As many of you may have experienced, welcoming a baby into the world can be both a joyous and potentially fraught time for parents. There’s the lack of sleep to contend with, the around-the-clock feeding regime and of course, the ongoing challenges of caring for a fragile infant.

With so many distractions emerging each day, few parents want to stop and consider what they should do if things go wrong - for example, if their baby is involved in a serious medical emergency. Sadly, these events do happen, and we’ve been working behind the scenes to assist new parents who may find themselves in these unfortunate situations.

We recently rolled out our First Steps campaign, targeting new parents who may not know how to appropriately respond in a medical emergency that involves their baby. To help new parents, we’ve developed Emergency Phone Cards for mums, dads and carers to keep with them as a user-friendly resource. The cards, which are distributed in Bounty Bags to maternity wards and birthing centres statewide, help prepare parents in the event of a medical emergency, citing questions they may be asked by Triple Zero (000) call takers. The cards also list key medical information that parents should have available in the event of an emergency.

Mother of two year old boy, Michelle, recently faced every parent’s worse nightmare when she awoke one night to attend to her son, who was convulsing uncontrollably. Michelle immediately called Triple Zero (000) and spoke to Marea, an ambulance call taker, who gave vital medical advice over the phone to Ms. Evans.

This medical intervention resulted in Michelle’s son making a full recovery and the two women recently took part in an emotional reunion at the launch of our First Steps campaign, where Michelle praised Maria’s professionalism.

In response, Ms Jones commended the First Steps campaign as a way to support new parents in confronting medical emergencies that involve their child.

“Ambulance Triple Zero deals with a lot of calls regarding children, from newborn onwards,” said Ms Jones. “The ‘First Steps’ campaign will be a great help to parents who are often stressed, frightened and unsure of the processes involved when they ring for an ambulance.”

> Download an Emergency Phone Card
> Comment from Richard Glover - ABC Radio

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You may have heard recent reports in the media focussing on our current procurement strategy to invite public tenders for fixed wing transport services. This service commercial contract is for a period of ten years from 1 January 2012 to 31 December 2021.

The traditional Royal Flying Doctor Service (RFDS) services to remote farming and Aboriginal communities are not linked to the current commercial tender but are separately funded through Federal and State Governments and RFDS donations.

The RFDS operate two services in NSW; one the iconic health services delivered across remote Australia for which it is rightly famous. The other is a less well known commercial contract providing aviation support for the Air Ambulance. This service has operated for more than 40 years with companies like Pearl Aviation, and most recently the RFDS providing aircraft and pilots under contract but still wearing the distinctive Ambulance Services livery and uniforms. It is time to renew that contract and a tender is the best way to ensure fairness, quality and value for money.

The Ambulance Service is given tax payer funds to deliver ambulance services, including the fixed wing air ambulance and has a responsibility to spend that money effectively. The RFDS won this commercial contract fairly through an open tender only 7 years ago. If more funding for RFDS services is needed, requests should be presented transparently so they can be fairly assessed by governments against the many health priorities. Clouding the issues over a competitive commercial tender is not the way.

This winter Ambulance transfers of critically ill patients have more than doubled. Thankfully the new helicopter fleet was in place and up to the task. We expect substantial growth in demand to continue into the future and it is vital that our fixed wing fleet is up to date in time for the new contract starting on 1 January 2012.

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We’ve read your online feedback and we’ve listened. You told us you wanted to find out more about our staff, who make it their job to help others – whether they’re based out on the road, in operations centres or even up in the sky!

In this new regular feature, ‘Five minutes with…’, we’ll profile a staff member and share their story with you, starting in this edition with Jane, a Sydney-based flight nurse. Here’s Jane’s story:

“ Before becoming a flight nurse with Ambulance, I worked in Emergency Departments for four years, after qualifying with a Bachelor of Nursing.

I remember one day on a shift in Emergency, I worked on a 20-year old shooting victim and after that experience my colleague and I decided that we wanted to work in an environment that I suppose you could say was a little happier! The next day we applied to become midwives instead.

While working as a midwife, I heard that Ambulance was advertising for Flight Nurses – and to qualify, you needed a background in emergency and obstetrics. I applied, was interviewed and I got the job – and here I am, still at Ambulance as a flight nurse ten years later!

All Ambulance flight nurses are required to have a background in both obstetrics and critical care. I’m one of 28 flight nurses in total, including the Nursing Unit Manager and Educator. We all come from a critical care background – such as intensive care, emergency or coronary intensive care. We’re all midwives as well and we’ve all been here for at least 10 years, one flight nurse has been here for 20 years. It’s the kind of job you take on and don’t ever want to leave!

I love flying, which is just as well really! My husband is a pilot, we actually met through work but we didn’t go on our first date until he left to work for Qantas – so it was all above board! I remember going for a ‘fly along’ before I started, to see if I was suited to flying and I just loved it.

Unlike other parts of Ambulance which rely heavily on teamwork, being a Flight Nurse is quite an independent role. You spend a lot of time up there on your own, or working one-on-one with a patient for extended periods of time. I enjoy the independence of the job, but I also enjoy getting to know people all over the NSW countryside – there is a nice community feeling across the State and I always know someone when we land, this is what happens over time in a role like this.

It can get tough though – night time and bad weather can make for a rocky ride. It’s important to stabilise the patient before taking off. I’ve transported patients to hospital who need defibrillating onboard and we do have babies delivered onboard every now and then, but so far – touch wood – not on any of my flights! The aim of the game is not to deliver onboard!

We’re well supported in the air though, not only with medical equipment but also through technology. We’ve got three different types of phones we can use if we need help and we also use the radio to contact other Ambulance people for advice or assistance.

You do build a relationship with the people you are helping. Often you are the only person helping them for an extended period of time, so it’s inevitable that you get to know them on a more personal level. I remember one patient in particular - I went to retrieve a man who had a heart attack on his tractor and broke his neck when he fell off. We took him to hospital and while he thankfully survived the heart attack, he was put in ‘halo traction’ for six months while his neck healed. Six months later, I got a call to visit the same man – only to find out that he had tried to loosen his traction with an old screwdriver from his shed out the back! Apparently the traction was giving him some grief! Unfortunately in doing so, he dislodged his fracture - but he’s healed now, thankfully.

One day I will always remember, is the day I collected an old lady who was moving out of her country homestead and into a nursing home. She sat by the window looking very thoughtful, and I said to her, “what are you thinking of?”. I’ll never forget what she said to me. She said, “I’m looking at God’s paintings”. Now, whenever I look out of the window at the sun beaming through the clouds, I always smile at God’s paintings.”

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We’ve recently had good news and bad news here at Ambulance.

We’ll start with the good news: for the sixth year running paramedics have trumped in the top position in the Readers Digest Most Trusted Professionals poll. This award means a lot to us, not least because it helps us to do our job well.

“Paramedics contend daily with stressful and challenging situations, made easier because of the complete trust our patients place on us,” says Broken Hill-based paramedic, David.

"We would like to say thank you to the community for the genuine trust that they place in them and for bestowing the title of Most Trusted Profession,” he said.

This is a fantastic achievement for Ambulance and we are honoured to receive this title.

In light of this achievement, we are disappointed to pass on the bad news. Recent statistics show that the assault rate on paramedics has risen by 60 per cent in the past year.

Over the past 12 months, a total of 120 paramedics have been assaulted while simply trying to do their job. As you are no doubt aware, these trusted professionals should not be in fear of their own safety and well-being. As the most trusted professionals, paramedics deserve the community’s upmost respect and courtesy. Unfortunately there is a small but growing element in the community who believe they are fair game.

In 2008-09, 120 paramedics were assaulted in NSW - up more than 60 per cent on 2006-07 figures. Of the 120, 59 were in the Sydney metropolitan area, 33 in the north, 19 in the south and nine in the State’s west.

Photograph: Most trusted profession: (Left to Right) Paramedics Rebecca, Adam, Daniel and Tanya.
Photo courtesy Barrier Daily Truth – Broken Hill.

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We have an interesting challenge here at Ambulance. It’s come to our attention that generally speaking, people in rural areas are more inclined to drive themselves to hospital when physically injured or unwell. However, people in our more densely populated areas such as cities, will often do the opposite – call for an Ambulance when there is no medical need for our service.

What to do? To overcome this, we have rolled out two very different community awareness campaigns – one for our rural residents and one for our city dwellers. Our rural residents are reminded not to drive themselves to hospital in the event of a medical emergency, while our city dwellers are being reminded that an Ambulance is not a taxi!

While our metropolitan campaign was rolled out last year and continues to reach our city residents, people living in rural areas should now start to see posters in local community centres reminding them to call Triple Zero (000) in a medical emergency and ask for Ambulance.

This rural campaign was recently developed in response to some cases recently where members of rural communities have driven critically ill children, relatives or even themselves in a critical condition, to hospital rather than waiting for an ambulance to arrive.

Time is not the only factor that should be considered. You can do more for the patient if you :
> Call Triple Zero (000) for an Ambulance
> Don’t move the patient inappropriately
> Stay calm
> Reassure the patient
> Keep the patient’s airway open
> Stop life threatening bleeding.

Far too often paramedics hear rural patients say that they are wasting ambulance’s time but this is not the case. Paramedics are highly trained medical professionals who are able to provide advanced medical treatment that is required prior to and during transport. Sometimes every minute counts.

Here are some other tips to help prepare yourself in the event of a medical emergency:

• Call Triple Zero (000) and do not hang up the phone. The call-taker needs to gather important information to help the Paramedics

• Learn First Aid – these vital skills may help you save the life of a friend or relative

• Keep a First Aid kit in your house and in your car

• Teach your children how to call Triple Zero (000)

• If possible, when you call for an Ambulance, have someone wait outside your address to guide the Ambulance to the correct location

• Remember, in an Emergency, call Triple Zero (000) and ask for an Ambulance.

Compare the two different campaigns:
> Rural campaign poster
> Metropolitan campaign poster

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Here at Ambulance, we continually involve ourselves in community events, often volunteering our time to help raise awareness on particular health and safety issues.

Most recently, we worked alongside Westmead Hospital’s Trauma Initiative and NRMA Motoring Services at the "Youth and Road Trauma Forum" in Sydney, to help educate young people on road safety. Paramedics Christie, Eileen, Chris and Eamonn generously gave their time at this three-day forum.

The forum, which was held in August at the Acer Arena, was a great success. We were involved in presenting a real crash scenario, a variety of interactive displays and demonstrations to over 12,000 students from years 10, 11 and 12 from across NSW and ACT.

The objective of the forum was to give young people a clear understanding of the responsibilities involved in driving a motor vehicle and also, insight into the potential risks associated with motor vehicle crashes.
The below alarming statistics motivate us to volunteer our time in this way, to help raise road safety awareness among young people.

• Young people account for only 15 per cent of licence holders but more than a third of road fatalities.

• A 17-year old driver with a P1 licence is four times more likely to be involved in a fatal crash than a driver aged 26 or older.

• Over a 12 month period as many as 7,000 young casualties can occur with many of these suffering serious injuries with long-term consequences.

• Nearly half of all trauma admissions to NSW hospitals with severe injuries are the result of road trauma and of these hospital admissions, almost a third are aged 15 to 24 years

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Here at Ambulance, we love ‘Thank a Paramedic Day’. This annual day gives the community an opportunity to celebrate the work of our paramedics and it also allows paramedics to step back and reflect on how their efforts have helped many people over the past year.

Our paramedics have genuine passion and commitment to their jobs and they are deservingly rewarded for their outstanding efforts on this special day each year. Over the past years we’ve found that many people want to thank a paramedic, often once the particular medical crisis in their lives has subsided.

It’s never too late to thank a paramedic, either by writing a letter of thanks to us, or showing your support by attending our ‘Thank a Paramedic Day’ celebrations.

At 10.00am on Friday 20 November 2009, ‘Thank a Paramedic Day’ will be simultaneously celebrated at four locations across NSW.

The venues are:
> Parramatta Town Hall, 182 Church Street Mall, Parramatta
> Gunnedah Ambulance Station, 16 Anzac Parade, Gunnedah
> Batemans Bay Soldiers Club, Beach Road, Batemans Bay
> Port Macquarie Ambulance Station, 1 Central Road, Port Macquarie

We invite you to come along to one of these venues on 20 November 2009, and show your support and appreciation for our paramedics, who provide potentially life-saving treatment in communities across NSW. It’s not a job for everyone, and that is what makes our paramedics so special.

Photograph: Ross Pearson, a spokesperson at Thank a Paramedic Day 2008 with Paramedic Paul McQuade.

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Following feedback received in our recent online review, we are busily working behind the scenes to deliver the news updates that you want to read. In particular, you told us you would like to see more articles on real-life emergencies and patient stories.

In response, we have designed this new regular feature for you, called ‘On Road’. In this section, we will share real life patient stories with you, to give you further insight into the type of situations we face every day.

In this edition, our focus is on heart attacks – a sad event for some of our friends and families. Unfortunately many of us may know someone who has suffered a heart attack, with the heart attack possibly triggering sudden fatalities in many instances.

We’ve recently been working with the Hunter New England Area Health Service to improve response times to patients experiencing life threatening heart attacks. This initiative also includes pre-hospital confirmation of symptoms by a doctor at John Hunter Hospital in Newcastle and implements cutting-edge technology in the form of clot busting treatment for arterial blockages.

We’re excited to share with you news that these developments have dramatically improved health outcomes involving out-of-hospital heart attack cases. To best illustrate this, we want to share this real-life incident with you, as told here by heart attack patient, Ian.

Dear Sir,

Re: Ambulance paramedics saved my life and my future.

I would like to express my sincere appreciation to Paramedics Steve and Ray from the Tea Gardens Ambulance Station.

On Friday evening 26 June 2009, my wife and I were watching TV when I experienced excruciating chest and upper body pain that didn’t ease off. After 10 minutes rolling on the floor I was sure I was having a heart attack so my wife rang Triple Zero (000). Within 15 minutes an ambulance arrived and Steve and Ray immediately began stabilising me. In another 5 minutes I was in the ambulance on the way to the Mater Hospital in Newcastle, a daunting hour’s drive away.

However, Steve was not content to just sit with me and manage my pain; he began the process of treating me for the heart attack. He was able to take an electrocardiograph (ECG) in the ambulance and transmit it to a cardiologist at the hospital who was then able to assess my condition and prescribe the commencement of blood clot dissolving medication. Meanwhile, in the front of the ambulance, Ray was a reassuring and calming influence for my wife, Gail, who was understandably very concerned.

Fifteen minutes after arriving at the Mater Emergency Department another ECG showed that the clot had dissolved and I was now pain free. The medical staff at the hospital said that it was fantastic that treatment had commenced less than an hour after my heart attack started. An ultrasound test two days after admission showed that I had suffered only minimal permanent heart damage. While I was in the hospital, Steve popped in to see how I was going and the following day Ray phoned to also enquire after my progress.

The ambos caring and professional service not only saved my life but also gave me the best possible prognosis for the future.

Thank you Steve and Ray!
Yours sincerely,
Ian

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If you frequently visit Sydney’s CBD district, you may have already encountered our motorcycle paramedics zipping around the city, attending to various medical emergencies. If you do see a motorcycle zipping through pedestrian concourses, be aware it may be a motorcycle paramedic hard at work, and not a random joy-rider!

We’ve found that these intensive-care trained motorcycle paramedics, who have been in operation for ten years, can quickly access the scene of a medical emergency in densely populated areas with traffic restrictions. For example, average motorcycle response times can be as little as 3.5 minutes.

Ambulance recently received a Triple Zero (000) call to attend to a 63-year old male in Martin Place, with chest pain and shortness of breath. A motorcycle paramedic at Wynyard was sent to the patient at the same time as the ambulance. The motorcycle paramedic arrived within minutes, cutting through Martin Place to get to the patient.

“The motorcycle paramedics are another resource that Ambulance can send to attend our emergency patients in the city CBD,” explained Mike Willis, our General Manager Operations.

"The motorcycle paramedics are constantly mobile and stay within designated zones to commence emergency patient treatment. The paramedics carry the same lifesaving drugs and much of the equipment as the emergency ambulances.

“Ambulance constantly reviews demand and implements response options to allow us to get to our emergency patients fast. Using the motorcycles in the city gives us an opportunity to save potentially vital seconds in starting treatment,” said Mr Willis.

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Every parent thinks their child is a hero. Now here is your chance to make it official! Our "Be An Ambulance Hero – Dial Zero, Zero, Zero" school education program is designed for Kindergarten, Year 1 and Year 2 students (aged 5-8 years), to teach young children how to respond in a medical emergency.

Perhaps your child is one of the 20,000 students who have already participated in this fun and informative program, which educates children on the following topics:

• Simple decision making skills

• The difference between a little accident and a big accident, including how to identify an unconscious person

• Understanding how to call an ambulance in an emergency

• Understanding that the emergency number in Australia is Triple Zero (000)

• The program is designed to educate children to effectively call for an ambulance in an emergency as well as to develop the confidence and skills necessary to answer questions asked by the Triple Zero (000) call taker.

We are encouraged to learn that independent evaluation findings show that nine out of 10 parents whose child had completed this program felt their child knew what to do in a medical emergency. Or put another way, 18,000 children are likely to know how to respond if faced with a medical emergency.

‘ Be An Ambulance Hero – Dial Zero, Zero, Zero’ is available to all NSW primary schools as a non-compulsory free program which assists teachers to educate children the above potentially life saving topics.

For more information about this and our pre-school program, Emergency Helpers, go to the ambulance internet site www.ambulance.nsw.gov.au and click on 'community info' then follow the links.

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You may know about “Life…Live it Save it!”, a community education program that we developed for people aged over 55, which teaches life saving techniques in the event of a medical emergency.

This free program takes only one hour to complete and there are no exams or tests involved. Our priority is to make sure you are familiar with the signs and symptoms of life threatening medical conditions - and that you complete the program knowing exactly what to do in the event of a medical emergency.

We often receive encouraging stories from ‘Live…Live it Save it!’ participants and we wanted to share the following story with you.

At a recent conference held in Coonabarabran, Chaplain Rev. Paul McFarlane conducted the “Life…Live it Save it!” program with 50 Anglican ministers and youth workers from northern NSW.

Rev. McFarlane introduced this course to local church leaders so that they might then run the program in their own communities. Rev. McFarlane also wanted to encourage the clergy to keep their own life saving skills up-to-date, especially given that many churches cater for older people who are more likely to suffer from cardiac conditions, stroke, diabetes and breathing problems.

Less than half of the clergy present had a current first aid certificate and very few were aware of the current CPR guidelines. As a result, the course was very much appreciated by all participants, who were encouraged to then run the course among their own local communities.

Two participants in particular were impressed by the program and the work that Ambulance does in rural communities. Bishop Edward Muhima and Rev. Amos Katushabe were visiting from Uganda and they said that back home, they have very little access to health care, especially for medical emergencies.

While our focus is on educating people in NSW with potentially life saving medical knowledge, it is encouraging to know that communities in Uganda may now also benefit from this program. It also reminds us how fortunate we are to have access to a free service such as this, which can potentially save a life.

> Find out more about ‘Life…Live it Save it’ and how it can benefit your local community.

Photograph: Bishop Edward Mumima practicing on his “CPR buddy” pillowslip.

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Mental Health Week is part of a national mental health promotion campaign which will run from Sunday 4 October to Saturday 10 October 2009. Its main aim is to promote social and emotional wellbeing to the population of NSW – encouraging people to maximise their health potential and enhancing the coping capacity of communities, families, and individuals.

Mental Health Week 2009 marks the second stage in the Mental Health Association NSW’s, three year 'Building Resilience' campaign. This year, our focus is on 'Sign up, link in, get involved' - promoting the importance of getting involved and participating in our community, local clubs, organisations and services. Creating and strengthening our links, such as a joining a men’s shed or a sporting club, can be a helpful resource during both the good and tough times. Getting involved is another way we can build our resilience and create a richer, more connected and meaningful life.

Mental Health Week is an opportunity to raise awareness about mental health in your local community or workplace by holding your own event or participating in one in your area.

To find out more about how you can get involved check out www.mentalhealth.asn.au or email: promoadmin@mentalhealth.asn.au

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Many of you may have already noticed that hayfever season has already landed on our doorstep, announcing the arrival of springtime. Some of you may still be battling colds and influenza, possibly picked up during our particularly challenging winter season.

It’s important to take extra precautions at this time of year, especially those who are at risk of respiratory infections and suffer from:

> asthma
> low immunity
> influenza
> pre-existing conditions to allergies

The elderly should also take special care as they are more susceptible to illness at these times.

These high risk groups should heed the following medical advice during these spring months:

• If you have known allergies, obtain an up to date emergency medical action plan from your doctor;

• Alternatively, for minor allergic reactions, you should consult your pharmacist;

• For patients such as the elderly, low immunity, healthcare workers, etc., it’s never too late to arrange an influenza vaccination;

• Carry your asthma and/or allergy medication with you;

• If sensitive to pollens and the like, reduce exposure to the irritants where practically possible;

• If a medical emergency arises dial Triple Zero (000), ask for Ambulance and wait on the line to ensure as much information as possible can be gathered while paramedics are on their way to you.

Help us to help you, by being ready to respond at the first sign of asthma symptoms and allergic reactions over the springtime months.

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You may have heard about our personal health diaries, which you can print off our website and keep with you in the event of a medical emergency.

The Personal Health Diary is a small publication that contains information on how and when to call Triple Zero (000) for an ambulance and also lists the important questions Ambulance call takers will ask you.

Many people keep their personal health diary by their phone, in their glove box, hand bag or even on their desk at work. The information contained in the diary shows your medical history, contact details, allergies and other essential medical details that help us to help you in the event of an emergency.

Not only are the personal health diaries an invaluable resource for paramedics at the scene of an emergency, they are also a great tool for you. It can really help to have your personal information and medical history written down for quick referral in a stressful situation, such as when you need to call Triple Zero (000).

> Download a copy of the Personal Health Diary from our website.

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From 1 July 2009 residents of NSW and residents of any other Australian state or territory that is party to a reciprocal arrangement will be charged at a rate of 51 per cent of the actual cost of the provision of primary emergency ambulance services.

The Ambulance Service of NSW recovers 100 per cent of the cost of ambulance services provided to residents of states that do not have a reciprocal arrangement with NSW.

New fees
From July 1 2009, NSW residents requiring road or helicopter emergency ambulance transport within NSW will be required to pay a $301 callout fee, plus an additional charge of $2.72 per kilometre or part thereof.

There are no changes to existing exemptions from ambulance transport fees – pensioners, health care card holders and veterans with an accepted war related injury continue to remain exempt from fees.

The Ambulance Service of NSW is one of the most highly subsidised ambulance services in Australia.

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