The Rural Emergency Responder Network (RERN) is unique to South Australia.
This model of nominated, trained and equipped rural doctors should be extended to other rural areas in Australia where there are gaps between frontline services and retrievalists.
Current arrangements are ad hoc. In a 2012 survey, 53% of rural GP-anaesthetists stated that they had attended a prehospital call out in the previous 12 months.
However such responses occurred without formal call out criteria, without formal training in prehospital environment and in the absence of equipment or protocols.
Personally I believe that the prehospital environment is very different to that in a well-lit and equipped ED…and is best left to the experts (ambulance and retrievalists) not “enthusiastic amateurs”.
Nevertheless, critical illness does not respect geography and expert help may be a long time in arriving….hence the fact that 53% of rural GP-anaesthetists had been called out in preceding year. Indeed, these doctors had been called by ambulance or retrieval in lieu of their presence.
So rather than continue with ad hoc arrangements, would it not be better to ensure that those who respond are
- tasked appropriately,
- well equipped & trained,
- and that cases are audited.
The UK has the British Association for Immediate Care Scheme (BASICS); New Zealand as Primary Response in Medical Emergencies (PRIME) – both smaller countries without the ‘tyranny of distance’. Come on – if the Poms and Kiwis can do it, surely we can in Oz?
I think that this paradigm could be extended throughout rural Australia – placing the clinician with the required skills to perform the necessary care in advance of the arrival of retrieval. Who knows, perhaps this would have made a difference in the Kerang rail disaster? Not to replace existing services – but to supplement them. There are obvious flow on benefits in case of State or National disaster planning…
If pushed for time, there is a Pecha Kucha talk on the same topic from GMEP.org.
See also the RERN video from SA Health – RERN scooped a SA Health award in 2013 for their model of care.
Click below to listen to Dr Doug Lynch interviewing Dr Rochelle Phipps at SMACC2013 – Rochelle is a Rural GP in NZ and participates in PRIME. She was also involved in the disaster response to the Christchurch earthquake.
See also this video on ‘RURAL DOCTOR UPDATE – DOCTORS BAG’ – with details of RERN kit