Mobile Intensive Care Ambulance
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Australian Mobile Intensive Care Ambulances are well-equipped ambulances staffed by highly trained paramedics dispatched to emergency situations where patients require a high level of care comparable to a hospital ICU.
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[edit] History
This is a brief history of the Melbourne metropolitan MICA ambulance service.
1971 MICA concept trialed in a bid to address the avoidable deaths from road accidents and heart attacks.
1972 Ambulance officers trained over some months at Royal Melbourne Hospital replaced medical registrars on the MICA ambulance. The network of MICA Ambulance teams based at hospitals grew to 10 over the next 20 years.
1978 The first student ambulance officers began the Certificate of Applied Science Course.
1986 Helicopter retrieval of trauma and time critical patients began.
1989 The current Doncaster headquarters opened.
1990 UHF radio introduced.
1991 Cranbourne, Epping and MICA 8 opened at Maroondah Hospital.
1992 The first three paramedics from the country (South Eastern Region) attended the MICA Course and graduated in October.
1992 A Computer Information System was introduced to streamline dispatch of ambulances.
1993 State Government opened non-emergency patient transport services to competition. 12 new emergency ambulance stations were opened. Emergency and non-emergency patient services were separated and five sub contractors appointed to provide non-emergency stretcher transport.
1994 The number of operational MICA Paramedics increased from 75 to 126. The Clinical Support Officer role was created.
1995 Computer Aided Dispatch/ Automatic Vehicle Location systems introduced with the commissioning of the Intergraph BEST (Vic) Pty Ltd communications centre. The first of 10 new peak period emergency ambulances commenced. Creation of the Duty Team Manager to manage resources in the Communications Centre.
1996 Advanced Medical Priority Dispatch system introduced to the Communications Centre. Recruitment drive to expand operational staff recommenced
1998 State Government approved MAS three year plan to significantly expand emergency ambulance services in Melbourne to meet projected workload growth.
2001 Metropolitan Ambulance Service celebrates our 100 year anniversary with a street parades. We also start the First Responder Program, where firefighters from the Metropolitan Fire Brigade co-respond to life threatening emergencies.
2002 In a major upgrade to our fleet we commence changing our vehicles across to Mercedes Benz Sprinters, increasing safety, efficiency and visibility.
2003 Two paramedics tragically killed in a road accident while responding to a case in Melbourne's outer east. Despite the Coroner's recommendation, the ambulance service fails to assess and minimize risks to Paramedics responding unnecessarily under emergency conditions.
2005 The Victorian Ambulance Clinical Information System (VACIS) is rolled out service wide. Mobile Data Terminals linked to computer aided dispatching system introduced into service using a private trunked digital network shared with Victoria Police.
2006 Bicycle Response Team introduced for major events
2007 Introduction of Digital Radio commences to replace analogue UHF voice communications. MICA in Melbourne reaches a Crisis. The Ambulance Service has neglected MICA for so long and failed to manage it effectively, they can no longer adequately staff the MICA service.
[edit] MICA Paramedics
Mica Paramedics are extremely highly trained and experienced medical professionals.As with all paramedics they hold a bachelor degree in emergency health such as the B.Emerg Health (pmed) from Monash University.
Mica Paramedics must also complete a graduate diploma in emergency health. This requires concurrent employment with ambulance services in a clinical role and at least two years experience as a paramedic in the service. While also working as a paramedic the student must complete a year’s worth of course work on advance emergency health. Paramedics may also choose to complete a Masters in Emergency Health (Paramedic). However, this focuses more on research, emergency services management and community health rather frontline clinical care.
Working as a MICA paramedic can be extremely emotionally taxing. Currently due to poor pay and excessive workload many MICA officers are resigning from the industry altogether or returning to work on the regular non MICA ambulances.
[edit] Equipment
During the course of a days work, paramedics will go through a lot of medical supplies to treat a variety of injuries and illnesses. Standard equipment that paramedics use include:
Defibrillator/electronic heart starter
Oxygen
Airway management set
Suction kit
Spinal collars
Spine board
Inflatable splints
Collapsible wheelchair
Medical kits
Drugs
Blood pressure cuff
Pulse oximeter
Scoop stretcher
MICA paramedics may also use:
12 lead heart monitor
Capnograph
Pneumocath
Intraosseus Kit
Advanced Drugs including inotropes, antiarrhythmics, sedatives and neuromuscular blockers
Syringe pumps
Cold Intravenous Fluids to induce hypothermia
[edit] Vehicles
Intensive care ambulances in Victoria are usually the Mercedes Benz 316D sprinter. However, intensive care may be provided in a number of ways depending on the situation at hand.
In the busy Melbourne CBD, MICA paramedics may reach their patients in Ford Territory and Holden Adventura 4WD wagons.
In rural settings, time sensitive patients are treated and transported by helicopter or by one of the Land Cruiser all terrain MICAs.
In response to the massive crowds expected for the 2006 Commonwealth Games, Melbourne Metropolitan Ambulance services established the bicycle response unit for use in heavy crowds and major events.
In addition to the primary response vehicles above, the NSW Service also operates specialised vehicles that have been designed to meet geographical and operational requirements, including:
· Rescue Trucks Ambulance rescue vehicles are equipped with a vast array of equipment including motorised hydraulic tools, air tools, hand held global positioning satellite units, fibre optic search scopes, portable atmospheric testing units, lighting and breathing apparatus.
· Rapid Response Vechicles Seven Subaru Forrester AWD vehicles and two BMW motorbikes make up the current rapid response fleet. All vehicles have distinctive signage, high visibility warning lights and sirens. Subaru Forresters are also equipped with an advanced satellite navigation system.
· Over Snow Vehicles Our fleet of vehicles at Perisher Valley Station include a Haaglund all terrain vehicle, a Kassborher oversnow vehicle, two Yamaha snowmobiles, a 4WD Quad Bike and trailer and a 4WD Mercedes.
· Mega Lift Trucks These multi-purpose vehicles are used for a range of incidents including chemical, biological and radiological (CBR) incidents.
· Command & Communications Vehicle This vehicle serves as a mobile command post for the management of incidents and major planned events. Wirelessly connected to the ambulance wide area network it offers video conferencing, SmartBoard and voice communications. The vehicle also provides remote dispatching capability with the system connected in real time to the central computer aided dispatching system.
[edit] References
http://www.ambulance.nsw.gov.au/what/fleet.html
http://www.mas.vic.gov.au/main-home.html
http://www.med.monash.edu.au/beh/overview.html
MOBILE INTENSIVE CARE AMBULANCE A SERVICE IN CRISIS Report on results of MICA Survey 2006. A report Prepared by Ambulance Employees Australia - Victoria
