EOC Western Australia Metropolitan Ambulance Service (ID 79815)

    • EOC Western Australia Metropolitan Ambulance Service (ID 79815)

      EOC Western Australia Metropolitan Ambulance Service (ID 79815)
      The Western Australia Metropolitan Ambulance Service covers the Perth Metropolitan Area as well as the City of Mandurah. It is home to a population of well over 2 million people and covers a land area of roughly 3400 square kilometres. St John Ambulance is the sole state contracted ambulance service provider in Western Australia.


      Play ID 79815

      Operational Area
      ~3400 km2
      >2.2 million people
      >900 POI’s
      >265.000 responses per year (emergency & non-emergency)

      Health Services
      General Health Services
      14 Hospitals
      10 Emergency Departments
      1 Specialized Children’s Hospital

      Mental Health Services
      3 Specialized Mental Health Institutions
      8 Hospitals with Specialized Mental Health Wards

      Emergency Medical Service Providers
      St John Ambulance Western Australia
      - 30 Depots
      - 84 Emergency Ambulances (RTW/NAW)
      - 45 Patient Transfer Ambulances (KTW)
      - 2 Complex Patient Transport Ambulances (NAW)
      - 8 Clinical Support Paramedics (NEF)
      - 4 Area Managers (NEF)
      - 2 Mass Casualty Incident Response Vehicles (NEF)
      - 1 Special Operations Response Vehicle (NEF)

      Newborn Emergency Transport Service Western Australia (NETS WA)
      - 1 Depot
      - 2 Mobile Intensive Care Ambulances for Babies (NAW)

      RAC Rescue Helicopters
      - 2 Helicopter Bases (1 within Operational Area)
      - 2 Rescue Helicopters (1 within Operational Area)

      WA Hospital Emergency Management
      - 14 Health Response Teams (NEF)

      Fleet Overview
      Display Spoiler


      Mercedes-Benz Sprinter Blanko's by Chr2 & Westfale
      Subaru Forester Blanko by Marcolone95
      Bell 412 Helicopter Blanko by Bass D.
      Holden Colorado & Holden Trailblazer Blanko's by EuRoo



      Dispatch Protocols
      The St John Ambulance State Operations Centre uses ProQA and MPDS for their ambulance dispatch. The base MPDS codes and sub categories have been implemented into this Operations Centre. St John Ambulance utilizes 4 levels to prioritise emergency calls which have been implemented into the dispatch. Lastly additional categories have been added for scaling up to declare emergencies as indicated under the Emergency Management Act 2005 or for deployment of Health Response Teams.

      Health Response Teams
      Within the operational area of the Metropolitan Ambulance Service exist a total of 14 Health Response Teams (HRT). A Health Response Team can be called upon in exceptional circumstances. Often HRT’s are mobilized in case of a disaster to augment and improve the pre-hospital response capabilities. They may also be called on scene to perform specialized procedures, such as field amputations. An HRT may not be deployed without appointing an HRT Health Commander (which can also be deployed in case of a large incident). Large (tertiary) hospitals can deploy a large team consisting of 2 doctors and 3 or 4 nurses, while general hospitals can each deploy a single team of 1 doctor and 2 nurses. A large team is indicated in the callsign by A1 and A2 (two vehicles) or B1 and B2 (2 vehicles), which can of course also be dispatched separately. A small team is indicated in the callsign by C1 (one vehicle). The B-team consists of pediatric doctors and nurses from Perth Children's Hospital.

      Mass Casualty Incidents
      A Mass Casualty Incident (MCI) is a prime example of a situation where one or more HRT’s may be deployed. Additionally St John Ambulance possesses two specialized Emergency Support Vehicles that carry special equipment for MCI’s. Each ESV provides units on scene with a field hospital, as well as equipment and supplies to treat up to 40 casualties. As a result ESV’s also provides a suitable base of operations for HRT’s to work or deploy from.



      Abbreviations used
      Display Spoiler
      AHS = Armadale Health Service
      CAS = Country Ambulance Service
      ESV = Emergency Support Vehicle
      CCP = Critical Care Paramedic
      CP = Community Paramedic
      CSP = Clinical Support Paramedic
      CPTV = Complex Patient Transport Vehicle
      FSH = Fiona Stanley Hospital
      HRT = Health Response Team
      JHC = Joondalup Health Campus
      KEMH = King Edward Memorial Hospital
      MAS = Metropolitan Ambulance Service
      MCI = Mass Casualty Incident
      MHC = Midland Health Campus
      PCH = Perth Children's Hospital
      PHC = Peel Health Campus
      RGH = Rockingham General Hospital
      RPH = Royal Perth Hospital
      SCGH = Sir Charles Gairdner Hospital
      SJA = St John Ambulance
      SOP = Special Operations Paramedic
      WA = Western Australia

      The post was edited 8 times, last by EuRoo: Information correction. ().

    • >>Approach 2 implemented at this time and turned approach 1 back to a private dispatch as a backup. Thanks to TheOssi for your help and input.<<


      Request for your help and input
      Western Australia adapts a system where I would distinghuish roughly 4 levels of emergency medical responders. These 4 would be:
      1- Volunteer Ambulance Officers at the level of Emergency Medical Assistent and Emergency Medical Technician (providing mostly Basic Life Support);
      2- Ambulance Paramedics (providing Advanced Life Support);
      3- Critical Care Paramedics and Clinical Support Paramedics with a post-graduate diploma in Intensive Care Paramedical Practice or equivalent (providing specialized treatment and interventions beyond Advanced Life Support);
      4- HRT Doctors (providing highest level of pre-hospital emergency medical care).
      Wikipedia provides a pretty good summary of the paramedic-levels that exist in Australia.

      In the Metropolitan Ambulance Service all emergency ambulances are staffed by paramedics from the second group. They are backed up by Critical Care Paramedics flying helicopters, and Clinical Support Paramedics as well as Area Managers from group 3 driving rapid response vehicles.
      In the Country Ambulance Service a large majority of emergency ambulances are staffed by volunteers from the first group. In populated areas full time crews consist of one paramedic (group 2) and one volunteer (group 1). In remote locations where ambulances are staffed only by volunteers, Community Paramedics back up these crews (unsure whether they are in group 2 or 3).

      My dilemma lies with how to implement these levels into this operations centre. This is also the reason why currently I have two different setups for this EOC. The main difference lies with how the Emergency ambulances are qualified ingame, as either RTW or NAW. I feel like two approaches exist:


      Approach 1 (ID 78816; Full time crew = NAW, Volunteer = RTW):
      All metropolitan emergency ambulances are NAW's here. Only country volunteer ambulances are RTW's. In regards to what calls they will be able to handle and the need for backup this might be the most realistic approach. It also offers the ability to distinguish between volunteer crew ability levels (RTW) and full time crew ability levels (NAW).

      Pro's:
      - Arguably most realistic approach;
      - Clear distinction between volunteer and full time crew training level and capabilities;

      Con's:
      - Critical Care Paramedics, Clinical Support Paramedics and HRT Doctors are mostly aesthetic and serve little actual purpose, other than being faster;
      - CCP's, CSP's and HRT's will leave the scene when an ambulance (NAW) arrives, even when the scene complexity may still warrant their deployment.


      Approach 2 (ID79815, All emergency ambulances are RTW):
      All metropolitan emergency ambulances and country volunteer ambulances are RTW's, however will be backed up by CCP, CSP & HRT units as NEF's. Arguably this could be the best/more enjoyable approach from a gameplay point of view. It increases the use of CCP, CSP and HRT units as they will actually be required for mostly effectively and efficiently dealing with certain patients and injuries. It will however remove the distinction between volunteer and full time crew training levels. It will also require adaptations in the Country Ambulance Service operations centres. Since in real life some populated areas are assumed to be covered by full time paramedic crews, there are no CSP or Community Paramedics deployed in these areas. If these full time crews become RTW's, it may be required to deploy rapid response vehicles in these areas for improved NEF cover, even though these units do not exist in real life.

      Pro's:
      - Arguably best/more enjoyable approach from a gameplay point of view;
      - CCP, CSP and HRT will be adopted as NEF units, and will actually serve a purpose ingame. They will stay involved in the scene as long as patient injuries do require this;
      - Since ambulances no longer provide 'Notartz-level treatment', one can even decide if NEF backup would realistically be best provided by a CCP, CSP or HRT unit. Time it takes to the get the appropriate crews and resources on scene will be more realistic.

      Con's:
      - Country areas will require the deployment of (in real life non-existent) rapid reponse vehicles to make up for the lack of Advanced Life Support otherwise provided by full time paramedics;
      - No ability level distinction between volunteer crews and full time crews.


      Question:
      Which approach do you think would be the better one? You can actually give it a try by playing both operation centres. Really appreciate all help and input! Thank you very much.


      >>Approach 2 implemented at this time and turned approach 1 back to a private dispatch as a backup. Thanks to TheOssi for your help and input.<<

      The post was edited 6 times, last by EuRoo: Change in text for better clarification. ().

    • If there are only those two options, then approach 1 seems to be the best.

      The second one won't work, since you cannot send just an RTW to all emergencies. That's not how the system works here in Germany.

      A third approach would be the following (assuming I understand the Australian EMS right; all I know, I know from the "Recruits: Paramedics" show, so...):

      Use RTW as the "normal" Paramedic Unit and NEF for the Critical/Intensive Care Paramedics who come to the scene and help/ride with the paramedic unit who does the transport, or NAW for those amblances, CCPs are a regular crew member.

      For better understanding of the German system:

      KTW mostly is for planned patient transports. Two EMTs (3 month of training) are on those units.
      RTW are manned by at least an EMT as driver and a Paramedic (Rettungsassistent with 2 year of training, or - and in the future only - Notfallsanitäter with 3 years of training). It varies from place to place what these units may do alone, but you can say, RTW are send to all not acute life threatening calls alone or to those which can be handled with a minimum of invasive measures, such as eCOPD which can be dealed with a little bit of salbutamol, or strokes or post-ictal patients.
      NEF are send to all life threatening calls, such as severe dyspnoe, resussitations, ACS, and so on. To those calls there's always send a RTW for transport, too. RTW+NEF=NAW.
    • @TheOssi

      Thank you very much for your response and clarifications. Your explanation of the German system has actually cleared up a few things that I previously missed or misunderstood. The difference between staff on German ambulances may actually not be as different from the Australian system as I thought.

      Your 'third approach' is what I intended to portray with my 'second approach', but reading back it may not have come across as such. I have made a few corrections to hopefully capture that intention better.
      I very much agree that the RTW+NEF (where necessary) may well be the most suitable approach to go with here. By making it lean more towards the German system it matches the gameplay features better and probably provides a more entertaining experience.

      Thanks again for your response.
    • Thanks for the suggestion @t.j.mann.
      I think @TheOssi is right though that it would cause for some problems. For Metro Perth it's not an issue since there are no EMT's on ambulances there. If I were to expand the Country Ambulance Service (either as neighbour or playable operations centre) it would cause for a almost non-existant cover of RTW-units in rural Western Australia however, also severely limiting emergency patient transport capabilities from small communities. So far I like how the system that TheOssi has also suggested has worked out ingame.
    • Just to clarify:
      Clinical support paramedics do not necessarily have any further education compared to a regular Ambulance paramedic and the clinical responsibility and decision is still with the Ambulance paramedic attending originally. They do backup a crew but unlike over east they do not take over a case.
      Furthermore there are no critical care paras on the road in every-day operations - a critical care para who is not currently on a helo rotation and is deployed on an regular ambulance has the same skillset as a normal Ambulance paramedic.
      HRT are extremly rare to be seen - tbh I can't recall ever seeing them deployed in Metro at all. They basically play no role at all in everyday operations.

      WA currently still has a single tier system when it comes to the metro ambulance service.

      (and btw: The second helo is in Bunburry and therefore technically a country ressource)

      Technically the Metro service is split up between "SOR" (South of the river) and "NOR" (North of the river), crews rarely are deployed to the other side and each dispatcher should try to "make things work" with his own ressources, but of course ambulances get dispatched to the other region daily.
      Country is a bit different, due to the current contract SJAWA has it is extremly rare for a volunteer only ambulance to ever see a Metro-patient - It might happen for mixed country crews (full-time Para+volly driver) in some areas e.g. Dawesville, but even that is not a daily occurence.

      Kind regards,
      Krumel
      Former SJAWA AP2 Paramedic