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

2. what does a GP know about critical care?

3. “Quality care, out there” #FOAMed

4. 2012 Survey of Rural Docs KIdocs.org

5. TENET #1 critical illness has no respect for geography

6. tyranny of distance

7. TENET #2 trauma outcomes worse rural vs metro Fatovich et al (2011) A comparison of metropolitan vs rural major trauma in Western Australia Resuscitation 82 : 886-890 “...pre-trauma centre interventions may significantly decrease mortality. These processes represent local solutions to a complex organisational problem” 4x

10. TENET #3 Prehospital care is no place for enthusiastic amateurs

11. quality care

12. 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

13. 53% of RURAL GP-Anaesthetists called to attend pre-hospital incident in the previous year

14. collisions

15. rollovers

16. extrications

17. farms

18. emergency airway

19. TENET #3 Prehospital care is no place for enthusiastic amateurs

20. who is calling rural docs?

21. experts in pre-hospital care

22. yawning gap in the country

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

24. 53% of rural docs involved pre-hospital in previous year agreed call out criteria relevant training & equipment using same protocols as retrieval 7% 12% 37%

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

26. 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

27. no more cowboys

28. more useful than this ?

29. Integrated Trauma System 53%

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

31. one size does not fit all Local GPs not called to Kerang crash, Rural Doctor’s Association tells inquest 11 dead 23 injured

32. Do we need BASICS in Australia?

33. Can we agree? Critical illness does not respect geography Prehospital is no place for enthusiastic amateurs Rural doctors may have relevant skills Early entry to trauma system = better outcomes Right Person, Right Place, Right Time

34. Stop calling us?

35. KIdocs.orgKIdocs.org / ruraldoctors.net @KangarooBeach ruraldoctors.net