Rural doctors have a pivotal role in their communities, providing not just primary care but also emergency and other procedural services, usually via local Hospitals.
On occasions rural clinicians may be tasked to incidents outside of their hospital - a car rollover, a collapse or another prehospital incident. In rare occasions, rural communities may face hazards from disasters, such as bushfire, cyclone, flooding etc.
The Australian College of Rural & Remote Medicine (ACRRM) considers it a core component of the Primary curriculum that Fellows are actively involved in emergency care for their communities . Despite their pivotal role in local community care, the place of the rural doctor in prehospital responses remains ill defined within State and National plans.
A 2012 survey showed that 58% of rural GP-anaesthetists had responded to some form of prehospital incident in the previous 12 months - yet such responses were 'ad hoc' with only 7% responding under formal arrangements with ambulance/retrieval services & only 12% reporting having had any training in prehospital care .
Overseas systems such as the UK BASICS and New Zealand PRIME system offer a structure using appropriately-trained responders to deliver the 'right clinician, to the right patient, at the right time' [3,4]. At present there is no such system in Australia, despite the tyranny of distance causing delays in delivery of care to trauma patients in rural areas. Similarly ambulance services in rural areas may be staffed by volunteers without advanced skills.
This survey is aimed at rural clinicians to determine whether there is scope for developing a cohesive national framework of rural responders, delivering appropriate care, under appropriate clinical governance and using standardised equipment. The aim is to ensure that the rural clinician remains pivotal to emergency care in their community, as well as offering a structure for future community resilience in the case of larger disaster (bushfire, floods, earthquake, cyclone).
Feedback from other relevant parties (paramedics, rural nurses, retrievalists) is also welcomed, mindful that the purpose of such a network is only to provide clinical support when needed, not to replace existing structures.
It should only take you 5 minutes to complete online. Your time and comments are much appreciated.
Dr John Hall FACRRM
Dr Tim Leeuwenburg FACRRM
GP-Anaesthetist, Kangaroo Island, South Australia
1/ ACRRM Primary Curriculum DOMAIN 3 https://www.acrrm.org.au/misc/curriculum/Default.htm#ACRRM
Primary Curriculum FINAL/2 5 Domain 3.htm#_Toc367272508%3FTocPath%3D2.0%20The%20Primary%20Curriculum%7C_____8
2/ Leeuwenburg T. (2012) Access to difficult airway equipment and training for rural GP-anaesthetists in Australia: results of a 2012 survey Rural and Remote Health 12: 2127. (Online) 2012 http://rrh.org.au/publishedarticles/article_print_2127.pdf
3/ BASICS UK (British Association of Immediate Care Schemes) via URL http://www.basics.org.uk
4/ PRIME NZ (Primary Response in Medical Emergencies) via URL http://prime.stjohn.org.nz/about/default.aspx