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Improving prehospital care in rural Australia - time to borrow from overseas models?

Improving prehospital care in rural Australia - time to borrow from overseas models?. Tim Leeuwenburg Kangaroo Island SA @KangarooBeach. what does a GP know about critical care?. #FOAMed. “Quality care, out there ”. KIdocs.org. 2012 Survey of Rural Docs.

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Improving prehospital care in rural Australia - time to borrow from overseas models?

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  1. Improving prehospital care in rural Australia - time to borrow from overseas models? • Tim Leeuwenburg • Kangaroo Island SA • @KangarooBeach

  2. what does aGP know aboutcritical care?

  3. #FOAMed “Quality care,out there”

  4. KIdocs.org 2012 Survey of Rural Docs

  5. TENET #1critical illness hasno respect for geography

  6. tyranny ofdistance

  7. 4x TENET #2trauma outcomesworserural vs metro “...pre-trauma centre interventions may significantly decrease mortality. These processes represent local solutions to a complex organisational problem” Fatovich et al (2011) A comparison of metropolitan vs rural major trauma in Western Australia Resuscitation82 : 886-890

  8. TENET #3 Prehospital care is no placefor enthusiastic amateurs

  9. quality care

  10. TENET #4 Prehospital care should be Timely Appropriate Standardised Audited Prehospital tracheal intubation in severe facial trauma: a short window of opportunity Bredmose P P, Rock S, & Lockey D J Emerg Med J 2012;29:767e768

  11. 53% of RURAL GP-Anaesthetists called to attend pre-hospital incident in the previous year

  12. collisions

  13. rollovers

  14. extrications

  15. farms

  16. emergency airway

  17. TENET #3 Prehospital care is no placefor enthusiastic amateurs

  18. who is calling rural docs?

  19. expertsinpre-hospital care

  20. yawning gap in the country

  21. TENET #4 Prehospital care should be Timely Appropriate Standardised Audited Roadkill ?

  22. agreed call out criteria relevant training & equipment using same protocols as retrieval 7% 12% 37% 53% of rural docs involved pre-hospital in previous year

  23. Overseas Models British Association for Immediate Care BASICS, UK Primary Response In Medical Emergencies PRIME, NZ

  24. RERN in South Australia airway & resuscitation skills training with medSTAR appropriate equipment agreed call out criteria use of SOPs regular case audit fee-for-service under SA Health

  25. no morecowboys

  26. moreusefulthanthis ?

  27. 53% Integrated Trauma System

  28. Rural Doctors are mostly private entities HENCE NOT INCLUDED IN STATE PLANS

  29. 11 dead23 injured Local GPs not called to Kerang crash, Rural Doctor’s Association tells inquest one size does not fit all

  30. Do we need BASICS in Australia?

  31. Can we agree? Critical illnessdoes not respect geography Prehospitalis no place forenthusiastic amateurs Rural doctorsmay haverelevant skills Early entryto trauma system = better outcomes Right Person, Right Place, Right Time

  32. Stopcallingus?

  33. KIdocs.org / ruraldoctors.net@KangarooBeach

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