owen Jones, Maud Bennett-Hol (South C)

Thank you for your prompt and professional treatment of the patient, and for your reassurance and team work. Jenny Copley (West B), Sam Keogh (West D), Lee Dale (Whyalla), Christine Cotton (West B)

Sincere thanks for the fantastic, helpful and reassuring care she received following her collapse on an international flight prior to arriving in Adelaide. Lui Morello, Jennifer Stevens (Ashford PIDT)

Sincere thanks for your caring and professional approach to a very distressed patient. Barry Manning, Mary Bagshaw (West B)

Grateful thanks to you for the care and professional manner in which you provided treatment. Your respect and maintaining his dignity was appreciated. Sarah Menadue, Kym Nguyen (NW 8 Hr Team)

Thanks to your swift actions and great clinical care my husband is here today, the outcome could not be better, our sincere thanks. Shaun Buesnel (West D), Winnie Peck (Fulham PIDT), Martin Kimber (OM Lower Murray / Fleurieu)

They were very impressed by your response, and wish to express their sincere thanks for the support and vital service you provided. Tony Sunic (Murray Bridge), Andrea Papini (West B)

Thank you for outstanding team work and patient care while attending their sick child. Ray Saxon, Catherine Brown (West A)

I would like to pass on my appreciation to the crews I worked with as a third in Adelaide in January. I was simply blown away by their professionalism, skills and knowledge. They were so helpful in sharing their expertise; I learnt more in four days than I have in the past few years (working in the mines). No matter the question, the answer was thorough, forthcoming and professional. Please pass on my appreciation to the crews and congratulate them on a brilliant job. From Colin Willoughby, BHPbilliton, Olympic Dam Christine Cotton, Olivia Delli Quadri (West B), Lee Dale (Whyalla)

Thank you for your outstanding help and service. With your professional approach, you made a traumatic time much better for the young patient and their terrified family. From Paediatrician Anthony Chitti, Flinders Medical Centre Michael Tuckfield, Alex Kenny (West B)

The McLaren Vale 67 (MV67) crew was at Flinders Medical Centre on 26 February when I arrived with McLaren Vale 71 with a post cardiac arrest Code STEMI patient. There was a significant mess including vomit and sand through the rear of the ambulance. In the timeframe that we were doing handover in Flinders Private Hospital and transferring the patient to the Cath Lab, the MV67 crew cleaned, mopped and restocked the heavily soiled ambulance. The crew’s professionalism and willingness to roll up their sleeves to help their peers was absolutely brilliant. From James Gardner, Acting Area Clinical Team Leader Billie Todd (PTS Gepps Cross), Doug Cooke (ESS D), Steve Low (ESS A)

Thank you for looking after my little brother when he was very ill. Your friendly manner was greatly appreciated. From Alexi Tuckey, Corporate Communications Courtney Ford, Kristi Lane (West C)


COMMENDATIONSECP

Thanks for the care and support provided to the patient and his family. Your attendance to administer medications was appreciated. He had a peaceful passing. Mary Maloney

Sincere thanks for your clear explanations and reassurance when you treated her anxious mother. Congratulations to you and SAAS for providing such a wonderful service, ECP in-home treatment, which negated what would have been a difficult trip to hospital. Stephen Garrett

COUNTRY

Cannot speak highly enough of them. They've made my life absolutely easy because of that back-up.From Dr Dan Wilson (formerly from Robe Medical Clinic) Robe volunteer staff members

EOC

Sincere thanks for your advice. He is grateful for the care and reassurance you provided for the patients during a frightening experience.Lisa Stevenson (Coordinator L3 Team E)

You may have noticed SAAScene is a little smaller than usual. Do not be alarmed! We still want to publish your stories. To help us along, please make sure your article is no longer than 300 words and has some awesome pictures.

For more information and submission deadlines go to:

SAASNET > PEOPLE AND SUPPORT > OUR COMMUNITY > SAASCENE

Articles and photos can be submitted to Corporate Communications at [email protected].

HAVE YOU GOT A STORY FOR SAASCENE?

COMMENDATIONS


SAMPSON FLAT FIRE

I just wanted to acknowledge the above and beyond support provided to me in recent weeks by SAAS during the Sampson Flat fire. In particular I’d like to acknowledge Emma Perry. While I composed a thank you card, I feel it doesn't do justice to the overwhelming effort Emma has put into supporting me and my family. My family and our 50 acre property were directly hit by the fire, all four fronts of it, Saturday 3 January. From early on, Emma was in daily contact with me. She was patient with my frequent inability to speak and pre-occupation with other matters. She provided an ever-ready ear for me to cry to, vent to, question, whatever I needed. She offered what support she could, understanding it was hard to know what we even needed and always understood the magnitude and acute danger of the situation.

Emma was always there if I needed to contact her, no matter the day or time. She provided timely and reliable advice regarding mobile phone towers, electricity and even delivered some equipment we desperately needed, all while living her own life and managing the rest of our team. Emma has been patient and completely understanding of my apprehension to come back to work. She has been encouraging, and supportive in my concerns and decisions. It is difficult for me to articulate what this unwavering and continuing support has meant not only to me, but to my whole family during this horrific time. I can never thank her enough. From Madeline Peters NW 8 Hr Team and property owner Emma Perry (CTL NW 8 Hr Team)


COMMENDATIONS

VACCINE PREVENTABLE DISEASESAll staff should be up to date with routinely recommended vaccines such as diphtheria-tetanus containing vaccines, poliomyelitis vaccine and measles-mumps-rubella vaccines.

WHOOPING COUGH (PERTUSSIS)• A booster dose (given as dTpa

vaccine) is recommended. A booster dose of dTpa is recommended if 10 years have elapsed since a previous dose.

MEASLES/MUMPS/RUBELLA (MMR)• Documentation of at least two doses

of MMR vaccine for all non-immune staff born during or since 1966. Serological evidence of immunity to measles is also acceptable. Those born prior to 1966 are considered immune.

• If in doubt, two doses of MMR vaccine a minimum of one month apart.

CHICKENPOX (VARICELLA)• A history of chickenpox is strongly

predictive of prior infection (>90 per cent).

• All non-immune staff should be vaccinated with varicella vaccine. Two doses of vaccine at least one month apart are required.

HEPATITIS B• A course of either three doses of

paediatric formulation hepatitis B vaccine or 2 doses of adult formulation hepatitis B vaccine (given between 11 and 15 years of age) or three doses of adult formulation hepatitis B vaccine.

• Have post-vaccination serological testing four to eight weeks after the third dose of vaccine.

• Persistent non-responders to hepatitis B vaccine will need HBIg within 72 hours of parenteral exposure to hepatitis B.

• Booster doses of hepatitis B vaccine are no longer recommended for people who have an adequate antibody response to the primary course, as there is good evidence that a primary course provides long lasting protection.

HEPATITIS A• Staff at higher risk of occupational

exposure to hepatitis A includes on road staff who frequently attend patients in rural and remote Indigenous communities.

INFLUENZA• All staff should have the annual

influenza vaccine.

Clinical staff may be exposed to, and transmit, vaccine-preventable diseases such as influenza, measles, rubella and pertussis. Maintaining immunity helps prevent transmission of vaccine-preventable diseases to and from staff and patients.

WHS

VACCINATION REQUIREMENTS FOR

ON-ROAD STAFF

SAASNET > CLINICAL > INFECTION CONTROL > INFECTIOUS DISEASE

INFO > FACT SHEETS

For more information please contact Belinda Purvis, Clinical

Practice Consultant Worker Health at

[email protected].



INFOREDIn February the latest batch of registrars joined the SAAS MedSTAR general service. As usual, they are an eclectic bunch coming from a variety of professional and geographical backgrounds.

Sam Gluck – ICU/Anaesthetics Sam hails from Wales and came to Australia after five years in anaesthetics in the NHS. He worked at the RAH as an advanced ICU trainee before moving to SAAS MedSTAR. Sam can juggle, do an ever decreasing amount of acrobatics, walk on stilts and ride a unicycle.

Kelvin Huang – EM Kelvin’s an Emergency Medicine registrar who grew up in Canberra, went to medical school in Adelaide, and is married to an FMC Geriatrics registrar, with a 15 month old daughter. Kelvin enjoys martial arts, growing vegetables and kayak fishing (he’s looking forward to the snapper run starting soon!).

Jens Olesen – ICU/Anaesthetics Grew up in Denmark, did nursing school before medical school and has worked in anaesthetics, cardiology and ICU. Jens loves Vegemite, ultrasound, Weet-Bix, shiraz and sunny South Australia. His family (wife and 12 year old son) have found they want to absorb a bit more of Australia too.

James Chua – EM James was born in Singapore to typical type-A Chinese parents, and moved to Adelaide in 1987 aged 10. He took the ‘scenic route’ though medical career, travelling, working in ED, ICU and renal. James is father to three kids, an ‘ok husband to a long-suffering wife’, and loves cooking, song writing, soccer, and the Crows.

Andrew Perry – EM Andrew worked at the RAH and Modbury and is interested in pre-hospital and retrieval medicine, with the long term goal of becoming an MRC. His wife, Emma Perry, is a CTL for the North West 8 Hour team. She thinks Andrew secretly wishes to be a paramedic because they get to treat acute patients with less paperwork (check out Gang Green on page 16 for more about Emma).

Jen Cade – Anaesthetics Jen is a UK Anaesthetic trainee, and chose South Australia for the wine; having done Barossa, McLaren Vale and Coonawarra since she arrived. She works half her time at SAAS MedSTAR and the other half as a Simulation and Research Fellow at the University of Adelaide. Jen has previous pre-hospital experience providing trackside doctoring for motorbikes and Formula 1.

Steve Colhoun – EM Steve arrived from Northern Ireland and Scotland eight years ago for a working holiday and liked it so much he decided to stay. He’s an advanced trainee in emergency medicine and may sit the fellowship exam once he’s ready to give up going to the gym and diving.

1. SAAS MedSTAR, SOT and AustHeli pose for a happy snap.

2. Fun times in the pool; SAAS MedSTAR get dunked.

3. A serious moment in class.

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POLICY FRAMEWORK

The following documents in the policy framework were distributed since the last SAAScene:

NEW OR UPDATED PROCEDURES:

• Study Support and Financial Assistance PRO-042

• Transportation of Blood Sample Vials PRO-222

• Continuous Improvement PRO-223

• Aortic Balloon Pump Transfer PRO-050

• Student Complaints and Appeals Procedure PRO-212

CLINICAL COMMUNICATIONS:

• Safety Alert: Fentanyl Intranasal Spray 600 Microgram/2 mL CLC-15-002

• ESS Consults for TNT CLC-15-003

• Managing Patients with Heat-Related Illness CLC-15-004

• Patient Safety Alert – MDI-Shaped Smoking Devices CLC-15-005

• Access to TOXINZ Database CLC-15-006

POLICIES:• SA Health Risk Management

D0207

These documents can all be found here:

SAASnet > People and Support > Our Resources > Office of the CEO > Policy Framework

STAFF MOVES

Last month we named our new paramedic interns, and now here they are: L – R: Aaron Baker (Clinical Educator), Shay Tippins, Kristian Rudevics, Laura Bainger, Ben Staude, Iggy Gabitov, Tom Gleeson-Hammerton, Lauren Bremner, Bill Toms, Ali Howie, Jordan Smith, Stephanie Penrose, Ebony Hewett, Christina Calvert, Rachel Borresen, Sophie King, Gemma Pfeiffer, Marcus Syvertsen (Clinical Educator).

We also welcome:Vicky Bonnici, who started in November 2014 as a Rostering Officer in the Rostering team.

Kestrel Blackmore, who took up the role of Manager, Service Delivery Systems in the Service Performance and Improvement Directorate in March this year.


WHEN EVERYTHING FALLS INTO PLACE

You’d expect a cardiac arrest in the middle of nowhere to have a bad outcome. But quick-acting workmates and excellent SAAS teamwork can make all the difference.

ON THE JOB


In the searing heat of the outback, 58-year-old Richard Armour is rummaging through the back of his ute when he collapses, dropping out of sight of workmates. He’s in cardiac arrest and needs CPR and defibrillation, but Richard’s on a sheep station more than an hour from the nearest ambulance resource at Woomera.

Boss Reg Hams and Wirraminna Station manager Rob Davidson quickly realise Richard has collapsed and isn’t breathing. They drag him onto the sunburnt soil and start CPR. The time from the collapse to ‘hands on chest’ is 30 seconds.

Rob does compressions while Reg dials triple zero (000). They erect a tarpaulin to protect Richard from the glaring sun. For the next hour, Kerry Gogler, Emergency Medical Dispatch Support Officer, talks them through exactly what to do. And Cindy Hein, EOC Clinician, provides additional treatment advice.

Two Woomera ambulance crews are sent and, after continued CPR, defibrillations, management of a seizure and cooling using frozen food, they transport Richard to the closest airstrip where he is retrieved by the Royal Flying Doctor Service (RFDS).

Six hours after Richard collapsed in the ute, he arrives at the Royal Adelaide Hospital where surgeons implant a defibrillator in his chest.

Two weeks later Richard walks out of hospital. He has no memory of the

events on that day but has suffered no other side effects—a remarkable outcome.

A week and a half after this, Richard and his family, along with Reg, attend the EOC to thank Kerry and Cindy. Joining the reunion via Skype are the ambulance crews from Woomera.

“I’d like to give everyone involved a big thank you,” says Richard. “Because it’s amazing when you’re 600 km from Adelaide, and the guys managed to keep me going with CPR, then the ambulance turned up, then the aircraft turned up, and it all sort of worked.”

Richard’s daughter, Jill, agrees. “The stars really aligned that day for him; everything was available, and all the help that he needed for him to be here today. It’s pretty amazing.”

Kerry says things went remarkably smoothly. “Reg was so calm when he got on the phone. Reg gave me a location straight away. He said ‘He’s under CPR. We’ve started and what do I do next?’”

Shane Crompton, Woomera Ambulance Officer, says improvisation was part of the success of the case. “Anything cold we could possibly give you [Richard], we were putting on you … and for out in the middle of nowhere, I don’t think we could ask for anything better.”

Reg jokes about not having a defibrillator available on the day.

“I was thinking about the cattle prod … but I never had time to go and get it.”

Richard’s wife, Jeanette, says she actually asked a specialist at the hospital about that.

“He [the specialist] smiled a bit and said, ‘Do you know what? It wouldn’t have hurt.’”

Reg says the case has spurred remote communities into action.

“Stations near where I live (near Peterborough) are all making sure they’ve got their first aid up to date, and a couple of stations are talking about buying defibrillators.

“We’re getting one, so we’ve always got one in the vehicle with us. It’s been a wakeup call to a lot of places, I think.”

DID YOU KNOW?Ambulance crews at Woomera are trained and equipped by SAAS but staff are provided by the Australian Defence Force (ADF). They respond to medical emergencies outside the defence base when needed.

STAFF INVOLVEDInitial response:WM81/WM82 – Daniel Tinker, Matt Gulin, Shane Crompton and Nick GrahamEOC team:EMDSO: Kerry GoglerEOC Clinician : Cindy Hein EMD: Kym MacDonald EMD: Sandra Jackson - Scaife

Retrieval from Adelaide Airport to Royal Adelaide Hospital:MS90 – Stuart Baker and Richard Reeve EW67 – Shane Irvine and Matthew Coombe

1. Reunion in the Emergency Operations Centre (L-R): Richard’s family (Jeanette, Jill and David Armour) with EMDSO Kerry Gogler, patient Richard Armour, ECP Cindy Hein and triple zero (000) caller Reg Hams.

2. Richard speaks to the Woomera ambulance officers via Skype.

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NO RUSH FOR AMYWith her first child due the end of June, Amy Rush says, “it’s scary but very exciting”. She’s gradually getting things ready for her son in amongst renovations to her home. The renovations are part of a slow and steady project that has been going strong for five years.

Amy even managed to plan her wedding and honeymoon around this renovation. The plan is to sell the renovated property and find another place to call home with her growing family. When she and husband Martyn are not working on their home, Amy likes to

spend time at the beach, doing yoga and walking her Blue Heeler Lizzie to unwind.

Fellow Volunteer HR Project Officer, Renae Fuss, has been great to go through the pregnancy with. The two both started at SAAS six years ago, and now work together in the Volunteer Support Unit, so have been a source of support for each other.

We wish Amy all the best with the birth of her bouncing baby boy!

Amy Rush

PERFECT TIMING, BEC!Married in October and baby due end June: With the perfect timing one would expect from an Emergency Support Services ambulance officer, Rebecca Sanders (née Menadue) is celebrating the imminent arrival of her Bali honeymoon baby with a baby shower that will include husband Ben, 14-year-old daughter Keeleigh, family and friends. (With a Circus baby shower theme, we’re hoping that you haven’t been primarily inspired by the acrobatics of Cirque du Soleil, Bec?!)

Although feeling confident about having a new baby, Bec says that the mass of birthing and parenting information now available through the internet can be intimidating, compared to what was available 14 years ago.

“A lot has changed since my first child was born in 2001, especially with regard to the baby information that is available. Both Ben and I find that some of the stuff on Google can stress us out. So we stopped looking at it and focused on positive thoughts.”

Bec came off the road at the end of January and is currently the Area Administration Assistant for Metro North West, working with acting Operations Manager Steve Wright.

We wish Rebecca all the best for the birth of her baby. May the Circus-inspired baby shower help to deliver a child that loves to smile!

Rebecca Sanders

GANG GREEN

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GOOD MEDICINEEmma Perry is the clinical team leader of an unusual new group, the north-west eight-hour team.

Its members work eight hours (between 8 am and 5 pm or 5 pm and 1 am), as part of SAAS’s endeavour to relieve pressure on other crews. (There’s an equivalent team for the south-east of Adelaide too.)

This arrangement is working out well for Emma, and she’s enthusiastic about the benefits.

“I think it’s fantastic,” she said. “It offers flexibility and lifestyle to people with families and outside interests.”

Seven months’ pregnant, Emma’s current interests are “resting and sleeping”—not

always easy with a five-year-old daughter and a SAAS MedSTAR registrar for a husband (see InfoRED on page 12).

While she originally intended to be a physiologist, Emma was lured to the ambulance field in the early 2000s by an ambo friend. And she’s hooked.

“I love this job, and I wouldn’t want to do anything else.”

Apart from spending time with her family, a long-held passion of Emma’s is the music of Bon Jovi. She even confessed to having Bon Jovi tattoos on her feet!

With part-time work, eight-hour shifts and a growing family, Emma seems to have achieved that much-talked-about work–life balance.

COMPLETING THE PIGEON PAIRGrowing up by the river has Renae Fuss enjoying the country-like community of McLaren Flat where she and her husband have just finished building their dream home. Expecting her second child, a girl, in early June she has timed it all very nicely. “We’ll have our pigeon pair,” says Renae. Her son, Riley, is four and a half years old and “excited about having a little sister,” will be sure to dote over her before he starts at primary school next year.

With only some final touches remaining on their property it certainly sounds like Renae’s family, along with their four chickens and German Shepherd, Kiki, are settled in. However, home is not the only

place they love to spend time at. With a shack by the Murray River they love to spend summer going down to the water. Although water skiing was off limits this year, Renae still enjoys going for a swim.

When Renae was younger her mum (Cindy Hein) was a volunteer ambulance officer at Swan Reach; so it seems like serendipity had a hand in her role as a Volunteer HR Project Officer for the Volunteer Support Unit.

The only challenge now facing Renae is naming her daughter. “That’s what they are stuck with for life,” she says after talking about names, but it’s clear whatever name she is given this will be one lucky and loved girl.

Do you know someone who you think should be featured in Gang Green?If so, drop us a line at [email protected]

Renae Fuss

Emma Perry


Stefan Mazur

Chief Medical Officer

A MOMENT WITH MAZUR

For many years we have managed patients by administering oxygen via a mask, almost as a brain stem reflex. Many of us will have suffered the ignominy of failing a medical or trauma simulation scenario because we didn’t put on oxygen. “Moulage effect,” we’ll say by way of excuse, “in real life I always put on oxygen”. And undoubtedly we always did. After all, everyone needs oxygen to survive, it seems to make patients feel better and reassure them (and us) that we’re doing something for them.

SO WHAT’S THE DOWNSIDE? Increasingly it seems there is an opinion (and even some evidence) suggesting there may be some downsides to routine oxygen administration, or more specifically excessive oxygenation. The British Thoracic Society has for some time now been advocating for a more rational approach to oxygen administration. Their guidelines for oxygen administration make for interesting reading. Of particular interest (especially for those with upcoming ICP exams), are the sections around general blood gas physiology and the physiology of oxygen therapy.

Oxygen is an essential substrate for cellular functioning and required for aerobic metabolism, but like many things in medicine there also appears to be some negative consequences to its use. The one we are most familiar with is the effect of excess oxygen on patients with Chronic Obstructive Pulmonary Disease (COPD). Some of these patients can develop hypercapnic respiratory failure when excess oxygen is applied. There are a few different interacting physiological mechanisms which are responsible for this, but it primarily relates to issues around ventilatory drive and other physiological factors such as V/Q mismatch, the Haldane effect, absorption atelectasis and the higher density of oxygen compared with air. Absorption atelectasis can occur outside of COPD as well, with partial collapse of some lung units with very high inhaled oxygen levels. We are currently working with Respiratory Physicians from Southern Adelaide Local Health Network to design a process where their patients, with known risk of CO2 retention on high flow oxygen, are given cards which will clearly describe the patient’s target

“Half of what you’ll learn in Medical school will be shown to be either dead wrong or out of date within five years of your graduation, the trouble is that nobody can tell you which half…” This quote is generally attributed to Dave Sackett, considered the father of evidence based medicine, and comes immediately to my mind when considering the current role of oxygen in patient management.


oxygensaturations, enabling us to tailor our management accordingly.

Other suggested downsides to oxygen use include that high oxygen concentrations may lead to an increase in reactive oxygen species which may in fact cause tissue damage. Some hypothesise this may be responsible for some of the detrimental effects that have been observed in myocardial infarction and stroke with oxygen. The biological rationale for this purported effect is that hyperoxia can cause a reduction in coronary blood flow, increased coronary vascular resistance, increased oxygen free radicals, and disturbed microcirculation.

A recent study conducted by Ambulance Victoria has added some important data to this area. Many of you will be aware of the AVOID trial (Air Verses Oxygen In myocarDial infarction and yes, I don’t know who makes up these acronyms either), which made the news in the popular press recently. This ambulance trial enrolled patients with symptoms suspicious for myocardial infarction (history and prehospital ECG with ST elevation on two or more contiguous leads) normal mental state and saturations of more than 94% on room air. Patients were randomized to receive either 8 L/min of oxygen right through admission to the cath lab and then until they were stable on the ward or, alternatively, no oxygen unless they became hypoxic (defined as sats less than 94%). The results were recently presented at the American Heart Association scientific meeting and will hopefully be out in print soon (so that we can all review the full trial). The results presented at the conference showed no difference in cardiac arrest, cardiogenic shock, or pain relief requirements

between the two groups. There also appeared to be a trend towards increased infarct size and myocardial injury in the group given oxygen. Prior to this study a Cochrane review was published which was also unable to establish any benefit from routine oxygen administration.

One of the other arguments given against routine oxygen administration is the decreased ability to identify the deteriorating patient early. For example, in a narcotic overdose with respiratory depression, normal oxygen saturation on high flow oxygen could actually mask significant under-breathing and a potential dangerous build-up of carbon dioxide. Or, a patient with respiratory failure due to pneumonia may be underappreciated as high flow oxygen is masking their relative hypoxaemic deterioration with declining PaO2. Supplemental oxygen will push a normal patient’s PaO2 anywhere up to 350 mmHg. Sats probes will record normal saturations anywhere above a PaO2 of 70-80 mmHg. So patient deterioration may only be recognised as the PaO2 declines below 70-80 mmHg, but at this late stage we may be chasing our tails with regards to potential management options and our ability to expedite hospital arrival.

Two interesting consequences of this recent increased interest in the role of oxygen are the changes in the Australian Resuscitation Council guidelines and the possibility of SAAS being able to contribute to a proposed trial on the use of oxygen cardiac arrest patients with ROSC.

SO WHERE DOES THAT LEAVE US?In the first instance it’s important we don’t over think it. Many more patients in our setting will die from hypoxia than will suffer any potential adverse effects from hyperoxia. Patients in cardiac arrest, or with shock, severe sepsis, major trauma, major head injury, near drowning, anaphylaxis, carbon monoxide poisoning or any condition where they have poor saturations as a result of their acute condition, must get oxygen. And this oxygen should be given in as high a concentration as possible, until the clinical condition has stabilised and is under control.

For all other patients, particularly if clinically stable, a reasonable first step is to titrate oxygen therapy to maintain saturations to at least 94% or above. The routine use of oxygen in well patients with saturations greater than 94-98% is likely to be of nil clinical benefit.

Our guidelines and protocols where oxygen therapy may affect the patient outcome are being reviewed to see where changes may be required.

And look out for our own pending contribution to better understanding of the use of oxygen in critical patients, with participation in a proposed trial of oxygen use in post arrest ROSC patients.

REFERENCE:

https://www.brit-thoracic.org.uk/guidelines-and-quality-standards/emergency-oxygen-use-in-adult-patients-guideline/


GENERAL NEWS

Pulse


PulseBETTER COMMS BETWEEN

EMERGENCY SERVICES WITH INTERCAD

Software that allows SAAS to very easily request other emergency services to attend at incidents began

operating on 24 March.

This new InterCAD software means SAAS can now communicate details of an incident electronically with other emergency services, and vice versa, rather than an EOC staff member having to phone them.

InterCAD will include a predetermined set of events (such as house fires, assaults and car crashes) that will automatically contact the relevant emergency service.

SAAS will also be able to share events that aren't on the predetermined

list if another emergency service is required. When there is a risk of violence, for example, SAPOL can be added to the event via InterCAD.

It also allows for a faster response from all emergency services because crews can be dispatched simultaneously, rather than having to wait for another emergency service to call with details.

Cathie Hamilton, SACAD Project Manager, said InterCAD “allows essential information provided by

triple zero callers to be shared immediately between the relevant agencies”.

“If one agency updates an event, all other relevant agencies see the appropriate information about the event, including both EOC staff and ambulance crews.”

She thanked the team at the Attorney General’s Department, led by Amanda Smith, and the team at SAAS “for working together brilliantly” to ensure the deployment progressed smoothly.

Nichole Bastian, Service Development Manager, also thanked “EOC staff who have been involved in development and testing to get us to the stage of implementation”.

InterCAD was developed by software company Intergraph and is an optional add-on to the SACAD product.

The three emergency services have jointly been working on the project for the past four years.

After 29 years serving the community, Bordertown Volunteer Team Leader (VTL) Geoff Mackereth has decided to call it a day. Geoff received a promotion of work and between that, SAAS, his love of flying and having a life somewhere in between, he decided the time was right to bid SAAS farewell.

Geoff joined St John Ambulance in 1985 and worked as a committed ambulance officer and first aid facilitator. In 1990 he supported the local team as training officer then moved on to be the training coordinator. In 2001 Geoff was appointed as VTL at Bordertown and worked in this role until his retirement on 8 December 2014. During his time

with SAAS he spent endless hours dedicated to his role to serving his community and team members.

The following is an excerpt of a speech put together for Geoff’s farewell:

It is a very sad day as we say goodbye to Geoff, who is retiring from SA Ambulance Service. Geoff, quiet in nature and, in our opinion, is exceptional and always so reliable, honest and there for us. Geoff has not only been our VTL, he’s also a friend to all of us and good friends last for life.

Geoff can proudly hold his head high as a brilliant and amazing team leader, a great mentor, and example to the new recruits.

Geoff, a job exceptionally well done, you should be very proud of yourself, as we are, for having the pleasure of working with you over many years. You will be missed.

The South Management Team and I agree with the comments from the Bordertown team. Geoff has been exemplary and an excellent role model to all volunteer staff members over his many years of service.

We wish Geoff all the best for the future and offer a very big thank you from all of us.

Ross Elliott Regional Team Leader, Central South East

BORDERTOWN VTL HANGS UP

HIS HAT

Geoff with Bordertown team members Jenny Marshall (left) and Lyn Exton (right).


NAME: DAVID GIBBSTATION: EUDUNDAPOSITION: VOLUNTEER TRAINING COORDINATOR

David joined the volunteer team at Eudunda in 2005 as he saw the ambulance service as an essential part of the community. He also wanted to contribute by doing something he would find rewarding on a personal level.

David is a self-employed artist, exhibiting and selling landscape drawings since 1981. Along with his art, David is a ‘Jack of all trades’, he plays drums in a local rock band, dabbles in video and photography, and has

worked at the Wendouree Cellars in Clare for nearly 20 years.

David became a Regional Educator for SAAS in 2009; he currently teaches clinical skills, driving and manual handling.

After two years with the Eudunda team, David became the VTL, and remained in this role for seven years. He is now the Volunteer Training Coordinator – a role he felt his personality and skills were better aligned with.

David also volunteers his time by fundraising for charities with the band, being on committees for community galleries, art exhibitions, local events, and walking trails. He has assisted with tree planting and other environmental projects in the Mid North and on Kangaroo Island.

WHAT ARE YOUR SAASVHAC GOALS?

“My SAASVHAC goals are to maintain and improve communication between volunteers and management, and to provide the best possible service to the community.”

NAME: ANN REDDENSTATION: CRYSTAL BROOKPOSITION: TRAINING COORDINATOR

Ann started her nursing career in 1966 at the Port Pirie Hospital. She has worked in all facets of health care, including child birth, theatre, intensive care, palliative care, medical and surgical nursing, Aboriginal health, home and community care, and gerontology, either as a registered nurse/midwife, Director of Nursing or CEO at rural hospitals in the Mid North and Eyre Peninsula. In 2010 she was asked to relieve the Residential Care Manager of the Willochra Home Aged Care, Crystal Brook. Coming out of her retirement, Ann now works

2-3 days a week as the Registered Nurse and Education Officer at the Willochra Home.

Ann joined the Crystal Brook volunteer ambulance team in 2006 and is the station’s Volunteer Training Coordinator, Central Zone Representative and SAASVHAC committee member. Ann believes SAAS to be an organisation that impacts on the wellbeing of her community which is an extension of her nursing background – the passion of her life.

Ann is also involved with other local organisations; she is the Treasurer of the Crystal Brook Show Society, where she has built many friendships and has helped develop strong community participation. Ann’s husband, David, two children and four grandchildren are all very proud of her.

WHAT ARE YOUR SAASVHAC GOALS?“To improve communication within teams and networking between stations so we know everyone’s on the same team. Also, to visit each station in my area so that all the teams know who their SAASVHAC representatives are and to promote SAASVHAC so attendance at zone meetings is improved.”

Pulse

SAASVHAC PROFILES CENTRAL ZONESAAScene is featuring SAASVHAC members throughout the 2015 editions. Today we meet Ann Redden and David Gibb from the Central Zone.


Since December 2014 SAAS has been removing non-essential equipment from ambulances and stations utilised by ambulance officer staff. The Ambulance Officer Equipment Project commenced in the Hills/Fleurieu/Kangaroo Island region and by March 2015 has resulted in $14K worth of stock being removed and redistributed before expiration. This is a great result and testament to the excellent work by both the project team and the ambulance crews in this area.

Prior to December, all SAAS response vehicles had been equipped exactly the same, irrespective of the clinical level of the staff utilising the vehicles. This was resulting in unnecessary

waste because some medical supplies were never used and discarded at the end of their use by dates.

The project was implemented after extensive consultation on what was clinically needed in fleets and stations staffed by ambulance officers. This project ensures you still have access to all of the equipment you need to perform your role as an ambulance officer. The Murray Mallee region is currently partaking in the project. Keep an eye on Talking Points for more information about how the project is progressing.

Please ensure you are using the most up-to-date ambulance officer equipment form when ordering from

stores, located here:

SAASNET > CORPORATE SERVICES > INFRASTRUCTURE PLANNING AND RESOURCING > SUPPLY

Planned rollout of project:

• Limestone Coast, beginning April 2015

• Patient Transport Services teams, mid-April 2015

• Emergency Support Services teams, end-April 2015

• Adelaide Hills / Barossa teams, mid-May 2015

• Mid North & Yorke teams, and Far North & West Coast teams, end-May 2015

SAVINGS SPOTLIGHT

MEGA VOLUNTEER: 50 years’ service for Pat

When Pat Kakoschke spied an advert in a Mallala shop window in the 1960s, seeking people to create a local ambulance service, she had no idea where it would lead.

Fifty years on, her exceptionally dedicated volunteer ambulance service was recognised during a lunch at Mallala Football Club in March.

Terry Whales, General Manager for Emergency Operations in the South, presented Pat with a volunteering service award and plaque.

Pat said the time had gone fast, and it had been her goal after reaching 40 years to try for 50. So what keeps her going?

“Just the fact that I enjoy helping sick people,” she said. “I find it very rewarding.”

In the early days, she and others raised funds for the new service.

“We ran a lot of cake stalls and mini-debutante balls,” Pat said. “It was hard work, but we did it.”

She’s been the Mallala team leader since 2000, received SAAS life membership in 2001 and an Ambulance Service Medal in 2011.

St John, Mallala Primary School, the RSL Auxiliary, Probus and Mallala Hospital have all benefited from her volunteering spirit too.

Colin Smith, RTL for Adelaide Plains, said such long service was extremely rare.

“If there is anyone else, I’ve not heard of it. It’s an incredible milestone!

“She’s been a huge part of making sure there is an ambulance service here.”

Congratulations Pat!

1. Pat cuts her cake to celebrate 50 years of volunteering.

2. Terry presents Pat with her award

3. Pat's cake - yum!3

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TRAVELLING NEPAL In November last year, Emergency Medical Dispatch

Support Officer Lachie Graham jetted off to Nepal for a month-long culturally immersive trip to look at how their healthcare system operates. Also a paramedic student,

Lachie spent time in a hospital, with the ambulance service and donating pharmaceuticals on the trip, which was made possible by a grant from the SA Health Young

Professionals Group.

1. Causing a stir: SAAS’s colouring books were a prized commodity amongst the local kids.

2. Hard at work: Lachie with fellow students Chloe Inder, Ellen Brown and Amelia Walsh at the Narayani Samudayik Hospital in Chitwan.

3. Blending in: Lachie (a.k.a. Laxman) with his host family, including the father with two wives.

Travelling with three nursing and paramedic students from New South Wales, the group spent their time in Chitwan District, Nepal.

The trip was eye-opening for Lachie who said medical equipment was virtually non-existent in the low socioeconomic communities – even in the hospital and four-wheel-drive used as an ambulance.

“The hospital had one defibrillator and that was in the ICU. Nothing was really cleaned in the hospital either; aseptic techniques were hard to come by. Having no hot water and remembering which hand was the ‘dirty hand’ due to a lack of toilet paper definitely made things interesting,” he said.

With 150 beds, the hospital was considered state-of-the-art by Nepali standards.

Lachie had a 4km walk to the hospital from his homestay every morning. During every trip he’d be followed by a crowd of gawking local children and many more would come out and wave as he walked past.

Although most of his time was spent in the hospital, Lachie also rode on the local ambulance (a four-wheel-drive with very basic equipment) and donated a stack of pharmaceuticals to a rural health clinic in Jutpani, a small community near the Chitwan District.

Throughout his time in Chitwan District Lachie stayed with a family who translated his name to ‘Laxman’ (which literally means ‘God’). The father of the family also showed off his two wives to Lachie and was quite shocked to learn he didn’t even have one!

Standard stowage on an ambulance in Chitwan District:

• Oxygen (often empty)• paracetamol• stretcher• bandages

“‘Diesel therapy’ appeared to be the most common form of treatment.”

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Pulse

GET READY TO BECOME ROADFIT Roadfit is the latest buzz word to come out of the SAAS

vernacular, however it is more than just terminology, Roadfit is a long term investment. We expect to see the results of Roadfit not in five years’ time but in 20 years.

SAAS has always been and will continue to be on a journey of continuous improvement. We have state of the art, up to date equipment and clinical standards. SAAS is a world leader and will never stop growing, improving, challenging and changing.

Since the introduction of manual task training, SAAS has already seen a 2% decline in muscular skeletal injuries among staff (this year compared to last). However, it still remains our single most common nature of injury to our staff.

Manual task training is well respected within SAAS and has even been ‘borrowed’ by the Tasmania and Queensland ambulance services.

To combat the expanding waistline of the nation, we have introduced engineering solutions to assist with manual handling including the CAMEL lift, bariatric vehicle and trained specialist staff in their use and applications.

So, it is best to think of Roadfit as the next natural evolution in SAAS’s support of health and wellbeing programs for its staff. It is the most state of the art, up to date tool to address injuries in staff.

SAAS does not expect any staff member to suddenly become a marathon runner or pro-cyclist. Rather, it wants to ensure staff are fit to do the very jobs they are employed to do (for the entirety of their career).

The Roadfit assessment is specifically designed to replicate common operational tasks staff do every day. It has been tried, tested and modified by

on road staff, those who know the job back to front.

“Roadfit hopes to change the mindsets of staff, it is not a scare tactic. Working on this project made me reflect on my own habits. While I did ‘pass the test’ I know there is always room for improvement. Now, my family and I ride our bikes in the evening before dinner,” said Chris Howie, Acting Operations Manager, Service Delivery.

Small changes for maximum results.

To join SAAS, staff must be prepared to pass pre-employment standards but ‘de-conditioning’ can occur after that assessment period. Roadfit seeks to keep you on that path of health and wellbeing long after your induction.

“Roadfit has a number of benefits to ensure staff are always fit to do their job. Maintaining an appropriate level of fitness is crucial to instilling confidence in yourself and your partner. Roadfit is a positive step for SAAS and through the implementation of this program we would expect to see a decrease in injuries and an increase in the health and wellbeing of our staff.” Steve Cameron, Chief Operating Officer

If you have any questions or concerns about Roadfit, please email [email protected]. An FAQ will be developed from your emails and published in the next SAAScene.

AND THE ROADIES SAY…

"Roadfit is an exciting new initiative by SAAS aiming to keep our roadies on the road for longer. Anything we can do to keep injuries to a minimum is a good thing." Simon Leonard, Intensive Care Paramedic

Roadfit will benefit you by:

• improving your overall health and wellbeing

• prevent the risk of career ending injuries to yourself and your partner

• improving attendance at work• reducing claims costs

Roadfit aims to:

• identify risk factors and work with staff to address any identified deficiencies

• NOT prosecute individuals; Roadfit travels with you on your journey

• achieve positive outcomes for staff and the organisation

• improve staff wellness so they are fit for work and fit for life


Pulse

CLINICAL FORUM SUCCESS The first SAAS Clinical Forum was held on 17 February,

with 60 staff in attendance. The aim of the forum was for staff to listen to key speakers and have the opportunity to

engage in debate. Staff were encouraged to make their suggestions for improvement, some of which are now

being implemented.

Dr Cathrin Parsch, Deputy Chief Medical Officer, presented on falls particularly with the elderly. It provided excellent clinical insight into the complexity of these cases, including pharmacological interactions to be aware of, morbidity rates and what decisions should come into focus when attending these patients.

“Cathrin reinforced the importance of falls patients being assessed at hospital and the catastrophic consequences of leaving potentially injured or falls risks patients at home. This will be reflected in my work practice.”

(Forum attendee)

Keith Driscoll, Executive Director, Clinical Performance and Patient Safety, discussed Treat No Transport (TNT), providing some concerning case examples. Attendees were asked ‘what would you do if you were us’. Many people expressed incredulity, some offered explanations relating to the current climate of hospital avoidance as a contributing factor, others made suggestions on how to correct the issue of inappropriate TNTs.

“TNTs are often a point of contention. The presentation was good in highlighting that even good paramedics made suboptimal decisions, and we can all be at risk of this.”

(Forum attendee)

Finally Dr Stefan Mazur, Chief Medical Officer, presented on cardiac arrests. He spoke about recent research on pharmacological advances and its effects on gaining ROSC vs walking out of hospital neurologically intact. He talked about automated compression devices, new pharmacology, the GoodSAM mobile phone app and the new SAAS One Life project, aimed at improving survival rate after cardiac arrest. Ideas suggested from the floor included paramedics becoming more active in community education (such as free CPR demonstrations in public) and offering training in regional schools.

The event was a great success. Clinical staff members from all areas and levels engaged with each other, questioned current issues and made suggestions as to how SAAS can improve practice and care of our patients.

“Thank you for the opportunity to participate in your clinical forum. It was encouraging to see clinical management engaging with the on road staff to help improve our service delivery to the public.”

(Forum attendee)

Details for the next forum will be released soon.

1. Rob Elliott, General Manager, Clinical Effectiveness and Patient Safety, welcoming staff to the first SAAS Clinical Forum.

2. Cathrin discussing falls with her colleagues.

3. The room heats up when TNT is on the agenda.

4. Stefan talks tickers and more.

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Paramedics Australasia International Conference2-3 October 2015Adelaide Convention Centre

Now open for abstract submissions

Join other like-minded Paramedic practitioners from all over the world at PAIC 2015 to discover new research and improve your skills.

For more information, and to join the mailing list, visit www.paic.com.au Photo Courtesy of www.ajspook.com

PAIC 2015 A4 Advert_FEB2015.indd 1 20/02/15 12:55 PM


CUSTOMER SERVICES STATSJanuary/February 2015

THE CUSTOMER SERVICE CENTRE (CSC) STAR AWARD

Congratulations to Carmina Yu!

Most people would know Carmina as the polite and happy person at reception. She was awarded because of her consistent approach to excellent customer service and team support.

Carmina is congratulated by Robert Morton, CEO.

SA Ambulance Service

Ambulance Cover

Because accidents happen

CUSTOMER SERVICE CENTRE

Inbound call volume – 30,045

REVENUE & BILLING

Case Cards received – 47,172 Case Cards processed – 42,277

AMBULANCE COVER

Members – 288,897

CALL DIRECT

Sales – 95 Members – 4140


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In Memoriam Nangwarry volunteer Norman Hill was known across the state for his dedication to ambulance volunteering and his unflagging energy and enthusiasm. Described over and over again as someone who could always be relied

upon, Norm will undoubtedly be remembered by his many friends in SAAS.

Sadly, Norm passed away on 10 March after a short battle with cancer. He gave over 40 years of service to ambulance volunteering, and will be dearly missed by his wife Rose McElroy, his four children, fellow team members, and many colleagues from teams across the state.

Norm also helped out at other stations such as Coober Pedy, Mt Gambier, Yankalilla, Ceduna and Kangaroo Island, where he not only went on the roster but also mentored and assisted in the training of younger ambulance officers. He became affectionately known as ‘Norm from Nangwarry’.

Flinders RTL Janet Brewer remembers Norm well from the times he helped out in Coober Pedy.

“Norm’s energy and enthusiasm made you think he would pretty much go on for ever, as his physicality and positive spirit belied his age even back in 2008. His attitude was so positive and happy. He and fellow team member Rose worked together extremely well when they came to help the team.”

Bruce Buck, a member of the Western KI volunteer team, recalls that Norm even took over some of the tasks that sometimes fall by the wayside in stations staffed by busy volunteers, saying that “he made things easier for us, and was a very good organiser, making sure that our stores and vehicle supplies were in order”.

Norm held several positions within the Nangwarry team, including Volunteer Ambulance Officer, Training Officer, Volunteer Team Leader and driving mentor. Indeed, Norm was a driving force behind the establishment of the Nangwarry station in 1989. He was also a member of the South East Zone Coordinating Committee (15 years), and South East Zone Secretary (five years). For some years he was also a member of SAAS’s Occupational Health, Safety and Welfare Coordinating Committee. All of these roles are a testament to the high regard in which he was held by his colleagues.

Nangwarry VTL Kelly Wyatt says that Norm will be deeply missed by the team and the community.

“He was a beautiful man who has left his mark not only on the immediate region, but on the state. He was a great mentor and leader, and a shining example of a volunteer.”

These sentiments were echoed by Kristie Cook, Administration Assistant for Emergency Operations – South who said, “Norm was a colleague and

a friend, and nothing was ever too much trouble for him. He always put his community and the ambulance service first”.

Many SAAS staff attended the funeral held on 18 March at the North Road Cemetery in Nailsworth. They formed a guard of honour, while two SAAS Motorbike Response Units escorted the hearse from the church to the cemetery.

Limestone Coast Operations Manager Andy Thomas spoke eloquently on behalf of SAAS at the funeral. He concluded his speech with the following words, which we would like to reproduce here:

Norm will be remembered by so many people … for his lifelong dedication and passion for the ambulance service and volunteering.

5FT Norm Hill. Rest in peace.

Pulse

Norm received several certificates of appreciation from SAAS; was honoured with the Australia Day Citizen of the Year award in 2001; and was recognised with SAAS Life Membership in 2013.Only a few days before Norm passed away, CEO Robert Morton presented Norm with a 2015 Premier’s Certificate for Outstanding Volunteer Service.

Rose McElroy and Norm’s children Christopher, Stephen, Olwyn and Matthew expressed their heartfelt thanks for the respect shown by the SAAS staff who attended the funeral, and also those who sent messages of condolence, respect and admiration.

1. Norm Hill with 2007 Nangwarry team members Jill Leslie (deceased), Rose McElroy and Greg McInerney.

2. Rose McElroy and Norm Hill in Coober Pedy, 2008.

3. Graham Denton presenting Norm with his Volunteer Distinguished Service Award in 2013.


EXTENDING PATIENT CARE This is the first in a series of case studies that illustrate the range of services that extended care paramedics (ECPs) can offer your patients to safely avoid their attendance at

an emergency department.

Nora is an elderly lady living independently who fell down a step outside her unit. She was initially attended by an emergency crew who helped her up and identified no serious injuries. However, she had a skin tear to her forearm so the case was referred to an ECP.

Although you won’t be able to code the case as ‘lift only’, it’s still a common expression. Rarely, if ever, is the situation that simple. People, old or young, don’t fall without a reason. This is where ECPs can analyse the person’s situation in greater depth than is possible with the scene time constraints emergency crews have.

As well as the 45 minutes it took to anaesthetise, clean, appose and dress the skin tear, the following assessments

and plans were put in place:

• Thorough orthopaedic assessment.

• Careful questioning elicited evidence of a urinary tract infection. Urine was tested on scene confirming this and Nora was started on oral antibiotics.

• Royal District Nursing Service organised to attend for on-going wound care.

• GP contacted by phone to get a better impression of her overall condition. (Nora wasn’t the world’s best historian.)

• Falls referral made to the Metropolitan Referral Unit.

• Nora was educated about use of her walking stick.

• Private provider organised to stay with Nora for next seven hours to take neurological observations.

• Family contacted and twice daily visits organised while on antibiotics.

• Letter written to the GP outlining the treatment and planning, and a federally funded Home Medication Review recommended as a result of an analysis of her complex medication list.

The total time on scene was more than three hours. Nora’s insistence she not go to hospital was safely complied with and a plan was put in place to make her safer in her own home.

ECPs can be used to fix simple and easily identified problems like blocked catheters, but they can be also used as problem solvers where there is no immediate need to go to hospital, but the actual issue is unclear.

If you believe your patient would benefit from an ECP’s assistance, please call the EOC Clinician on 1800 247 885.

Pulse


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1. Robe volunteer Debra Mackey with her husband Richard, shortly after receiving an Australia Day Mayoral Award for Community Commitment in Robe. Debra donates her time and energy to SAAS, the local footy team and is the Secretary and Treasurer of the Robe Tourism Association. Congratulations, Debra!

2. Bruce Paix, SAAS Medstar doctor, volunteers with the Echunga CFS. During the Sampson Flat fires his team helped to save houses; fed and watered surviving alpacas in a burnt-out paddock; and blacked out and patrolled fire lines.

3. Cyclone Tracy 40-year ‘Storm Trooper’

reunion: In December 1974 Cyclone Tracy devastated Darwin, and the then- SA St John Ambulance sent 12 staff members to help. In January this year, nine of the original team got together at a reunion organised by John and Gloria Pohl. Note John in the front row, left, wearing his official taskforce T-shirt, sadly ‘shrunken’ over the years! Back row (l-r): Malcolm Pascoe, Charlie Stal, Peter Simms, Don DeGiglio, Ray Benzie, Lee Francis, Graeme Stewart. Front row (l-r): John Pohl, Mike Horsman.

4. SAAS was well represented at the ‘Made in SA’ exhibition held at the Adelaide Convention Centre on 13–14 March, where

Kerry Wordley promoted Ambulance Cover and Call Direct.

5. Robert Morton thanked Volunteer Support Unit staff member Sue Dickson for her service as she left SAAS for another role.

6. Tim John and Danny Harnas get to grips with the Clipsal 500 track.

7. Mel Beer, Bianca Hillier and Libby Williams check out Garth Tander’s car in pit lane.

8. Jemai Couzens (centre) recently celebrated his 18th birthday, completion of his SAAS traineeship and getting a new job in the EOC! He’s pictured here (l-r) with Graham Denton, Erin Standish, Kate Firmager and Adelle Moss.

THE SAASFAMILYALBUM

saascene april 2015 edition

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