Downgrading emergency services !

There is no doubt that the ambulance service is under constant pressure, but the plan by the New South Wales government to bolster response to medical emergencies by using the Fire Brigade introduces a new risk factor.

The " Ambo's " who crew our ambulance fleet are clinically trained paramedics and their vehicles come equipped with both drugs and medical devices to respond to a full range of medical conditions.   In comparison, the " Firies " are " trained to minimal medical assistance skills " .   They simply lack the ability to deliver the first response attention to keep the patient alive prior to arrival at hospital.

In rural areas, the Fire Brigade is often the first to arrive at an accident scene and it's members are required to do what they can to help medically - and wait until the ambulance arrives.  To suggest that the Fire Brigade replaces that trained ambulance team seems to be a matter of " sending someone with a first aid kit "

This seems to be a matter of tackling the problem from the wrong end.   The reason that our Paramedics are under such pressure is because handling the patient flow has obstacles causing delays.   " Bed block " prevents patients moving from the emergency department to the wards and in many instances paramedics and their ambulance vehicles are locked in a queue at the emergency department door for hours - waiting for triage to accept their patient into hospital care.

Using the Fire Brigade to care for these patients waiting for Triage makes better sense.   It frees up the ambulance and it's trained crew to do the first response work, and the lesser trained " Firies " can require Triage upgrade if the patient shows signs of deteriorating.

Such an arrangement ticks many boxes.  The highly trained Paramedic has first attended and stabilised the patient.  This advanced care has been present during the journey to hospital - and now that a less trained operator is taking over, the patient is just metres away from a fully operational emergency room in a hospital.

In a perfect world there would be no hospital delays and all patients would receive immediate care from a fully trained professional.    Welcome to the " real world " - and with it the inevitable tug of war between resources and need.

There is no doubt that health services have a few problems.   Solving those problems can be a better blend of using the resources available in a mix that allows the best trained and best equipped to to be the first providers on the emergency scene.

Using " Firies " as first response paramedics does not meet that criteria !