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00:00:01
Who You Gonna Call?
27 Plays1 month ago
Dr. Aidan and Julie chat with Executive Director and co-Founder of Community Health Support, Jesse Lenn, about all things paramedicine and pre-hospital care.
Learn more about CHS at their website.
Get in touch with us at questions@thismightsting.com.au
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Transcript
Introduction and Guest Welcome
00:00:00
Speaker
Hi there, and welcome to another episode of This Might Sting, where we diagnose nonsense and prescribe the truth. I'm Dr. Aidan Barron, and today I'm joined by the ever-gorgeous Julie McCrossin.
00:00:11
Speaker
Julie, it's so great to have you again with us today, and I'm very excited to introduce our special guest of the day, Jessie Len.
Jessie Len's Background and CHS Creation
00:00:18
Speaker
Today we're going to be interviewing Jesse about the work of Community Health Support.
00:00:23
Speaker
Jesse's the co-founder and executive director of CHS or Community Health Support New South Wales, which is a not-for-profit organization dedicated to enhancing community health resilience. Jesse has a background as a physiotherapist in both public hospitals and in private practice, and has worked across multiple fields, including orthopedics, neurology, aged care, ICU, and has a passion for accessible community-based care, which led to the creation of CHS New South Wales.
00:00:49
Speaker
And this organization aims to empower individuals and strengthen emergency medical response at the grassroots level. Jesse, welcome. Thank you. Thanks for having me. It's ah great to be here with you both and looking forward to a robust discussion.
00:01:06
Speaker
And I should say, Jessie, this is all totally new to me, this community initiative of yours. I understand it involves twenty four seven medical support powered by the community. So I'm absolutely fascinated. But you kick off, Aidan, and I'll join in later.
Dr. Barron's Role and CHS's Mission
00:01:21
Speaker
Look, I should probably start at the beginning with a bit of a disclosure, which is that I'm very much involved in this organization myself as the clinical lead for community health support and volunteer regularly with CHS.
00:01:32
Speaker
So it was fortuitous that the stars aligned. And when our producer Josh said, I've got a really good idea for another episode. talking about how people can access help in emergencies and when people aren't sure where to go, when they've got health problems, and how communities can help each other in emergencies. And I thought, you know what? I know just the guy.
00:01:55
Speaker
Jesse, can you start by telling us a bit about how CHS came to be?
00:02:02
Speaker
Definitely. So as you've kind of stated, my background is in physiotherapy, started working in the public health system, moved into private practice. um So had a reasonable idea of how the health system works, had done various volunteering in the community around health, around safety,
00:02:25
Speaker
bit of experience there. So ah started to understand the space a little bit better in terms of medical out of hospital emergency kind of care, understood what it looked like from a hospital perspective, private practice perspective,
00:02:44
Speaker
And got really interested and and fascinated in the space and really went quite deep on on researching and understanding how various volunteer organizations and how they run and how they operate what space they operate in.
00:02:59
Speaker
various private paramedic services, how they run, and of course, New South Wales Ambulance, and just really started to dig my heels in and start understanding a lot more about the space. And it was really interesting to me.
00:03:13
Speaker
It's a really interesting space. I think many people find it relatively interesting. And I started to question and wonder what what space is there?
00:03:24
Speaker
what does What does this look like and how could it be potentially improved? And I guess you need to go back to the initial kind of points of, is there a problem at all in the space?
00:03:36
Speaker
What does the current healthcare system look like? How overwhelmed is it or isn't it? um And going back to the fundamentals and they started doing quite a bit of research at the time into what are the wait times for ambulance, what services are available for people in non-emergencies but urgent medical incidents, how much is that costing people, how much is that costing the government.
00:04:04
Speaker
And it was really interesting to look at all of the information that they were receiving and see that the system is really overwhelmed at times. There's a huge...
00:04:16
Speaker
influx of patients, particularly around the COVID times. And that sometimes the system rightly can't handle it. There's just a huge influx of patients. And we saw that continue in post-COVID.
00:04:31
Speaker
And unfortunately, there have been stories out there of people waiting long, long times for ambulance or waiting really long times in, in the emergency departments.
00:04:43
Speaker
And it's just the reality there's finite resources. And sometimes when there's lots of patients, all systems get, get overwhelmed and it's a struggle for everyone involved. And unfortunately the case.
00:04:55
Speaker
I'm so excited to hear what you decided to do because you've taken on not just a big issue but a big responsibility to try and become active in that space. So what did, you know, Aidan's mentioned that word community resilience.
00:05:09
Speaker
So what did you set out to achieve if you could get really specific?
Emergency Response and Training Focus
00:05:14
Speaker
Yeah, so initially we were understanding the space and and some of the gaps that existed.
00:05:21
Speaker
We initially went out to enhance the resilience of our local community. And we did that through CPR and first aid training and trying to provide as much of it as possible at very little or no cost to the community.
00:05:36
Speaker
Our idea is that if we could... prepare people in the community for medical emergencies, that we will hopefully start to close the gap between medical emergency occurring and effective help arriving.
00:05:53
Speaker
And so we started by providing that training in education. We started by providing volunteers to attend high risk community events. And we started by going to other community organizations and not-for-profits and providing them with a consulting service, letting them know what procedures, what equipment they might have in place.
00:06:16
Speaker
And I guess naturally, as an organization that was in the space, we actually naturally got pulled into this kind of really interesting space, which is our current twenty four seven emergency medical response and advice service.
00:06:34
Speaker
Naturally, we were sitting in the office one day and we'd have someone call us and say, hey, I came to one of your first aid courses the other day. my kids actually hit his head. He's come home from school.
00:06:47
Speaker
He's been vomiting a bit. He's a bit dizzy. what should I do? I'm not sure what to do. And all of a sudden there was this light bulb moment of, we've got lots of volunteers.
00:06:59
Speaker
We've got a community that trusts us. And why don't we start exploring this and looking at what we could what we could make this into? And that kind of led to the inevitable creation of the emergency response and advice part of our service as well.
00:07:17
Speaker
I know, Aidan, you're really involved with this. So I'll just ah tell you the question, gentlemen, that's on my mind and you'll decide who's best to answer it. But I live in Adelaide now, but I lived in New South Wales for a long time with a mother who regularly rang the ambulance service.
00:07:34
Speaker
And here in Adelaide, i couple of years ago, my partner fell off a wall and I rang the ambulance. So I'm trained in this notion of you've ring triple o And so I guess I'm really interested in how...
00:07:47
Speaker
this community health support service within the area that you're active interacts with those that mainstream triple o obligation because of course delay can be not good for a patient too or the soon to be patient ah so that's the questions that are in my mind yeah definitely i think to kind of Go one step back from that and just give you a brief understanding of how our system works when someone does call. When they call, they're met with a voice prompts, a virtual triage, which is a self triage.
00:08:23
Speaker
If someone believes that this is an emergency. they'll press one. If they believe that it's urgent but not emergency, they'll press two. And non-urgent health advice, they'll press three. Now, when, let's just say it is an emergency, someone's collapsed in the middle of the street and someone's called a 1300 number, they will press one for emergency.
00:08:45
Speaker
One of our emergency call takers will answer the phone and find out their location and the specific incident that they're calling about. Now, if that if what they describe meets our criteria of an emergency, then we will um send responders, but we'll simultaneously add triple zero into the call.
00:09:08
Speaker
So it's 45 to 60 seconds of speaking to us. And the benefit is that now you not only get triple zero, but you also get nearby community first responders that are local nearby, usually minutes away that are equipped and trained. So you get the best of both worlds in the areas that we cover within Sydney's Eastern suburbs.
00:09:34
Speaker
ah Julie, the thing I'm most interested in and find other people tend to be the most interested in and is why would you do this and why would you not just call the ambulance service? If my child is having an anaphylactic attack or if someone stops breathing, why would I ever call a bunch of volunteers when I could just call triple zero? And what's the real benefit there?
00:09:55
Speaker
What added benefit does a community organization like this deliver?
00:10:03
Speaker
That's exactly what I'm thinking. Jessie, can you speak to that? I can definitely early on. It's been two years now since we launched this and early on, it was a more difficult question to answer because I didn't have real life examples to give.
00:10:24
Speaker
But now on a daily basis, we have real life examples and it comes down to volunteer network being embedded in the local community.
00:10:39
Speaker
It could be your neighbor, it could be the person that lives two streets away. It could be that someone's just visiting a friend nearby that gets alerted of the medical instance that's occurring.
00:10:50
Speaker
And it it comes down to their ability to get there. They're highly trained. They have medical equipment that can assist. And it means that, as I said, you get that two in one where,
00:11:04
Speaker
you You don't know how long the ambulance is going to take. You hope, and in many cases, they can come pretty quickly, but you don't know that there isn't a whole bunch of higher priority or high priority cases in the area and the nearest ambulance is coming from out west or somewhere 20, 30 minutes away.
00:11:24
Speaker
you hope that they'll be there quickly but you don't know and in many cases what we've seen is that our responders our volunteers will arrive on scene 5 10 15 20 an hour before an ambulance arrives and it means that we can start providing that treatment early and stabilize the patient in emergency cases and in perhaps non-emergencies, but you know some sort of urgent incident, we can reassure the patient and we can speak to them and we can get on everything in motion to to support them while we await the ambulance.
00:12:03
Speaker
Or in many cases, 25% actually, we are able to avoid or cancel an ambulance altogether because we were able to go through, assess the patient, go through our processes and speak to our, speak to the duty managers and make a decision that perhaps there's a more appropriate pathway that this patient can go down that will actually alleviate the pressures on the health system and on the ambulance service.
00:12:32
Speaker
And how's it gone developing that cooperative relationship with the ambulance service? Because it's a deal of trust with your service as well, isn't it? Yeah, definitely. We're very fortunate that there have been a number of really helpful players within the ambulance service that that understand our model, that understand the local community, understand the need.
00:12:56
Speaker
and have been really collaborative and appreciative of the support. And so we were in regular contact with various players ah in the ambulance service to make sure that we're only continuing to add a benefit to the ambulance.
00:13:12
Speaker
We're not, we're by no means a replacement of an ambulance service, and we don't try to be that. When paramedics arrive from New South Wales ambulance, whether you're a doctor, a paramedic, first responder, whatever you may be, we're always handing over to the New South Wales Ambulance paramedics for them to take over.
00:13:33
Speaker
And yeah, we've been very fortunate to have built a great relationship with New South Wales Ambulance in this space, which helps a lot. And as you can imagine, we have a lot of interaction. So it's very helpful to have that kind of higher level relationship with them.
00:13:49
Speaker
Can I ask you, how do patients or families hear about you so that they know to ring you? How do you build that connection? And there's something called Health Direct. Can you explain what that is and how that works in with what you're doing in Eastern Sydney?
00:14:05
Speaker
And I'd love so a couple of examples too, would be great. Yeah, definitely.
Community Health and Expansion Plans
00:14:09
Speaker
So um how do people find out about us? Mostly local marketing, word of mouth.
00:14:15
Speaker
We spend a lot of time and we put a lot of time and effort into the marketing channels that we use and local newspapers, mail drops, things like that, just to provide education to people about our services and of course, how to get in contact.
00:14:31
Speaker
So that's how people find out about us. And ultimately it's everyone's personal decision as to whether they contact us or choose to contact either triple zero or Health Direct, as you've mentioned.
00:14:43
Speaker
ah So Health Direct is a government initiative, federal government and state governments combined, and they provide health advice to anyone in the community that would like it.
00:14:57
Speaker
They're staffed by healthcare professionals and you can call them about almost anything. And if they can't directly help you, they'll certainly point you in the right direction of who can help you.
00:15:09
Speaker
And they provide a really, really excellent and robust advice service for anyone that requires it, including being able to tell you what nearby resources or facilities are available to be used and also providing general health advice in the absence of perhaps your GP or an emergency department. And they've done a really wonderful job of keeping patients at home.
00:15:39
Speaker
and keeping patients out of the emergency department.
00:15:44
Speaker
And, you know, it it's interesting. Health Direct has been such a huge success in Australia. And when I compare it, I'm putting my sort of researcher hat on here for a second. When I compare it to my experience in the UK or historically in Australia, we used to have this saying of save triple zero for emergencies.
00:16:02
Speaker
and emergency departments are for emergencies. And it was a great throwaway slogan that everyone thought they understood until it was your emergency and my emergency. And then suddenly what we realized is actually when I'm having something terrible happening to me on ah an urgent health episode,
00:16:20
Speaker
If I wasn't a health professional, I have no freaking idea how serious it is or not. I'm in pain. I can't move properly. I feel sick as a dog. How am I supposed to know whether this is life-threatening, not life-threatening, whether it can wait five days, whether I can see my GP in the next 48 hours, if I could even see my GP in the next 48 hours because GPs are under so much strain because of...
00:16:42
Speaker
poor government funding. What we realized in Australia, which was really good, because a lot of other countries are still struggling with this concept, is that actually it's not fair to put that responsibility on the person in the community to decide what is and isn't an emergency. You actually, that's the job of a healthcare professional.
00:17:00
Speaker
to to help inform what is and isn't an emergency. And it's not fair to make people try and decide that. And so things like Health Direct and now CHS is providing an additional layer of phone advice and and triage actually allows people to get advice over the phone of is this serious or not? Because When we talk about life-threatening emergencies, as a paramedic, I feel very confident to say that the vast majority things that paramedics go to are not life-threatening emergencies.
00:17:29
Speaker
They're urgent healthcare care episodes. we We don't do like lights and sirens saving lives every hour of the day. We do it once a shift, maybe once every two shifts. But...
00:17:41
Speaker
That's what the community needs. And so organizations like CHS have done this really cool thing, which, and Julie, do you mind if I nerd out for a second here?
00:17:52
Speaker
If I could just say don't use acronyms, Aidan, I think it's really important we say community health support because people don't know what CHS means. You're right. Thank you. I'd be a bit of a pennant. And I'm just aware too we're a podcast that will go across Australia. Indeed, it can turn up anywhere in the world. So being clear that this amazing initiative we're hearing about in the eastern suburbs of Sydney is in a relatively small location. I'm interested to know where you're hoping to be in the future and whether there are other models in other places. But just being clear what we're talking about. So Health Direct, I think, is ah is it statewide or national?
00:18:31
Speaker
So Health Direct is an Australia-wide place we can ring and get the kind of guidance that you're alerting us to need to do when we're not sure for it how urgent our emergency is.
00:18:44
Speaker
And community health support that Jesse's talking about is in one area of suburbs in Sydney. And of course, triple o is an Australia-wide number, isn't it, for emergencies.
00:18:55
Speaker
So i'm just sort of I'm just thinking of the listener who's joining us who's not familiar with the territory, but... forgive me, I was interested in where you were going there. No, I'm glad. this This is the thing. It's confusing.
00:19:07
Speaker
Like it is confusing. It's a confusing space. We've got this proof of concept organization in Sydney's eastern suburbs doing something different and cool. And there's a few different groups around the world doing similar things a few different offshoots. But what it comes down to is, and I'm going to deep dive. I'm going to go full nerd on you, Julie, for a second, strap in.
00:19:26
Speaker
This philosopher are really called Ivan Illich. And he wrote this book, a Deschooling Society. And he also wrote a book called Medical Nemesis. And we'll talk more about some of those the concepts later on, because I think some of his sort of philosophies ring really true with a lot of patients.
00:19:41
Speaker
But one of the things he talked about is that as societies, health care used to be something that we did within the community. There was no such thing as a doctor.
00:19:51
Speaker
There was no such thing as and nurse. There was no such thing as a physiotherapist. You had... mothers and grandmothers who knew how to put poultices on and who knew how to strap bones and set bones and maybe the witch doctor did a bit but these weren't professionalized roles there were things within communities that people used to do the best that they could and over hundreds of years with professionalized healthcare and unfortunately what that's meant is with and the word Illich uses is expropriated
00:20:25
Speaker
which means to take away the role of healthcare care from what we as communities do to something that outside professionals do. And so what that means is as communities, we can become vulnerable when suddenly the system, which is full of professionals, becomes overwhelmed and doesn't work like it's supposed to.
00:20:48
Speaker
And then the real question is, what can we do as communities to try and take back some ownership of our own care during an emergency? I'm just going to try and jump in after that conversation, my bit.
00:21:01
Speaker
At one level, Dr Aidan Barron, I'm startled by this exploration Illich because our whole podcast, This Might Sting, is based on a commitment to evidence-based healthcare, evidence-based medicine and not misinformation.
00:21:18
Speaker
And to me, the As a patient who's been you know a cancer patient, but as someone who accompanied my late mother on many journeys in the health system, I'm grateful for the registration of clearly identified clinicians with scope of practice.
00:21:34
Speaker
You, sir, are doctor and Jesse, our special guest on this episode, a physiotherapist by background. And we have regulatory bodies that will investigate if you go beyond your scope of practice or engage in activities that aren't evidence-based. And that's an enormous challenge.
00:21:49
Speaker
protection So it's not that I'm speaking against this initiative. I understand our emergency departments are under immense pressure and that must lead to the prioritising of level of need by our ambulance services.
00:22:05
Speaker
But I'm not sure that I... I'm assuming that the Community Health Support Organisation in its selection of volunteers, its training of volunteers, I've gone onto your website and there is ah a clinical advisory group and that many of them seem to be doctors, that you're going to enormous lengths to make sure that the volunteers that turn up and under this model in the eastern suburbs of Sydney are qualified volunteers.
00:22:30
Speaker
and safe to do the best they can until the ambulance arrives and that's the nub of it if needed is that correct yeah Definitely. Yeah, no, that's totally correct.
00:22:43
Speaker
I think just because we're a volunteer organization doesn't mean that we've lowered the standards in any way, shape or form. Being in the health space and in that system, we've acknowledged and recognized that we need to meet all of the standards that you've touched on. And that's really important.
00:23:02
Speaker
for our local community and for the patients that we see and provide advice to that they're getting high quality health care definitely. And so where is this model heading? Is your dream that other communities will engage in similar highly organized mechanisms for providing triage and support to people who need help, some of whom will need ambulance help and some won't.
00:23:31
Speaker
Is your vision, say, five years down the track is what? Perhaps I could hear from both of you, Aidan and Jesse. Yeah, definitely. So the, look, the way that we see this is really a proof of concept in our local area, in our local community.
00:23:48
Speaker
And what does that mean, proof of concept? Well, look, it it doesn't really exist. The idea of having locally embedded volunteers within a community, it does exist in some rural and remote areas, but in ah kind of the metro areas, it certainly doesn't exist. And we've seen great results from the high acuity cases where we've seen our volunteers arriving on scene to a cardiac arrest and being able to start early CPR and applied defibrillator to the lower acuity cases where, as I mentioned, we're able to avoid or relieve the ambulance service and and possibly the emergency department in some cases.
00:24:32
Speaker
That model that that we've created, it doesn't exist more broadly. And our future vision is definitely, as you say, that we can take this model and roll it out to other communities where There are volunteers in other communities and other areas that are just as eager to help their local community and just as willing to jump out of bed at 3 a.m. for an elderly grandmother that's fallen, going to the bathroom in the middle of the night.
00:25:02
Speaker
They're just as willing as people and volunteers in our local community to do that. And so there's no reason why this model can't or shouldn't exist in other areas across the Sydney, New South Wales and all over Australia.
00:25:17
Speaker
How does it fit Aidan and Jessie with things like the Red Cross that does training and involves many volunteers but does some training as well and also St John's Ambulance is another group that as I understand it uses volunteers in a significant way.
00:25:35
Speaker
So what's the interface but with those sorts of organisations? I guess when we look at the power of volunteers in Australian society and more broadly in society, in the healthcare care space, there's a current unmet need, which is what Jesse was speaking to, which is that gap between when someone has something bad happen to them and when professional help arrives.
00:26:01
Speaker
And when I say professional help, in this case, I'm specifically referring to help that the government is in charge of. So ambient services, they get to hospital. There's a gap that exists there.
00:26:15
Speaker
That gap is termed as urgent and unscheduled care in healthcare. care It's urgent, which means you have to do something about it now, and it's unscheduled, which means we didn't plan for it.
00:26:26
Speaker
Organizations like the Red Cross, like St. John Ambulance, like Surf Lifesaving, they provide incredible care to the community and they save lives every year in Australia. but they provide emergency care in a planned way, which is that they do first aid at events, they patrol beaches, they do disaster relief to areas affected by floods, bushfires.
00:26:48
Speaker
What we're talking about, which is not yet being solved in Australia, is that when you and I are lying in bed at night and something bad happens to us on a Tuesday night, who in my neighbourhood is going to be able to come to my aid in the gap between when something bad happens and when the ambient service and professional services are going to be able to come and rescue me.
00:27:10
Speaker
And that is where I think there's a role for communities to take on increasing ownership of self rescuing, of rescuing ourselves. And I wanna be very careful there because there's, as you so rightly identified, we have regulation in Australia and we have one of the safest healthcare systems in the world, right?
00:27:30
Speaker
And so when it comes to using volunteers who are professional in their attitude, but many of whom might not be healthcare professionals, There are certain scopes of practice of what they can and can't do. And there are certain things like CPR, EpiPens, automatic defibs, asthma puffers, the green whistle.
00:27:50
Speaker
These are all things that highly trained first medical or first responders can give to help save lives that you don't need to be a nurse, doctor, paramedic in order to do.
00:28:01
Speaker
I see. And the green whistle, I happen to know, because when my partner fell off the wall, the green whistle was vital during a rather long ramping outside a hospital when we couldn't get in into the emergency department.
00:28:13
Speaker
And I can also see that because I'm the 70-year-old on this podcast, Jessie, I am the baby. Not a day over 50. You don't look a day over 50, Julie. But I have the personification of the baby boomer demographic bubble that everyone's been talking about in healthcare.
00:28:27
Speaker
So I'm very aware that as we look forward 5, 10, 15 years, the pressure on our emergency departments, on our ambulance systems and so on is going to but increasing so I can see the vision.
00:28:40
Speaker
You said earlier you were going to ask, I think, a nerdy question. This is the ultimate nerdy question, Aidan and Jessie, and that is insurance. I come from a clinical family and we all know that insurance is critical and I'm just interested in the insurance issues here because particularly if you decide an ambulance is not needed you know what I'm saying there there's sort of duty of care legal responsibilities that usually have insurance implications and I'm fascinated how you're dealing with that within this model
00:29:13
Speaker
Definitely. So I think just speaking more broadly about insurance and perhaps aiding can go into the kind of things like our clinical guidelines and the clinical advisory committee in a little bit more depth.
00:29:24
Speaker
But generally speaking, we of course have insurance across our whole organization for all of our volunteers and for any medical work that they do.
Volunteer Standards and Growth
00:29:34
Speaker
And we Really, ultimately, the decision making comes down to really sophisticated and really well thought out guidelines that we have in place that Aidan and the Clinical Advisory Committee have discussed and debated and made sure is really tight and aligns really well with what is being done in out of hospital care across Australia and the world and aligns with the best healthcare standards and practices as well.
00:30:06
Speaker
I think following on from what Jesse said, the big challenge in all emergency medicine around the world is is not the sickest patient in the room. The thing that keeps emergency doctors up at night is not, oh no, I brought someone into resuscitation and I missed something. It's someone who's currently sitting in the waiting room who...
00:30:28
Speaker
having a silent heart attack, something happening to them, that's actually an emergency that I don't know about. that That's the real thing that keeps doctors, health professionals, health managers in Australia up at night.
00:30:40
Speaker
It's that we've missed something in someone who we... haven't thrown the entire kitchen sink at, who we haven't taken through a CT scan and done blood tests and x-rays.
00:30:52
Speaker
It's have I missed something in someone I haven't fully investigated. That's in healthcare, care no matter whether you're in a ah specialist hospital or you're in a clinic in the middle of nowhere, or you're on the side of the road,
00:31:05
Speaker
That's the big risk. And I think you'll find that whenever you're dealing with health professionals and doctors, that's what we're always worried about. The risk that I've missed, not the risk that I've picked up on.
00:31:15
Speaker
And so it's not so much about insurance. It's about assurance, if you will. Permit me that sort of gimmicky line. If you've got systems which take care of people well, and also explain to them the risks and benefits of what's going on, you allow a conversation between people which informs them of what you're doing. And that helps to share the decision because at the end of the day, no one in healthcare care is right 100% of the time. So whenever we discharge people in the hospital, on the side of the road, what we try and tell them every time is, this is what I think is wrong with you.
00:31:53
Speaker
But these are the things I'd like you to watch out for what we call red flags. And it comes from the Bondi beach has yellow and red flags. And these are the red flags to look out for. So if someone, for example, had a problem related to their stomach and their intestinal system,
00:32:10
Speaker
And we said, you're okay to stay at home now, but if you start vomiting, call us back or come to hospital, come to the emergency department because it means something's wrong. It then means that I'm empowering that person to go, oh, I'm safe at the minute, but if I start vomiting, I know that is related to this condition and something's going wrong.
00:32:30
Speaker
And if you're listening to this and you're thinking, hang on a second, I haven't been told that, you can ask us as health professionals in any encounter, what are the red flags I should be looking out for?
00:32:41
Speaker
Because that helps us as health professionals to reduce risk and make you safer, as well as it helps it helps you take better care of yourself. And that's how that's the way that we're able to make sure that people get the most appropriate care.
00:32:57
Speaker
whether that's the ambience or taking themselves to the emergency department or staying at home and seeing a GP. Should we offer our listeners a bit more information about how you recruit people as volunteers and the sort of training and support you give them? And just maybe an example of a call and and what happened to the person to their benefit. But how do you recruit and how do you train and support?
00:33:21
Speaker
Yeah, again, a lot of this comes down to marketing. Of course, if people don't know about us, they certainly won't have the opportunity to put up their hand at volunteer. So through various marketing channels, we do a bit of an outreach and see who's interested.
00:33:36
Speaker
Then we have a recruitment process. So people are interviewed. Again, just, I guess, speaking to the standards that we have, not everyone will be suitable.
00:33:47
Speaker
Some people more suitable than others. And just because we're a volunteer organization doesn't mean that we open the door for everyone. And so we have that process that we go through.
00:33:59
Speaker
And then whether you're volunteer, healthcare professional or not, there's a training program that will span ah number of months, Sundays and weeknight evenings where we're training the fundamentals of, I guess, out of hospital care, but also healthcare in general so that people have a better understanding of how their knowledge or um or not knowledge to begin with, how that kind of relates to the world that they're entering.
00:34:31
Speaker
And so after four to six months of training, assuming that they've been assessed and have been credentialed to go beyond that path, then they become what's called a trainee responder and trainee responders are then able to hit the road and they can go as a second or a third responder where they are not the primary responder, but they can start to have interactions with patients. They can start to, to learn the ropes under supervision of a primary responder and,
00:35:06
Speaker
In that process, they're learning, but they're also continuing to train and be upskilled. And they have what we call competency logbook, which they has all of the competencies of a primary responder.
00:35:22
Speaker
And they're getting that signed off by the supervisors that they're going, by their mentors that they have at various specialized trainings that we're running for them. And at the time that they can show that they've gone through that process and be assessed again, which is typically six to 12 months from when they've become a trainee responder, so 12 to 18 months from when they initially joined,
00:35:48
Speaker
that's the moment at which they can be assessed and potentially move on to become ah medical first responder in the organisation, someone that can operate in unsupervised fashion and can start moving towards supervising others as well.
00:36:04
Speaker
And you also have volunteer dispatchers. Can you explain what that role is? Definitely. They are the the unseen heroes of the organization, if you will, because they're the ones that don't end up, you know, where all of the action is and often don't necessarily get recognized, but very much the blood of the organization.
00:36:29
Speaker
And so for dispatchers, it's a little bit of a more simple process, if you will, to get trained as a dispatcher because, There's less clinical knowledge and more understanding the rules and understanding the flow charts and all of that. So again, recruitment process interviews, not everyone's suitable to come on board in that role.
00:36:52
Speaker
And then they go through... A slightly shorter recruitment, probably about half the time, but still lots of drills and lots of training.
00:37:04
Speaker
And then they too will go through an assessment period where they will be assessed in kind of real life conditions. And they will also move on to become a probationary dispatcher if they pass that assessment and will continue training and will continue having mentorship and having all of their calls audited and provided with feedback.
00:37:29
Speaker
And we'll basically continue operating as a dispatcher and moving through the ranks to off their probationary period and then into kind of senior dispatcher roles and more mentorship and training training facilitator roles as well.
00:37:45
Speaker
For so people listening to this are unfamiliar with volunteer-based organisations, it can sound quite extraordinary, but they you've reminded me, i i watched religiously a series on our SBS TV in Australia's special broadcasting service that was about the rescue off the coast of the United Kingdom.
00:38:06
Speaker
And there's a very organised system that sounds so similar to what you're describing, where volunteers up and down the coast, and yeah they're dealing there with extraordinary seas and often great personal risks, go out on these boats. They call in at any time and they go out on these boats and rescue people at sea. And again, it's it's ah ah entirely volunteer-based. It's structured. It's supervised. It's everything you're describing.
00:38:33
Speaker
Can I ask you roughly how many people have you got involved? and Is anybody funding you? Yeah, I think just to your point about the power of volunteerism, it's really incredible to see. I truly think that there is not many things that are stronger than the heart of a volunteer, um someone who's doing it of their own free will and for something greater or they feel as though they're doing something greater than themselves and in almost every case they are.
00:39:03
Speaker
And this is a It's just an incredible space to see and to follow and to be a part of. So we now have coming up on 120 volunteers in the organization.
00:39:15
Speaker
um It's probably a 70-30 split of responders to dispatchers. and And we're growing and we're constantly growing and recruiting and building on that to to be able to continue to provide the service that we do as it scales and the demand grows as well.
00:39:36
Speaker
And on the funding side, we're very fortunate enough over the last few years to have a lot of very generous philanthropic support through donations. We have a couple of corporate partners as well that support us.
00:39:51
Speaker
We've received various grants through the federal and state government, as well as on a kind of a local council level. But the the bulk of our kind of support comes from donations, comes from people that like what we're doing, perhaps have been a beneficiary of our service, or just really believe in our mission and understand that it's the the importance of it being there and feel as though it's a safety net for everyone in the local community.
00:40:23
Speaker
But every year we run a what we call it a giving day. And that's an opportunity where for 12 hours, we We get the phones going and we call the people in the community that we know and might support us. And we say, this is who we are and this is what we're doing. And we'd love it if you supported us. And funnily enough, the outgiving day is coming up on the 4th of May. So we're gearing up for that.
00:40:49
Speaker
And yeah, hoping that the community will step forward in a big way. Like they did last year, we had 1300 donors in 12 hours, which was really remarkable to see.
00:41:00
Speaker
the support of the community and the belief in what we do in and in our mission. Aidan, I'd love to hand back to you now ah well on what you think are issues or information that we should offer our listeners. and I guess I'm also interested in your vision. You clearly have ah passion? Is that a fair word for the notion of community offering mutual aid and support to each other, albeit within a well-trained and safe framework within the health context? So, you know, over to you.
Importance of Bystander Intervention
00:41:34
Speaker
Thanks, Julie. And thank you again, Jessie. The dream in pre-hospital and emergency medicine, paramedicine, is that common people walking around on the street are the first to take action when someone has life-threatening emergency and that passerby starts CPR, cpr ah passer by yells, help, does someone have an EpiPen, put someone in the recovery position. it Almost all of the interventions that are lifesaving that we offer in ambulances and in hospitals rely on that first few minutes of bystander aid
00:42:13
Speaker
And so the whole weight of the last 120 years of resuscitation research is essentially waiting there for people in communities to help each other.
00:42:26
Speaker
Because the chain of survival doesn't continue. And that chain of someone starting CPR, someone getting an AD, someone calling triple zero, and then an ambience racking up, it just doesn't work without those few, the first few links.
00:42:41
Speaker
And so it's a research area for me and it's something I'm passionate about. And I'm excited to see organizations like Community Health Support and hopefully other organizations similar to it around the world starting to embrace this philosophy because there is there's no competition. It's a mutually beneficial collaboration between communities who are taking ownership of those first few minutes and saying, actually, yeah, we want good outcomes. We want to take care of each other.
00:43:10
Speaker
And professional health services going, we're so glad you did the first few things so that now we can do our job and get the best outcomes possible. And so there are programs even now where if you don't live in a community that has an active organization, there are still opportunities for
Technology in Emergency Response
00:43:28
Speaker
you. So there's a thing called the Good Sam app, which was developed by a colleague of mine called Mark Wilson, who's ah genius The guy was an anesthetist and then became a neurosurgeon after becoming a specialist. And he works as a helicopter doctor in London's Air Ambience. And he designs this system where when in the UK, a 999 in Australia, a triple zero call comes into the call center.
00:43:51
Speaker
They hit a button on the computer that finds the two closest people. within 500 or so meters who've signed up and said, I'm willing to do CPR if someone needs CPR. And it finds the two closest people and sends them to the person who needs CPR.
00:44:07
Speaker
And that has had the most remarkable outcomes. I have friends and colleagues who've successfully resuscitated three-year-olds, 83-year-olds. I've personally been really fortunate to be a good SAM responder for a while and to have been part of some really wonderful resuscitations.
00:44:23
Speaker
There are, and Good Sam works in most of Australia. Most Australian states now have active Good Sam programs. New South Wales does Victoria, which is now one of the and of the safest places to have a cardiac arrest in the world, has a pioneering Good Sam program.
00:44:39
Speaker
In the United States, they've got different programs. In the UK, they've got Good Sam programs. So there are opportunities that you can get involved in today. you You don't even have to be formally first aid certified. You just have to be willing to do CPR and you can sign up for one of these.
00:44:56
Speaker
ah But if you wanted to take a step further, I think speaking to the power of volunteering, there are so many people in our community who get so much benefit from being a part of something. And as we've we've spoken about before, Julie, loneliness is such an epidemic in today's society.
00:45:11
Speaker
Being part of a volunteer organization is the antidote to some of the mental ill health that and frankly, physical illness that comes from loneliness. So if you're listening to this and you're thinking, gosh, I wish I could do something like that, I'd say do it.
00:45:28
Speaker
Get in touch with Jesse at Community Health Support New South Wales. Get in touch with your local SES unit. Get in touch. See if the ambulance service has a rural community first responder program where you are.
00:45:40
Speaker
Because there are incredible opportunities that will allow people to learn new skills that will fulfill you with confidence that will really bring meaning to your life. And ultimately it saves lives. Like the reality is the research shows time and time again, that it's about people in the community, your next door neighbor,
00:45:59
Speaker
being willing to step up in an emergency and save your life. And it works. I am making a personal commitment that I'm going to training do some first aid training and some CPR training.
Healthcare Advice and Episode Conclusion
00:46:10
Speaker
That's something everyone listening can do if they haven't done it already.
00:46:14
Speaker
Because i it's true, isn't it? Our systems ah health systems are going to be under increasing pressure as the baby boomer generation ages. It's already happening, isn't it Totally, and it's not just about, you can have the world's most perfect healthcare system. We could have an empty hospital and 50 ambulances waiting outside the hospital ready to respond to you, and it would still take more than a few minutes for them to get to you.
00:46:37
Speaker
So even in the best setup system, and keep mind, we have an amazing healthcare system in Australia. We have an incredible, incredible quality of paramedicine here, a phenomenal world-leading ambulance services, a really great hospital system compared to a lot of other countries out there.
00:46:54
Speaker
Despite that, it still takes a few minutes for someone to get to you when you need help. Notwithstanding, we also have hospital pressures at the moment. And when you say paramedicine, what is a paramedic? What is paramedicine?
00:47:10
Speaker
So great question. A paramedic is a healthcare professional who has become an expert in the care of patients outside of the hospital. And traditionally they were employed by ambulance services and most work for the ambulance services.
00:47:24
Speaker
Nowadays, you might find some in clinics or in other areas, but it's someone who who's gone through nowadays in Australia, a degree program. So a bachelor's degree of paramedicine or equivalent. who practices as a paramedic, who's registered as a paramedic and has a bunch of advanced skills where they can make diagnoses, they can give high level drugs, put drips in cardiac monitoring, shock your heart back, do a whole bunch of things which traditionally were the remedy of only doctors in emergency departments to bring emergency care to the patient.
00:47:58
Speaker
shock your heart back if it ever happens to me gentlemen I want to be shocked back and I realize I have to get my partner and my neighbors to do the training too don't I it's I just suddenly realize I'm in a small cul-de-sac here just outside this window and yeah we all ideally can help each other that's what you're saying when we're in trouble ah until other experts can arrive if needed yeah
00:48:26
Speaker
and Jesse fields calls all day and every day from people who aren't sure whether what they're having is an emergency or not. Jesse, what's a message you would love to leave people with?
00:48:39
Speaker
think that that if you're unsure, Get in touch with whether it's Health Direct or if you're in Sydney's Eastern Suburbs, Community Health Support, or these days, triple zero, even if it isn't an emergency, they can pass you on to be further triaged as well.
00:49:02
Speaker
If you have a feeling that something might not be going 100%, you have a feeling that it might be urgent, whether you're picking up the phone, visiting your GP, visiting an urgent care clinic or an emergency department.
00:49:18
Speaker
We obviously hope that the pathway is the most suitable for you, but you know, it's better to be safe than sorry when it comes to health. And there are too many cases where people shrugged off a few things that they probably should have gotten checked out. And unfortunately, I've had pretty poor health outcomes as a result. So if you're not sure, seek help. And hopefully it's nothing major, but it's better to be safe than sorry at the end of the day when it comes to your or your family and friends health.
00:49:50
Speaker
ah think we might have come to the end of another episode of This Might Sting. I really want to thank Jesse Len, who was Head of Community Health Support, New South Wales and the eastern suburb of Sydney.
00:50:01
Speaker
Dr Aidan Barron is an endless inspiration to me with his visionary thought about and mutual aid. It's been a really thought-provoking episode for me, I must say. And if you're new to This Might Sting, please have a look at the notes wherever you're watching us, whether it's on YouTube or somewhere else. We'll put a link to the website of of community health support.
00:50:24
Speaker
And we'd love your feedback. We'd love your ideas. We'd love your corrections. We'd love your challenges. We really want to link with you. And remember that we diagnose nonsense, And we prescribe the truth. And my own personal motto is to take my medication as prescribed. I don't know, Aidan, if you want to add an extra motto for our paramedic opportunity today.
00:50:46
Speaker
I think we live in a society which means we rely on the people around us when we need help. It means it's to our benefit to invest in the people around us.
00:50:58
Speaker
It is probably the message for today. Thank you, and we'll see you next time on This Might Sting. Bye. Thanks, Julie. Thanks, Aidan. This Might Sting is hosted by Aidan Barron and Julie McCrossin.
00:51:12
Speaker
Executive produced by Joshua Kirsch. While we always work to give you the best information and tips, nothing in This Might Sting should be construed as personal healthcare advice.
00:51:23
Speaker
You should always make health decisions in consultation with your general practitioner and specialists. If you'd like to hear us talk about a topic on the show, or if you think we've made a mistake and wanna request a correction,
00:51:36
Speaker
please contact us at questions at thismightsting.com.au.