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16 August 2001

We lose again, ambulance downgrade may cost lives

When Ambulance Officer, Steve McMahon recently relocated to South West Rocks it meant much more than losing a very capable officer and community minded resident.

Steve was the only Advanced Life Support Ambulance Officer attached to the Lightning Ridge centre. By attaining this level an Advanced Life Support Officer can apply the Primary Care Skills of Levels 1,2, and 3 but additionally they can perform the following Primary care skills; cannulation (drip into the vein) decompression of tension pneumothorax (collapsed lung) paediatric interosseous cannulation ( special cannula drilled into childs leg bone when can't get cannula into vein- in near death situation) tracheal suction.

Most importantly the range of drugs that may be administered in addition to the primary care drugs are vital to a patient's survival in many of the life threatening incidents that Ambulance officers are called to attend each day. It is that initial contact between patient and Ambulance officers that saves many lives; that ability to administer the appropriate drug. The additional primary care drugs that may be administered are; Adrenaline (Injection in vein for asthma, allergic reactions and cardiac arrests)
Atropine (injection in the vein for cardiac conditions, organophosphate poisoning's and funnel web spider bites)
Dextrose 50% (sugary injection into vein for fluid in lungs)
Hartmans, (solution that goes via drip into vein)
Haematocele (special solution for blood loss that goes into a drip into a vein)
Metoclopramide ( injected into vein for vomiting)
Morphine sulphate (pain relief injected into the vein)
Midazolam (injected into vein for fitting)
Naloxone (injected into the vein for overdoses).

Compounding the problem is the discontinuation of the level 4 Course and the offer to upgrade to paramedics- Level 5. Training Officers from level 3 to Paramedic Level would appear to be the answer. However, officers are required to move to a large metropolitan centre in order to begin work as a paramedic. These officers can then only move back to a small rural community if they have been a Paramedic for two years in a metropolitan centre.
This effectively prevents rural communities having the same access to these skilled services as our city counterparts.

The restrictions that are being placed upon officers are ludicrous, equally it is outrageous that such a low value be placed upon the lives of country dwellers. Again cost is a predominant factor.

Maintaining suitably qualified officers in rural centres and making available the range of drugs applicable to this qualification is considered costly. In a Shire such as Walgett serious consideration should be given to the facts. Our mix of farming and mining entails heavy machinery and a danger level higher than most industries.

The area should be assessed on this need and a more equitable distribution of officers applied.

Recognising the seriousness of this situation and the likely deterioration of services, Walgett Shire Council, at its July meting adopted the following motion:
That Council writes to the Minister for Health; the Shadow Minister. The Chairperson of Country Labour, and Mr. Steve Winfield, Manager of the Ambulance Service of NSW, requesting that:
The staffing at each Ambulance Station in the Walgett Shire (i.e. Walgett, Lightning Ridge and Collarenebri) have a minimum of one Advanced Life Support/Paramedic Ambulance officer;
All existing level 3 Ambulance Officers in the Shire be upgraded to the new Qualified Ambulance Officer skill level as reported in the media as a priority, and;
All Ambulance officers in the Shire have equal opportunity of undertaking paramedic level training, and be permitted to return to the Shire on completion of their training.

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