Ms Keirstie Bull1, Dr Mardi Steere1
1Royal Flying Doctor Service (Central Operations), Adelaide Airport, Australia
The Australasian Triage Scale (ATS) is uniformly used in emergency departments to establish the maximum ideal waiting time for a patient, with the goal of ensuring that patients are assessed and treated according to clinical urgency. No formal analogous scale exists across Australia, however, for clinical coordination of retrievals. As retrieval coordination, retrieval registries and more are coalescing and becoming standardised across Australia, it is evident that different states and organisations may have quite different definitions and criteria for fixed-wing aeromedical tasking.
This talk will propose the standardisation of both
1) Urgency – the time critical nature of an aeromedical task, harmonising what conditions may meet eg “Priority 1” criteria and
2) Acuity – attempting to define an appropriate ideal crew mix for patient acuity eg crtical (requiring a full retrieval team), versus high dependency (requiring dual responders), versus low acuity (requiring single responder).
Additionally, distance adds nuance to both responsiveness and risk of deterioration/potential acuity.
1) Response: While an emergency department P2 results in uniform time to commencement of assessment, for aeromedical responses, a P3 task with a 3 hour “doors closed” time may result in a nearby patient arriving at definitive care within 4 hours, whereas a remote patient with the same condition may not receive definitive care for 7 hours – should distance from care change the priority of the patient, or should Priority Levels be determined not by doors closed, but time to effective intervention?
2) Risk of deterioration – if escalation is remote, should additional crew members be considered?
Royal Flying Doctor Service (Central Australia) has implemented both an Aeromedical Tasking Guideline and Long Haul Tasking guideline for traditional remote tasks that attempt to define and standardise some of these elements, and their benefits and limitations will be discussed.
Biography:
Dr Mardi Steere is a Paediatric Emergency Physician and Retrievalist who is the Executive General Manager of Medical & Retrieval Services at RFDS SA/NT. She has lived and worked as a doctor in the Australia, the US and most recently in Kenya from 2011-2019 where she co-developed East Africa’s first accredited subspecialty training program in Paediatric Emergency & Critical Care and worked as medical director of a 348-bed tertiary referral hospital. She is passionate about improving health outcomes for those with limited access through innovative, multidisciplinary approaches, whether in low-middle income countries or rural and remote Australia.