A correspondent has drawn my attention to this news story –
- Isabel Moussalli, ‘Stingray attack prompts call for change about who can give pain relief to patients at sea’ ABC Esperance (Online), 16 October 2018.
The essence of the story is that a man who was stung by a stingray ‘suffered hours of pain because a marine rescue service was not allowed to give him pain relief and volunteer ambulance officers were not allowed to board rescue boats’. The story tells us that the Esperance Volunteer Marine Rescue Service (VMRS) ‘personnel were trained in first-aid but were not allowed to administer pain medication’. As a result the VMRS requested a paramedic be sent aboard the rescue vessel but this was not possible as:
… the town’s only career paramedic was unavailable.
A St John Ambulance spokesperson said because volunteer ambulance officers were not trained to give medical care on board boats in open water or aircraft, they were not able to help the patient until he reached shore.
“St John has expertise in the provision of land-based pre-hospital care and land-based patient transport,” the spokesperson said.
“Once on land, our crew was able to deliver two forms of pain relief to the patient, including a ketamine product.”
The patient, Mr Black is quoted as saying:
“The Government needs to look into this and actually make some ruling where volunteer paramedics are allowed on boats, just to allow better care of the patient,” he said…
Mr Black said if changes could not be made to allow volunteer ambulance officers on boats, he believed the VMRS should obtain qualifications to administer pain relief.
My first comment is that I think it is unfortunate that people presume everything is ‘up to the government’. In conference I go to government officers bemoan the fact that everyone looks to government for a solution as evidence of a lack of personal resilience. That is not the issue here but the statement that ‘the government needs to look into this…’ is still reflective of the view that governments are the cause of, and solution to, every problem.
Recognising that I have only this story to go on, it has to be that the change ahs to come from St John Ambulance (WA) not the government. There is no ambulance service legislation in Western Australia and no regulation that says ‘a Volunteer ambulance officer must not be dispatched in a boat’. One can infer that it is St John (WA) that has determined that the risk to staff and patients of using volunteers to try and treat people on boats exceeds the potential benefit. If St John (WA) would allow a career paramedic to travel on the VMRS boat then one might infer (or at least hope) that there has been a risk assessment to determine in what circumstances and with what training and PPE a paramedic will be allowed to set off with the VMRS. Presumably the relevant risk mitigation could be extended to volunteers if St John wanted to do that.
The government, as the contractor with St John for the provision of emergency ambulances may want to discuss the matter with St John but it unlikely that they are in a position to ‘make some ruling’. The key driver for change has to be St John.
As for the alternative, that the ‘VMRS should obtain qualifications to administer pain relief’ that would surely be a matter for the VMRS. No doubt the VMRS could approach the WA Health department and find out what training, record keeping and storage was required to then get an authority under the Medicines and Poisons Act 2014 (WA) to carry, supply and administer the relevant pain relief medication. Again I wouldn’t expect the government to take the initiative here, it would be up the VMRS to determine whether that was a path they wanted to follow and then approach the relevant department to identify, and follow, the process for a drug authority.
Mr Black’s situation must have been terrible to endure, but I don’t see that it’s a problem for the government to address. If there are issues with responding ambulance volunteers on VRMS boats or with VMRS volunteers not being able to access pain relief, the solution lies with either St John (WA) and/or the VRMS. It’s not an issue that government could or should be expected to come in and wave an magic edict to solve.