The Queensland Ambulance Service (QAS) is the state emergency ambulance and patient transport provider in Queensland, Australia. QAS is part of the Queensland Government under the Queensland Health portfolio and is one of the largest ambulance services in the world.About QAS . Department of Community Safety. Retrieved on 9 November 2011.
QAS provides emergency response services, pre-hospital patient care, specialised transport services, coordination of aero-medical services and inter-hospital transfers to all of Queensland, accounting around 4.7 million people spread over .Queensland Ambulance Service performance report 2009 . Department of Emergency Services. Retrieved on 9 November 2011.
Over 4500 FTE staff are employed by QAS, around 87% of whom are front-line staff. QAS operates out of 290 response locations across the state, and handled over 946,000 cases and 737,803 triple zero calls in 2015/16.
History
Ambulance services in Queensland first began in 1892. Military medic Seymour Warrian held the first meeting of the City Ambulance Transport Brigade on 12 September of that year. Queensland's first ambulance station operated out of the Brisbane Newspaper Company building; the first officers possessed a stretcher, but no vehicle, and so transported patients on foot.Queensland Ambulance Service History and Heritage . Department of Community Safety. Retrieved on 9 November 2011. A year after the establishment of the Brisbane centre, another was established in Charters Towers in north Queensland, eventually growing to over 90 community controlled ambulance centres.
The Queensland Ambulance Service (QAS) as currently known was formed on 1 July 1991 from the amalgamation of 96 individual Queensland ambulance service transport brigades (QATB). While QAS originally operated under the banner of the Department of Emergency Services, in 2009 the Queensland Government restructured the organisational hierarchy and appointed new ministers. It became part of the Department of Community Safety, along with the Queensland Fire and Rescue Service, Emergency Management Queensland and Department of Corrective Services. As a result of the Keelty Review of Police and Community Safety in Queensland, the QAS transitioned into the Queensland Department of Health as of 1 October 2013, retaining its separate identity, rank structure and commissioner.
Structure and operations
Support The QAS was initially divided into six operational regions across Queensland, until the Northern Region was split to form 'Far Northern Region'. This model reflected a similar structure in the then Queensland Fire and Rescue Authority. In 2012, the QAS Structural Reform Report, a comprehensive review of QAS operations, lead to a restructure of operations, and a decentralisation of control to local networks. Instead of large regions, the service would be divided into fifteen geographical local ambulance service networks (LASNs) aligning with Queensland health and hospital service networks. A sixteenth network was established as state operations centres, with the existing seven communications centres to become operations centres, reporting directly to a central assistant commissioner. The LASNs vary in size according to population and stations, and are categorised from Category 1 (largest) to Category 5 (smallest). The categorisation simply reflects their size and gives a foundation for staffing allocation and command structure.
Local ambulance service networks
Category 1 (General Manager – Assistant Commissioner) Metro North Metro South
Category 2 (General Manager – Assistant Commissioner) Cairns Darling Downs Gold Coast Sunshine Coast Townsville
Category 3 (Director – Chief Superintendent) Central Queensland
Category 4 (Director – Chief Superintendent) Mackay West Moreton Wide Bay
Category 5 (Executive Manager – Superintendent) Cape York and Torres Strait Central West North West South West
State Operations – Assistant Commissioner Seven Operations Centres (Cairns, Townsville, Rockhampton, Maroochydore, Toowoomba, Brisbane, Southport)
Headquarters There are five key central office commands that divisions report to: Office of the Commissioner Office of the Deputy Commissioner State LASN Operations Office of the Deputy Commissioner Service Planning and Performance Office of the Deputy Commissioner Corporate Services Office of the Medical Director
These commands, plus some additional senior staff, form the Central Office Senior Executive (COSE), which in turn report to the QAS Board of Management (BoM).
Clinical operations
Following a redesign in 2014, the overall clinical governance of the service is ensured by the director of clinical quality and patient safety, currently filled by Chief Superintendent Tony Hucker ASM. The office ensures that patient care services provided by officers of the Queensland Ambulance Service are delivered at a consistently high standard, and that current clinical research is included within contemporary practice. The office also responsible for QAS Policy on Staff Health and Wellbeing and setting medical priorities for ambulance resource dispatch. There are a small number of medical officers, with the team led by Medical Director Dr Stephen Rashford ASM FACEM, who also holds the rank of deputy commissioner.
Ambulance operations of the Queensland Ambulance Service are performed predominantly by its own operational staff. QAS operational staff include student paramedics, advanced care paramedics (ACPs), critical care paramedics (formerly known as intensive care paramedics), patient transport officers (PTOs) and emergency medical dispatchers (EMDs). In some of Queensland's rural areas, QAS first responders provide emergency care until the arrival of paramedics, while in remote areas first responders may also work as volunteer drivers or operate ground transport vehicles (such as the Torres Strait). In some areas, non-QAS staff operate the QAS ambulances as unpaid volunteers, or as QHealth nurses as part of a hospital-based ambulance station, for example in Morven and Thargomindah.
Advanced care paramedics possess either a Diploma of Paramedical Science (Ambulance), a Bachelor of Paramedical Science, or equivalent qualifications.Paramedic 3 . Department of Community Safety. Retrieved on 9 November 2011. In addition to this, critical care paramedics possess a graduate diploma in intensive care paramedic practice, or very commonly a master's degree in emergency health.Paramedic 4 (Intensive Care) . Department of Community Safety. Retrieved on 9 November 2011. ACPs and CCPs attend medical, surgical and trauma emergencies. Patient transport officers possess a Certificate III in non-emergency patient transport or equivalent, and provide non-emergency patient transport services.Patient Transport Officer . Department of Community Safety. Retrieved on 9 November 2011. Emergency medical dispatchers have completed a Certificate III in ambulance communications (call taking) and a Certificate IV in ambulance communications (dispatch) or equivalent. EMDs receive emergency calls and direct ambulance services to the emergency, and advise callers in performing first aid until the ambulance arrives on scene.Qualified Emergency Medical Dispatcher (Level 3) . Department of Community Safety. Retrieved on 9 November 2011.
ACPs are competent in many emergency medical skills, including airway management (oropharyngeal and nasopharyngeal airway, oropharyngeal suctioning, laryngoscopy and Magill's forceps, laryngeal mask airway, intermittent positive pressure ventilation), cardiac management (cardiac monitoring – basic ECG interpretation and 12-lead ECG, manual defibrillation), drug/fluid administration (intramuscular injection, intravenous cannulation, fluid replacement), and the administration of basic and advanced drugs (aspirin, glucose, glyceryl trinitrate, adrenaline, morphine, fentanyl, etc.).
Critical care paramedics typically respond when an advanced level of clinical practice is required. In some areas, they will respond as a single officer in units known as 'pods'(priority only dispatch). CCP pods operate around the state, focused on metropolitan, major regional centers, or where a rescue helicopter is located. These ambulances are not equipped to transport patients, but contain much of the same equipment as a regular ambulance, as well as advanced equipment. CCPs are competent in all ACP procedures, as well as advanced emergency medical skills, such as endotracheal intubation, synchronised cardioversion, transcutaneous cardiac pacing, continuous positive airway pressure ventilation CPAP, decompression of tension pneumothorax, extra-jugular venous cannulation, procedural sedation (midazolam, ketamine, and droperidol.), pre-hospital thrombolysis (tenecteplase), pre-hospital direct referral to primary PCI, intraosseous access, as well as the administration of advanced drugs (atropine, heparin, ketamine, benztropine, magnesium, etc.). In addition to standard CCP skills, officers on the High Acute Response Unit (HARU) perform general anaesthesia via Rapid Sequence Induction, with the additional use of rocuronium and propofol, transfuse packed red blood cells, perform chest thoracostomy, and carry some additional pharmacology specific to major trauma such as TXA. As of 2018, there are HARU units located at Brisbane and the Gold Coast
Vehicles
The most common metropolitan ambulance are the Mercedes Benz Sprinters. In rural areas, due to the need for extra traction or rough roads, 4x4 vehicles are common,
based upon a Toyota Landcruiser Cab Chassis (1+1 modular 4x4s) or Toyota Landcruiser Troopcarrier. QAS has also trialed a Mercedes-Benz G-Class as a 4x4 ambulance. All 4x4s carry one stretcher patient in addition to the normal equipment found on a typical Mercedes Sprinter. These vehicles (Mercedes Sprinters) are used by both advanced care paramedics (ACPs) and patient transport officers. The acute vehicles carry one stretcher and the patient transport vehicles Mercedes Sprinters carry two. Toyota Hiace PTO vehicles with twin stretchers are also in use around the State, along with a variety of other transport vehicles including wheel-chair vehicles. Additionally, two stretcher Mercedes 519 acute ambulances operate around the state by ACP and CCPs, particularly in regional and rural areas. Critical care paramedics (formerly known as ICPs) and station OIC's now often drive Isuzu MUX's (formerly using Hyundai Santa Fe's and Subaru Foresters). These vehicles cannot carry patients, however they carry much of the same equipment as the Sprinters, as well as specialised equipment, with their sole purpose serving as fast response vehicles. Local Area Referral Unit or Low Acuity Response Unit (LARU) vehicles, generally Volkswagen Transporters or Hyundai iLoads, carry medical equipment for minor injuries such as broken arms, strains and sprains. They are unable to transport patients, and are not fitted with lights or sirens.
A station's officer in charge (OIC) or area supervisors often use dual-cab Utes, serving a similar purpose to other fast response vehicles.
Previously, the QAS used Ford F-series truck (Ford F-250 and F-350) until Ford stopped importing these in 2008. The last Ford ambulance in use by the QAS was decommissioned in 2021.
Fixed Wing Retrieval Operations Fixed wing aeromedical retrieval in Queensland is provided by the Royal Flying Doctor Service (Queensland Section) and LifeFlight Australia. This is done in conjunction with Queensland Ambulance and Queensland Health.
Rotary Wing Retrieval Operations