RESPONSE - Community paramedicine in Wiluna - VOL 49 - The Australasian College of Paramedicine
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VOL 49
SUMMER 2022
RESPONSE
Community
paramedicine
in Wiluna
06 10 12 14
Community Expanding The CCP/ECP Private sector
paramedicine in paramedics’ mixed model paramedicine
Wiluna horizons
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Contents
09
We chat with Queensland Ambulance Service
Paramedic Isabella Carbone, who the College
facilitated to assist St John PNG’s COVID-19
response during a surge in cases last year
Up front 14 Opportunities, challenges and News & Reviews
professional development in
03 Message from the Chair private sector paramedicine 25 Aphra update
05 From the CEO The College 25 Te Kaumihera Manapou
Paramedic Council update
Features
16 ACPIC 2021 highlights 26 How to create a self-care plan
06 Ngangganawili Aboriginal 21 College consultations and 27 National COVID-19 Clinical
Health Service at the forefront submissions Evidence Taskforce updates
of community paramedicine
in Australia 22 C
hief Paramedic Officers a Research
necessity in holistically meeting
09 Queensland paramedic joins
PNG’s pandemic efforts
community healthcare needs 29 Talking Research: Meet the
23 C
ollege awards for paramedic College Research Committee
10 Expanding paramedics’ student excellence at Flinders
horizons University
12 The CCP/ECP mixed model
Paramedicine
Australasian College of ®
BOARD OF DIRECTORS NATIONAL OFFICE ADVERTISING ENQUIRIES consequences arising from the use The Australasian College of
Jonathon Tremain of information contained in this Paramedicine acknowledge Aboriginal
Chair – Ryan Lovett PO Box 3229 Umina Beach NSW 2257 jonathon@tremedia.com.au publication; the views and opinions and Torres Strait Islander peoples as
Vice-Chair – Marty Nichols 1300 730 450 expressed do not necessarily reflect the traditional custodians of the land
Michael Smith info@paramedics.org RESPONSE is published quarterly those of the College and its Editor, and sea in which we live and work, we
Simone Haigh ASM https://paramedics.org/ by the Australasian College of neither does the publication of recognise their continuing connection
Dr Bill Lord ACN 636 832 061 Paramedicine. Editorial and advertisements constitute any to land, sea and culture and pay our
Dr Bronwyn Tunnage ISSN 1836-2907 photographic contributions are endorsement by the College and its respects to Elders past, present
Astrid Kuisavaari welcome and can be submitted to Editor of the products advertised. and future.
Clive Addison MEMBER ENQUIRIES EditorResponse@paramedics.org All
members@paramedics.org material accepted for publication is The College acknowledge Māori
Gabrielle Follett AM COVER
subject to editing. as tangata whenua and Treaty of
EDITORIAL ENQUIRIES
CHIEF EXECUTIVE OFFICER Ngangganawili Aboriginal Health Waitangi partners in Aotearoa
Lauren Daws ©2021. The Australasian College of Service New Zealand.
John Bruning lauren.daws@paramedics.org Paramedicine. All rights are reserved.
john.bruning@paramedics.org The College and its Editor cannot
be held responsible for errors or any
RESPONSE VOL 49 SUMMER 2022 | 1
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2 | RESPONSE VOL 49 SUMMER 2022
MESSAGE FROM THE CHAIR
As paramedicine evolves,
so too must our definition
of the profession
with Ryan Lovett
Developed by Liam Langford MACPara
(@liamlangford), used with permission
Welcome to our Summer edition of We recognise the work
Response. The past decade has been of the team at Monash
a period of rapid evolution for the University and their
paramedicine profession, with para- drafting of a wide-rang-
medics increasingly taking on a range ing definition of the pro-
of duties across multiple settings in fession as a reflection of
primary, community and extended the many dimensions
healthcare beyond the provision of of paramedicine prac-
traditional ambulance-based services. tice around the world:
“Paramedicine is a
Despite the continued growth of the
domain of practice and
profession, paramedic practice and
health profession that
its place within the health system was We see this shift happening today.
specialises across a range of settings
long defined in terms of pre-hospital In rural and remote areas, doctor
including, but not limited to, emer-
care. As the profession expanded to shortages and the limited availability
gency and primary care. Paramedics
include such dimensions as extended of community nursing staff means pa-
work in a variety of clinical settings
care, aeromedical, specialised op- tients are increasingly being managed
such as emergency medical services,
erations and referral pathways, that by paramedics, who are attending to a
ambulance services, hospitals and
evolved into the more encompassing variety of patient presentations, from
clinics, as well as non-clinical roles
definition of out-of-hospital care. critical, traumatic injury to chronic,
such as education, leadership, public
However, with professional maturity complex medical syndromes in aged
health and research. Paramedics pos-
and continued evolution into areas care facilities, mental health illness,
sess complex knowledge and skills, a
of practice beyond traditional modes substance use disorders, and pallia-
broad scope of practice and are an es-
of jurisdictional ambulance services, tive and end-of-life care. They are also
sential part of the healthcare system.
framing the profession as it relates to a increasingly using their experience in
Depending on location, paramedics
hospital is acutely limiting our ability the provision of low-acuity healthcare
may practice under medical direction
to reflect the full breadth of paramedic in GP and health clinics, hospitals,
or independently, often in unsched-
practice. urgent care centres, aged care, and
uled, unpredictable or dynamic set-
other key primary health care settings,
While for the vast majority of para- tings.”
reducing costs to the health system
medics, time is spent with patients
The ongoing challenge of any defi- associated with ED presentations,
in the context of ambulance services,
nition is to make sure it accurately improving the management of chronic
and a number of those patients do ulti-
reflects who we are and what we can health conditions, and reducing early
mately end up receiving ongoing care
and will do. It is also essential that in entry into aged care.
in hospital, the continued contextual-
attempting to define us and be as in-
isation of paramedics in relation to a As paramedicine continues to advance
clusive as possible, that we don’t unin-
hospital is becoming less appropriate as a profession, we need to ensure
tentionally limit ourselves in the way
with every passing day. As the profes- that our definition of the profession
pre-hospital and out-of-hospital does
sion continues to evolve, so too must encapsulates the depth of paramed-
today. Definitions can also serve to be
our definition of paramedicine to fully ics’ professional experience and skills
aspirational, providing the prompt to
encompass the totality of current and now and into the future. We welcome
ourselves, our peers, our partners and
future paramedic practice, and to en- further discussion on this issue, and
our regulators to provide the opportu-
sure that paramedics are accepted as always seek your opinion on how we
nity to chart our own path.
an integral and integrated component define our profession.
of the health system. RESPONSE VOL 49 SUMMER 2022 | 3
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FROM THE CEO FROM THE CEO
Leadership
objectives for 2022
with John Bruning
In November’s Response I focused on may ultimately end up being in the Workforce survey and
the College’s efforts in advocating for allied health group, there is an oppor- career pathway
our members and the profession. This tunity now to advocate for paramedi-
The data on paramedicine is currently
time I want to lay out what we have cine as a standalone health profession
disjointed and unsuited to highlighting
planned in 2022 in leading and advo- alongside medical and nursing.
the important role paramedics play in
cating for paramedicine.
the health system. It is vital that the
“
Chief Paramedic Officers College addresses this.
An important focus
Last year we produced our first major this year will be to clearly We will be undertaking a significant
position statement as a College on workforce survey this year covering
Chief Paramedic Officers (CPOs) and establish where paramed- all facets of paramedicine, all work
have engaged with all jurisdictions ics fit within the health and employment areas (jurisdictional
about the introduction of this role (ex- services, private, industrial, maritime,
cept Victoria where one is already in system and highlight mining, events, etc.), academia, man-
place). We will continue our efforts in the broader ways that agement, students, graduates, and vol-
this area and advocate for strong para- unteers. Our goal is to create a complete
paramedics can mean-
”
medic representation. Our advocacy picture of paramedicine and provide
for a CPO in Aotearoa New Zealand will ingfully contribute usable and publishable data to show
start with a similar position statement, what is happening with paramedics
to be released soon. and students and the work you do.
Community Paramedicine
The role of paramedics This data will help the College create a
A key focus for us is expanding the
in the health system Paramedicine Career Framework that
roles and opportunities for paramed-
will define pathways and opportunities
Throughout 2021, as we engaged with ics outside of emergency response,
for paramedics and students across all
stakeholders, it became evident that mainly in primary care as community
areas of paramedicine in 2023.
there was no clear understanding of the paramedics. While advocating for this
role paramedics can play in the wider expansion, we remain focused on the Student paramedics
health system. Generally, paramedics fact that you trained to be and wanted
The learning environment has been
aren’t considered beyond emergency to be paramedics, so any such expan-
particularly difficult for our student
response, so an important focus this sion needs to retain the core aspects of
paramedics in the past two years.
year will be to clearly establish where paramedicine.
Before COVID, there was significant
paramedics fit within the health system
Regarding paramedic practitioners, competition for employment with more
and highlight the broader ways that
while the College recognises that there graduates than available roles, chal-
paramedics can meaningfully contrib-
is a future opportunity for independent lenges with effective placements, and
ute to the health system.
paramedic practice (potentially with varied internships and development
There is also debate about whether prescribing rights), there is consid- provided by employers. While some
paramedicine should be in allied erable work to be done before this changes may flow from the pandemic
health or a standalone health profes- becomes a government consideration. experience in these areas, we will be
sion. There are some immediate ben- The College will continue to execute focused on advocating for how the pro-
efits to being in allied health, but also a strategy that ensures the greatest fession sets up graduates for success.
longer-term issues with paramedicine possible recognition for paramedics
Stay safe and well.
being appropriately recognised if we across emergency, community and
are considered allied health. While we primary care. RESPONSE VOL 49 SUMMER 2022 | 5
FEATURE
Ngangganawili Aboriginal NAHS is the only
Health Service at the Aboriginal Medical
Service in Australia
forefront of community to utilise community
paramedicine in Australia paramedics
Wiluna Shire, Martu Country staff and on-call nurses. However, ral stations, many mine sites and two
they were only able to the provide major transit and tourist routes, this
In the vast desert country of central
the level of care stipulated under the proved to be inadequate.
Western Australia, the Ngangganaw-
St John volunteer system, such as
ili Aboriginal Health Service (NAHS) In response to the challenges, the
the issuing of over-the-counter med-
in Wiluna Shire is pioneering an NAHS adopted a community para-
ications and no invasive procedures.
innovative model of community medic model, encompassing emer-
paramedicine that capitalises on the gency response, primary healthcare
“
unique skill set of paramedics to pro- and preventive healthcare. It is the
vide a more holistic and integrated The role of community only Aboriginal Medical Service in
approach to remote healthcare. paramedicine is well Australia utilising community para-
medics.
NAHS Community Paramedic Gary established overseas and
Pyle said the NAHS was contracted “The community paramedics are
is one that is in great need
”
by the WA Department of Health to primarily employed for emergency re-
provide comprehensive accident and here in Australia. sponse,” Gary said. “However, emer-
emergency services. Initially, the gency response is only a small part
ambulance response fell under the St of what we do. Most of our workload
John volunteer system and was pre- Given the shire’s large geographical is general clinic-based, general GP-
dominantly undertaken by support area, encompassing multiple pasto- style presentations, similar to how a
6 | RESPONSE VOL 49 SUMMER 2022
military or mine site medic operates,
only in a town. We also find ourselves
working as an extension of the clinic
staff, going out to the community and
surrounding areas and providing in-
home treatment, ranging from simple
dressings to IV AB’s.”
The benefits of this model include
better community integration and
continuity of care.
“As we are out in the community a
lot, we found that we have built a
good rapport and the divide/ barrier
between clinic and community is
lessened. This helps a lot with health
promotion, as evidenced by our
higher-than-average covid vaccine
numbers (more than 80% double
vaccinated). When education is con-
veyed via an informal chat, people
are more open and receptive.”
In terms of continuity of care: “Gener- stipulated by St John. Imagine if these
ally, once we collect a patient, we will roles were supplemented with an
then transfer them to the clinic and extended care paramedic; that high
assume the role of primary treatment level of initial paramedic response
provider. These treatments are gener- would be enabled on scene then con-
ally at a level higher than most nurs- tinued through into the clinic.”
es’ training but lower than the doctor, He said the first step would be the rec-
so there is no stepping on toes.” ognition of paramedic practitioners
Procedures include advanced wound as a field of specialisation, in the
closing and suturing, X-rays and cast- same manner as nurse practitioners,
ing, pathology collection, processing, one that is registered and regulated
as its own specialty. “As many on-road paramedics will
and interpretation.
attest, so many calls could be easily
“There is a reason the paramedic pro- treated in home and not transported,
fession is the specialty field that it is.” if allowed the scope, tools and time. I
“
personally believe it is inevitable that
Gary said the community paramed-
icine model could be replicated in
There is a reason the this role will be formalised here in
paramedic profession Australia soon. If so, this could pro-
other parts of Australia, particularly
vide an avenue for those paramedics
in rural and remote areas of the is the specialty field wanting a change of pace but not
”
country, providing opportunities for
the expansion of roles for paramedics that it is. wanting to leave the profession.”
within the health system. For students/graduates and working
paramedics wanting to embark on
He said that like Wiluna, many small
“We already have the qualification such a career pathway, he recom-
towns had small clinics or Silver
and training framework available at mended exploring extended care
Chain nursing posts, and experi-
many universities. Once recognized, paramedicine studies available at
enced the same health service chal-
the role would then be able to be many universities.
lenges. In the event of an emergency,
a nurse from those clinics responded put forward to some of these clinics “Regardless of your current area of
with volunteers to assist. The major as it is easily comparable and inter- work, you will still learn advanced as-
issue, however, was the authority to changeable.” sessment tools and gain a better un-
practice. He said the role of community para- derstanding of many chronic health
medicine was well established over- issues and treatment pathways.”
“The nurse is not cleared outside their
clinic, and they are only permitted to seas and was one that was in great
work to the level of the volunteer as need Australia.
RESPONSE VOL 49 SUMMER 2022 | 7
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8 | RESPONSE VOL 49 SUMMER 2022Queensland UP CLOSE
paramedic joins
PNG’s pandemic
efforts
Heeding the call for support, Isabella
Carbone headed to PNG to assist St
John’s COVID-19 response during a
surge in cases
Queensland Ambulance Service Ad- ing from backing up crews on cases, She said St John was extremely sup-
vanced Care 2 Paramedic Isabella Car- aeromedical evacuations of patients portive in helping overcome those
bone, who is based at Durack station in different provinces, and providing challenges.
in south Brisbane, spent six weeks on education for ambulance officers on
“The local ambulance officers were
the frontlines of Papua New Guinea’s COVID-19, particularly in relation to
very welcoming and receptive to ed-
emergency medical response in mid- PPE.
ucation. They really taught me about
2021 as the country grappled with a
“During the period between waves, I their culture and language. Jacquie
rapid surge in COVID-19.
was also helping St John to complete Hennessy, the Chief of Clinical Opera-
Seeking a challenge, she had re- vital projects that they had to put tions, was also available by phone or
sponded to the College’s expression on the backburner during the large in person 24 hours a day if I needed
of interest in facilitating paramedics COVID outbreaks.” advice about a case.”
to assist St John Ambulance PNG in
She said the biggest challenge was After her six-week stint, Isabella con-
the provision of medical support as
learning about the infrastructure and tinued to work remotely for St John
rising case numbers placed growing
capability of the health system in PNG while in hotel quarantine. She
pressure on the medical system and
PNG and how it differed from that in said her time in the country was one
strained health staff and infrastruc-
Australia. of her best work experiences.
ture across the country.
“It was fantastic being able to work
“
“I jumped at the chance to travel to
I jumped at the chance with not only other health profession-
another country and work during the
als from around Australia, but also to
pandemic,” she said. “I didn’t really to travel to another work directly with the local ambu-
have any expectations when I went
over as everything associated with country and work during lance officers. The local community
”
were very friendly and welcoming;
COVID had been moving so quickly; it the pandemic. it made being away from home a lot
was difficult to tell what it was going
easier.”
to be like when I landed.”
She encouraged other paramedics to
When she arrived in Port Moresby on
“Their common cases were also very undertake emergency response work
June 1, she found St John had set up a
different to the frequent cases we in other jurisdictions.
large field hospital next to its station
would get at home. Traumas like as-
to support hospitals in the area. It “Not only was the work interesting,
saults with weapons and extremely
was about to be dismantled, but as challenging and fulfilling, but learn-
serious motor vehicle accidents were
case numbers increased, they began ing about another culture, meeting
common, as was obstetrics, so that
providing COVID tests and reutilising new people, and exploring another
was a challenge for me professional-
the facility. country on days off was a privilege as
ly, as we don’t have much exposure to
well.”
The work she undertook varied, rang- that work in Queensland.”
RESPONSE VOL 49 SUMMER 2022 | 9FEATURE
Expanding
paramedics’
horizons
Paramedic David McLeod is advocating for
greater scope for the paramedicine profession
Sydney, Gadigal Country
As an advocate for the expansion of
roles for paramedics beyond tradi-
tional ambulance-based duties in
Australia, Paramedic David McLeod,
Clinical Governance and Medical
Response Manager with Crown
Resort Sydney, is keen to see the
development of more specialisation
pathways to enable the profession
to better respond to health system
needs, gaps, and priorities.
David said paramedics had the capa-
bility to reduce pressure on both the
health system and on other health-
care professionals by utilising their
extensive out-of-hospital experience
in reducing patients’ reliance on the
hospital system, and by becoming
part of multidisciplinary medical
teams that would improve patient
health outcomes.
“ It’s amazing the
misunderstanding that
still exists throughout
the healthcare industry works (PHNs) in reviewing current undertake clinical assessments and
on what paramedics are after-hour services and examining provide emergency and non-emer-
”
capable of doing. new models of care. Initially, the gency treatment.
majority of the work was focused on
“It’s amazing the misunderstanding
In the past 12 months, he has been educating healthcare managers and
that still exists throughout the health-
involved with Primary Health Net- senior clinicians about the ability of
care industry on what paramedics are
paramedics to safely and effectively
10 | RESPONSE VOL 49 SUMMER 2022FEATURE
capable of doing, as well as the edu- “Even post-registration, there is still assessment and commencing refer-
cation and training the paramedics an internal struggle about the defini- rals isn’t new to our profession.
undertake compared to 20 years ago,” tion of paramedics and still the belief
“Let’s take this a step further; while
he said. that paramedics ‘scoop and run’ to
paramedics are doing those tasks,
hospital. Some of our own clinicians
“Once these misunderstandings were they’re uploading this information to
still believe that all patients are better
dismissed, healthcare managers and the medical centres’ patient records
cared for in hospitals and that para-
clinicians rapidly opened up to look- and requesting pathology (even radi-
medics are only capable of ‘using
ing at where paramedics can fit in ography if needed), all in the comfort
diesel’ when providing care. How do
to assist with after-hours services in of the patient’s home. The next day,
we expect other healthcare profes-
metropolitan, regional and rural ar- their regular GP is notified that there
sions or policymakers to understand
eas. It quickly became apparent that are notes and results to be reviewed.
that paramedics are capable of work-
due to the unique training, education
ing outside of traditional roles if we “GPs review those results in conjunc-
and experience of paramedics, they
continue to struggle with the idea tion with the paramedics’ clinical,
had the potential to offer improved
ourselves?” ADL and environment assessment
patient assessment, treatment
and are able to tweak the patient’s
and referrals within the after-hours He said support was also needed from
treatment plan or medications. What
setting.” academia to undertake research and
impact could this have on the patient?
studies on the ways in which para-
He said these sectors were entering a It could improve quality of life, reduce
medics can reduce pressure on the
modernisation phase in the way they potential hospital admissions, reduce
healthcare system, and in ensuring
provided contemporary healthcare, pressure on emergency services, and
that paramedics have the necessary
with growing recognition that para- assist in ensuring that the correct
skills and capabilities to safely and
medics were well-placed clinicians multidisciplinary care is being pro-
effectively treat patients in primary
able to provide primary healthcare vided to the patient. This is just one
heath and community settings. Doc-
services to the aged care and dis- idea of how one model of community/
tors and nurses could also assist in
ability sectors, brought unique clin- primary health paramedicine can
advocating in both the public and
ical experience to multidisciplinary have a positive impact on the wider
private sectors.
healthcare teams, and could assist healthcare system, and most impor-
in providing advanced autonomous “Having the support of associations tantly on patient outcomes.”
clinical care in patients’ homes, par- like the Royal Australian College
Paramedicine education was also
ticularly after hours. of General Practitioners will have a
evolving to encompass more profes-
sional specialisation pathways, with
“
a number of universities shifting from
There is still an internal struggle about the an emergency clinician focus towards
definition of paramedics.
”
the development of all-round under-
graduate clinicians, and postgradu-
ate courses similarly were starting to
His advocacy work and discussions offer Extended Care and Community
massive impact on future policy and
with PHNs have resulted in para- Paramedicine courses as they adapt-
legislative changes that could impact
medics being included in modellings ed to the changing needs of patients.
primary health paramedics.”
of remote and rural primary health
“Continuing to make changes in not
services outside of the traditional With that support, he said those dif-
only the course context but also in
jurisdictional ambulance service set- ferent models of care could easily be
assessment scenarios will help de-
ting, and has begun to challenge the replicated throughout metropolitan,
velop well-rounded clinicians and
thinking of policymakers. regional and rural Australia with
help with the internal sigma of para-
minimal modifications to meet juris-
However, he said that before ap- medics only being skilled to work for
dictional needs.
proaching government and pushing statutory services.”
for professional practice changes, “Imagine paramedics being embed-
there was a need for internal advo- ded into medical centres and under-
cacy and re-education within the taking home visits. The experience
paramedicine profession on the roles that paramedics have in assessing
paramedics could play within the patients in their homes and initiating
community. treatment while undertaking an ADL
RESPONSE VOL 49 SUMMER 2022 | 11FEATURE
The CCP/ECP
mixed model
Aotearoa New Zealand “I struck up a conversation with him
about having a Critical Care/Extend-
Advanced Health Care A fortuitous meeting in the middle of
ed Care Paramedic mixed model
the night during Aotearoa New Zea-
Practitioner Jack Faxon land's first lockdown in 2019 lay the
staff member in his clinic as part of a
multidisciplinary team. He loved the
Jr pushes for a new groundwork for the development of a
new direction in paramedicine in the
idea, and it grew from there.”
direction for the para- country. Jack submitted a proposal, and he, Dr
Patel, City Medical General Manager
medicine profession in Jack Faxon Jr, then a St John Inten-
Leanne Mandeno and Clinical Nurse
sive Care Paramedic, was waiting in
Aotearoa New Zealand the carpark at Hawke’s Bay Hospital
Manager Rowan Plater then worked
to make the concept a reality, con-
about 1:45am while his partner
sulting with their Board of Directors,
finished paperwork when hospital
other clinic staff and doctors across
consultant Dr Umang Patel, an
Aotearoa New Zealand, and research-
emergency physician and Medical
ing other countries' programs. A year-
Director at urgent care centre City
and-a-half later, he began work at
Medical, came outside to say hello.
City Medical as an Advanced Health
Care Practitioner.
12 | RESPONSE VOL 49 SUMMER 2022“My current role is that of a Critical now well accepted in his role and is
Care and Extended Care Paramedic. treated equally as a colleague.
We decided on the term Advanced
Jack is eager to see the Advanced
Health Care Practitioner with the
Health Care Practitioner model rolled
hopes that this will become the stan-
out across the country to benefit the
dard for the paramedic practitioner in
national health system. He said a pa-
the country.
per was recently submitted to Interim
“Although there have been a few reg- Health New Zealand that focused on
istered nurses who have cross-trained the incorporation of paramedicine
as paramedics/ICPs and the odd ECP, into all facets of healthcare, which
to my knowledge this is the first clinic was met with positivity and was in
in Aotearoa New Zealand to develop the process of being discussed.
the CCP/ECP mixed model.”
In the interim, opportunities for
It was a concept that he became inter- paramedics to undertake different
ested in exploring in his postgraduate roles in the paramedicine profession
studies at Auckland University of in Aotearoa New Zealand remain lim-
Technology while studying commu- unwell, I am to diagnose and treat ited. Some paramedics were working
nity and remote paramedicine. them as I previously had in the ambu- in GP and urgent care clinics, some in
lance service. I am also able to help palliative care, and some in emergen-
“There was a group of us that all of
the nurses and doctors if they need a cy departments, although most were
a sudden had all of this knowledge
hand with anything. not being used to their full potential.
and ability, but due to practice lev-
els changing, we weren’t allowed to “I still see the same patients as in an
“
practice any of the treatments we had ambulance, just in a different setting.
learned.” I have everything available to me I’m hoping this will
in the clinic: Nurses, doctors, labs, create a set standard
”
x-rays, additional medications, and a
that we all work to.
“ To my knowledge, pharmacy on site. A big difference is
that I only work eight-hour shifts. Tra-
this is the first clinic in ditional ambulance staff in Aotearoa
Aotearoa New Zealand New Zealand work 12 hours. This has “With registration only being new
been great for family life, and the fact here, I think there will be a national
to develop the CCP/
”
I don’t work nights I think has added shift to fill gaps that paramedics are
ECP mixed model. about another 15-20 years to my life.” qualified for but have never been
considered for. With specialist reg-
The shift to this mode of paramedic
istration set to happen in the near
practice has not been without its
future, I’m hoping this will create a
The chance meeting with Dr Patel challenges, including accepting a
set standard that we all work to.”
enabled his vision to take shape. In larger amount of risk when treating
his position as Advanced Health Care and discharging patients, and discov- Jack has offered his assistance and
Practitioner, he is responsible for ering areas in which his knowledge guidance for other paramedics,
assessing and treating patients that is lacking due to a lack of exposure students and graduates with similar
present to the clinic. to such things as interpreting lab aspirations.
results and converting that informa-
“Dr Patel and I decided that I would “Umang, Leanne and I have agreed
tion into diagnoses. To overcome the
not just pick patients that I could treat that if someone is in need of advice or
challenges, he has worked closely
within my scope of practice, but that I a discussion about some of the chal-
with the clinic’s nurses and doctors
would see all patients who presented. lenges, we're keen to help where and
and furthered his education through
This has helped with expanding my when we can.”
extensive research.
assessment in the low-acuity space,
Jack can be reached at ahcp.jfaxon-
and if a patient presents and I need And while he said the nurses and
jr@gmail.com; Leanne at leanne@
a hand with medications or a diag- doctors he worked with or to whom
citymednapier.co.nz.
nosis, I discuss it with the doctors on he referred patients initially were
duty. If a patient comes in critically hesitant in trusting his abilities, he is
RESPONSE VOL 49 SUMMER 2022 | 13Opportunities,
challenges and
professional
development in
private sector
paramedicine
After graduation, paramedic
Georgia Sirec is honing her
skills in private practice
Sydney, Gadigal Country
After graduating from Western Syd-
ney University with a bachelor’s
degree in Health Science (Paramed-
icine) in January 2021, paramedic
Georgia Sirec has embarked on a
career in the private sector as part
of the Cynergex Group’s Safety and
Emergency Response Team, a profes-
sional trajectory that has proved both
challenging and rewarding.
Georgia, who currently works across
two sites at the Star Sydney casino
complex and the DP World Port Bot-
any terminal, began her job search in
2020, initially seeking work through
NSW state service recruitment, but
found that opportunities were limit-
ed. She turned to more general online
job sites, searching for paramedic
and graduate paramedic positions.
14 | RESPONSE VOL 49 SUMMER 2022“At the time, only a few roles came needed to explicitly request items vided a range of professional devel-
up, but I applied for them,” she said. and inform them of plans of action. opment opportunities and the chance
“I mostly got calls asking whether to work in different settings. She said
“You must move away from the use of
I had registration yet; as I did not, most companies offered a variety of
jargon and used closed loop commu-
most said contact us when you do. in-house training and had a prede-
nication. This is very different from
Cynergex, however, invited me for an termined scope for different levels of
how we train at university; the major-
interview and clinical assessment. training. For volunteering opportuni-
ity of the time we’re paired, and ev-
After successfully completing those, ties, she highly recommended St John
eryone has the same knowledge. It’s
they held a position open for me Ambulance.
a big adjustment, but I have become
to start after the completion of my
better at bystander management and “I joined in 2020 and it has been a
course.”
have stronger situational awareness great experience thus far, both for my
as I need to know what everyone is clinical skills but also for networking.
doing.
“
“Most companies understand that
Our skill sets can be “In my role, we generally respond the private sector is not your big plan,
used in a variety of set- with a backpack that carries first aid but ensure you make the most of your
tings… with registration equipment, a defibrillator and ob- experience. Any clinical experience is
”
servation gear. We also have oxygen, highly favoured on a resume, and you
we can branch out. masks and igels. This means that must have a good reference to accom-
while we are well equipped, we do pany it. Every opportunity you get is
have limited equipment at the point a great chance to learn. Think outside
of care, so we must be resourceful traditional paramedic roles. Our
She began in a part-time role before
when treating patients. If a patient skill sets can be used in a variety of
quickly progressing to full-time
needs something I can’t provide, I settings, including first aid training,
employment, with her job predom-
have to either call an ambulance or in-school health clinics, in a primary
inantly focused on work-related
refer them to an appropriate service. care setting, GP clinic, even risk-man-
injuries, from strains and sprains
This is also a change to how we were agement roles. With registration we
through to major trauma events such
trained; at university we had a set can branch out.”
as falls from heights. Working at an
scope, so moving away from what
international shipping terminal, she Georgia is also currently studying
was considered standard is difficult.”
also responds to shipboard incidents,
“
and her work at The Star Sydney sees In addition to her professional
her providing care for all patrons and growth, she said the benefits of hav- Every opportunity
staff on site. ing paramedics on sites as “an extra you get is a great
”
triage step” helped to alleviate pres-
“This can be incredibly challenging
sure on ambulance services and the chance to learn.
as it's possible to have more than one
broader healthcare system.
patient at a time. You see everything
here: Strains/sprains, burns, suspect- “We are qualified to decide whether
at Western Sydney University for a
ed drug overdoses, cardiac arrests, this person needs an ambulance, can
Master of Research in paramedicine
even minor electrocution. With the make their own way to hospital or be
degree, and has completed a Certif-
pandemic and many lockdowns, referred to their GP. Additionally, with
icate IV in Leadership and Manage-
we have also seen a spike in mental work-related injuries we have the op-
ment and is working on completing a
health-related presentations.” tion to refer them to a physiotherapist
Certificate IV in Training and Assess-
or a healthcare provider specialising
Working individually also proved ment. Her future career aspirations
in occupational injury management.
challenging, but she said it enabled are to become a qualified paramedic
This also helps to alleviate the bur-
her to build confidence and learn to researcher and working towards a
den on the healthcare system.
trust her instincts, and had bolstered PhD, an Extended Care Paramedic or
her communication skills. This was “Having a paramedic on site that has Paramedic Practitioner, and taking
particularly important in her duties referral capabilities allows the staff to up a training role either as a clinical
at The Star Sydney, where she worked have any injury assessed immediately educator or a university academic
with a security team when respond- and minimise long-term complica- in paramedicine or broader health
ing to incidents. While staff generally tions from not being quickly seen to.” sciences.
had a first aid or advanced first aid
She said a career in private sector
certificate, good communication was
paramedicine was an option that pro-
RESPONSE VOL 49 SUMMER 2022 | 15WRA
PU P
ACPIC
2021
What will you decide? #ACPIC2021
74 SPEAKERS The second annual ACP International Conference
was held in a hybrid format from 25-26 November. We
welcomed more than 400 online attendees, as well as
71 PRESENTATIONS delegates who joined us in person on day two in Hobart
and on the Sunshine Coast.
35 RESEARCH PRESENTATIONS This year’s conference theme, “What will you decide?”,
provided attendees with a range of presentations to
challenge thinking, explore changes in practice, and
13 POSTER PRESENTATIONS showcase the latest in pre-hospital research.
The conference started with keynote speaker Ant Wil-
liams, who has swum 223 metres on a single breath,
“
freedived to 100m, and held his breath for eight min-
The knowledge and experience of utes. Ant’s keynote session discussed techniques for
the speakers complemented each other performing under pressure.
well. Their passion was contagious, Day two started with the “Best of the Best” research
and I felt so inspired and excited about presentations and was followed by in-person presenta-
tions in Hobart and on the Sunshine Coast (which were
paramedicine as a growing profession also livestreamed). The program covered a broad range
after hearing them speak. Love them of paramedic practice with presentations, workshops
and discussions featuring clinical and operational
all and love what they do. I could have
”
topics such as ramping, referral pathways, critical liter-
listened to them for hours. – Attendee ature appraisal, health system pressures, and a variety
of interesting and unique clinical case studies.
16 | RESPONSE VOL 49 SUMMER 2022WRA
PU P
Some of the most interesting sessions were: To our in-person moderators: Alex Ball, Lucy Oatley, Hay-
ley Grant, Stuart Cook and Kirsty Mann.
• Industrial action and “controversial” service policy in
the context of professional responsibility under registra- Finally, a huge thank you to Lead Event Manager Georgia
tion, by Ruth Townsend Coetzee, supported by our College staff.
• The hijacked ambulance – amygdala activation in para- Thank you to our event partners Laerdal and Guild In-
medic care, by Sunny Whitfield surance, and our event sponsors Edith Cowan University,
Charles Sturt University, Zoll, Noble Oak, and Medical
• Adverse events from nitrate administration during right
Developments International.
ventricular myocardial infarction: A systematic review
and meta-analysis, by Matt Wilkinson-Stokes
MISSED THE CONFERENCE?
THANK YOU Session recordings are available on the College website
under Online Courses. Recordings are free for College
We would like to acknowledge those who made this event
members: https://paramedics.org/courses
possible.
Thank you to the conference organising committee: Jamie EVENT PARTNERS EVENT SPONSORS
Rhodes-Bates, Lucy Oatley, Alannah Morrison, Andrew
Odgers, Craig Campbell and Tim Andrews.
To the Scientific Research Committee: Dr Linda Ross, Dr
Louise Reynolds, Dr Nigel Barr and Harry Reeves, as well
as all the abstract reviewers.
To our session chairs: Michelle Murphy, Lindsay Mack-
ay, Brendan Shannon, Robin Pap, Tim Andrews, Lauren
Clothier, Louise Reynolds, Linda Ross, Laura Wirth, Stuart
Cook, Paul Simpson, Sascha Baldry, Lucy Oatley, Alecka
Miles and Hayley Grant.
To our facilitators: Levi Karschimkus, Andrew Odgers,
Julie Johnson, Laura Wirth, Kirsty Mann, Chris Campbell,
Alex Ball and Alannah Morrison. RESPONSE VOL 49 SUMMER 2022 | 17ACPIC ACPIC 2021
2021
AWARD WINNERS
What will you decide? #ACPIC2021
The College is committed to supporting and promoting paramedic research, and it was pleasing
to see more than 30 research sessions presented at this year’s conference, as well as a portfolio of
research posters that are available on the conference platform (https://paramedics.org/acpic2021/
posters). We extend our congratulations to all who submitted abstracts and delivered their research.
We would also like to congratulate the following research award winners:
BEST RESEARCH POSTER BEST 5-MINUTE THESIS
PRESENTATION PRESENTATION
Brian Haskins – Caitlin Wilson –
Cardiac arrests in Enhancing pre-hospi-
general practice tal feedback for emer-
clinics or witnessed gency ambulance staff
by emergency medical to promote workforce
services: A 20-year wellbeing and patient
retrospective study safety: A mixed-meth-
ods multiple sub-
study PhD project
BEST ORAL RESEARCH BEST OF THE BEST RESEARCH
PRESENTATION PRESENTATION
Tegwyn McManamny Matt Wilkison-Stokes
– Pre-hospital health – Adverse events from
initiatives to reduce nitrate administration
the potentially during right ventricu-
preventable hospi- lar myocardial infarc-
talisation of older tion: A systematic
people in rural and review and meta-anal-
regional Australia: A ysis. As the Best of
growing opportunity the Best winner, Matt
is able to present his
research at this year’s
EMS999 conference.
18 | RESPONSE VOL 49 SUMMER 2022Alisha McFarlane Over 500 online courses
RE-ENTRY TO
RE-ENTRY TO PRACTICE
PRACTICE
(PARAMEDICINE)
RE-ENTRY TO PRACTICE
(PARAMEDICINE)
(PARAMEDICINE)
RE-ENTRY TO PRACTICE
(PARAMEDICINE)
This course is suitable for those who have graduated for more than two years and not
This course is suitable for those who have graduated for more than two years and not
practiced, if your registration has lapsed, or you are still registered but have had a break
practiced, if your registration has lapsed, or you are still registered but have had a break
from the workforce,
This course is suitableor shifting
for thosefrom
whoone have area of practice
graduated for to another.
more than two years and not
from the workforce, or shifting from one area of practice to another.
practiced, if your registration has lapsed, or you are still registered but have had a break
from the workforce,
OVERVIEW
This course is suitableor shifting
for thosefrom
whoone
ASSESSMENTS
have area of practice
graduated for to another.
more2022 INTAKE
than two years and not
OVERVIEW ASSESSMENTS 2022 INTAKE
practiced,
To prepare forifpractice
your registration
this eight- has lapsed,
Formative andor you areMCQ,
summative still registered
Course but have
1: 7 Feb - 1 had
April a break
To prepare for practice this eight-
OVERVIEW Formative
ASSESSMENTSand summative MCQ, Course 1: 7 Feb - 1 April
2022 INTAKE
fromcourse
week the workforce,
enables you or shifting and
to build
week course enables you to build
from one
short areaassessments.
answer of practice to another.
Course
and short answer assessments.
2: 2 May - 24 June
Course 2: 2 May - 24 June
your knowledge, skills, experience Clinical competency of Course 3: 18 July - 9 Sept
To prepare
your knowledge,for practice this eight-
skills, experience Formative
Clinical and summative
competency of MCQ, Course3:1:18
Course 7 Feb
July--19April
Sept
and may help you prepare to meet psychomotor skills, tasks and safe Course 4: 10 Oct - 2 Dec
week
and may
OVERVIEWcourse
help enables
you you
prepare build
to meet and short
psychomotor
ASSESSMENTS answer assessments.
skills, tasks and safe Course
Course 2:
4: 10
2022 INTAKE 2 May
Oct -
- 224
DecJune
the requirements of registration as competent practice of clinical
yourrequirements
the knowledge, skills, experience
of registration as Clinical competency
competent practice ofofclinical Course 3: 18 July - 9 Sept
a
To paramedic
prepare forinpractice
Australia. This
this eight- simulations.
Formative and Theoretical
summative MCQ, 1: 10
7 Feb
and may help you prepare
a paramedic in Australia. This to meet psychomotor
simulations. skills, tasks and
Theoretical safe Course 4: Oct- -12April
Dec
course
week will include
course enables a combination
you to buildas of assessment
and short will
answer beassessments.
undertaken Course 2: 2 May - 24 June
the requirements
course will include of registration
a combination of competent practice
assessment of clinical
will be undertaken LOCATION
online
your and on-campus
knowledge, learning
skills,learning
experience online,
Clinical while all practical
competency of skills and LOCATION
Course 3: 18 July - 9 Sept
a paramedic
online in Australia.
and on-campus This simulations.
online, while allTheoretical
practical skills and
including
and may practical
help skills,
you skills,
prepare to meetof clinical scenarios
psychomotor willtasks
skills, be undertaken
and safe Notting
Course 4:Hill,
10Victoria
Oct - 2 Dec
course
including will include
practical a combination assessment
clinical will
scenarios be
willundertaken
be undertaken Notting Hill, Victoria
simulations,
the requirements and assessments.
of registration face-to-face. LOCATION
online and on-campus
simulations, and assessments.learning as competent
online, whilepractice
face-to-face. of clinical
all practical skills and
a paramedic
including
The course in Australia.
practical
will cover the This
skills, following simulations.
clinical Theoretical
scenarios will be undertaken Notting Hill, Victoria
The course
course will
simulations, will cover
include the following
assessments. of
a combination
andFoundations, assessment
face-to-face. will be undertaken
eight modules: COST
eight
onlinemodules: Foundations,
Cardiology, Respiratory,learning
and on-campus Trauma, CLASSES
online, while all practical skills and LOCATION
COST
The course
Cardiology, will cover
Respiratory, the following
Trauma, CLASSES
including practical
Medical, Paediatrics skills,
and clinical scenarios will be undertaken $2650 Notting Hill, Victoria
eight modules: Online theoretical classes will be
Medical,
simulations,
Obstetrics, andFoundations,
Paediatrics
Transition
and
assessments.
to Practice, face-to-face.
Online
CLASSES theoretical classes will be $2650
COST
Cardiology,Transition
Obstetrics, Respiratory, Trauma,
to Practice, held Monday to Thursday, while Completing the Re-entry to Practice
SWOTVAC and Final Assessments. held Monday to Thursday, while Completing the Re-entry to Practice
The
SWOTVACcourse
Medical, willFinal
Paediatrics
and coverAssessments.
the following
and practical classes will be delivered $2650
(Paramedicine) course may help
Online theoretical
practical classes willclasses will be
be delivered (Paramedicine) course may help
eight modules:
Obstetrics, Foundations,
Transition to Practice, online and face-to-face every Friday prepare COST you to meet the registration
held
online Monday
CLASSES to Thursday,
and face-to-face while
every Friday prepare
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you to themeet
Re-entry to Practice
the registration
Cardiology, and
SWOTVAC Respiratory, Trauma,
Final Assessments. from 10am-3pm. requirements and practice as a
PREREQUISITES practical
from classes will be delivered
10am-3pm. (Paramedicine)
requirements and course
practicemay ashelp
a
Medical, Paediatrics and Online theoretical classes will Friday
be $2650
paramedic in Australia.
PREREQUISITES online and face-to-face every prepare you
paramedic in to meet the registration
Australia.
Obstetrics, Transition to Practice, held
All applicants must hold a Bachelor from Monday
10am-3pm. to Thursday, while Completing the
requirements andRe-entry
practicetoasPractice
a
SWOTVAC
All applicantsand
PREREQUISITES mustFinal
holdAssessments.
a Bachelor REGISTRATION
practical classes will be delivered
of Paramedicine or Bachelor of REGISTRATION (Paramedicine) course
paramedic in Australia. may help
of Paramedicine or Bachelor of online and face-to-face every Friday prepare you to meet the registration
Nursing/Paramedicine or monash.edu/medicine/spahc/paramedicine/short-
All applicants must hold
Nursing/Paramedicine or a Bachelor from 10am-3pm.
equivalent. monash.edu/medicine/spahc/paramedicine/short-
REGISTRATION requirements and practice as a
of Paramedicine
equivalent.
PREREQUISITES or Bachelor of courses
courses Contact Us
paramedic
Nursing/Paramedicine or ContactinUsAustralia.
monash.edu/medicine/spahc/paramedicine/short- Professor Brett Williams,
All applicants must hold a Bachelor
equivalent. courses
REGISTRATION Professor
Contact Brett
Us Williams,
brett.williams@monash.edu
of Paramedicine or Bachelor of brett.williams@monash.edu
Nursing/Paramedicine or Ph: 03 9904 4283
monash.edu/medicine/spahc/paramedicine/short-
Ph: 03 9904Brett
Professor 4283Williams,
equivalent. courses brett.williams@monash.edu
Contact Us
Ph: 03 9904 4283
CRICOS provider: Monash University 00008C.
Professor Brett Williams,
CRICOS
Monashprovider: Monash
College Pty University 00008C.
Ltd 01857J.
monash.edu/medicine/spahc/paramedicine/home Monash College Pty Ltd 01857J.
brett.williams@monash.edu
monash.edu/medicine/spahc/paramedicine/home
Ph:provider:
CRICOS 03 9904 4283
Monash University 00008C.COLLEGE CONSULTATIONS AND SUBMISSIONS ADVOCACY
The College regularly engages in government and industry consultations to represent and advance
the interests of the paramedicine profession. This behind-the-scenes work is often a result of the ded-
ication and hard work of our College’s advisory committees and special interest groups.
The College will provide updates on future consultations and submissions as they occur.
2022 SUBMISSIONS/CONSULTATIONS
Submission/Consultation Organisation/Body Date submitted
SA Ambulance Service Resourcing Parliament of South Australia 14 January 2022
The College made a submission in response to House of Assembly Petition No 84 of 2021 – SA Ambulance Service Resourc-
ing. The submission focused on four system-wide recommendations to address the issues of ramping and access block
within the South Australian health system. The recommendations spanned the wider implementation of Community/
Extended Care Paramedics, more comprehensive telehealth services, expansion of the Urgent Care system, and the in-
troduction of a Chief Paramedic Officer to oversee better utilisation of the paramedic workforce within South Australia.
The College looks forward to appearing before the Legislative Review Committee to speak to our recommendations.
2021 SUBMISSIONS/CONSULTATIONS
Submission/Consultation Organisation/Body Date submitted
Australian Commission on Safety
Low Back Pain Clinical Care Standard 19 April 2021
and Quality in Healthcare
Targeted consultation on draft amendments to
Health Chiefs Executive Forum 20 April 2021
Health Practitioner Regulation National Law
Regulatory Guide chapter re Procedural Fairness Ahpra 21 April 2021
Public consultation on revised regulatory
Ahpra 19 May 2021
principles for the National Scheme
English Language Skills Registration Standards Ahpra 26 May 2021
Revised code of conduct Ahpra 5 July 2021
Primary Health Care Reform Primary Health Reform Steering Group 27 July 2021
Developing the next National Plan to Reduce
Department of Social Services 30 July 2021
Violence against Women and their Children
Ambulance Victoria Strategic Plan Ambulance Victoria 26 August 2021
Inquiry into the provision of GP and related
Senate Community Affairs
primary health services to outer metropol- 30 September 2021
References Committee
itan, rural, and regional Australians
Opioid Analgesic Stewardship in Acute Australian Commission on Safety
5 October 2021
Pain Clinical Care Standard and Quality in Healthcare
Inquiry into the delivery of ambulance Legislative Council Committee
28 October 2021
services in Western Australia Office of Western Australia
Future focused primary health care: Australia’s Primary
Primary Health Reform Steering Group 9 November 2021
Health Care 10 Year Plan 2022-2032 Consultation Draft
For more information, contact the College’s Policy and Project Officer Rachel Shanahan at rachel.shanahan@paramedics.org
RESPONSE VOL 49 SUMMER 2022 | 21You can also read
