Record demand for Queensland paramedics

Exclusive: Q&A with the Queensland Ambulance Service Deputy Commissioner.

Following the busiest year on record for the Queensland Ambulance Service (QAS) in 2017, we met with Deputy Commissioner Dee Taylor-Dutton to find out what’s behind the spike in call-outs.

QAS faced the busiest year on record in 2017. Why did Queensland see such a dramatic increase?

It was several factors that impacted on our demand. Namely, there is an increasing population in Queensland. We are also seeing an increased ageing population with people living longer, so those things are really contributing to increased health demands and in turn ambulance service demands.

Is that why the number of life-threatening callouts reached such a high level exceeding 803,126?

Certainly, the elderly are increasing their calls to QAS and for most people as they get over 65 and 85, the statistics increase even more. While you’re less likely to call an ambulance when you’re young, fit and healthy, obviously when you have chronic disease and your age increases you’re more likely to call. It’s something we have seen across all demographics but particularly in the ageing population.

Have all these callouts been warranted? We often hear of times when people unnecessarily call emergency services?

There are some cases that might not necessitate an ambulance response. But it is tricky for people who don’t have medical training to know when that is. Most people treat it symptomatically and will call 000 when they believe they need an ambulance response and we will provide instructions before our paramedics are able to respond. Then our paramedics work with the patients and complete a full assessment and provide advice, treatment on scene or recommend they see their GP and in other occasions transport them to hospital or even a GP clinic. It really depends on the individual patients needs and not everyone has the training our paramedics have so its very difficult to make that decision. We always say if you’re not sure and feel like it is an emergency then call 000 and we will triage the call and send an appropriate response.

Ambulance

Is there any training you recommend people have in case of a medical emergency?

About 86% of all cardiac arrests happen in the home, so CPR awareness and training is essential for everyone in the community. We do a lot of CPR awareness at our local ambulance stations for a gold coin donation and people walk out of there feeling quite comfortable about the right time to call an ambulance and how they can assist. Other training that people can do to help build resilience is just basic first-aid training – knowing what are the minor injuries to more serious ones, how to control bleeding, how to respond to a snake bite. They’re two good things everyone should know.

Last year QAS saw a 17.17% increase in the amount of call outs for mental health-related incidents. Was there any reason as to why it jumped so high?

More and more people in the community are experiencing mental health issues. They say one in five people in their lifetime will suffer some sort of mental health crisis and require some form of treatment. I think this is just something that we are seeing more in health care globally. The statistics speak for themselves. There has been a dramatic increase and I think its recognition that the stigma for mental health isn’t what it used to be, and people are now more likely to call if they aren’t travelling well and seek some form of assistance. We treat them as health professionals and help get them into the broader medical community for further help.

With that in mind, what is QAS role in the response to these incidents. What do paramedics do in the event of a mental health crisis?

It really depends on the situation. The most important thing for us to do is build trust with our patients. We can’t do anything if the patient doesn’t trust us. So, the patient and paramedic relationship is essential. Depending on how the patient presents and if they are amid a mental health crisis and are erratic and disturbed, we have medication we can provide, if the patient is unable to be voluntarily and calmly treated on the scene. At times it is required for the patients own safety and the safety of our paramedics that they be sedated so they can be treated and transported for further care. In other situations, it could just be listening to the person and getting them the help they need. It really varies depending on how the patient presents, but our paramedics are highly trained, and all have qualifications and we have ongoing training for them around abnormal and disturbed behaviour and de-escalation training to keep paramedics safe.

Building upon the safety aspect, there have been multiple campaigns to improve safety conditions for paramedics with a high number of them being injured and assaulted by patients. How did paramedics cope in 2017?

Occupational violence is a real concern for us. We think any instance of occupational violence is unacceptable and we really want to see those numbers reach zero. For assaults against paramedics last year we had 301 compared to 343 the year before. So, we did see a reduction, but we won’t be stopping what we are doing until we have zero across QAS. More than half (185) of those assaults were deliberate, another reduction on the year before. We are doing everything we think we can to reduce violence, but we really need the community to get behind that. Assaulting any kind of health or emergency service worker needs to be a principal we reject in our community.

Paramedics covered over 42 million kilometres travelling in 2017. How were other motorists during this time? Is it still an issue with people not pulling to the side and giving way?

We have coverage in all parts of the state, right from the cape all the way to the Gold Coast and everywhere in between. People tend to be very respectful of emergency service vehicles and do what they can to get out of their way. Unfortunately, people do drive with their stereo turned up and their aircon blasting, which means cars become very insulated to external noise, so they might not hear a siren or see the lights in their rear-view mirror. We encourage people to be actively keeping an eye out on the road.

To check out RACQ’s full investigation into QAS busiest year on record, read the Oct/Nov edition of The Road Ahead. For exclusive content, subscribe to the digital Road Ahead.