Prehospital and Retrieval Medicine – THE PHARM dedicated to the memory of Dr John Hinds

In times where external standards are increasingly applied to health services, where does retrieval medicine fit in? Dr Alan Garner shares his insights after wrestling with the Australian National Safety and Quality Health Service Standards process. 

In Australia, national reform processes for health services began in the years following the 2007 election. Many of the proposed funding reforms did not survive negotiation with the States/Territories but other aspects went on to become part of the Health landscape in Australia.

Components which made it through were things like a national registration framework for health professionals. Although the intent of this was to stop dodgy practitioners moving between jurisdictions, the result for an organisation like CareFlight was that we did not have to organise registration for our doctors and nurses in 2, 3 or even more jurisdictions as they moved across bases all over the country. Other components that made it through were…

22 years old male hit from a car on the roadside of an urban area.
The ground EMS ambulance (physician, nurse staffed), dispatched on scene, find the patient alert, oriented and spontaneously breathing. His vitals are:
GCS 15 , RR 20, SaO2 95, HR 85, SBP 110
No mention of head trauma.
Chest no sign of trauma, bilateral and equal expansion and air entry.
Pulse is strong.
He has a profound laceration with loss of substance but not evisceration on left flank and no external bleeding from the wound.
The abdomen is painful and resistant to palpation in left flank.
There is an open fracture to left tibia (VNS 9).
The ground team, after the primary survey, activates the local medical helicopter.
The place is 10 k from a level 1 Trauma Center on a local road in an urban area and the helicopter is at 10 minutes flight distance…