Florian Breitenbach

Rettungsdienst und mehr

Paramedics Australasia Conference #3

Day three in Sydney was another early morning start, with a slightly nervous yours truly, as  it was to be the day of his first conference presentation. But first, there were talks to attend:


  • “What can Australian paramedics learn from the modern battlefield” by Col Dr John Crozier. apparently, we can learn that if the enemy shoots at us, we should shoot back. The first half of the presentation was very military focussed, and I found myself tuning out a lot because, you know, this is a paramedic conference, and not a manual of “how I won the war”. Finally, though, we got in to the clinical side of things, and my parasympathetic responses began to be suppressed: wound clotting bandages in general have come in to a recession, now that they are not as good as they thought to have been. Tourniquets are a last measure for haemmorhage control, but when used are life saving. An interesting fact that was points out was in regards to tourniquets in surgery: patients can have tourniquets applied for hours in an operating theatre – surely we can too in an out of hospital environment? Thing is, in the operating theatre, the patient is a) in a controlled environment, and b) generally haemodynamically stable. So 60 – 90 minutes is the general consensus to leave a tourniquet on. One last point of interest was the fact that 28% of tension pneumothoraces were missed in the battlefield, which was traced down that clinical signs don’t always tell you what is happening to the patient. Time for portable ultrasound, in my opinion!
  • “The history of paramedic education” by Dr Ric Bouvier: hop in your Delorean, dial in 1950, and slowly drive towards the now, and admire the view of past education systems and general progression in our profession. Ric got the audience on his side early on with the witty but accurate comment: “I’m glad to see so many paramedics without balls here!”. He was referring to the nearly 50/50 gender split amongst paramedics in Australia – not bad seeing that (depending on the state) females were not allowed to work on the frontline 20 – 30 years ago.
  • Professor Hugh Grantham continued with the topic with a very clear and informative presentation style, highlighting the journey from Ambulance Driver with a first aid certificate, moving up the ranks via structured courses, diplomas and now to tertiary level educated clinicians, driving research via Masters degrees and PhDs.  “Paramedicine needs to be driven by paramedics. Paramedics need to be driven by patients needs.” His quote sums it up nicely – history has shown us that instead of taking the patient to care, care needs to be taken to the patient. And for care to be take to the patient, quality caregivers are needed – decently educated paramedics. And who better to look after our profession than our own?
  • “Community Paramedics – here, there and everywhere” by Gary Wingrove. Gary brought up some great issues, such as that paramedicine needs to adapt to the needs of the community, and to coordinate these changes and learn from each other there needs to be an international exchange – this is where the International Roundtable on Community Paramedicine (IRCP) comes in . Other things he mentioned were…oh…umm…I have to admit, I got a bit sidetracked during Gary’s speech. Not because it was boring or I was disinterested, not at all, but because Gary is also a founder and leader of International Paramedic – and his talk had very many parallels and good idea for International Paramedic. He would talk about something, and that would trigger my mind off in to a world of thought…so, sorry Gary! I’ll make it up with a dedicated post to International Paramedic.
  • “A model of paramedic decision making in cases involving pain” by Bill Lord. A very interesting subject, as I believe we generally under treat pain in patients. Also a very tricky topic, as pain is such a personal experience – who am I as an outsider to judge what is going on inside someone else’s body? Bill’s extensive research (which won him an award at the conference) has shown amongst others that vital signs have no correlation to pain and that females are less likely to receive pain relief. Personally I am still a little sceptical in regards to some of the findings – probably warranting a dedicated blogpost.
  • “Perceptions of clinical leadership in St John Ambulance Service WA: A research report” by Joseph Cuthbertson. A report on Paramedics preferences and reactions to clinical governance and leadership by Clinical Support Paramedics. Interesting from a leadership perspective because Western Australian does not have a tiered response system, every out of hospital emergency care provider is a paramedic (or student paramedic). Clinical Support Paramedics have a supportive role only, and do not have additional skills. Findings were that Paramedics wanted leadership and guidance from Clinical Support Paramedics who were confident, had experience, extensive background knowledge and patience.
  • By now my presentation was quickly approaching, so I clinked out of the buzz and retreated for a little last minute preparation. I’ll give you a more detailed version of my presentation in a dedicated post (hey, I have to give myself the special treatment somewhere!). Meanwhile, I had some spies scattered around reporting some interesting findings:
  • “Can relief from chest pain with nitrates inform a clinical decision?” by Laura Roberts. Studies have shown that you may as well flip a coin. That right, a complete 50/50 chance that the chest pain is of cardiac origin if it is relieved nitrates. Good knowledge to have in the back of your mind next time you respond to a chest pain call.
  • “Paramedic Response to Suicide Bombings: Learning form the Israeli Experience” by Christopher Foerster. Do you know how long it takes for an Israeli bus service to take up normal service after a bomb attack? 90 minutes. Pretty clued in, unfortunately the have had a fair bit of experience in these things…
  • “Occupational risks on undergraduate paramedic students in clinical placements” by Tegwyn Bath. The lecture prior to mine, but I still managed to soak up a little information as how to minimise risks for potential future students that may be riding with me.
  • “Recent Australasian Disasters – Fire, Cyclones, Earthquakes” by Paul Holman, Neil Noble and Major Brendan Wood. The closing talk of the day, showing the efforts and effects of the bush fires in Victoria, cyclone Yasi in Queensland and the Christchurch earthquakes. A little more on that in the next post though!


Brandon Oto says:

Do you know the studies that Laura Roberts referred to? That’s a stronger stat that I’m familiar with and would be very valuable to be able to hang my hat on.

flobach says:

Hi Brandon,
I’ll try and get in touch with her to find out, and post it on the blog.

Brian says:

Did you ever get an answer on this?

flobach says:

Yes I did, never got round to publishing it though. Thanks for the reminder, post coming shortly!

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