Extended Care Paramedics An Innovative Step Towards Integrated

Extended Care Paramedics An Innovative Step Towards Integrated Care Sarah Rivett Ambulance Liaison Officer

What is an ECP? ü ECP stands for Extended Care Paramedic ü ECPs were invented to treat low acuity patients with subacute conditions and where appropriate, identify and initiate not emergency department care. ü To complete ECP training within Ambulance, you have to either be a registered nurse or completed Intensive Care Paramedic/or Paramedic training (highest Ambulance clinical levels).

S ou S n m ds el ls Lik lik e e. . C a U n’ nl t ik ru el le y o to u be t. .

What do ECPs treat? ü ü ü ü Allergies/hives Asthma Back pain (non-traumatic) Cervical spine assessment Chronic pain Croup Dislocations Fitting/convulsions Falls/back injuries Haemorrhage/lacerations Person ill (range of diagnosis) Soft tissue injury Minor injury and illness presentation ü Acute pain ü Stings/animal and insects bites and stings ü Catheter changes/urinary retention/urinary tract infections ü Burns ü COPD exacerbation ü Diabetic problems ü Epistaxis ü Eye problems/injuries ü Fish hook injuries ü Gastroenteritis ü Palliative Care ü Skin Infections ü Wound Assessment

Patient Contact ü Primary Survey ü Validating concerns ü Long case history ü Physical examination ü Providing patient options ü Interventions ü Referral / Transport ü Fact Sheet

Current Referrals ü General Practice ü Wound Care ü Falls Clinics ü ACAT ü Occupational Therapy & Physiotherapy ü Hospital in the home ü Mental Health ü Rapid response teams

How do I request an ECP? ü Calling 131 233 from RACF ü Pro. QA – standard questions ü State “Requesting an ECP” ü Triple Zero (000) only for Life Threatening (would not be requesting an ECP anyway)

Benefits of ECPs ü People being able to remain in their place of residence ü Right treatment, right patient, right location, right time, right place ü Avoiding long waits in ED for patients ü Unnecessary NSW Ambulance transports ü Unnecessary ED presentations or admissions

Future Opportunities ü Fracture management / Radiology ü APAC / HITH • Cellulitis • CAP • COPD

ECP Governance ü All non transported cases attempted to be called back within 72 hrs for follow up ü Representation within 72 hrs are flagged and sent to clinical governance for review. (Currently makes up 1% of cases)

Contact Details Sarah Rivett HNE & North Coast Ambulance Liaison Officer srivett@ambulance. nsw. gov. au 0419 038 649 (business cards available)