Queensland Ambulance Service

"QAS" redirects here. For other uses, see QAS (disambiguation).
Queensland Ambulance Service
Agency overview
Formed 1 July 1991
Preceding agency
  • 1892
Jurisdiction Government of Queensland
Employees 4000
Agency executives
  • Mr Russell Bowles ASM, Commissioner
  • Mr David Eels ASM, Deputy Commissioner
Parent agency Queensland Health
Website www.ambulance.qld.gov.au
www.facebook.com/qldambulanceservice

The Queensland Ambulance Service (QAS) is the chief provider of out-of-hospital emergency care and ambulance transport in the state of Queensland, Australia. It falls under the control of the Queensland Health and is one of the largest ambulance service in the world.[1]

The service provides a high level of emergency care and transport services to over 4.1 million people in Queensland, covering an area of 1.77 million square kilometres. They provide such services as emergency response, pre-hospital patient care, specialised transport services, coordination of aero-medical services and inter-hospital transfers.[2]

Almost 4000 staff are employed by QAS, with almost 85% as front-line operatives, who together deliver their services from over 260 response locations across the state.[2] In 2011/12, the service handled over 833,000 cases, answered over 160,000 triple zero calls and had an overall patient satisfaction rating of 97%. [3]

History

The QATB Hospital, ca. 1915

Ambulance services in Queensland first began in 1892. Military medic Seymour Warrian held the first meeting of the City Ambulance Transport Brigade on 12 September of that year. Queensland's first ambulance station operated out of the Brisbane Newspaper Company building; the first officers possessed a stretcher, but no vehicle, and so transported patients on foot.[4] A year after the establishment of the Brisbane centre, another was established in Charters Towers in north Queensland, eventually growing to over 90 community controlled ambulance centres.

The Queensland Ambulance Service (QAS) as currently known was formed on 1 July 1991 from the amalgamation of 96 individual Queensland Ambulance Service Transport Brigades (QATB). While QAS originally operated under the banner of the Department of Emergency Services, in 2009 the Queensland Government restructured the organisational hierarchy and appointed new Ministers. It became part of the Department of Community Safety, along with the Queensland Fire and Rescue Service, Emergency Management Queensland and Department of Corrective Services.[4] As a result of the Keelty Review of Police and Community Safety in Queensland, the QAS transitioned into the Queensland Department of Health as of 1 October 2013, retaining its separate identity, rank structure and Commissioner.

Structure and operations

Support

The QAS was initially divided into six operational regions across Queensland, until the Northern Region was split to form 'Far Northern Region'. This model reflected a similar structure in the then Queensland Fire and Rescue Authority. In 2012, the QAS Structural Reform Report, a comprehensive review of QAS operations, lead to a restructure of operations, and a decentralisation of control to local networks.[5] Instead of large regions, the service would be divided into fifteen geographical Local Ambulance Service Networks (LASNs) aligning with Queensland Health Health and Hospital Service Networks.[6] A sixteenth network was established as State Operations Centres, with the existing seven communications centres to become Operations Centres, reporting directly to a central Assistant Commissioner. The LASNs vary in size according to population and stations, and are categorised from Category 1 (largest) to Category 5 (smallest). The categorisation simply reflects their size and gives a foundation for staffing allocation and command structure.

Local Ambulance Service Networks

Category 1 (General Manager - Assistant Commissioner)

Category 2 (General Manager - Assistant Commissioner)

Category 3 (Director - Chief Superintendent)

Category 4 (Director - Chief Superintendent)

Category 5 (Executive Manager - Superintendent)

State Operations - Assistant Commissioner

Headquarters

Clinical Operations

Following a redesign in 2014, the overall Clinical Governance of the Service is ensured by the Director of Clinical Quality & Patient Safety, currently filled by A/Chief Superintendent Tony Hucker ASM. The office ensures that patient care services provided by officers of the Queensland Ambulance Service are delivered at a consistently high standard, and that current clinical research is included within contemporary practice. The office also responsible for QAS Policy on Staff Health and Wellbeing and setting medical priorities for ambulance resource dispatch. There are several Senior Medical Advisors within the directorate, including Dr Stephen Rashford ASM FACEM, and Dr Rob Cardwell FACEM.

Ambulance operations of the Queensland Ambulance Service are performed predominantly by its own operational staff. QAS operational staff include Student Paramedics, Advanced Care Paramedics (ACPs), Critical Care Paramedics (formally known as Intensive Care Paramedics), Patient Transport Officers (PTOs) and Emergency Medical Dispatchers (EMDs).[1] In some of Queensland's rural areas, QAS First Responders provide emergency care until the arrival of paramedics, while in remote areas First Responders may also work as volunteer drivers or operate ground transport vehicles (such as the Torres Strait). In some areas, non-QAS staff operate the QAS ambulances as unpaid volunteers, or as QHealth nurses as part of a hospital-based ambulance station, for example in Morven and Thargomindah.


Advanced Care Paramedics possess either a Diploma of Paramedical Science (Ambulance) or a Bachelor of Health Science (Paramedic) or equivalent qualifications.[7] In addition to this, an Critical Care Paramedic possesses a Graduate Diploma in Intensive Care Paramedic Practice or equivalent.[8] ACPs and CCPs attend medical, surgical and trauma emergencies. Patient Transport Officers possess a Certificate III in Non-Emergency Patient Transport or equivalent, and provide non-emergency patient transport services.[9] Emergency Medical Dispatchers have completed a Certificate III in Ambulance Communications (Call Taking) and a Certificate IV in Ambulance Communications (Dispatch) or equivalent. EMDs receive emergency calls and direct ambulance services to the emergency, and advise callers in performing first aid until the ambulance arrives on scene.[10]

ACPs are competent in many emergency medical skills, including airway management (oropharyngeal and nasopharyngeal airway, oropharyngeal suctioning, laryngoscopy and Magill's forceps, laryngeal mask airway, intermittent positive pressure ventilation), cardiac management (cardiac monitoring - basic ECG interpretation and 12-lead ECG, manual defibrillation), drug/fluid administration (intramuscular injection, intravenous cannulation, fluid replacement), and the administration of basic and advanced drugs (aspirin, glucose, glyceryl trinitrate, adrenaline, morphine etc.).[7][11]

Critical (Intensive) Care Paramedics typically respond when an advanced level of clinical practice is required. In some areas, they will respond as a single officer in units known as 'pods'. CCP pods operate around the state, focused on metropolitan, major regional centers, or where a rescue helicopter is located. These ambulances are not equipped to transport patients, but contain much of the same equipment as a regular ambulance, as well as advanced equipment. CCPs are competent in all ACP procedures, as well as advanced emergency medical skills, such as endotracheal intubation, synchronised cardioversion, transcutaneous cardiac pacing, continuous positive airway pressure ventilation CPAP, decompression of tension pneumothorax, extra-jugular venous cannulation, procedural sedation (midazolam, ketamine etc.), pre-hospital thrombolysis (tenecteplase), intraosseous access, as well as the administration of advanced drugs (atropine, heparin, ketamine etc.).[8][11]

Vehicles

A QAS ambulance, in original livery.

The most common metropolitan ambulance is the Mercedes Sprinters with the new livery (see image), which is intended to allow for a uniform vehicle across Australia. In rural areas, due to the need for extra traction or rough roads, 4x4 vehicles are common, based upon a Toyota Landcruiser Cab Chassis (1+1 modular 4x4s) or Toyota Landcruiser Troopcarrier. Both 4x4s carry one stretcher patient in addition to the normal equipment found on a typical Mercedes Sprinter. These vehicles (Mercedes Sprinters) are used by both Advanced Care Paramedics (ACPs) and Patient Transport Officers. The acute vehicles carry one (1) stretcher and the patient transport vehicles Mercedes Sprinters carry two (2). Toyota Hiace PTO vehicles with twin stretchers are also in use around the State, along with a variety of other transport vehicles including wheel-chair vehicles. Additionally, two stretcher Mercedes 519 acute ambulances operate around the state by ACP & CCPs, particularly in regional and rural areas.

Critical Care Paramedics (formally known as ICPs) often drive 'pods' (commonly Suburu Forrester, or in some areas, dual-cab utes). These vehicles cannot carry patients, however they carry much of the same equipment as the Sprinters, and are able to get to scenes relatively quickly.

Previously, the QAS used Ford F-series truck (Ford F-250 and F-350) until Ford stopped importing these in 2008. These are still in use in some rural areas, however are not common in the Metropolitan areas.

Aeromedical Services

Aeromedical services around Queensland are provided by the Royal Flying Doctor Service in conjunction with the Queensland Ambulance Service.

Helicopter operations

Helicopter retrieval incorporates both pre-hospital rescue and interhospital transfer services across Queensland and has done so since 1979. Queensland Health contracts six medical rescue providers to provide emergency air rescue and air transfer services. Each contractor is designated a region of Queensland and has the option of providing more than one helicopter to their region.

Helicopters operate from Brisbane, Townsville & Cairns (Rescue 500, 521, 510 (3 AW139's and 2 Bell 412's which are provided by Air Services Public Safety Business Agency), while a contracted government rescue helicopter operates from Thursday Island (Rescue 700) called Torres Strait & NPA Rescue (Bell 412). RACQ CareFlight operates out of the Gladstone, Gold Coast, Roma and Toowoomba (6 Bell 412's, 1 Bell 230 and 1 Eurocopter AS350 Squirrel, AGL Action Rescue Helicopter out of Bundaberg (1 Bell 206L) and Sunshine Coast (2 BK 117s), RACQ CQ Rescue out of Mackay (Rescue 422 and Rescue 412, 2 Bell 412's), RACQ Capricorn Helicopter Rescue out of Rockhampton (Rescue 300 Sikorsky S-76 and RACQ NQ Rescue out of its Mount Isa base (Rescue 300 MBB B-105).[12]

Funding

From 2003, the service was funded by the Community Ambulance Cover scheme, a levy added to all customers of electricity retailers in Queensland.

In 2009, the amount payable was a flat fee just above $100 annually. This amount and collection method is designed to provide a reliable flow of income to the service.[13]

On 1 July 2011, the levy was abolished, with funding now directly provided by the Queensland Government.

Ranks

The ranks feature from lowest to highest.

Support

Paramedic

Classified Officers

See also

Wikimedia Commons has media related to Queensland Ambulance Service.

References

  1. 1 2 About QAS. Department of Community Safety. Retrieved on 9 November 2011.
  2. 1 2 Queensland Ambulance Service performance report 2009. Department of Emergency Services. Retrieved on 9 November 2011.
  3. ↑ https://ambulance.qld.gov.au/docs/PPI_Q1_2013-14.pdf. Missing or empty |title= (help); External link in |website= (help);
  4. 1 2 Queensland Ambulance Service History and Heritage. Department of Community Safety. Retrieved on 9 November 2011.
  5. ↑ QAS Structural Reform Report. Department of Community Safety. 2012.
  6. ↑ "QAS LASN Structure".
  7. 1 2 Paramedic 3. Department of Community Safety. Retrieved on 9 November 2011.
  8. 1 2 Paramedic 4 (Intensive Care). Department of Community Safety. Retrieved on 9 November 2011.
  9. ↑ Patient Transport Officer. Department of Community Safety. Retrieved on 9 November 2011.
  10. ↑ Qualified Emergency Medical Dispatcher (Level 3). Department of Community Safety. Retrieved on 9 November 2011.
  11. 1 2 http://www.ambulance.qld.gov.au/medical/pdf/scope%20of%20practice.pdf Archived 4 July 2009 at the Wayback Machine
  12. ↑ "Who is PSBA?" (PDF).
  13. ↑ The Community Ambulance Cover scheme. Queensland Treasury. Retrieved on 9 November 2011.

External links

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