saascene april 2016 edition

SAASceneAPRIL 2016

WE’RE ON SOCIAL MEDIA!

CALENDAR

136

APRIL / MAY 1-7 APRIL 2016 CLUB CREW WORLD CHAMPIONSHIPS

25 APRIL ANZAC DAY

1-8 MAY TASTING AUSTRALIA

13-16 MAY CLARE VALLEY GOURMET WEEKEND

CONTENTS

Editor Alexi Tuckey

Graphic Design Jamshop

Writers Leda KalleskeLisa MorrisonSimon NankivellBirgitt OlsenCarissa TuckerAlexi 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: Social media AMBassadors Wayne Stoddard and Amanda Cameron are excited about SAAS joining Facebook and Twitter.

GPO Box 3, Adelaide SA 5001

Telephone 8274 0413 Facsimile 8272 9232 [email protected]

© SA Ambulance Service 2016

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.

MAYSun Mon Tue Wed Thu Fri Sat

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APRILSun Mon Tue Wed Thu Fri Sat

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2Features4 New patient clinical records

8 Foreign correspondents: from across the globe

Commendations10 Commendations to our staff

Family album20 Four weddings and a retirement

Gang Green22 The 40 year club! Meet the people

truly dedicated to SAAS

Social media31 Finally SAAS goes social!

mailto:healthsaasnews%40sa.gov.au?subject=

Last week saw the final strategic planning workshops. Judging by the excellent turn out with around 500 colleagues attending one of the 28 events, they have been a great success.

Discussion has been robust and the feedback collected highlights how truly passionate we all are about SAAS and our work. I personally hosted 21 workshops, covering over 5500km along the way. I was amazed with the passion everyone showed to do the right thing and work toward improving what we do and how we do it; so our patients receive ever increasing levels of care. I would like to thank everyone who attended for their honesty and ideas. There have been some recurring themes popping up in the workshops, including:

• The future of SAAS service delivery and the impact of primary care

• Integration with SA Health• Barriers to career progression for

on-road staff• The role of managers vs leaders• A need to focus on the continuing

development of our people• The need to make use of technology

to drive improvements in our work

So what happens next? The information that everyone provided during the group sessions will be reviewed, along with the themes that emerged in conversation, by the executive team in May. This will form the basis of the plan for the next 3 to 5 years. We will then engage key external stakeholders such as SA Health, politicians and service leads, to gather their thoughts on what they think our organisation should be doing in the long term. Following this, we will draft a final plan with the aim of publishing this in July.

I’ve been on Twitter since 2010, so when I joined SAAS and found we didn’t have any social media presence, I made it my priority to get us into that space. With

the tireless assistance of the Corporate Communications team, we now have corporate social media. We now join every other ambulance service in the country with Facebook and Twitter. These tools will help us engage with the community, and will be used for volunteer recruitment, community education, showcasing events we’ve been working on, patient reunions, and many other great things we get up to.

Now is the time to put SAAS in the online spotlight and we need your help to do it! Flick to page 31 for information about how you can get involved and help us build our profile in the communities we serve, and help them to understand what we do and how we do it.

As you know the Oakden station has been completed, and we are busily preparing it to become fully functional. We are working with the Minister’s office to set an official opening date and media launch. We are also intently watching the progression of our new Noarlunga station. It too is ahead of schedule and we are expecting handover to occur in September. Both of these purpose built stations will serve their local communities and help us get to our patients faster. Next up, Seaford station and a range of other capital infrastructure projects...

The SAAS Leadership Team Briefing was recently held at the Adelaide Pavilion (see page 32). I truly believe this event is not just about providing managers and team leaders with information – like a day-long live action Talking Points. It’s about offering colleagues the opportunity to share ideas, things that work well and things that don’t, so we can learn from them and enhance skills and confidence. Through this networking opportunity and listening to the experiences of external speakers, we can all become better leaders.

One particular session that struck a chord with me was on fraud and corruption. While a seemingly innocent act, such as accepting a bottle of wine or movie tickets, might seem harmless, it is our responsibility as public servants to keep our reputation pristine and ensure we are informed as to our rights and obligations. There isn’t necessarily anything wrong in accepting appropriate gifts, however we must ensure we disclose these through our gift register, and that we don’t create actual or perceived conflicts of interest in doing so. For more information, go to SAASnet > People and Support > Our Resources > Office of the CEO > Gift Register.

You will have seen that the metro area has been experiencing some extended handovers in recent weeks, with some EDs seeing more than others. You will have also seen the recent Rapid that set out how the AEA and SAAS are working together on this issue. Our shared intent is to work with colleagues across SA Health to reduce the frequency and duration of any extended handovers. We are leading a state-wide review of the escalation arrangements for EDs when they are busy, and we plan to publish those revised arrangements before the winter.

Just before I sign off, a big congratulations to Terry Whales, David Schilling, Gary Wyld and Jon Jaensch, who each recently completed 40 years of service (either as a paid or volunteer staff member). It is no small feat to dedicate your working life to one organisation, and I thank these gentlemen and their families, for supporting them in their continued commitment to SAAS and the community.

Cheers, Jason

Jason Killens Chief Executive

FROM THE CEO

SAAScene APRIL 2016 | 1

14 February 2016. My phone buzzes with a text message from the team leader: ‘Can you deploy to Tas Fires? Let me know your availability.’

My first thought is SA has fires, not Tasmania! Tassie is cold, wet, pretty much covered in rainforest and requires creative ways to keep warm! The rest is in dispersed with lush cattle country and rolling vineyards of Pinot!

I make the call which hits message bank and I leave a somewhat colourful message. “Virge! Rain forest doesn’t burn! (Expletives removed.) Are you having a laugh?”

For the first time in living memory fires have penetrated the rain forests. Until now rain forests were the fire breaks! And with the severe lack of rainfall they have actually dried out enough to burn.

SA, along with other states, is sending CFS strike teams to be based in Stanley. Their purpose is to contain the fires within the fire breaks, which are ironically within the rainforest itself, thus giving the Tassie guys a chance to recuperate. SOT will be providing

medical/rescue support to a strike team operating in remote NW Tasmania.

For the first deployment I was accompanied by Marco Pillen for a five day tour, along with approximately 70 CFS volunteers. Subsequent tours were with Ryan Kennedy and Steve Tebbett, then Marco again with Simon Cradock.

On arrival in Wynyard our initial brief informed us that a total 11,000 hectares of rain forest has been burnt with a perimeter greater than 800km! Species of plants, some exceeding 1000 years old, along with native fauna, had been destroyed.

Over the next two weeks our role was immediate on scene support for medical monitoring, treatment of illness, exacerbation of existing or new medical conditions and potential traumatic injuries to these guys and girls. Ages were ranging from 19 through to late into the 60s with the majority being towards the upper end.

Such a diverse demographic presented us with an array of things to consider. Examples were we had two amputees,

SOT deployment to Tasmanian fires

… a NSW fire appliance roll over with five persons on board. Two had injuries requiring transport…

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one organ transplant member and a plethora of medical conditions from, well, just having lived that long! But despite such obstacles these guys had not only donated their time, away from families and professions but they worked tirelessly to keep these fires contained and eventually won the battle.

I was fortunate not to see any fire fighters succumb to trauma or serious medical illness. Especially given the extreme terrain and the fact numerous hollowed trees had been smouldering inside for weeks and were falling close by or across our entry and exit paths daily.

On the subsequent tour Ryan and Steve responded to a NSW fire appliance roll over with five persons on board. Two had injuries requiring transport to Burnie Hospital. Ryan and Steve along with a NSW paramedic treated the occupants, sourcing two available helicopters for transport. Ryan managed to score a helicopter ride back to base, rather than the long arduous drive in a fire appliance. He subsequently was asked, more than once: “Are you pulling a Bronwyn Bishop?”

Simon and Marco completed the final tour with fortunately no major trauma; however the entire deployment

presented a continuous myriad of general medical issues and minor trauma to keep us busy.

It was a pleasure to be a part of a multi-state, multi-agency task force with career and volunteer staff working seamlessly together to limit further loss of a national treasure.

I think personally my greatest contribution to the task force was contacting the local barista and convincing him to open up early so we could source a quality coffee before deploying out of Stanley each morning. I’m calling it a win…

Clinton Daniels Special Operations Team

1. The inhospitable terrain encountered in Tassie.

2. One of our dedicated CFS volunteers – his SpO2 wasn’t reading too well!

3. Clinton with some CFS volunteers with a significant tree saved from the fire.

4. Marco looking after the CFS crews as they go to work.

5. The incredible wilderness the fire fighters were trying to protect.

…numerous hollowed trees had been smouldering inside for weeks and were falling close by or across our entry and exit paths daily…‘

3

4

5


SAAS will join other acute health-care facilities in SA when it starts using rapid detection and response (RDR) charts for recording patient physiological observations this April.

This is the most significant change to the new SAAS patient clinical record (PCR).

This type of track-and-trigger observation chart can really help the user to recognise patient deterioration and intervene quickly. This should improve safety and outcomes for all patients, whether transported or not.

These charts – best used at the point of care – are an additional tool to support the clinician’s education, experience and knowledge when identifying and managing unstable or deteriorating patients.

NEW PATIENT CLINICAL RECORDSFROM APRIL

How and when will they appear?

The new PCR will first be distributed to volunteer teams during April after they complete face-to-face training with their RTL. Then it will start being used by other country stations, followed by metropolitan stations as existing patient report form stock is depleted. This distribution will be coordinated by the Health Distribution Centre (HDC).

The current sieve/sort cardboard backing and insert has been superseded by SMART Triage (packs are in each fleet). So the cardboard backing for the new PCR pads has changed. It now includes clinical and historical risks for deterioration, risk factors for TNT, paediatric and maternity RDR observation charts and other useful clinical aids such as ROSIER, APGAR, and care and control statements.


Designer: please include these images

This cardboard backing/insert is used as a reference, in conjunction with the PCR, to assist in clinical decision-making, particularly when considering the safety and suitability for non-transport of patients (TNT). Thorough clinical documentation on the new PCR, which takes into account relevant elements of the new insert, will replace the requirement for the current separate TNT checklist.

Clinical notes supplement pads will be distributed to all stations by the HDC. These allow clinicians to document as much clinical information as required, not limited by the free-text space on the PCR. As long as the patient information, event date and dispatch number are completed, all information is linked and will form part of the complete SAAS medical record for that patient.

Data in = data out

Completing PCR codes and treatment summaries not only helps the Billing and Collections Unit issue invoices appropriately, it also helps SAAS analyse the work we do.

Data can help us when advocating for funding, form evidence for training programs that meet the needs of the workforce or help identify and anticipate trends in patient care so SAAS can develop appropriate scope-of-practice protocols and guidelines.

However, this data is only as good as the information entered, so it is important that all relevant codes and data-capture sections of any PCR are completed.


We usually save this edition of SAAScene to talk about Mad March, but we can safely say it’s been a Mad Summer! From major events to disasters, we have had our fair share of incidents to keep us on our toes, and it’s time to have a look at the lot.

Martin Kimber (centre) with colleagues from MAC, SAPOL and Encounter Youth at the Schoolies press conference

Simon Leonard, Santa and Cassie Clark

The Credit Union Christmas Pageant contains themed floats and walking performers, all throughout the streets of Adelaide. Over 320 000 people come to watch the show, lining the streets from South Terrace to North Terrace. SAAS provides a bicycle response unit, FIV, liaison in the Police Operations Centre and, most importantly, an ambulance driving behind the Santa float, carrying a spare Santa (but shhh, don’t tell anyone)!

Credit Union Christmas Pageant 14 November 2015

With extremely hot weather and northerly winds of up to 90Kph, the devastating Pinery fire started at 1230hrs. The fire caused widespread devastation across the Barossa and Mid North – an area covering over 85 000 hectares.

SAAS activated its command centre at 1350hrs, with a Level 3 Incident declared by the Gold Commander at 1420hrs. SAAS field commanders, paramedics, volunteers, other clinicians and equipment were deployed to the area, notwithstanding the chaotic nature of the fire. This continued for three days.

It was a heartbreaking incident, with two fatalities and many people hospitalised as a result of the ferocious fire. Homes, sheds, machinery, vehicles and extraordinary losses of livestock and animals were also destroyed in the fire.

Each year up to 15 000 school leavers head to Victor Harbor to celebrate the end of their exams. In the Warland Reserve, Encounter Youth provide entertainment, and usually sell about 6500 tickets. This year, in addition to normal crewing in the area, SAAS provided additional ambulances, FIVs, an ECP, SOT, TSU Command centre, volunteer crews and a Silver/Bronze Command structure.

Schoolies 20-22 November 2015

Pinery Fire 25 November 2015

MAD SUMMER


All of this couldn’t

be done without the meticulous work of the Emergency Preparedness

and Major Events Teams. They work tirelessly throughout the year to ensure SAAS

is always prepared for the next incident.

And of course, thank you to the staff who put themselves forward to be at any of these events, particularly to those who worked above and beyond the call of

duty during the Pinery Fire. We salute you.

Andrew Young, Grace Crawford and Amy Defluiter with other members of the Clipsal medical team

Over the years we have seen an increased number of public events taking place over the Christmas and New Year period. To ensure we are prepared for this, SAAS plans for the entire ‘Festive Season’.

As it is usually a time for Christmas parties, hot weather and all things fun, there can be an increase in our workload. To help combat this, SAAS proactively puts messages in the media calling for people to be safe over the period, to remain hydrated in the heat or when drinking alcohol, and to look after their family and friends if they are vulnerable in any way.

The major events we participated in include the Big Bash Cricket at Adelaide Oval and many New Year’s Eve celebrations (i.e. Glenelg, Normanville, Victor Harbor, Mt Gambier).

Stephanie Symonds, Bryan Ward, Andy Hillier, Wayne Armitage, Erin Weldon, Lawrence DePasquale, Sam Keogh and Emma Hayes.

Santos Tour Down Under 16-24 January 2016

The Santos Tour Down Under (TDU) is an international cycling event for professional cyclists. The Race Director is assisted by specialist coordinators including the Race Doctor, SAPOL, SAAS and cycling team managers.

SAAS’s resources follow the race convoy for each stage of the event, including two ambulances, an FIV, motorbike response unit, and an ICP who travels in the race neutral car. We also provide resources for the BUPA Challenge, an amateur cycling event, which follows the same route as Stage 4 of the TDU.

Clipsal 500 is a motor sport event hosted by the South Australian Motor Sport Board on a street racing circuit. The event runs over four days, and has nightly concerts. SAAS provides a number of resources to respond to incidents involving race drivers and race officials. We also have a staff member at the Event Communications Centre to assist with our response to incidents involving members of the public.

December 2015 – 15 January 2016

Clipsal 500 3-6 March 2016

MAD SUMMER


PARAMEDICS MADDIE PREECE AND HANNAH MILLER LEFT SAAS NEARLY A YEAR AGO TO MOVE TO LONDON AND ABU DUBAI RESPECTIVELY. THEY’RE NOW EIGHT MONTHS INTO THEIR NEW ROLES AND DROPPED US A LINE TO TELL US ALL ABOUT IT…

FROM ACROSS THE GLOBE

MADDIELast July I moved to the UK to work for the London Ambulance Service (LAS). The biggest shock to my system was how much higher the workload is compared to SAAS. I guess I should have expected it, seeming LAS is one of the busiest ambulance services in the world!

At my station induction in the Wimbledon complex, my team leader laughed when I asked where the bedrooms on station were! They don’t have any because it’s very rare to return to station. At the start of a shift, there is a ten minute vehicle check and then the first job comes down the MDT, then it is job after job until the end of your shift. Almost every call gets a lights and sirens response (I am yet to do a job without them), and crews are expected to clear hospitals within 14 minutes of handing their patients over.

It took me a little while to adjust to the pace and intensity of the shifts. I guess I took for granted that although we had busy shifts at SAAS, we more often than not received rest breaks on station, and had the opportunity to debrief jobs at hospital or even stop for coffee!

The paramedic scope of practice is very similar to South Australia however I have now been trained in EZIO, anti-arrhythmic administration, Code STEMI recognition, and even jugular cannulation and needle cricothyroidotomy. Thankfully, I haven’t had to use the last two yet!

At the moment I’m working on the First Response Unit, similar to SPRINT – pretty crazy for someone who only qualified as a paramedic two years ago. It can be quite intimidating attending patients on

Above: Even though their substations might be tiny, the large building houses the communications centre.


my own – but I think it will ultimately make me a better paramedic. Not having a partner definitely forces you to step up. A particular highlight was delivering a baby by myself.

I love living London. It’s an amazing city with so many different things to see and do. I’ve already been to parts of Europe and the UK; one of the main reasons I decided move here. In the meantime enjoy that sunshine for me!

HANNAH“Marhaba” from Abu Dhabi! That means “hello”. However, the most common greeting in Arabic is “as salaamu alaykum” meaning “may peace be upon you”. The reply is “alaykum as-salaam” meaning “and upon you peace”. Learning to adapt to the culture and language has been an interesting and challenging experience!

Last year I moved to the Middle East to continue my paramedic practice, joining the National Ambulance Company, which operates in conjunction with the police force. I work a ‘four-on, four-off‘ rotation (four day shifts, four night shits) at Abu Dhabi City Station. I’m sure the idea of working four nights in a row doesn’t appeal to many, but the workload here is very light, so it works well.

We have a main station where all the paramedics come to at the beginning of shift. We get paired with an emergency medical technician (ambulance officer equivalent) and a police officer driver, and assigned to our substation. The six substations are tiny little outpost rooms that we sit in for the day, and are a far cry from the luxury stations at SAAS!

I obtained some new qualifications in my time here, including EZIO, advanced airway skills and KAMS (ketamine, adenosine and midazolam). Our trauma workload is higher than the average, but medical cases and history taking are made somewhat difficult due to the language barrier. Unfortunately my Arabic is coming along rather slowly. As all radio transmissions are in Arabic, I never know what the job is until I get there! This was scary at first, but helps you to think quickly on your feet.

I enjoy work and life in the desert; the United Arab Emirates is a fantastic place to be if you can handle the heat. It’s a great location for easy travelling, and there’s plenty to do on days off. The work community is hugely multicultural and I have enjoyed meeting and working with many different clinicians from the UK, USA, Ireland, South Africa and Philippines. Ma’a salama for now!

Maddie with her first responder car in London.

Hannah next to a National Ambulance Company fleet.

FROM ACROSS THE GLOBE

If you have any questions, feel free to send them an email:

Maddie [email protected]

Hannah [email protected]


mailto:[email protected]

COMMENDATIONSMETROThe patient required a chair lift downstairs; a significant task that you managed with great teamwork. She remained calm, comfortable and reassured. Your kindness and respect were greatly appreciated during a very distressing time. Jason Wright, Kym Hobbs (East A), Steve Tebbett (SOT), John Reeves, Kerry Dohnt (Bariatric ESS)

Grateful thanks for the special care you provided to her four month old daughter, you were very reassuring and comforting. Your professionalism was appreciated. Michelle Holmes, Amanda Stefaniak (South A)

Grateful thanks for your caring treatment following a fall through the roof. It was greatly appreciated. Jenny Copley, Laura Bainger, Anthony Letcher (West B)

Heartfelt thanks for your prompt response, and professional manner. You treated a very shocked and scared five year old that had lost her vision following a fall from a trampoline. Your clear explanations of treatment provided reassurance and comfort during a frightening experience. The family have nothing but high praise for you and feel extremely lucky to have such a wonderful ambulance service in South Australia. Rajan Thomas (West A), Shane Kuhlmann (SPRINT), Michael Comis (South B)

Thank you for your professionalism, you were fantastic. Kym Tank (ESS C), Tracey Richards (ESS A)

Sincere thanks for your kindness and the tremendous care you gave her father. Your professionalism and support will not be forgotten. Amy How, Kersty Day (Fulham PTS)

Grateful thanks for your professionalism and the excellent care received. Your kindness and support was appreciated. Christine Cotton, Danielle Spencer (West B)

Please pass on our most sincere thanks to the amazing paramedics that attended to our daughter. They were prompt, professional and brilliant. The clear explanations of treatment and reassurance for us all throughout provided much comfort. Darren Brealey, Scott Smith (North C)

Sincere thanks for your professional and caring support. It was much appreciated. Aria Kallonen (West C), Pat Bruse (South C)

Grateful thanks for your compassion, care and professionalism. It was deeply appreciated. Stephen Millar, Merrilyn Kelly (West C)

Sincere thanks for the excellent service you provided. Shaken and frightened, you provided reassurance, kindness and compassion. David Norris, Marcus Syversten (South B)

Thank you for the professional and respectful manner in which you provided treatment. Her grandparents were very impressed with your care and remain grateful for the kindness you showed them. Garth Gill, John McIntyre (East B)

Sincere thanks for the care and professional manner you provided after the passing of her husband. Your kindness, respect and support were greatly appreciated. Joseph Schar, Elena Caon (West A), Toby Dodd, Renee Vestris (Ashford PIDT)

Grateful thanks to you for the professional and supportive care received. James Gardiner, Kevin Saunders (South A)

Sincere thanks for your care, reassurance and professionalism. They remain very impressed and admire the work you do. David Grinsted, Brooke Johnston (ESS D), Matthew McLean, Andrew Roesler (Bariatric ESS)

Thanks for your prompt attendance and care. The patient subsequently went into cardiac arrest at the hospital, and without you he may not be here today. Your kindness and support was greatly appreciated during a very distressing time. Michael Rudman, Simon Bernard, Suzie Smith (South C)

Please pass on grateful thanks for courteous and professional service, it was appreciated. Leanne Greenslade (North B), Tyson Le Clercq (North D)

Family wish to pass on their sincere thanks for your professionalism and understanding. The patient was suffering from secondary cancer, and you managed to get her into her hospital of choice and assisted her with the utmost respect and reassurance. Renee Vestris (Ashford PIDT), Abbey Wyness (ESS A)

Sincere thanks for the support, understanding and professional manner in which you provided treatment to her son. Your dedication to your profession was impressive and she wishes you all the best for your career. Sebastian Lesnicki, Jessica Hutchings (NW 8Hr Team)

“Fire Safety Day” – Please pass on my sincere thanks and appreciation to Peter McEntee (ICP). With his support and involvement in this community awareness program, local residents were able to find out valuable information regarding health care and staying safe in an emergency. From Hon Jennifer Rankin MP (Member for Wright)


COMMENDATIONS


Most sincere thanks for your professional and kind manner. Your efforts to make her comfortable and calm were reassuring. Kathryn Reeks, Chantelle Cruise (E Shift)

Sincere and grateful thanks for your professionalism, calmness and reassurance throughout the ordeal, it was deeply appreciated. Ashlee Veale, Gemma Pfeiffer, Stacey Solomou, Nicholas Kaye, Chloe Fogg (East C)

Please pass on the family’s sincere thanks for the professional and respectful treatment of the patient, who had broken his hip. Your reassurance, compassion and care were greatly appreciated. Benjamin Lindsay (ESS D), Rebecca Knight, Allen Grant (South A), Tracey Richards (ESS A), Clinton Daniels (SOT)

Grateful thanks for the impressive care you gave to her husband. Elena Caon, Lawrence De Pasquale (West A)

Sincere thanks to colleagues who saved my father-in-law and provided comfort and reassurance to him and my husband who was in attendance, obviously traumatised but in awe of the crew that assisted his father. Lucky to be alive and surviving a triple bypass, my family have asked that I pass on their most sincere thanks to everyone involved. They appreciate your professionalism, skills and compassion. Andrew Martin, Vashti Henderson (North C), Paul Pegoli, Danny Harnas (SPRINT), Brad Mathew (EMD Team D), Maryanne Elsby (ECP)

Many thanks to my colleagues for attending me after a bike fall. I am thankful for your prompt assistance and professional treatment, especially the pain management. Toni Lindner, Simmone Joyce (SE 8Hr Team), Luke O’Callaghan (SOT)

Gratitude and sincere thanks for the wonderful care, concern and kindness you both extended. Bradley Harrison, Chantelle Puliatti (South A)

Sincere thanks for your exceptional care and concern. You provided much needed comfort and reassurance. Belinda Gawlik (North A), Andrew Martin (North C)

Grateful thanks for your professional and kind treatment of her father who had fallen in the bathroom. Your efforts made this unfortunate experience a better one. Alicia Marcus (E Shift), Erin Pankoke (East B)

I was impressed and comforted by the professionalism of all involved. The fantastic call-taker and paramedics managed this emergency with expertise and good humour which was tremendously reassuring. Ron Linnane, Lisa Gurney (East C)

Please pass on our sincere thanks for patience, understanding and the professionalism shown by all SAAS staff concerned. Considerable time taken with the difficult and reluctant patient enabled a good outcome and comfort for the family. From Southern Palliative Care Stuart Brand, Jake Rawe (ESS D)

Thank you for the amazing service, paramedics went above and beyond their call of duty, job well done. Sebastian Lesnicki (NW 8 Hr Team), Jayden Milde (West D)

My heartfelt thanks to everyone who attended; what a great service SAAS provides. Mel Alexander, Beau Griffiths (East C)

Please pass on my sincere thanks to the attending crew; your calm and professional manner was outstanding. If they are an indication of the calibre of staff from SAAS we are in very good hands. Daniel Grey (South B), Ebony Hewett (NW 8 Hr Team)

Thank you for your professionalism, friendly manner and reassurance. Your kindness and support was greatly appreciated. Nick Mark, Cecilia Facey (Redwood Park PIDT)

Thank you for the care and professional manner you provided to the family, after the death of a loved one. Your kindness and support were greatly appreciated. Shane Leonard, Suzie Smith (South C), David Norris, Marcus Syversten (South B)

Sincere thanks to you for your professionalism, friendly manner and reassurance. Ebony Hewett, Matt Astraukas (South B)

COUNTRYThank you for being professional, friendly and reassuring. It was greatly appreciated. David Portolesi, Ben Poppy (Mannum), Lloyd Tonkin (RTL Lower Murray)

Sincere thanks for your care and courteous manner. Your support was appreciated. Tom Hutten (Mt Gambier), Samuel Papini (Millicent)

The clear explanations that provided reassurance for me and my partner was greatly appreciated. Scott Baulderstone, Scott Bemmer (Stirling)

To all involved in my dad’s care, a massive thank you from me and my family. Your quick thinking, considerate and caring support was reassuring and I am humbled by this support from my colleagues and the amazing work crews do. Dieter Scheurich (EMD Team C), Michael Bohrenson (CTL Mt Barker), Paul Williams (Murray Bridge), Emma Cook (EMD TL)

Thank you for your care and special attention when I needed it most. Your families and the community of Port Broughton can be justifiably proud of you and what you do. Bill Kerry, Chris Ellsmore (Port Broughton)

Please pass on our thanks and much appreciation for all that you did, you were awesome and thanks a million. Alyce Yeates, Stacey White, David Beal, Steve Rice (Mt Gambier)

Thank you all very much for your assistance, it was much appreciated. Harry Barolo, Chris Meaney, Dave Hanke, Dave Reubenicht (Port Augusta)

Sincere thanks for the prompt and professional clinical care received, when the patient had a sudden cardiac issue. She highly commends you for your ability to keep her calm. William Schonfeldt (North D), Simon Polling (Mt Barker)

Most sincere thanks to you for your kindness and the tremendous care her father received. Your professionalism and support will not be forgotten. Scott Baulderstone, Benjamin Loiterton (Stirling)

Heartfelt thanks for your friendly manner and reassurance. Your kindness and support was greatly appreciated. Jordan Pring (CSO), Emily George, Pauline Furst (Mt Barker)

Sincere thanks for your professionalism, respectful manner and compassion. Your ability to keep all in attendance, including family members calm, was impressive. Thank you for providing such a fantastic service to the community. Paul Strachan (CRRT), Kevin Shortt (Ardrossan)

Thank you for the amazing care she received. Patrick Vandeleur (Gawler), Debbie Harrop (SOT)

ECPOur dealings with the ECP service have been fantastic. They are prompt, skilled, friendly and great with our patients. Those who have attended here have taken the time to explain procedures to the patients, and sometimes us, educating staff if we want to be present. In addition, I imagine it would have to ultimately be saving health dollars and waiting times in ED too. I can’t tell you how vital I believe the ECP service is to facilities such as ours.

I think it’s really important, amongst all the complaints, to give positive feedback when it’s due and I want to let you know that I really feel strongly about the importance of this service. I think it’s great that we don’t have to send our elderly patients back to hospital to wait hours for minor treatment. Please pass on my thanks to all involved. From St Margaret’s Rehabilitation Hospital, Semaphore

Sincere thanks for your care, reassurance and professionalism. They remain very impressed and admire the work you do. Chris Paton (ECP)

What a great service SAAS provides. Karen Darby (ECP)

EOCPlease pass on our thanks for your support. The patient is grateful, and knows that without your care, she may never have had the opportunity to pass on her thanks. Robert Manfrin (EMDSO Team E), Steven Moore, Grant Gallagher (North B)

Most sincere thanks for your professionalism and calming influence. Your kindness, respect and support allowed patient to pass away at home surrounded by his family. It was greatly appreciated and thanks will never seem enough. Adam Hausler (EMDSO Team B)

Sincere thanks for your professionalism and respectful manner. Your ability to keep all in attendance, including family members calm was impressive. Thank you for providing such a fantastic service to the community. Heide Dent (EMDSO Team B)

I was impressed and comforted by the professionalism of all involved. The fantastic call-taker managed this emergency with expertise and good humour which was tremendously reassuring. Russell Jaszewski (EMDSO Team A)

At night, on my own, stranded by a flat tyre and feeling very uncomfortable, thank goodness for procedures and the genuine support and care provided by the SDM / colleague on shift. I appreciated all his efforts to ensure I was ok and supported throughout this ordeal. Andrew Albury (SDM)


SAAS, the MFS and SAPOL gathered at the Wakefield Street MFS station on 22 March for the formal signing of White Ribbon commitment documents by the MFS and SAAS. WHITE RIBBON

MFS Chief Officer Greg Crossman and our CEO Jason Killens signing the White Ribbon Statement of Commitment.

(L-R) MFS Deputy Chief Officer and White Ribbon Ambassador Michael Morgan, SAPOL Assistant Commissioner Paul Dickson, MFS Chief Officer Greg Crossman, SAAS CEO Jason Killens, SAAS COO Steve Cameron.

Meet the SAAS White Ribbon Committee!

(Back) Steve Cameron, Stuart Elliott, Jason Killens, Lachlan Ophof, Michael Borrowdale, Chris Howie (Front) Ryan Mitchell, Jake Dedert, Tony Warren, Ana Stevanovic, Leeann Faddoul. Absent: Tara Fuller, Birgitt Olsen and Andy Thomas.

At the SAAS Leadership Team Briefing, held at the Adelaide Pavilion on 30 March, leaders from across the state were privileged to hear from Atena Abrahimzadeh, survivor of domestic violence, and Maria Hagias, Executive Director of Central Domestic Violence Service.

(L-R) Steve Cameron, Jason Killens, Atena Abrahimzadeh, Chris Howie, Maria Hagias.

SAPOL Assistant Commissioner Paul Dickson spoke about the prevalence and effects of violence against women in our society and shared some experiences from SAPOL’s White Ribbon Accreditation Journey.

Don’t forget to contact Lachlan Ophof if you’d like a White Ribbon banner to add to your email signature.


HYPOGLYCAEMIAHypoglycemia is characterised by a reduction in plasma glucose concentration to a level that may induce symptoms or signs such as altered mental status and/or sympathetic nervous system stimulation.

Hypoglycaemia causes altered conscious level, seizures and coma. It is potentially life threatening if undiagnosed or untreated. The glucose level at which an individual becomes symptomatic is highly variable, but it is generally regarded as BGL <3.6 mmol/L. Particularly, diabetic patients can be symptomatic at higher levels.

Symptomatic hypoglycaemia constitutes severe hypoglycaemia, rapid diagnosis and treatment are essential.

Prolonged or recurrent hypoglycaemia, especially when associated with symptoms and signs, can cause long term neurological damage or death.

DON’T EVER FORGET GLUCOSE

CLINICAL JOURNEY

DR CATHRIN PARSCH – CHIEF MEDICAL OFFICER

CASE 1: 60 y old IVDU, recently self-discharged after Tricuspid Valve Endocarditis. Non-compliant with antibiotics. Found semiconscious in the carport night before. Carried into the house. When checked in the morning, unconscious. GCS 8. Palpable femoral pulse. SpO2 unobtainable, hypothermic. Confluent ecchymoses. BGL 1.6.

CASE 2: 26 y old aged care worker, found after insulin overdose. BSL 2.2. GCS 3, Seizure activity. 10% dextrose and glucagon given. BSL 9. At arrival at hospital BSL had dropped to 1.4 again.

CASE 3: 46 y old with Parkinson’s Disease, IVDU, suffering severe acute movement disorder, difficult IV access, BSL 2.6. GCS 15 but motor activity so uncontrolled that management/extrication very challenging.

CASE 4: 42 y old known insulin-dependent diabetic suffers from a tonic-clonic seizure and CHI from fall. Given oral glucose prehospital. On arrival in ED, triage P 1 to resuscitation room. GCS 14 (confused), BSL of 1.8 and tachycardia 125.


CAUSES• Overdose of insulin or oral

hypoglycaemics

• Excess insulin or oral hypoglycaemic administration

• Hepatic failure, hypothermia

• Sepsis and multiorgan failure

• Drugs – ethanol, MAOIs, haloperidol, sulfonamides, salicylates

• Insulinoma or islet cell hyperplasia

• Adrenal insufficiency (Addison’s disease)

• Patients with documented DM can also become hypoglycaemic due to: – Increased exercise – Decreased calorie intake,

or missed meals or snacks

PAEDIATRICS• Hypoglycaemia is the most frequent

acute complication of type 1 diabetes either due to excess insulin or illnesses causing nausea, vomiting or diarrhoea and decreased oral intake.

• Hyperinsulinism is the most common cause of persistent hypoglycaemia under 2 years. The presence of ketonuria and/or ketonaemia makes this diagnosis very unlikely.

• Accelerated starvation (previously known as “ketotic hypoglycaemia”) is the most common cause of hypoglycemia beyond infancy, usually presenting between 18 months to 5 years. It occurs after a prolonged fast and is usually precipitated by a relatively mild illness. It requires documenting a low BSL in association with ketonuria and/or ketonaemia, but definitive diagnosis requires exclusion of other metabolic and endocrine causes.

• Hypoglycaemia may be an early manifestation of other serious disorders (eg. sepsis, congenital heart disease, tumours).

MANIFESTATIONSAdrenergic response: Catecholamines are released secondary to an absolute decrease in blood glucose. The degree of catecholamine response is inversely proportional to the BGL. Adrenergic symptoms usually precede neuroglycopenic symptoms (see below), and provide an ‘early warning system’ for the patient. They include:

• Sweating

• Palpitations

• Tremulousness

• Anxiety

• Hunger

• CNS response (neuroglycopenia): if untreated may lead to permanent deficits or death

• Headache, diplopia

• Difficulty in concentrating, hallucinations

• Confusion, irritability

• Focal neurological deficits (e.g. hemiplegia or dysphasia – check the BGL in a patient with a suspected stroke!)

• Seizures

• Coma

MANAGEMENTAll symptomatic patients with hypoglycaemia require urgent treatment.

(As per CPG.)

• Oral glucose

• Glucagon

• IV dextrose 10%

Repeat BGL in 30 min. Earlier, if symptoms have not resolved or if any secondary deterioration.


CASE 1 • Required complex resuscitation,

ongoing 10% dextrose infusion to maintain BGL. Multiorgan failure. Rhabdomyolysis. Coagulopathy. Not for intubation or renal replacement therapy. Died day 2 in ICU.

• Cause of hypoglycaemia: severe sepsis, acute on chronic hepatic injury, multiorgan failure.

CASE 2• Ongoing hypoglycaemia, 5 days ventilated in ICU. Significant cognitive

impairment due to hypoglycaemic brain injury, after 1 month in acute care hospital transferred for brain injury rehabilitation.

• Cause of hypoglycaemia: Insulin overdose.

Commonly used insulins and oral hypoglycaemics:

* Treatment for Type 1 DM combine short and longer acting insulin unless patient has an insulin pump*

1. Short acting insulins: Glulisine (Apidra), Lispro (Humalog), Insuline aspart (Novorapid): onset <15 min, duration 30min-3 hours. Given before meals.

2. Levemir (insulin detemir): long onset of action of 3-4 hours, time to peak of 9 hours and duration 12-24 hours.

3. Insulin glargine ( Lantus ): onset of action of 1-2 hours, peak 6 h and duration of 24 hours.

4. Long acting insulins like Isophane (Humulin NPH et al): onset of action 1-2 h, peak 4-12h and duration of action of close to 24 hours.

5. Duration of action of oral hypoglycaemics.


CASE 3• Symptoms manageable after

correction of BGL. Later aspiration event in ED, intubated and ventilated in ICU.

• PMX: Pituitary adenoma, on hydrocortisone. Parkinson’s on Levodopa.

• Previous dyskinetic reactions and unstable BGL after amphetamine use but also L Dopa induced dyskinesias.

• Cortisol level: normal. Amphetamines not detected.

• Cause of hypoglycaemia: likely multifactorial including L Dopa induced dyskinesia, prolonged extreme motor hyperactivity, IVDU.

CASE 4• Hypoglycaemia corrected in

ED with resolution of symptoms.

• Renal function normal.

• CT brain: no acute injury.

• Admitted under endocrine team.

• Regular insulin therapy: Lantus 10 Units-mane, 8 Units nocte, Apidra 10 Units twice daily.

• HbA1C 8.8 suggesting poor glycaemic control leading to increased risk of microvascular complications.

• Self-discharged against medical advice.

KEY MESSAGES• Symptomatic hypoglycaemia = severe hypoglycaemia

• Symptomatic hypoglycaemia is a medical emergency that requires time critical intervention.

• If symptoms are consistent with hypoglycaemia and BGS< 3.6: TREAT.

• BGL level causing symptomatic hypoglycaemia may be higher in diabetics – if in doubt, ask for help or treat.

• There are many causes for hypoglycaemia.

• Small children are particularly prone to hypoglycaemia.

• Some cause relatively short lived episodes (e.g. short acting insulins).

• Many cause prolonged hypoglycaemia (long acting insulins, oral hypoglycaemic, systemic illness, endocrine diseases such as Addison’s).

• Initial therapy with oral glucose, Glucagon and D 10 may only have a temporary effect.

• It is very important to monitor and maintain normoglycaemia through repeat BGL and often re-dosing of corrective therapy.


WELCOME TO:Jesse Chau joined SAAS on 21 March as a Senior Administrative

Support Officer in the Emergency Operations Centre.

Simon Roughana, though not new to SAAS, recently won the ongoing role of Manager Fleet Services. He officially started on 26 March.

Angela Cosenza, Executive Assistant to Denise McMillan-Hall started on 22 February 2016.

Lisa Golder, Exercise Physiologist, joined the SAASfit team on 22 February.

WE ALSO WELCOME THE LATEST GROUP OF EMDSO CASUALS:

Rick Candy Benjamin Poppy Henry Brooks Derek Irvine

AND A WHOLE BUNCH OF PATIENT TRANSPORT OFFICERS:

Patrick BarryKali GrahamChelsea GuinaneIlse GulpersJosh HollandBruce Hosking

Ruby LaingTina LynchHayley MannixMerrilyn SattlerThalia Staude Christian Taormina

Michael WellsJessica WilliamsStafford WulffAndrew McDougallNaomi Thompson

STAFF MOVES

CUSTOMER SERVICES STATS JANUARY – FEBRUARY 2016

✰CUSTOMER SERVICE CENTRE STAR AWARD✰ Congratulations to Adele Pitman-Jones! Adele received a number of compliments for her professional attitude while sitting on reception. She displays excellent customer service skills, using them to her advantage when she recently was able to turnaround a potentially difficult call.

Customer Service CentreInbound call volume 32,210

Revenue & BillingCase Cards received 44,517Case Cards processed 43,156

Call Direct

Sales 103Members 3930

Ambulance Cover

Members 284,352

Carmela presenting Adele with her Star Bear.


We want to hear from you! SAAScene is your magazine, but we need your input. All you need to do is contact the team at [email protected].

For more information and submission deadlines go to: SAASnet > People and Support > Our Community > SAAScene

HAVE YOU GOT A STORY FOR SAASCENE?

INFOREDOUR NEW REGISTRARS

The latest group of general service registrars commenced at SAAS MedSTAR in February. As always, they’re an interesting group from far and wide, providing a wealth of clinical knowledge and life experience.

CHRISTIAN AHLSTEDT, ANAESTHESIA AND INTENSIVE CARE Hailing from Stockholm, Christian is still mourning the break-up of the group Swedish House Mafia. Apart from EDM he has a special interest in FOAM (Free Open Access Meducation) and cardiac ultrasound. His family (wife, two young kids and dog) ensures there is no problem filling spare time. They’re all crazy about sunny weather and the beach; and living in Henley Beach means enjoying life in Australia to the fullest. Prior to working with SAAS MedSTAR, he spent a year working in the RAH ICU.

ADRIANNE BOONSTRA, EMERGENCY MEDICINEOriginally from Canada, Adrianne swapped snow-capped mountains for the searing Adelaide summer. Although the initial plan was to remain in Australia for just the four years of medical school, 11 years, two cats, and a fellowship in emergency medicine later, she hasn’t left yet and probably never will! Though, she’s always looking for quality snow to go skiing when on holidays.

ADAM CZAPRAN, INTENSIVE CAREAdam is an intensive care trainee, previously working at Kings College Hospital in the UK. This is his second year in Adelaide, having loved it so much the first time he visited, he chucked his life up in the air and came back. He previously worked in the RAH ICU and emergency department. Being British, he has an extreme love of tea and complaining about the weather. He enjoys a bit of exercise, twentieth century history and cold beverages on warm afternoons down at The Bay.

BEN DAVIDSON, INTENSIVE CAREBen grew up in Adelaide and attended the University of Adelaide, where he completed a Bachelor of Science with honours and a PhD in Biochemistry. He worked for three years as a post-doctoral fellow at Flinders Cancer Centre before moving to Sydney where he studied medicine at Sydney University. He’s an ICU trainee at Flinders Medical Centre and completed his fellowship in 2015. To relax, Ben goes fishing, cycling and camping with his wife and two kids.

ADAM MOSSENSON, ANAESTHETICSAdam is an anaesthetics registrar from Western Australia and has moved to Adelaide to get exposure to work in pre-hospital medicine. Outside of medicine his interests are in food and wine, travel and chasing a little black ball around a squash court. Prior to medical school Adam started training to become a chef and is forever is planning his next food venture.

RICHARD WOOD, ANAESTHETICSRichard is originally from Middlesbrough in the North East of England but has spent the last 10 years in Scotland studying and training. He is an anaesthetics registrar and tells people that he came to Australia for pre-hospital experience, though he actually moved for the finer weather! Most of his spare time is spent in the mountains paragliding, climbing or kayaking.

PAUL MACLUREPaul heralds from the UK, with a background in anaesthesia and ICU. In between his clinical work and university work in simulation, Paul likes to run... and run... and run! He can be found pursuing his passion for ultramarathons and adventure races.

Above: Christian Ahlstedt and Jo Wood braving HUET training.

Above: Christian Ahlstedt, Adam Czapran, Richard Wood and Paul Maclure during an RFDS flight briefing with Rosemary Moyle.


https://www.saambulancestaff.com.au/SAASIntranet/People+and+Support/Our+Community/SAAScene/

https://www.saambulancestaff.com.au/SAASIntranet/People+and+Support/Our+Community/SAAScene/

SAAS Wedding Album

1. Kate Firmager & Tom Bates – Kate from Metro Operations said ‘I do’ at the gorgeous Bird in Hand Winery. It was a stinking hot day but the champagne was ice cold! #batesealsthedeal

2. Alexi Tuckey & Nicola Seneca – Alexi from Corporate Communications married her Italian stallion at Partridge House in Glenelg. They celebrated with Aperol spritzers and a tango! #lexicola

3. Shana Brewer & Simon Leonard – What happens when a paramedic and an ICP fall in love? Sparks fly! Here are the two love birds in Thailand at Sangsuri Villa, Koh Samui. #parasinlove

4. Alex McKenzie & Najree Lydiard – Maximillian’s in Verdun was filled with love when ICP Alex married his fair beauty. Here they are with their very good looking bridal party! #apocketfullofdaisies

Tis the wedding season! Over the last couple of months SAASers have been getting hitched, so here’s a selection of the beautiful brides and handsome grooms.

21

3 4


And back to the rest of us…5. Cyle Sprik and Brett Braysher recently met William White and his family

for a Today Tonight patient reunion. Little William lost his leg in 2014 when a tree fell on him. He was looked after by his mum until Cyle and Brett arrived. He’s now running around with his Superman prosthetic leg and was all grins for the camera.

6. Here’s a happy snap of the latest paramedic interns at the HMB Endeavour after completing their driving course.

7. Ali Mohtasham from the Operational Intelligence Unit was caught practising his Halloween face while cutting his birthday cake!

8. Peter Mace, team leader in the EOC, said his final farewell to SAAS after almost 40 years of service. Steve Cameron was on hand to wish him well in his retirement.

5

6

7

8


FROM HOBBY TO CAREER

When the new power stretchers arrive, they’ll hold special significance for Terry Whales. He will have been in the ambulance field from “when we carried stretchers through to not having to lift stretchers.”

Looking back on 40 years of service, Terry, now the Operations Manager for Murray Mallee, counts himself fortunate to have turned a teenage hobby as a St John ambulance cadet into a career.

“I was sixteen when the organisation advertised for a junior ambulance officer position,” he says. “Unfortunately … I was deemed too young. The same position became available only six months later, when I was offered the position without application.”

Back then, fellow 40-years-club member David Schilling was an apprentice mechanic in the ambulance workshop. They became friends and remain so.

It was a time of hats and ties for ambos and calling the boss ‘Sir’. In Terry’s words, the ambulance service was a “grab and go” affair rather than providing high-level clinical care.

So he’s enjoyed seeing the service professionalise and filling a range of roles, including time as a regional general manager.

But being an ambo has meant sacrifices, including inevitably missing some special family times because of shift work.

“I have been very fortunate to have my wife of 35 years and my two children, who are so understanding,” says Terry.

“And I say ‘thank you’ to them for allowing me to have had such a wonderful time during my working life in SAAS.”

I WANT TO BE AN AMBO

As a boy, David Schilling wanted to be an ambo like his dad. Even his stint as a mechanic at St John’s Hindmarsh station in the 1970s was a step towards his dream job.

“In those days, you couldn’t be a full-time ambo until you were 21,” says Dave. “So I was filling in time.”

He’d volunteered with St John since 1969 as a cadet, was on an ambulance as a volunteer from 1973, and then out on the road as a full-time ambulance officer in 1980.

He doesn’t even remember doing any training for his new paid role.

“I had a swag of experience already by then,” says Dave. “There was no qualification attached to it. No pass marks or assessment.”

One part of the job he can’t believe past officers had to do was carrying decomposed or mutilated bodies, a ghoulish task they did up until 1979.

“Hindmarsh was the main station, and there was a steel coffin we used,” he says.

“We’d wash the decomposed bodies and maggots in the wash bay where you washed the ambulance and everything.”

One day he was tasked to a grisly job at a railway line.

“We’d went down to the tracks with a shovel and pick up a bit and put it in the coffin and pick up another bit and put it in.”

After 40 years, “the unknown” still keeps Dave interested in the ambulance field.

“You don’t know when you’re going to go and where you’re going to go,” he says. “Sometimes you don’t even know how you’re going to get there!”

GANG GREEN

Terry Whales Dave Schilling

Dave and Terry, in shorts!

THE 40-YEARS CLUB!These distinguished gentlemen have all reached, or will soon reach, the milestone of 40 years of ambulance service. What attracted them? And what’s kept them on the ambulance journey for all these years?


HOT SUMMER AMBO

It was a sweaty December day in 1975 when Gary Wyld realised he’d had it with welding and wanted to become an ambo.

The 22-year-old sheet-metal tradie already volunteered at St John’s Port Adelaide Division. So he knew what he was in for “rocking up to Hindmarsh Station and straight into training on the top floor”.

Now a paramedic at Millicent (after a long recent stint as a regional team leader and time in the EOC, ‘Comms’, in the mid-1980s), Gary still remembers the sights and sounds of SA’s ambulance past – some of them are even still with us!

“I do smile when I do a shift at Naracoorte these days and visit the gents toilet that hasn’t changed in sight or deodoriser scent from 1976!” he says.

Major changes have been in staffing, the split with St John in the early 1990s and clinical development and equipment – including an end, in the 1980s, to the ergonomic nightmare of “double carries in a panel van ambulance with the patients being attended to over the front bench seat”.

“Early on you could go anywhere and do almost anything in this vocation,” he says. “It was a happy place to work, full of young ambos who were just a little bit mischievous at times and didn’t take themselves too seriously.”

Gary’s achievements include representing country ambos as an AEA state councillor and his input into driver training programs.

Today, he’s happy to be a paramedic and then disappear into his vegie patch on days off.

“I have an interest in seeing the youngsters coming through now getting amongst it, taking on roles that us oldies have held,” he says.

“The next 10 to 20 years is their time to leave their mark.”

CARING FOR THE LOVE OF IT

Car crashes were half the workload when Jon Jaensch first donned white overalls and jumped into a St John ambulance at Yankalilla in 1976. Today they’re around five per cent.

“People were ejected from cars a lot more,” says Jon. “They didn’t wear seatbelts as much.

“And the road surfaces have improved dramatically. There are steel barriers on the sides of the road, so people don’t go into the bushes like they used to!”

Volunteering in Jon’s early days meant being near a landline phone when on call – no mobiles or pagers.

“It was a bit more restrictive,” he says. “Mind you, it wasn’t as busy. You could go for months without getting a job.

“Certainly our skill level and knowledge has increased – but the basics have remained the same.”

Later on, volunteers even managed the station’s financial affairs, including sending out transport accounts and subscription notices.

In addition to helping countless sick or injured people, Jon’s been heavily involved with training new members. He is the current VTL and a member of SAASVHAC (and previously of the former Country Ambulance Service Advisory Committee).

Jon’s still keen to keep helping his community as long as he can.

“I like helping people,” he says. “While my health allows me to do it, I will continue doing what I’m doing.

“I think it’s really special being a volunteer for something as important as ambulance. It would be a sad day if there weren’t ambulance volunteers.”

Gary Wyld

Gary's old ID.

Jon Jaensch

Jon in St John circa 1978.

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


GENERAL NEWS

Pulse


Over the past three months we have been asking staff members what they want from the rostering department.

Staff were asked a series of questions pertaining to how they think rostering could be improved, if current processes work for them, and how they would like to access their rostering information. The response from staff and departments has been fantastic. Many colleagues contributed to the conversation at PDWs and other meetings, attended by ‘rostering ambassadors’, and they also emailed in their ideas.

It was obvious that we have a very tech-savvy workforce, who would like this kind of delivery from us. We received some great ideas from outside the left field, which was exactly what we were looking for.

‘Rules of Rostering’ not widely known, and in some cases very outdated, was another of the common areas highlighted.

A recommendation document has been formulated, and this is in no way the end of the project. From here we will conduct detailed analysis on what those recommendations may entail, and how we can go about implementing them.

For the first time in a long time, we now know what it is you want and need from rostering to help you do your job.

PROJECT UPDATE

OPERATIONAL ROSTERING AND RESOURCING


WHILE A NUMBER OF QUALITY REFERRALS TO EXTENDED CARE PARAMEDICS (ECPS) ARE CURRENTLY GENERATED BY SAAS CREWS, NOT ALL REFERRALS ARE SUCCESSFUL AND THIS CAN UNDERSTANDABLY LEAD TO SOME FRUSTRATION. THIS ARTICLE WILL OUTLINE THE PROCESSES THAT OCCUR PRIOR TO A CREW REFERRAL WHICH HOPEFULLY WILL EXPLAIN WHY NOT EVERY REFERRAL WORKS.

As a call works its way through the Emergency Operations Centre (EOC) it is subject to a series of filters, each of which is directly or indirectly designed to identify ECP work.

ECP CREW REFERRALS A NUMBERS GAME

CONGRATULATIONS PAUL,

AND THANK YOU!

Kingston VTL Pauline Parsons, Paul Bleasby and Jarred Gilbert.

With all of the above filters the ECP will call the scene back to get a more detailed clinical and social picture of the patient and the situation to decide if it is safe to delay an emergency response and send an ECP for possible emergency department avoidance. Sometimes, after all this, it is still not safe to send an ECP to the case because the details are not clear. How long since you last went to a case that wasn’t exactly what it seemed?

In these situations, and when the ECP is busy with other tasks in the EOC, like clinical consults or providing medical advice to callers, an emergency crew will be sent so that a clinician can assess the situation first-hand. Having been through three or four filters already, it’s inevitable that not every case referred by an emergency crew will be successful, but that doesn’t mean we don’t appreciate the call! It’s often the case that factors unknown to the crew like ECP availability or information from the patient’s medical records impact on the decision to send an ECP or not.

Currently we receive about 150 referrals a month and respond to 78% of these (the remaining 22% either pose too much risk for referral or an ECP is unable to respond to the patient in an appropriate timeframe). We’d really like to increase the referral numbers this year, so please make use of the ECP Referral Guide.

Andrew Noble Relieving ECP Clinical Team Leader

FILTER 1:

The caller asks for an ECP. This most commonly comes from residential care facility callers who are familiar with what an ECP can offer.

FILTER 2:

The emergency medical dispatch support officer identifies a keyword from the case which alerts them to the possibility of an ECP job, such as ‘skin tear’ or, you guessed it, ‘catheter’.

FILTER 3:

The emergency medical dispatcher picks up details of the case which similarly make them alert the ECP.

FILTER 4:

The ECP in the EOC scanning through all the cases coming in (well over 1200 a day) notices a possible ECP case not already identified.


15-YEAR NATIONAL MEDAL FOR VOLUNTEER PAUL BLEASBYIn February this year, the Kingston volunteer ambulance team honoured long-standing volunteer Paul Bleasby with a 15-year service medal.

Paul was an integral member of both the Kingston and Coonalpyn teams and commented that SAAS gave him skills that he will never forget. Also that he will always remember the close relationships he formed during his time in such a fantastic organisation such as ours.

Jarred Gilbert, RTL Lower South East

Made a successful referral to an ECP? No need to complete a Treat no Transport form. The patient isn’t being discharged from SAAS care, so a good patient report form will suffice.

SupportECPs can provide:• crewconsultation (careerandvolunteer)• CPGextensionpara- medics(ifnoICPavail.)• clientcallbackin appropriatecases• alternativepathways whereavailable• referraltorespite servicesforcarers• ptinformation/ managementplans.

ECP referral guideExtendedcareparamedics(ECPs)canprovidetreatmenttopatientsathomeorinaresidential-caresettingandthushelpavoidunnecessarytripstohospital.However,it’simportantthattheyarecalledtotherightcases.Certainpatient(pt)conditions,situationsandlackofsupportmaymeananECPmaynotbeappropriate.Paediatricpatientsaregenerallyexcluded(ECPprecautions/exclusions).If unsure about ECP precautions/exclusions, please discuss with EOC clinician.

Wound careECPs can attend:• lacerations• skintears• abrasions• bites• minorwounds• existingwounds.

ECP precautions/exclusions:• injuriestoface,genital area,handsorfeetor overjoints• deeptissuewounds• injuriesrequiring extensiveclosure• lossoffunction• penetratinginjuries• distalskinflaps• foreignbodies• ptonanticoagulants andhasheadinjury• Workcover.

Palliative careECPs can attend:• generalised deterioration• breakthroughpain• respiratorydistress• vomiting• agitationanddelirium• medicationdelivery- systemissues,e.g. pumps.

ECP precautions• ptwithoutadvance- directivedocument.

InfectionsECPs can attend:• UTI(ptnotpregnantand noanuria)• cellulitis• respiratory(ifnoprevious ICU/HDUadmissionsand notneedingincreasedO2).

ECP precautions/exclusions:• firstpresentationofmale UTI• suspectedpyelonephritis• immunocompromisedpt orincreasedriskofinfection• febrileneutropenia (chemo.)• suspectedsepsis• ptcurrentlytakingsteroids• comorbidities,i.e.CCF, COPDordiabetes.

Musculoskeletal painECPs can attend:• backpain(considerAAA)• chronicpain• dislocatedjaw.

ECP exclusions:• acutelossof neurovascularintegrity• acuteneckpain(if secondarytotrauma)• undiagnosedabdo.or chestpain.

Continence and feeding devicesECPs can attend for insertion of or issues with:• indwellingcatheter(IDC)• supra-pubiccatheter(SPC)• feedingtube(PEG).

Note: ECPs only attend if regular continence provider is not available, e.g. RDNS.

ECP precautions/exclusions:• first-timecatheters• acuteurinaryretention• bleedingaroundcatheter, recentTURPorhaematuria• tractionpullPEGs(discusson consult).

HeadachesECPs can attend:• simpleheadaches• migrainewith previousHxand identicalpresentation.

ECP exclusions:• newpresentationof severeheadache• suspicionof CVA/positiveROSIER• pregnantpt• Hxofrecenthead trauma• suspectedinfection, e.g.meningococcal septicaemia• lossofconsciousness• lackofresponsible personforsupervision• decreasedGCS.

Gastrointestinal/GenitalECPs can attend:• diarrhoeaand/orvomiting• dehydration/heatwave• rectalprolapse• paraphimosis.

ECP precautions/exclusions:• decreasedurineoutputover extendedtime• malaenaorhaematemesis• Hxofbowelobstruction(abdo. distensionortenderness)• haemodynamiccompromiseor alteredGCS• significantcomorbidity thatmaybenefitfromhospital assessment.

AllergiesECPs can attend:• mildtomoderate allergicreactions• ptwithnoHxof deterioration• casesnotrequiring adrenaline.

ECP exclusions:• anaphylaxis• significantcomorbidity (e.g.immunocompromisedpt)• airwayormucosal angioedema.

Aftercompletingaprimaryandsecondarysurvey,contacttheEOCon1800247885andasktospeakto

theEOCclinician.Thischartisonlyaguide.PleaseuseISBARwhendiscussingeachcasewiththeECP.

DizzinessECPs can attend:• vertigo/Hxof Meniere’sdisease• dizzinesswith knowndiagnosis/ Hxofbenigncauses.

ECP precautions/exclusions:• cardiacHx• CVA/other neurological pathology• considermetabolic, sepsis,gastrointestinal bleedsorothernon- benigncauses.

OtherECPs can attend:• tocorrectexcess anticoagulationfrom warfarininsuitablept• ringremoval.

ECPReferralGuidev2-Feb2013

THE ECP REFERRAL GUIDE IS…

On your mobile data terminal Reference Information > Clinical Documents > ECP Referral Guide

In your case card folder as a hard copy. We’ve recently distributed a bunch of these to metro and metro fringe stations, so if you can’t find one ask your clinical team leader/regional team leader.


Injuries sustained at work can have a big impact on all aspects of a person’s life. The proposed Roadfit initiative seeks to ensure staff are fit for work and fit for life. It aims to contribute to a safe work environment by ensuring operational staff have the capacity to undertake their important role, and decrease the risk of injury to themselves, their work partner and patients.

As mentioned in previous communications, staff evaluations will focus on capacity for job tasks such as lifting, pulling and pushing. It is based on the current pre-employment and return to work Functional Capacity Evaluation; it is not a purely fitness-based assessment. The proposed program provides a holistic approach to injury prevention and early intervention, and assists staff to recognise potential injury or general health risk factors, while providing a supportive framework to address these identified risks.

A ROADFIT SNAP SHOT

CORE COMPONENTS OF THE ROADFIT ASSESSMENT

You will be provided with adequate instructions and your heart rate will be monitored throughout the assessment to ensure you are working within safe ranges.

Dynamic lift

The dynamic lift of a weighted box is primarily based on the force required to lift the head end of a laden stretcher from half height to full height. It also reflects other tasks that we do, like lifting and carrying laden spinal boards.

The requirement for this CORE component is 41kgs. You will be required to lift a weighted box, while maintaining a safe and correct technique. This will be monitored to ensure safe lifting and capacity.

Dynamic push/pull (waist height)

The static push and pull demands are based on the forces required to load and unload laden stretchers. They also reflect the forces involved in lateral transfers, manoeuvring stretchers, and sliding patients on the blue slide sheets or on spinal boards.

The requirement for this CORE component is 23kgs for the push, and 22kgs for the pull. You will be required to push and then pull a weighted sled over a certain distance in a safe and controlled manner.


A decommissioned ambulance has been fitted out to carry the testing equipment. This means both Roadfit and SAASfit assessments can be conducted state-wide.

CPR compressions

The ability to perform compressions at an adequate rate and depth is critical to patient care and survival. You will be required to perform compressions at a required rate and depth on a mannequin, while receiving feedback from a Simpad for two continuous minutes. You will be required to stand unaided and rest for two minutes, followed by a final two minutes of CPR compressions, and return to standing position. The Simpad will provide a report and percentage. You will be required to pass at 85% or above.

Clinical risk factors will also be identified by the assessing Exercise Physiologist in the non-core component of the test. These may include things like hypermobile joints (especially shoulders), low fitness, poor manual handling technique, previous injury which impacts on current function, and low static strength (achieved job demands but little reserve muscle power available). The Functional Capacity Evaluation process helps SAAS to meet the requirement to provide employees with a safe work environment and safe systems of work.

Non-core assessments include:

• Body Composition – weight, height, BMI, cholesterol and blood glucose (optional, not compulsory)

• Unilateral carry (11kg)

• Plank (1 minute)

• Sharpened Romberg test (balance test for 30 seconds)

• Sit and reach

• Queens College Step Test

What are the benefits to you?

• Give you an insight into your health profile, strengths and weaknesses

• Identified early risk factors and implement early intervention

• Injury prevention

• Ensure we keep you safe on the road

Grip strength (stretcher height)

The grip strength minimum requirements are based on the force required to operate the stretcher levers. The Jamar measuring equipment is positioned at the same grip width and angle to mimic the hand position of loading a stretcher. The requirement for this CORE component is 27kgs bilaterally.



BIG BOOST IN VOLUNTEERS AT ORROROO

Alison Sellwood and Sam Gum have each found their life’s passion, volunteering at Orroroo.

If you’d like to let us know how things are going for your volunteer team, please drop us a line at [email protected].

Orroroo is proud of its recent boost in team members. A group of 10 recruits commenced last year, and seven of them should finish by May. This will give us a team of 10 operational volunteers and two non-operational volunteers.

We have decided SAAS is a great recruiting agency for further educational pursuits, providing skills and confidence to go on to bigger and better things.

Alison Sellwood has started her Diploma of Enrolled Nursing; and Sam Gum (who was on a gap year and planning to study a Bachelor of Environment) saw the light during his ambulance training and part-time work at the local hospital and has now commenced his registered nursing training. He is continuing with his ambulance volunteering as well.

Among the team, we now have two registered nurses, plus one in training; two enrolled nurses, plus one in training; and one emergency services officer.

The operational team is also supported by a couple of wonderful community members. We continue to be guided by the infamous duo of John (Cozens) and John (Schmidt), who – between them – have 68 years of experience to share.

We would like to acknowledge that we have been very fortunate to have volunteers from the Country Regional Response Team and Volunteer Regional Response Team supporting us regularly while in this huge training transition period.

They have been supporting our team and community, of which we are very grateful. Many have become unofficial team members. They’re envious of our huge station – built in 2011 and nicknamed the ‘Taj Mahal’ – which is apparently very homely.

As VTL, I am very proud to be part of this team and so glad to see our numbers increase.

Jacqui Tapscott Volunteer Team Leader, Orroroo

STATS ON ORROROO:

Population: 500 (approx.)

Origin of town name: An early settler, CJ Easther, named the area, possibly after an Aboriginal girl who lived on a station nearby or for the Aboriginal word for dust, drift, or a windy locality.

Number of ambulance cases: 75 cases for last financial year.

Best tourist attractions: Giant Gumtree Picnic Ground (with a 500-year-old red gum with a circumference of almost 11 metres), the local reservoir (created in 1906), Store on Second (for its clothing and gifts) and Lion’s Park (including duck pond, barbecue facilities and walking trail).

Best place to get a good feed: Maggie’s Rendezvous Coffee Shop for its homemade goodies.

A surprising fact you may not know: Orroroo is a very clean and tidy place with a sense of community and pride in their town.

mailto:[email protected]


If you have any stories, photos, ideas or anything that you would like to share, please send it through to Corporate Communications. Also, register your interest to become an AMBassador:

• personal message (PM) us on social media

• email us at [email protected]

• snail mail to Corporate Comms – 216 Greenhill Road, Eastwood 5063

• chats – 8274 0482

• fax – 8272 9232

• text – 0407 399 460

Let’s make SAAS go viral!

SAAS is on social media! With Facebook and Twitter accounts we can now be better connected with the community. Having this presence gives us an insight into public events, and the way the public views SAAS and reacts to what we do. It also gives the public an opportunity to contact SAAS publically about any commendations, requests and information that we can easily pass on.

This is a huge success and shows us that people are enjoying and interested in our social media posts. So far our posts have shown the new Oakden station, Street

QUICK STATS (since we joined on 30 March to 12 April)

More than 3000 Facebook likes and 500 Twitter followers

12 Facebook posts, 11 Tweets

Facebook post about the new Noarlunga station reached 21 600 people

Best Tweet had 9300 impressions

SA Ambulance Service

@SA_Ambulance

Smart demonstration and members of our team doing a great job.

We are still looking for AMBassadors to help guide our social media project along. We are keen to include all aspects of SAAS – career and volunteer, operational and support etc. Wherever you work, we would love to hear from you. Things that could be included in our social media posts are: pictures showcasing SAAS, special training sessions, award presentations and exceptional cases with good outcomes (e.g. births).

#SAAS IS ON THE SOCIALS!

GIVING OUR LEADERS THE RIGHT TOOLS

A great turn out for the first SLTB of 2016 at the Adelaide Pavilion.

The next SLTB is on Wednesday 15 June.

Do you have what it takes to be a leader? Register your interest to attend the next SLTB with your manager today!

Knowledge is power, and that is exactly what the SAAS Leadership Team Briefing (SLTB) aims to give. All team leaders and managers from across the organisation are invited to get together for a full day of presentations and networking with peers every three months. This year, for the first time, up and coming leaders are also invited to attend.

It’s a great opportunity for leaders to catch up on what is happening in and around SAAS, the government and the community.

On Wednesday 30 March the first SLTB for 2016 was held at the Adelaide Pavilion. Attendees were presented with a number of informative sessions, including an update from Andy Hillier on the new expiation notice process, dispelling a number of rumours, and explaining the importance of the new rules.

We also welcomed Atena Abrahimzadeh, who courageously spoke of her personal experience of violence against women. Her story was a confronting reminder of the importance of SAAS’s involvement with the White Ribbon campaign and our commitment to achieve White Ribbon workplace accreditation.

As always, we saw a great turn out on the day and expect that your manager, team leader or director has already updated you on the presentations.

Tarnya Hannam-Tasker Project Administrator, Corporate, Business & Support Service

It has come to our attention that some people who couldn’t make the ceremony have not yet received their award. If this is you, please contact your OM, RTL or ACTL to arrange a time to be presented with your award. Presentations can be held at team meetings, conferences or training days, or you can have an individual meeting with your manager. All outstanding awards were sent to the relevant OM in November 2015.


DIDN’T MAKE THE GRADUATION AND PRESENTATION CEREMONY LAST YEAR?

Robe volunteers Michelle Everett (VTL), Trudy Regnier and Gary Thomas; Millicent ICP Michael Boland and paramedic Gary Wyld; and Mt Gambier CTL Sandy Johnston have done SAAS proud by going beyond the call of duty.

The case involved a lad in his mid-teens who had sustained a nasty fracture to his wrist after mistiming a jumping manoeuvre while attending a Surf Lifesaving Cadet Development Camp in Robe in January this year.

CTL Sandy Johnston arrived first and found the patient in significant pain but being well cared for by the camp organisers. Not long after that, Robe volunteers Michelle Everett, Trudy Regnier and Gary Thomas arrived in the ambulance.

Ambulance staff and the patient plus two members of the South Port Surf Lifesaving Club (SLSC) set off to meet the Millicent ambulance and its crew, Michael Boland and Gary Wyld, at the designated rendezvous. Then it was off to Mt Gambier hospital, where the patient received excellent care.

Sounds just like another morning’s work, doesn’t it? But as you will see from the comments in the camp organisers’ report, it was much more than that:

We send a huge thanks to the ambos at SA Ambulance Service, in particular Sandy, for his outstanding care of and compassion for our patient and (for South Port SLSC members) Deb and Nicole. This amazing man offered the girls a place to stay at his house because of the danger of many big kangaroos on the road, and was concerned about them driving back to Robe late Saturday night. A true gentleman.

Nicole Berry and Deb Sinclair also wrote to the Border Watch to express their appreciation.

Sandy said he had been impressed by the organisers at the camp grounds.

“I knew they had volunteered their time and energy to run the camp. When I saw how they cared, it brought out the best in me too! You want to help people like that.”

Michelle told us that Trudy was the ‘new girl’ on the team and, thanks to Sandy’s expertise, the case turned out to be a very good one for Trudy.

“I drove and Trudy sat in the back with Sandy, who was amazing – he explained everything to her. From a learning point of view, Trudy got so much out of it. It was great that he was prepared to take the time to go into more depth.

“We are very fortunate in the South East to have paramedics and ICPs who are highly supportive of volunteers and are great to work with.”

Now that’s what we’d call an all-round win!

From left: Mt Gambier CTL Sandy Johnston and Robe volunteers Michelle Everett (VTL) and Gary Thomas

Borderwatch article, 15 January 2016

Medical care praisedHealth workers thanked for professionalismfollowing youth development camp accidentLAST Friday, a group of children aged 14-15 and their mentors from South Port Surf Life Saving Club travelled to Robe for a Youth Development Camp to help and mentor South Australia’s newest Surf Life Saving Club, Robe SLSC, with their Nippers Program.

On Saturday morning, one of the children suffered a horrific broken arm in a freak accident at the campsite and required urgent medical attention and transfer to Mount Gambier hospital.

Deb went in the ambulance and I had to follow them via car.

The care and professionalism of paramedic Sandy and volunteers of SA Ambulance at Robe and Mount Gambier (Michael and two other lovely ladies whose names we can’t recall) and the staff at Mount Gambier hospital (surgeon Barney McCusker and nurses Ruth and Kristen among many others) provided went above and beyond the call of duty and we felt compelled to publicly thank them for the amazing care and compassion they showed, not only to the injured lad, but to us while we waited for his parents

to make the five hour drive from Adelaide.

There were three other ambulance officers who attended and all were volunteers.

They do not get paid for what they do.

Their care was second to none.

A huge thanks to them for their good humour and outstanding care.

They are true heroes. Surgeon Barney McCusker

was so lovely with a very frightened child and put him to ease with his lovely bedside manner.

Sandy the paramedic came back to see us eight hours after he transferred us to the hospital to check on his patient and was concerned about us driving back to Robe so late at night to return to the others back at camp due to the many large kangaroos that frequent the roads between Mount Gambier and Robe.

We had been warned by numerous staff not to drive back as it was extremely dangerous.

Sandy was that worried about us he even offered us both a

place to stay at his place so that we could drive back safely in the morning.

He was just amazing.A true gentleman whom we

thank wholeheartedly and will never forget.

Even though we were not the boy’s parents, the staff and hospital treated us like we were.

They fed us (twice) and kept us informed every step of the way.

They even put his parents up for the night when they arrived in Mount Gambier late on Saturday night.

We were treated with first class service by everyone involved and are truly humbled by not only what they did for our injured member, but the way they looked after us as well.

We would also like to thank Anthony and Keryn at Robe Holiday Park and the Robe SLSC for their support during this time.

We wanted to thank each and every one for the outstanding care they provided us.

We will never forget it.Nicole Berry

and Deb Sinclair,South Port SLSC

Copyright Agency licensed copy(www.copyright.com.au)

Border Watch (Mt Gambier), Mt Gambier SA15 Jan 2016

General News, page 15 - 244.00 cm²Regional - circulation 5,933 (-TWTF--)

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SOUTH EAST VOLUNTEERS AND PARAMEDICS DO SAAS PROUD
