Abandoned or Strategic withdrawal?

>I wonder if Bracks would have got re-elected had the fires happened earlier?

Doubt it would have made any difference - most people in the city have no real idea of the location of the fires or the type of country they are burning in - it's just "Gippsland" or "the High Country".

Mike Harding

Nor do they appear to particularly care, unless it affects their holidays.

Last time round they were ringing the ABC by 2 weeks in to complain about the amount of time the designated emergency broadcaster was dedicating to fire bulletins.

Had the election been two weeks later Bracks would have been on a plane before Howard and Rudd got around to visiting the fireground, but would have needed an advisor to tell him he couldn't get a tram to Mansfield.

Dave

Dave, Bracksie knows how to use our taxes. It is much more advisable to use them to have a helicopter to get him to Mansfield. For us down the South West he would to get him away from us quicker. No, no emergency one for us - if there is an emergency, wait til one gets from Melbourne, but that will be after an ambulance has a look first. That may take over an hour of course. Whats an emergency?

Hi John,

I'll have to agree to disagree with you on that one.

Mildura, Warrnambool and Portland are far better serviced by fixed wing. The flight time by HEMS to Melbourne is far in excess of that by a SuperKingAir over those distances.

This is as a result of the vastly diferent airspeeds of the two. The SuperKingAir has a cruising speed of nearly 190 knots, versus the Bell 412's cruising speed of just less than 130 knots. The greater the distance the more difference it makes to the trip, and the ability to get the patient to a trauma centre.

There are skills maintenance issues for the Air MICA Officers due to the workload down in the South West and up in the North West. They are some of the most highly qualified Aeromedical Paramedics anywhere in the world, but to maintain those skills requires constant use. The workload stats for the type of work required down there is not high. The work is there but the volume is not.

Road MICA to a fixed wing retrieval bypassing the local hospital is the best option for you by about 45-60 minutes of valuable life saving time.

Once the local hospital gets involved you can kiss two hours good bye at minimum.

Politicians and doctors love helicopters, they are much sexier than planes. They also fall out of the sky faster when the prop stops...

They don't understand the logistics though. Unless they are involved in retrieval. And one of the reasons you won't get a chopper is that the retrieval doctors advising the minister do know what they are talking about.

Dave

Dave, I know what you are saying, but Warrnambool airport is over an hour away even by ambulance, then all the transfer times. Portland more than two by the time you get through Warrnambool and Port Fairy. Cobden has been used by the fixed wing but you have to get the plane there and the ambulance pickup first. Cobden is 1/2 hour from the coast so a one hour round trip assuming no stopping.

I am aware of the effect of gravity on helicopters and their failing rotary wings mate. Prefer scheduled aircraft myself.

Sometimes we would just like better ambulance services too though as suggested above and below. It took over an hour to get an ambulance to a young guy with a dislocated hip playing football. It really only had to drive 20 kms or so There were some medicos there a short time after it happened, but they couldn't administer painkillers. The poor kid was in agony and no one could touch him.

That aside, we have an ambulance that can take an hour to get along the Great Ocean Road or to the gas fields near by. They are industrial sites and potentially hazardous. At long last the government has said that we will get two permanent ambos in our community. The new ambulance station was in speeches but not in the financial promises. We had good service from the volunteers but of course the provisions have all changed and we can't have those now doing much at all. Now ambos can come from Terang or Camperdown but more likely Warrnambool as I understand

We swung further from Labor at the last election despite lots being thrown to a couple of electorates in the form of ministerial visits. Stuff all money. Denis Napthine was supposed to lose, but got better support. Terry Mulder got an absolute majority in the face of all sorts, first time for that electorate. All that means we don't seem to attract state expenditure from all the GST revenue. We didn't potentially swing like South Barwon.

Dave, from what you say and what I am saying, perhaps the feeder service is the failing part at the moment. I do note what you are saying of the constant supply situation to use services. I thought we had enough Europeans driving the wrong side of the road to justify that! Capacity for head on collisions on the Great Ocean Road when they are tired seems never ending.

I'll pick up on one point there.

It's interesting that off duty paramedics can't legally carry more than a basic first aid kit as they don't have any provision under the act for the administration of Advanced Life Support or Mobile Intensive Care skills and procedures unless on duty.

Conversely they have the ability if they turn up at an incident off duty to be "clocked on" but can only work with what they carry legally. (Bandaids, bandages and not much more.)

I have attended several accidents off duty, and several more incidents while away 4wding where help is further away by a factor of 10 or more.

It's very frustrating not to be able to carry & administer pain relief at the least, and a few other things from the work bag of tricks would be more than usefull. (Adrenaline for one - for anaphylactic reactions to insect bites or food stuffs which are common enough and deadly.)

On my wish list of things I could legally carry would have to be:
Penthrane - inhaled pain relief, very useful while splinting fractured trailbike riders splints.
Adrenaline
IM antibiotic for lengthy retrievals of patients with open fractures

The other skills that would be useful are:
fluid resuscitation - replace lost blood volume
tension pneumo decompression - life saving treatment for complications arising from a punctured lung
LMA - better airway management than a head tilt

I can do all of the above at work. I could do all of the above off duty. Particularly in the middle of nowhere where help is a long way away. Hopefully not for anyone here!

It's about time the politicians realised they've created a raft of skilled individuals in society who would number more than 850 in rural Victoria alone. I'd be guessing but there's possibly more of us off duty in rural Victoria than GP's (who can carry and use anything they like).

Off topic mode off. Sorry.

Dave

Dave, yes well O/T but an area where we should play an interest role. Would like to talk with you see if we can get a rural policy change to cope with the issues. Reckon we could get one side of the state parliament to see the need.

>It's interesting that off duty paramedics can't legally
>carry more than a basic first aid kit

I didn't know that - it seems a bit silly. If we trust their judgement when on-duty I can see no reason why we shouldn't trust it off-duty. I suspect this is an "accident" of law more than intent and not something anyone would lobby for change to.

As it happens I know someone in senior Vic government in this area, I shall bring it to their attention over the next few days - you never know we might even be able to get some sensible law, for a change!

Mike Harding

Mike, that sounds too eminently sensible to be done. The public service could not allow it to happen as it would remove their control over the last pills and potions. The paramedics then would also have to be paid for their off-duty hours too or the unions would have to be paid out. Then of course the doctors would see that the medics have doctor privaledges and ...........

Met a senior health beaurecrat during the election campaign period who could barely contain his distain for the current controllers.

Fellas,

The original post was about the CFA.

The Government does NOT run the CFA.

Mike and Dave, seems like we have a troll hooked...........

Nah, only a tiddler, throw it back.

You wouldn't get any argument at all from most of us, and I don't think the union would have any beef. I haven't discussed it in any detail but you would be addressing something that concerns nearly if not all paramedics about their ability to use their skills outside of work hours.

Paramedics already get paid for work they do out of hours on a "Recall" to duty, as it's the only way they and the ambulance service are covered legally. As we are without medical malpractice insurance we are not covered unless on the books at the time we do something.

So you are mad not to ring the control room, report the incident & call for backup, and then go about doing what ever it is you have to do.

Once the big white truck turns up you can do what you had to do with the gear they bring with them, but much could have been done to save valuable time prior to their arrival.

If it was the next door neighbours kid having an anaphylactic reaction to the peanut butter his cousin shouldn't have given him, or the kid off the motorbike with the punctured lung from his fractured rib that's tensioning (jargon sorry) or the kid in at Davies Plain hut reacting to a Euro Wasp bite they'll all be dead before help arrives.

example 1
Adrenaline would save in under 2 minutes, help might be 14 minutes away at average response times
example 2
Chest decompression would save instantly - but from DP hut I can't contact the control room to be put on duty
example 3
See example 1, but help in this case help is at least an hour away by helicopter if you have communications.

The insurance issue is a conundrum. Nurses are covered by a policy that is arranged through the ANF, or they can arrange their own. Insurance companies like them because they largely work in a controlled environment.

Mention the word Paramedic to an insurance company and they don't react nearly as positively. I'm not aware of a successful litigation for medical negligence against a Paramedic in Victoria thus far, but someone will have a go sooner or later. At that point in time someone will lose their house, particularly if they were off duty.

An 8 million dollar payout, even if the person injured was found to be 90% responsible for their own situation still leaves $800,000 to be found against the Paramedic and their employer (MAS, RAV or ADAS).

This has a lot to do with why it's so hard to get a Paramedic who is off duty with kids at your school, or a member of your mates 4wd club to come along and do first aid for the event.

I'd love to go back and do the medical support for Speedweek at Lake Gairdner next year. I can't unless I can find an event medical company to employ me, that has insurance, and will send me over but charge $150 an hour for the privilege.

If I ever found the lawyer that started this I'd have a few things to say....

Dave

PS. That's why a mate of mine who 4wds with us from another station, if he's sitting around the camp fire in the Wonnangatta, and the conversation turns to the potential for one of the kids belting around in the back of the ute getting hurt, or the kids on the dirt bikes playing on the widow maker gets hurt has one response:

"Don't look at me, I'm just a truck driver for the health department..."

Not much of a title for a MICA Training Officer with 20 years experience who's saved more lives than you can poke a stick at.

Not much use to the person who's hurt - particularly if it's you - if he elects not to get involved - which he can legally choose to do. There's no obligation to help in Australia other than the moral one that your conscience usually uses to kick you into uninsured action.

But if he does choose to help the legal expectation is that he will do what he can within the parameters of his training, subject to the limitations placed on him by whatever equipment he has access to at the time.

Doesn't help you much if the Paramedic is only carrying a few bandages and some bandaids.

In the past 18 months I have run into other Paramedics off duty in
Mungo National Park
Wonnangatta Valley
Davies Plain
Omeo
Wilsons Prom

Off the top of my head I know of other colleagues who have done
Fraser Island
Simpson Desert
Butcher Country
Craigs Hut
Mt Skene
Toolangi
Woods Point

All of the above are places where you are a long way from help, or your only help coming is a helicopter - if the weather lets it fly.

None of them would have been able to do much more with any sort of confidence they weren't putting their house on the line than maybe 10% of what they do every day at work.

Dave

Interesting Post.

In Vic the Wrongs Act 1958 is the Act that protects the Good Samaritan who acts in that capacity.

Wrongs Act 1958 – Section 31B
Protects:

any person, acting without expectation of money or financial reward, providing assistance, advice or care, in good faith, at the scene of the emergency or accident, or providing advice by telephone or other means of communication to a person at the scene of the emergency or accident, in relation to an emergency or accident to the person at risk of, or apparently at risk of, death or injury (including prenatal injury, psychological or psychiatric injury, disease, and aggravation, acceleration or recurrence of an injury or disease), even if the emergency or accident is caused by an act or omission of the good Samaritan.

Every state bar Tasmania??? has a "Good Samaritan Act" of some description.

Also interesting to note that there has never been a liability action brought against a person in Australia acting in a "Good Samaritan" capacity.

I would have thought that even a "Paramedic" acting within the above capacity would have no issue.
But as soon as you "Clock On" so to speak then the ball game changes and now there is a "Duty of Care" applicable.

Also of consideration is that the purpose of a law suit is to gain a financial reward of some sort and if the individual is acting in a "Good Samaritan" capacity then they would have no insurance and hence "No money trail" to gain from.
Once your "On the books" then you have Insurance and a money trail.

John, it does bear investigating further so will be talking to a few...........

Hi John,

You are right. As soon as we clock on or identify ourself as a Paramedic there is an issue. It's a bit hard to explain why I even carry some of the stuff I carry in my firstaid kit when I travel by passing myself off as a firstaider. Then there's the other situation where you arrive at a scene where there are already 5 people trying to help who have a limited or no idea of what they are doing, and their actions are potentially going to put the patient at risk. If I want to gain scene control sometimes the only way to do so is to identify yourself.

A "good samaritan act" in the true sense of the term as I understand it is one that implies a need on any fellow man to assist someone in need, but protects them in the event that they do so. As such you are obligated to assist and can be criticised for refusing to assist. I could be wrong there.

As such in Victoria at least (I can't speak for the rest of the states) we don't have a "good samaritan act" as there is no obligation to assist. But should you choose to assist you are afforded as a voluntary first aider (Lev I, II or III) a degree of protection from the wrongs act. You are however expected to perform any treatment or assessment as would be reasonably expected of someone who has been taught that treatment or assessment, as there is an expectation that you should now know what not to do.

Even as an identified firstaider however you are afforded a further degree of protection in that there's no insurance company or employer to sue in the situation where you assist a patient on the footpath or road who you stumble across in your travels.

The whole lot goes out the window once as far as I've been advised, once you provide your services as a first aider to an event or organisation where there are event coordinators and organisations to target.

For example, to have a few teachers at a sports day qualified as Level II First Aiders is fairly common practice. I not long ago ran the Level II course for a local school.

If a child is injured, treated and transported off to hospital (by ambulance) for a broken arm and the teachers made the child comfortable, splinted and slinged the arm prior to ambulance arrival and the child makes a full recovery there probably won't be an issue.

But what if the teachers did little more than pat the child on the hand and wait for the ambulance to come, or walked the child across the oval to a first aid tent and waited for the ambulance to come without doing anything else. Not uncommon.

Later the child develops an infection at the site of the fracture and the bone isn't mending as it should - or the fracture was at the site of a growth plate and the arms growth is stunted.

Then the family talks to "We win you pay Legal Bastards Inc." and the lawyer says, hmmm well the teacher who should have known better as a firstaider, and was the designated first aid support for the event, didn't do their job.

Next thing the Education Department and potentially the teacher are in court defending their actions.

Same goes for a 4wd club first aider doing first aid for the sanctioned club event.

It gets really ugly.

Worse still the organisation can apparently be negligent for failing to provide an appropriate level of care at an event. The two first aiders may be appropriate for the athletics day, but what of the 4wd or car club running an event where there lies the potential for a serious motor vehicle accident?

This is where paramedics and doctors who are prepared to pay for insurance & run their own businesses, and St Johns and my employer are making big $$ out of charging out their services (& insurance) to clubs who can barely afford it to absolve them of their risk.

But if I go along as a volunteer and provide the same service - maybe even take the same equipment - I and the club or organisation suddenly become a litigants target.

Even if I go as a spectator and step in over first aiders I'm a target.

I can't by law carry or administer Penthrane - despite the fact that the St Johns First Aiders there may have it on hand I can't even use theirs unless I'm "on duty".

I approached my employer to ask permission to take a drug kit and some gear to the local 4wd clubs event a year or so back, as the club had had issues with St Johns cancelling at the last minute the previous year and without first aid support they couldn't run the event. My employer declined even though I would have clocked on regardless of whether I had it or not and I got involved. There's no legal cover for me to carry the drugs off duty.

But a GP could go and carry and administer what ever he wants while "off duty", despite the fact that he may have done little but seen patients across a desk for many years. Now I'm not having a go at GP's or their ability here, they are far more widely qualified in medicine than I am. But speak to most if not all GP's and they will admit that in acute trauma in the field Paramedics are in their element, and many GP's find the situation very daunting & confronting of skills they haven't practiced for many years.

The drugs I'm talking about are even found in the RFDS kits on stations, and station staff & owners can be instructed in their use over the phone! Parents carry epipens of adrenaline for their children if they have a known anaphylactic history. The reason is that it will save their life in under 2 minutes.

There need to be controls over it, but that's not that hard. Christ if they can stock stations with it they can work out a way of recording whether a Paramedic is in possession of it. No smart individual is going to risk his job over 2 ampules of something like Penthrane or 6 of Adrenaline.

It's a huge can of worms, but it's not a good situation that you have over 2000 paramedics in the state, many of whom wouldn't be comfortable not assisting at a scene, who can't carry what they need to do that properly without breaking the law and risking their job & litigation.

Ironically, when in WA on the Canning it was easier to organise to carry more than that to support friends riding bikes down the Canning than it would have been to do the same thing in the state in which I am qualified.

Dave

I agree with ya mate. The firies are doin the best job they can with the little they have got. And yea with fires ide say you have to send enough resources to quash the flames or you may as well stay home. They are spread thin, really thin... So to spread themselves thinner would be another reason to have a go at them. Good on the locals though. Really shows the aussie way (and altho im of indian heritage, i still consider myself an aussie) banding together in their time of need.

As it stands this morning the fire control lines now total about 390km.

The equivalent of driving from Melbourne to Holbrook.

You have to decide where you are going to fight and where you are going to let nature take its course.

With 40knot northerlys already in the high country this morning there are going to be a few places where natures course is about all that's left by way of options.

Dave

Dave the "emotive residents" were some of the most experienced people around on a direct feed , with names you would recognize, I wouldn't dismiss their (not my) local knowledge so readily.

Robin Miller

Robin,

I grew up in Mansfield, so you are right I do recognise some of the names.

I don't dispute they know their area well.

That compromises their ability at times to make an objective assessment of the safety of a strike team in that environment.

I too know the area pretty well and control emergency resources for that area on a near daily basis at times. It is a dangerous place at the moment, as is Sawmill Settlement.

One of the residents you speak of is a master of the media. He has been spinning the media on various issues to sway city folk for years.

You mention you aren't a local. Therefore you wouldn't understand the anarchy that would develop if helicopters just "dropped in to see if they could help".

This has already been a problem enough with local fire crews at times in the area, and calls for UHF CB to be fitted to trucks so locals can call them away from their assigned duties are one such dumb idea mooted by ABC journalists a week or so back.

The next stories from the media once these ones are done will be the "Dealing with the fires at Christmas" and "lost presents in burnt house stories".

Hope you find those as captivating.

Dave

>I don't dispute they know their area well.

>That compromises their ability at times to make an objective
>assessment of the safety of a strike team in that environment.

This approach always worries me Dave:

"You know the situation well; so you are emotionally biased"

"You haven't been in this situation; so you don't know what you're talking about"

Damned if you do and damned if you don't.

Mike Harding

Hi Dave

I can't be a local everywhere but do know some of those people enough to know that any claims they make should be given careful consideration and that what is considered "spin" can depend on your position. A few years ago we were at the end of the line in the Strathbogies fires , when communication was less effective than it now can be (as opposed to is).
Bureaucratic cost saving caused the feedlines to the Mt Womat UHF repeater to be above ground ,and it was lost during the fires, not to be replaced.
The lack of information caused a lot of concern to locals at a crucial time and there was no effective alternative.
I know what it is like to be effectively alone in the presence of fire, and its massively different from sitting back as I am now just looking at the situation rolling in.

I presume (but do not know) that effective communication exists with those left
in general Howqua area.

I guess I am hoping that the current situation its not like New Orleans , where while technical communication existed , effective communication did not exist and it required appeals from TV reporters , and personnal rescue missions to be undertaken while lines of offical help stood parked by offical gridlock.

In my opinion the physcological support of a helicopter "dropping in" to those on the front line is massive, and goes well beyond any actual help.

Right now, the actions of the fire teams seems to me to have behind them a philosphy of "do what you can , and get out early".

This has probably resulted in an almost nil loss of life at the cost of the forest.

You may note that in these posts I have refrained from criticizing either position , and so far just relaying things that passby me.

I expect a full picture will take some time to emerge , but I hope not the years it has taken for say the facts of the Canberra fires to come out.

When they do I hope we all take it in from the point of view of mutual future improvement.


Robin Miller

Local emotion has thus far in the last three weeks caused problems controlling local crews looking after local areas at times - occasionally not frequently.

It has also resulted in someone who disagreed with a position taken borrowing (without permission if you are being nice - stealing if you are being technically correct) a tanker from a staging area and leading to it being found where it was taken to "protect" a property not all that far away.

Helicopters can't just drop in on residents which ever way you want to look at it. Their time is more valuable in the air and doing what they do best.

Those that task resources are looking at a much bigger picture than the residents in any local area. They are trying to use the at times less than adequate resources they have, to maximal effect.

I do this for a living every other day. Operations Centres are constantly criticised by road crews who are looking at the small picture. I know cos I used to do it too before I trained in dispatch, and now I do both about 50:50 - on road and dispatch.

It's not easy either. I've had a doctor in theatre abuse me on the phone because I couldn't facilitate transport of an older gentleman to Melbourne and there was a strong risk that he would lose his leg as a result.

That sounds pretty unreasonable doesn't it.

The doctor was looking at the small picture. He couldn't see how I was resourced to manage an area with 60,000 people in it. He just knew there was an ambulance and he wanted it for his patient. As far as he was concerned the local ambulance station had 8-10 ambulances parked in it.

My big picture told me I had only one ambulance staffed that night for those 60,000 people, and sending it to melbourne with a patient who was at serious risk of losing his leg even if we transported him was not a good management of risk. I had already tried air transport and none was available, I knew as I'd rung them that there were no off duty staff available within a 75km radius. So if I sent him to Melbourne the next chest pain patient would possibly die at home of a cardiac arrest, or the next 19 y/o who wrapped his car around a power pole or tree would not get an ambulance for nearly 45 minutes until it came from a nearby town - if it were available.

No matter how you put it at the time the doctor, and the anaethetist who tried to convince me also, could see that the reasonable thing to do was not what they wanted. They were looking at the small picture, and the most important thing to them was the only thing in front of them at the time.

Looking at the small picture and making decisions about how to use a resource will, can and has in the past cost lives. It doesn't make good logistical sense.

I'm not saying Incident Controllers or Dispatchers or Logistics Officers get it right all the time, but if you want to look at the alternative go to the NSW fires in the late '90s where everything was macro managed at a local level.

Fire crews were not allowed to fight in other area's juridictions, so they fought a fire to the boundary and if there wasn't someone to take over at the line on the ground they let it go. Tankers from different areas were fitted with incompatible fittings so that they couldn't work as a team even if they wanted to.

I respect your knowledge of those that live there. Just don't assume that they are right just because they live there. At times they will be. Just not all the time.

It's a big call to send a strike team into danger with the knowledge that extrication is near impossible when the conditions change for the worse. You have to live with what ever the result is - and the Coroner isn't generally kind to negligent managers.

Damned if you do, damned if you don't.

Not pleasant to be the monkey in the middle.

Dave

Thanks for the well reasoned post Dave. I too have worked in operational management and know exactly where you are coming from and the stresses involved.

I am glad that there are people like you still involved in the process who have the moxie to make the tough calls when resources are thin and need to be managed for the greatest good.

All the best and keep up the good work.

Pete

Hi Dave

Well some rains have come and first reports I here are encouraging.
The load won't cease but it will surely ease.

The heart of this matter is really our value system.
With some putting the definition of reasonable risk at a different level
than others.
These pressures exist in many professional engineering fields as well
even though they do not hit the news like fires.

I'm outa here on my way to north east in a couple of hours
and this post will be long gone before I'm back.

So I don't wish to put any unfair questions or statements in it, or
create a need for a reply.

When back maybe we can persue in another post some elements of
both our value system and the value system we must professionaly
respond to as they can be quite different.

I hope the pressures on you and all in the fire areas ease and have
the best Xmas.

Robin Miller

Thanks Pete,

Robin, Have a safe trip and a good christmas.

Dave

As the question seemed a little unclear I've responded to this one in a PM.

Dave