Aside

Paramedic Services within Australia…. A personal “probe”

Hey there Guys,

Today I wanted to share a really great article that was sent to me by a good mate, Craig.

I first met Craig at his civil union recently in New Zealand and of course, when ambo and doctors get together we get along like a house on fire. Today he’s been kind to share a little of his life and also some important tips on how you can help the ambulance service if you need their help. Please enjoy this great article.

In January 1989, a young, fit and enthusiastic man of just 19 years of age commenced his first shift with the local ambulance service in Christchurch, New Zealand. Within a few hours of starting on a bright and sunny day he would be subjected to doing cardio-pulmonary resuscitation on a complete stranger, and followed this up by immediately attending to a high speed motor vehicle versus motor vehicle entrapment where the driver died despite what he saw was his feeble and futile efforts. His supervisor promptly packaged him in the fast response car and drove him directly to the city morgue where he witnessed, with a rather “green” face, his first post-mortum.

“This will harden you up son”; the rather emblazoned words that have remained stamped in the dark, distant past of his memories. “Oh by the way, go and get changed, the (white) shirt is too bloody” advises the supervisor.

My time has changed from then to now.

Back when I started as an “ambulance driver”, I never knew quite what I had got myself into. The name and terminology has changed, the public’s expectations have changed, the peer perception from primary and allied health services have also changed.

The most common phrase that I get from people when we meet and I divulge my occupation is “Oh you must see some terrible things!” well as “Homer” would say, “d-oh, do you think??”….. Seriously, and more politely, yes it comes with the territory. I have thought many times over the years whether there is any situation that I have not yet been to, and thankfully, and with fingers crossed, I would have to say that the terrorism mass casualty incident would probably be the only thing left on the “to-do” list.

My career started while I was working full time as a medic in the NZ Air Force, yes those were the days when we actually had an Air Force, and my interest in becoming a paramedic was probably somewhere in the gene pool. My father had been a “driver” for a while and my brother was working for the Queensland Ambulance Service, or QATB in those days. I had applied to become an Ambulance Officer when I was just 16 years of age, but was turned down by the QATB and told that I should get some “life experience” first.

I was working 30 odd hours a week with ambulance and doing my work with the Air Force at the same time, and eventually something had to give. Marched into my Flight Sergeants office, I was told, “Give up the ambulance and concentrate on the Force, or leave the Force and go work for them”. Naturally a red flag to a bull and I wrote out my resignation letter on the spot. Walking out of the office it suddenly dawned on me that, crap, I am going to have to find a new job!

I contacted the largest Service in New Zealand and thankfully the recruiting officer there was my old Air Force sergeant, and was given a position immediately.

Starting with what we used to call, rather poorly I might add, was the “spit and dribble” run. The geriatric day clinic run. Believing of course that I would never get old, and thus, never find myself in their shoes one day, the term seemed to fit the clientele perfectly.

Eventually the day came where I could work independently on the emergency “trucks”. I have heard all kinds of names for ambulances over the years, cars/trucks/meat wagons/blood baths, just to name a few.

Ambulance services across NZ and Australia were beginning to start a generation of reform, a rebirth of services and a focus on the long term future rather than the “here and now”.

“Driver’s” were now called Ambulance Officers, and there were these elite guys, just a few of them, that were called Paramedics. The name reserved for the cream of the crop, the most highly skilled boys out there. But wait… there was a few women in there as well. God forbid that in this male bastion of employment that females were allowed in! Times were changing, and not before long.

One of the first female Ambulance Officers had passed the first Paramedic course. Pauline Mellor was here name. And apart from being a trail blazer of her profession, yes this outstanding lady was a lesbian. Now admittedly, Pauline was not the lady that I would have personally had the bollocks to dare question her about this aspect of her life. I feel that at the time my life expectancy would have been measured in the milliseconds had I done so, but this lady knew her stuff and that’s all that mattered to me, and anyone else.

Being a gay, lesbian “ambo” in those days was not common. Yeah we were around, just not spoken off, not yet anyway. Boys will be boys and well, playing rugby, drinking with the lads after your shift was what mattered. The rest was not spoken of.

In 1997 I had an “inebriated” bet with my best mate that I would get into the New Zealand Police Service before he did. I fancied a change and hey, there were some hot “coppers” around. During my training I sustained a serious knee injury and my new choice of a career was now well in doubt. Thankfully I made it back and completed my training and managed to go on and work in the Special Operations branch of the Bomb Squad.

Hungering to get back to what I enjoyed more, the call was made to re-enter the ambulance service and work on the rescue chopper. Great fun, and challenging to match.

In 2001 I, along with approximately 15 others from the Christchurch area all made the decision to cross the “ditch” and join the cuzzi-bro’s. Sheep jokes, Velcro gloves,…. Yeah, yeah, have heard them all!!

I started working in the central Melbourne station based out of the St Vincent’s Hospital. I had no idea what it was like to work my butt off. The quantity of Narcan, the anti-dote for Heroin was being dispensed by the box load.

My favourite station to work from was of course Windsor, central to the gay area of Prahran, Commercial Road, yep it was “Gayville”.
A new life and a new start for me had begun. I was finally working for a service that had such a long and established existence. The Metropolitan Ambulance Service, now called Ambulance Victoria, had the longest running Intensive Care Paramedic program in Australia, and that’s what my heart was set on.

MICA’s as they are called, standing for Mobile Intensive Care Ambulance, were considered the most highly trained in Australia.

From 1989 when I started with an advanced first-aid certificate, to now having a post graduate diploma was a far cry, and world apart.

Intensive Care Paramedics have a skill set that varies from State to State, as does the majority of paramedic skills. What is applied in the State of Queensland where I work now, is different to that of the Northern Territory, NSW etc. There are many skills that I am able to perform that would normally be the domain of the emergency Dr, and most ambulance services have advanced web sites where the skill sets of their staff are detailed.

It is also important to note that where some States have ambulance subscription schemes, where by you pay for membership of your service, thus avoiding the somewhat expensive invoice that you will get if you have an ambulance arrive at your door, does not automatically mean that your subscription will be recognised in another State. For example, if you are from Sydney and you are in my State of Queensland, and need an ambulance, you will be invoiced for the Queensland ambulance irrespective of whether you have subscription, private medical insurance etc. The cost of an ambulance is a little over $1000. Some private insurance coverage will throw in ambulance, but check the fine print. They (the insurance company) may have a clause in there that states that it must be deemed as an “emergency”, not something like a twisted ankle etc.

The days have simply gone where people called for an ambulance because they or someone they called for was dying. Now days we get calls for everything, and there is an approximate increase in ambulance demand by about 4% annually. Your emergency call is answered by a professional EMD (Emergency Medical Dispatcher) and they program into the computer direct answers to the questions that you are asked. Some people get frustrated at what seems to be a long period of time that they are being asked vital questions. The reality is that the ambulance will have already been dispatched to you, and the questions are designed to ensure that the correct level of care is on the way to you.

Sadly, the number of assaults on paramedics has increased substantially over recent years. Whether this is a change in social perceptions towards paramedics or general social behaviour is unclear. Paramedics in Australia have been voted each and every year for the last 7 years as the most trusted profession conducted in a survey by Readers Digest. Something that we are all very proud of.

There are a number of things that you can do to assist your local paramedic service, whether that is a metropolitan or rural service. Firstly, stay calm!! It is understandable that its not every day that you have to call for an ambulance, but remember, your EMD is there to get the right information, the right crew and the right level of skills to you.

Make sure that you stay on the line, don’t be in a hurry to hang up. You will be told by the EMD when to do that. Getting the most accurate address, especially at night (leaving an outside light on) or if rural, getting someone to meet the ambulance at the gate of your farm, is a huge help. If you are rural, get your property’s SatNav coordinates in advance so that they can be given to a rescue chopper.

Having the patients medications that they take daily in a plastic bag is very helpful. It can be a huge source of information about a patients medical history in one simple place.

Lastly treat the crew with respect. They don’t have the luxury of having the equipment that the local emergency department has, but they will do all that they are trained for to help you.

My life has been blessed by the people that I have worked with and for. I have never had two days that have been the same at work. I have delivered 9 children, and seen many adults leave this world. But would I give it up for something else?? NEVER!!

Craig Downing
Station Officer in Charge
Intensive Care Flight Paramedic
Port Douglas Ambulance Station
Queensland Ambulance Service

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