Pre-hospital and retrieval services ensure that people who are seriously injured receive optimal assessment and resuscitation at the scene of injury, and rapid transport to the nearest appropriate trauma service.
The pre-hospital component of the NSW trauma system runs from the time of injury to the patient’s arrival at a definitive care trauma hospital.
Entering the trauma system
There are two ways an injured patient may enter the trauma system:
- Non-ambulance arrivals - when the patient arrives at the hospital without engaging the ambulance or other emergency services. For example, a patient may be taken to hospital by a family member.
- Ambulance or helicopter transport - these services transport a patient to hospital, after the person has been assessed and triaged to determine which hospital is the most appropriate for their injuries.
Pre-hospital - NSW Ambulance
NSW Ambulance provides pre-hospital care to injured patient in NSW.
There are three trauma-focused elements of NSW Ambulance.
Protocol T1: Pre-hospital Management of Major Trauma outlines the management of a major trauma patient from assessment through to transport decision making. It is supported by a trauma triage tool to ascertain the patient’s risk for serious injury and the subsequent transport decision and destination.
Patients who meet major trauma criteria should be transported to the highest level trauma service within an estimated 60 minute travel time (metropolitan area) or 90 minute travel time (regional and rural areas).
If required, a helicopter may be dispatched to the scene of the injury, or may meet the ambulance enroute or at local hospital.
NSW Ambulance – Protocol T1 tool
The protocol is also available via the NSW Ambulance Protocols app. The publicly available app version does not contain NSW Ambulance internal phone numbers and client codes.
The rapid launch trauma coordinator monitors the computer-aided dispatch entries (000 calls) from across NSW.
The objective of the rapid launch trauma coordinator is to reduce the morbidity and mortality of major trauma patients by:
- identifying major trauma early
- providing clinical and hospital referral advice to the control centres and road crews
- activating specialist resources, such as helicopters or fixed-wing aircraft and medical retrieval teams.
The major trauma team incorporates all aspects of ambulance, including road and aeromedical responses and the operations centres, into one system to improve times to definitive care.
The team consists of three senior paramedics.
The 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.
NSW retrieval services
NSW is a vast territory (801,150 km2) and delivering timely care to critically-injured patients can be challenging. Sometimes it is best to bring specialist clinicians, equipment and rapid transport to an injured patient.
Two specialist medical retrieval services conduct most trauma retrievals across NSW. These are the Aeromedical Operations and the Newborn and paediatric Emergency Transport Service (NETS). These two services also provide consultant-level clinical advice, supporting clinicians caring for complex trauma patients while they wait for the retrieval team.
These statewide services, in conjunction with regional retrieval services, conduct retrievals by road, helicopter and fixed-wing aircraft.
The specialist teams and associated road, helicopter and fixed-wing assets are coordinated by the aeromedical operation centres of NSW Ambulance in Sydney.
Helicopter services
The helicopter services in NSW are spread across the state, reaching most of the population. NSW Ambulance, through the Greater Sydney Area Helicopter Emergency Medical Service, conducts the largest number of helicopter missions in NSW. The other regional helicopter services have a contract with NSW Health to provide helicopter services to their local area. All helicopter services are coordinated and tasked through the central aeromedical operations centre.
Fixed-wing services
Air Ambulance, the fixed-wing service of NSW Ambulance, is located at Sydney Airport, Mascot. The aircraft, pilot and ground support staff are supplied by the Royal Flying Doctor Service and the clinical staff are from NSW Ambulance. The clinical staff consists of expert nurses, with the option of teaming up with retrieval doctors from the Greater Sydney Area Helicopter Emergency Medical Service if required.
Helicopter and fixed wing service locations
Helicopter services based at
- Sydney (Bankstown Airport) – Greater Sydney Area Helicopter Emergency Medical Service
- Sydney (Westmead) – CareFlight
- Sydney (Westmead) – Telstra Child Flight
- Wollongong – Greater Sydney Area Helicopter Emergency Medical Service
- Orange – Greater Sydney Area Helicopter Emergency Medical Service
- Newcastle – Westpac Rescue Helicopter
- Tamworth – Westpac Rescue Helicopter
- Lismore – Westpac Rescue Helicopter
- Canberra – Snowy Hydro South Care
Fixed wing services based at
- Sydney (Sydney Airport, Mascot) – NSW Ambulance
- Dubbo – Royal Flying Doctor Service
- Broken Hill – Royal Flying Doctor Service