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Argument National Registration Paramedics

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Argument National Registration Paramedics

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Ambulance services in New South Wales are predominantly provided by a government operating statutory authority known as the New South Wales Ambulance. New South Wales Ambulance was initially established as the Ambulance Service of NSW under the Ambulance Services Act, 1976 (NSW) and it operates within the Health Services Act 1997 (NSW) (Eburn & Bendall, 2013). Private ambulance services are equally tolerated in NSW, but their niche of play is narrow compared to the market share owned by New South Wales Ambulance. Some of the private insurance providers include EMT Medical Services and Paramedical Services.
As an ambulance service, whether government-owned or privately-owned has two primary components: providing pre-hospital care, and the transportation of the sick and injured (Eburn & Bendall, 2013). In New South Wales and other regions including the Australian Capital Territory, Tasmania, Queensland, ambulance care services often include emergency treatment, provision of first aid, transportation of the sick or injured, and the provision of other forms of prehospital care (Queensland Consolidated Acts, 2010).
As outlined by Eburn and Bendall, (2013), under the Victorian Law, an Ambulance Service is mandated in five key areas. First, they should rapidly respond to medical emergency requests, second, they provide specialised transportation facilities for the transportation of individuals who require emergency care. The third mandate involves the provision of specialised medical skills for the purposes of maintaining life and reducing injuries in cases of emergency or in the transportation of those who need the services. They are also expected provide services suited for specialised medical or transport skills. Lastly, they ought to foster public education in first aid.
New South Wales Ambulance
In line with these regulations and expectations, the New South Wales Ambulance strives to provide clinical care and transport services related to health to close to 7.5 million inhabitants of New South Wales, spread across in an area of more than 800, 000 square kilometres (Health Ambulance Service of NSW, 2011). The service responds to both emergency and non-emergency health care needs. NSW Ambulance responds to more than one million service demands each year. However, there is an observed decline in the number of responses made between 2014/2015 and 2015/2016. The service evidenced a decline of approximately 1.3 percent between the two periods with a total of 1,127,545 responses in 2014/2015 against 1,115,635 responses in 2015/2016 (Health Ambulance Service of NSW, 2011). This translates to averagely 3048 responses each day – equivalent to two responses every minute. The decline is attributed primarily to the transfer of a majority of Non-Emergency care activity to Health Share in mid-2014 (NSW Ambulance, 2014). 
Ambulance Staffing
New South Wales Ambulance Service employs over four thousand people working in over 250 stations spread across the state, primarily in the frontline of service provision. The majority of these personnel includes both paramedics and specialists in areas such as aeromedical and medical retrieval, intensive care and extended care paramedics, counter disaster, and special operations, while less than ten percent of whom serve in the capacity of offering support services, administration, human resource and finance and payroll (Health Ambulance Service of NSW, 2011).
The standard practice in NSW ambulances is to equip each ambulance with two paramedics. Paramedics are perceived as the greatest assets in the delivery of care out of the hospital setting, owing to the fact that they provide life-saving treatment. Paramedics are trained and expected to perform duties that include manual defibrillation, 3, 6 and 12 lead ECGs, airway management, medication and IV administration (Ambulance Service of NSW, 2011). The provision of this services ought to be guided by approved protocols and standard procedures (both clinical and pharmacological) in the management of the different clinical conditions.
Ambulance service of NSW employs two major cadres of paramedics; intensive care paramedics, and extended care paramedics (Ambulance Service of NSW, 2011). Intensive care paramedics have a higher skill level following further training and education that will help them address the demands they face in practice.  Intensive care paramedics undertake an advanced diploma of Paramedical Science delivered by NSW Ambulance Education Centre (Ambulance Service of NSW, 2011).  The extended care paramedics, on the other hand, take more of a ‘GP’ type approach and they do not respond to emergency calls (‘000’) as their counterparts do. Extended care paramedics perform duties such as prescription of some medications, changing patient catheters, wound care, and attending to dislocated bones and joints. For large-scale emergencies, NWS ambulance employs both extended care and intensive care paramedics, special causality access team (SCAT), Paramedic rescue and Medical Physicians. For helicopter operations, a SCAT paramedic and a medical physician specialised in emergency medicine, anesthesiology or trauma are deployed as the minimum staff.
Specialist Sections
Some situations may require specialised medical care and response. For this, NSW Ambulance has formed highly trained, specialised and equipped units/sections. These sections include, Special Causality Access Team (SCAT) which are deployed to multi-casualty disasters and incidents; Rescue Operations for complex situations that may involve road crash, and chemical and biological accidents; the Special Operations Team are deployed to multi-casualty incidents and disasters and provide lifesaving interventions for people who are lost, trapped or in any form of precarious situation; and the Rapid Response unit which is tasked with providing early patient intervention and also cutting on the response times.
Types of Ambulances
The service also deploys an extensive fleet of about 1500 vehicles, of which over sixty-five percent are ambulance vehicles that respond to emergencies, non-emergencies, and rescue, aeromedical, and retrieval services. Due to the differences in the services provided, NSW Ambulance has different ambulance types which include emergency medical care ambulances, patient transport service, rescue trucks, rapid response vehicles, multi-purpose accounting, over-snow vehicles, special causality access team (SCAT) and the airwing (uses aircraft owned and operated by Royal Flying Doctor Service, and helicopters (Ambulance Service of NSW, 2011).  To be able to cover the over one million responses, the road fleet is said to travel over forty-four thousand kilometres each year (Health Ambulance Service of NSW, 2011).
Ambulance Service of NSW. (2011). Paramedics. Retrieved from Ambulance economics of NSW:
Ambulance Service of NSW. (2011). Patient Transport Service. Retrieved from Health: Ambulance Service of NSW:
Eburn, M., & Bendall, J. (2013). The provision of Ambulance Services in Australia: a legal argument for the national registration of paramedics. Australasian Journal of Paramedicine, 1-10.
Health Ambulance Service of NSW. (2011, November). About Us. Retrieved from Healthcare Ambulance Service of NSW:
NSW Ambulance. (2014). NSW Ambulance Year in Review 2014/15 32. Sydney: NSW Ambulance.
Queensland Consolidated Acts. (2010, January). Ambulance Services Act 1991. Retrieved from Queensland Consolidated Acts:

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