OzSAGE has today released a ‘rapid advice’ to assist ambulance services and governments in addressing issues related to growing demand and complexity of care, and the protection and wellness of staff dealing with the inherent challenges of a pandemic in relatively uncontrolled clinical settings. We believe that these issues must be addressed to help maintain ambulance service capacity and staff safety during COVID-19.
The current COVID-19 outbreak has placed extreme demands on all health services resulting in compromised access to healthcare. Ambulance services are often seen as the last, and frequently only, resort for many people needing to access healthcare when GP services are at capacity and emergency departments are full. As the epidemic continues in NSW and Victoria, ambulance services are predicted to become more stressed from increased patient numbers and staff absences related to COVID-19. It is therefore vital that ambulance services are appropriately staffed, equipped, resourced, and prepared to manage these short-term and longer-term surges in demand.
The single biggest issue reducing ambulance availability is hospital ramping, which is where patients cannot be moved from the ambulance to the emergency department because there are no available beds. Ramping results in paramedics, providing care to the patient while waiting, and being unavailable to respond to new emergency calls. These delays can result in increased ambulance response times, poorer patient outcomes, heightened risk of infection, and unacceptable burnout of paramedics. Additionally, paramedics provide healthcare in the community, often in uncontrolled environments, placing them at additional occupational risks not seen in other healthcare settings. While ambulance services provide personal protective equipment (PPE) and have developed safety procedures for their staff, further testing and investigation into their effectiveness during the COVID-19 pandemic is needed.
OzSAGE recommends strategies that address system problems such as ramping, paramedic safety and welfare, and the need for national regulatory reform that will oversee and implement paramedicine infection control policies. In addition, the available paramedic workforce needs to be deployed in ways that better utilise the capabilities of paramedics as registered health professionals.