1. Extended Care Paramedics An Innovative Step Towards Integrated Care Sarah Rivett Ambulance Liaison Officer

2. What is an ECP? ECP stands for Extended Care Paramedic ECPs were invented to treat low acuity patients with sub- acute conditions and where appropriate, identify and initiate not emergency department care. To complete ECP training within Ambulance, you have to either be a registered nurse or completed Intensive Care Paramedic/or Paramedic training (highest Ambulance clinical levels).

4. What do ECPs treat? Allergies/hives Asthma Back pain (non-traumatic) Cervical spine assessment Chronic pain Croup Dislocations Fitting/convulsions Falls/back injuries Haemorrhage/lacerations Person ill (range of diagnosis) Soft tissue injury Minor injury and illness presentation Acute pain Stings/animal and insects bites and stings Catheter changes/urinary retention/urinary tract infections Burns COPD exacerbation Diabetic problems Epistaxis Eye problems/injuries Fish hook injuries Gastroenteritis Palliative Care Skin Infections Wound Assessment

5. Patient Contact Primary Survey Validating concerns Long case history Physical examination Providing patient options Interventions Referral / Transport Fact Sheet

6. Current Referrals General Practice Wound Care Falls Clinics ACAT Occupational Therapy & Physiotherapy Hospital in the home Mental Health Rapid response teams

7. How do I request an ECP? Calling 131 233 from RACF ProQA – standard questions State “Requesting an ECP” Triple Zero (000) only for Life Threatening (would not be requesting an ECP anyway)

8. Benefits of ECPs People being able to remain in their place of residence Right treatment, right patient, right location, right time, right place Avoiding long waits in ED for patients Unnecessary NSW Ambulance transports Unnecessary ED presentations or admissions

9. Future Opportunities Fracture management / Radiology APAC / HITH Cellulitis CAP COPD

10. ECP Governance All non transported cases attempted to be called back within 72hrs for follow up Representation within 72hrs are flagged and sent to clinical governance for review. (Currently makes up 1% of cases)

11. Contact Details Sarah Rivett HNE & North Coast Ambulance Liaison Officer srivett@ambulance.nsw.gov.au 0419 038 649 (business cards available)