I have previously written about the role of paramedic and retained firefighter – see Registered paramedic or firefighter? (July 10, 2018) and NSW Paramedic and fire fighter – when does one role start and finish? (July 8, 2015).
I’m not sure if today’s question comes from the same person, or people who asked those questions but regardless of whether it’s the same person, they are both a retained firefighter and NSW paramedic. Today they say:
As a retained FF and registered paramedic on a truck if there is ever a need to treat or assess a patient at a job, I inevitably get tasked to do this. Even if I am pump operator, since the introduction of ‘Registration’ I cannot really take the ‘cap’ of paramedic off and as such I am obliged to do this as the senior clinical person at a job. My question is:
What documentation do I now use to state the level of care, assessment and/or recommendations that I have given either to someone who does not want any further treatment, or to give to another clinician (paramedic on duty) etc etc. F+RNSW seems to not see this a priority, I have bought it up on a local level and there were no answers, which is fine in theory if nobody ever needs to know what I did, but we all know that sometimes things turn to shyte, and in the worst case can go to Coroners Court for investigation. Like all Government Business units, the old adage of ‘if you didn’t document it, you didn’t do it’ rings true. We need a clinical incident form for medico-legal documentation on the truck to show what first aid or other clinical assessments or treatments are and were made. This is a significant risk to FF who are on the truck who either have their First Aid skills or other clinical skills and they carry the can if there is a police, clinical, F+RNSW procedural or coronial investigation
First some observations. Surely the worst case is ‘someone dies who did not need to’, not that it goes before a coroner. If the matter got before a coroner and if the matter came down to a lack of documentation so there was an incomplete handover or the paramedic/fire fighter could not know recall what happened, what’s the coroner going to do? Recommend that FRNSW get a system in place to record patient care.
Second I have no idea what is meant by the assertion that the first aid person will ‘carry the can if there is a police, clinical, F+RNSW procedural or coronial investigation’. That they may be asked – what did you do? But I don’t know what ‘carry the can’ means in this context.
Now to turn to the question of what documentation. Of course, there should be patient care records – ‘a clinical incident form … to show what first aid or other clinical assessments or treatments are and were made’ – even if patient care is secondary to FRNSW’s primary purpose. Records are required to ensure continuity of care and to remind the treating firefighter what happened if that is a matter that needs to be recalled in the future; see First aid patient records – who and what are they for? (January 31, 2015) and record appropriately.
The WorkSafe Australia Model Code of Practice for First Aid in the Workplace says (p. 19):
A record of first aid treatment given should be kept by the first aider and reported to managers on a regular basis to assist reviewing first aid arrangements. First aid treatment records are subject to requirements under Health Records legislation. Further information is available from the Office of the Australian Information Commissioner.
But there is no prescribed form or standard – use a notebook (ideally a notebook with carbon paper if such stuff still exists, but that would do).
I would expect that there are forms to be completed if a firefighter is hurt on duty and they could be used in the station or on a truck. Or as a registered paramedic, design your own and take it to FRNSW with a suggestion that they adopt it, print it and put one on every fire truck. If FRNSW won’t issue such a form, get your own. There are plenty of examples of patient care records and no doubt a shop like ‘Officeworks’ can supply a book with relevant records or see this from St John Ambulance Australia – https://shop.stjohn.org.au/workplace-patient-report-forms-10pack_1001836/. Perhaps FRNSW should buy a pad of these for every appliance?