Ambulance Service of NSW

The Ambulance Service of NSW (ASNSW) provides the pre-hospital care to injured patient in NSW. It is the 3rd largest ambulance service in the world, employing over 4,000 personnel, 226 ambulance stations using over 1500 road vehicles and 5 helicopters. It conducted over 1,219,000 responses in the 2011/12 financial year of which over 7,000 were for major trauma incidents.1

There are 3 trauma focussed elements of the ASNSW:
  • Protocol T1
  • Rapid Launch Trauma Coordinator
  • Major Trauma Team

Protocol T1

The ASNSW introduced the Protocol T1: Pre-hospital Management of Major Trauma on 1st July 2008, replacing the Pre-hospital Trauma Triage Protocol (Protocol 4).

It outlines the management of a major trauma patient from assessment through to transport decision making and is supported by a Trauma Triage Tool that utilises MIST criteria to ascertain patient risk for serious injury and the subsequent transport decision and destination. Patients meeting major trauma criteria should be transported to the highest level trauma service within an estimated 60 minute travel time.

If required, a helicopter may be dispatched to the scene of the injury, or may meet the ambulance en route or at local hospital, all with the aim of delivering the right patient to the right hospital in the right time.

Rapid Launch Trauma Coordinator

The Rapid Launch Trauma Coordinator (RLTC), it is located at the Aeromedical Operations Centre in Sydney, monitoring the computer aided dispatch entries (000 calls) from across NSW.

The objective of the RLTC role is to reduce the morbidity and mortality of major trauma patients through the early identification of major trauma, providing clinical and hospital referral advice to the control centres and road crews, and the ability to activate specialist resources such a helicopter or fixed wing assets and medical retrieval teams.

Major Trauma Team

The Major Trauma Team was born out of the Major Trauma Program, a project to incorporate all aspects of ambulance including road and aeromedical responses and the operations centres, into one system to improve times to definitive care.

The Major Trauma Program has been fully implemented and is now incorporated into core practice, supported by the Major Trauma Team. The team consists of 3 senior paramedics with the role of supporting clinical excellence in the pre-hospital management of trauma patients.

The Major Trauma Team has various responsibilities including:
  • Quality, performance and system monitoring
  • Supporting paramedics through feedback, education and training
  • Liaising with the trauma services of NSW
  • Data reporting
  • Collaboration with NSW Health.


  1. Ambulance Service of NSW website - About Us; accessed 6 April 2022.



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