Clinical presentations, physician consultations and patient transport options for Australian remote and industrial paramedics
PDF

Keywords

paramedic
industrial
remote
workforce
prehospital

How to Cite

1.
Johnston T, Acker J. Clinical presentations, physician consultations and patient transport options for Australian remote and industrial paramedics . Australasian Journal of Paramedicine [Internet]. 2022Jul.27 [cited 2022Aug.15];19. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/1011

Abstract

Introduction

The aim of this study was to provide a snapshot of Australian remote and industrial paramedics’ patient clinical presentations, experience with physician consultations and options for patient transport to tertiary care.

Methods

This exploratory, cross-sectional descriptive study employed a purpose-built online survey. Participants were 78 paramedics working in Australian rural and remote industrial settings recruited in 2015 using web-based, respondent-driven sampling. In addition to a series of closed ended questions, respondents were asked to recall the number of times they encountered specific clinical presentations during the past year. Data were analysed using descriptive statistics and modes were calculated for ordinal data associated with clinical presentations.

Results

The traumatic presentations that participants recalled encountering at least 10 times the preceding year included back pain (39.7%), minor lacerations (38.5%), joint (36.4%) and hand (30.8%) injuries. Respondents selected headache (64.1%), nausea, vomiting or diarrhoea (52.6%), respiratory infections (50%), ear, nose or throat problems (43.6%) and localised infections or rash (39.7%) as the most common medical presentations. Of the respondents, 38.4% managed patients with mental health presentations a minimum of six times in the preceding year, and 45.3% treated at least one patient in cardiac arrest. While 94.8% of participants said topside support was available, over half described consulting physicians infrequently and if they did, it was typically by telephone. Most respondents (61%) indicated that their worksite was located over 100 km from a hospital.

Conclusion

Survey findings indicate that paramedic participants recall encountering a wide range of clinical presentations and managing low acuity illnesses more commonly than traumatic injuries. Most respondents were located at least 100 km from the nearest hospital and although almost all had access to topside support, over half stated they consulted physicians infrequently.  

https://doi.org/10.33151/ajp.19.1011
PDF

References

Australian Government Geoscience Australia. Australia’s size compared. 2021. Available from: https://www.ga.gov.au/scientific-topics/national-location-information/dimensions/australias-size-compared.

Statistica. Number of employees in the mining industry in Australia from the financial year 2012 to 2020. 2021. Available from: https://www.statista.com/statistics/682989/australia-employment-in-mining-industry/.

Parker S, Fruhen L, Burton C, McQuade S, Loveny J, Griffin M, et al. Impact of FIFO work arrangements on the mental health and wellbeing of FIFO workers. Perth, WA: Centre for Transformative Work Design; 2018.

Dittrick P. Offshore care on line. Oil Gas J 2009;107(39):16.

Asare BY-A, Kwasnicka D, Powell D, Robinson S. Health and well-being of rotation workers in the mining, offshore oil and gas, and construction industry: a systematic review. BMJ Glob Health 2021;6(7):e005112.

Gibson Smith K, Paudyal V, Klein S, Stewart D. Health, self-care and the offshore workforce – opportunities for behaviour change interventions, an epidemiological survey. Rural Remote Health 2018;18(2):4319.

Jones R, Cattani M, Cross M, Boylan J, Holmes A, Boothroyd C, et al. Serious injuries in the mining industry: preparing the emergency response. Australas J Paramedicine 2019;16. doi: 10.33151/ajp.16.652.

Nowrouzi-Kia B, Gohar B, Casole J, Chidu C, Dumond J, McDougall A, et al. A systematic review of lost-time injuries in the global mining industry. Work 2018;60(1):49–61.

Evjemo TE, Reegård K, Fernandes A. Telemedicine in oil and gas: current status and potential improvements. Procedia Manuf 2015;3:1289–96.

Ponsonby W, Mika F, Irons G. Offshore industry: medical emergency response in the offshore oil and gas industry. Occup Med 2009;59(5):298–303.

Norman JN, Ballantine BN, Brebner JA, Brown B, Gauld SJ, Mawdsley J, et al. Medical evacuations from offshore structures. Br J Ind Med 1988;45(9):619–23.

Adams ME, Lazarsfeld-Jensen A, Francis K. The implications of isolation for remote industrial health workers. Rural Remote Health 2019;19(2):5001.

Witham H. Remote and rural nursing: an endangered profession? Aust Nurs J 2000;7(9):18–21.

Acker J, Johnston T, Lazarsfeld-Jensen A. Industrial paramedics, out on site but not out of mind. Rural Remote Health 2014;14(4):2856.

Seel D, Turner M. Industrial paramedic: an emerging speciality? J Paramed Pract 2016;8(7):350–5.

National Offshore Petroleum Safety and Environmental Management Authority. Qualifications of medical personnel on offshore petroleum facilities. Perth, WA: NOPSEMA; 2020.

Mair F, Fraser S, Ferguson J, Webster K. Telemedicine via satellite to support offshore oil platforms. J Telemed Telecare 2008;14(3):129–31.

Phillips JC. Medical support by a team of doctors to offshore paramedics. J R Coll Gen Pract 1987;37(297):168–9.

Institute of Remote Healthcare. Competency and training for health practitioners working in remote environments: a revised consensus document. Aberdeen, UK: IRHC; 2017.

Mulholland P, O’Meara P, Walker J, Stirling C, Tourle V. Multidisciplinary practice in action: the rural paramedic – it’s not only lights and sirens. Australas J Paramedicine 2009;7(2). doi: 10.33151/ajp.7.2.166.

O’Meara P, Furness S, Gleeson R. Educating paramedics for the future: a holistic approach. J Health Hum Serv Adm 2017;40(2):219–53.

National Rural Health Alliance. The paramedic workforce in rural, regional and remote Australia. Deakin, ACT: NRHA; 2019.

University of Tasmania. Graduate certificate in healthcare in remote and extreme environments. 2020. Available from: https://www.utas.edu.au/courses/chm/courses/m5a-graduate-certificate-in-healthcare-in-remote-and-extreme-environments.

Wejnert C, Heckathorn DD. Web-based network sampling: efficiency and efficacy of respondent-driven sampling for online research. Sociol Methods Res 2008;37(1):105–34.

Keane S, Smith T, Lincoln M, Wagner S, Lowe S. The Rural Allied Health Workforce Study (RAHWS): background, rationale and questionnaire development. Rural Remote Health 2008;8(4):1132.

Worley P, Strasser R, Prideaux D. Can medical students learn specialist disciplines based in rural practice: lessons from students’ self reported experience and competence. Rural Remote Health 2004;4:338.

Torkington AM, Larkins S, Gupta TS. The psychosocial impacts of fly-in fly-out and drive-in drive-out mining on mining employees: a qualitative study. Aust J Rural Health 2011;19(3):135–41.

Acker J, Johnston T. The demographic and clinical practice profile of Australian remote and industrial paramedics: findings from a workforce survey. Australas J Paramedicine 2021;18. doi: 10.33151/ajp.18.959.

Lee Abbott M. Using statistics in the social and health sciences with SPSS® and Excel®. Hoboken, New Jersey. Wiley-Blackwell; 2016.

Health and Safety Executive. Offshore statistics & regulatory activity report 2020. Available from: https://www.hse.gov.uk/offshore/statistics/hsr2020.pdf.

Brown E, Williams TA, Tohira H, Bailey P, Finn J. Epidemiology of trauma patients attended by ambulance paramedics in Perth, Western Australia. Emerg Med Australas 2018;30(6):827–33.

Shaw M, Hughes KE. High-risk, low-volume: evaluation of a reusable cricothyrotomy model in a paramedic difficult airway training course. Air Med J 2020;39(4):246–7.

Jewer J, Parsons MH, Dunne C, Smith A, Dubrowski A. Evaluation of a mobile telesimulation unit to train rural and remote practitioners on high-acuity low-occurrence procedures: pilot randomized controlled trial. J Med Internet Res 2019;21(8):e14587.

Waage S, Moen BE, Pallesen S, Eriksen HR, Ursin H, Akerstedt T, et al. Shift work disorder among oil rig workers in the north sea. Sleep 2009;32(4):558–65.

Gibson Smith K, Paudyal V, Klein S, Stewart D. Medical evacuations and work absences in offshore oil and gas industry personnel. SelfCare 2019;10(4):105–15.

Ross JK. Offshore industry shift work – health and social considerations. Occup Med 2009;59(5):310–5.

Health Safety and Executive. Assessment of medical status of the offshore population. Offshore technology report OTO 97 057. 1998. Available from: https://www.hse.gov.uk/research/otopdf/1997/oto97057.pdf.

Gardner R. Overview and characteristics of some occupational exposures and health risks on offshore oil and gas installations. Ann Occup Hyg 2003;47(3):201–10.

Osakwe Adakporia KA. Exploration of competency requirements and current training models in remote medical emergency response in the oil and gas industry of Nigeria: a mixed method study [PhD thesis]. Aberdeen, UK: Robert Gordon University; 2020. Available from: https://doi.org/10.48526/rgu-wt-1447366.

Parent A, Smith R, Townsend R, Johnston T. Mental health education in Australian paramedic curriculum – a scoping review. Australas J Paramedicine 2020;17. doi: 10.33151/ajp.17.791.

Roberts L, Henderson J. Paramedic perceptions of their role, education, training and working relationships when attending cases of mental illness. Australas J Paramedicine 2009;7(3). doi: 10.33151/ajp.7.3.175.

Institute of Remote Healthcare. Remote healthcare for energy and associated maritime activities. Aberdeen, UK: IRHC; 2013. Available from: https://slideplayer.com/slide/7680711/.

Anscombe DL. Healthcare delivery for oil rig workers: telemedicine plays a vital role. Telemed J E Health 2010;16(6):659–63.

Greater Sydney Area HEMS. Interhospital patient packaging. 2021. Available from: https://sydneyhems.com/resources/curriculum/interhospital-patient-packaging/.