Who cares, matters. (the Emu makes sense later)

When you're planning an operation in an austere location, such as an island in Indonesia going hiking or potentially in the Federated States of Micronesia doing a bit of diving, a question needs to be asked about what resources you're going to deploy.

Is having an Advanced First Aider enough (which could be someone like a Security Medic think TCCC, Combat Medic, PHLTS) vs. having a Degree-Qualified Paramedic.

It really should form a part of your risk assessment for the health risks to the principal or their guests. What activities are the individuals going to get up to, and what pre-existing medical conditions exist (two of a non exhaustive list of questions to prompt your thinking), let alone the distance from a mid tier 2nd or 3rd world quality hospital.

Oftentimes, the Executive Protection agents have a TCCC or Combat Medic background maybe they're even qualified vs trained. The value (or perhaps lack thereof) only becomes pertinent when the shit has hit the proverbial fan.

Where I started was in the bush, it looked a little like this:

When I left the Police College, I had an advance first aid ticket, I knew blood went round and round, air went in and out and that's about the extent of it.

It's hot as hell in most of the landscapes of Australia's Northern Territory and when something bad happens, the risk of a fatality is pretty damn high and that's just from the environment killing you let alone some sort of emergency medical event.

Average monthly maximum temperature in Northern Territory

Now the differences between the medical capabilities of a police officer with advanced first aid training and the care administered by degree-qualified paramedics should be pretty obvious.

But in light of getting this far, humour me and allow me to illustrate a little further the differences. To do so I want to go back to an accident I attended on the Stuart Highway north of Tennant Creek as indicated on the map with the giant red arrow further on in this piece.

Here cometh the Emu..... as promised

This incredibly unlucky couple involved in this incident had the bad luck of duelling it out on the Stuart Highway with an Emu who ended up causing them to crash their beautiful Goldwing motorcycle into the hard deck when the cheeky bugger tried to outpace them and ran onto the road in front of them, placing them hundreds of kilometres from the nearest critical care hospital and spread out "from arsehole to elbow" (across the road) needing pretty immediate serious medical attention.

The Cavalry arrives!

With...... some Advanced First Aid Training, oh dear.

Northern Territory police are often the first responders to incidents in remote areas. Many officers have completed advanced first aid training under the HLTAID framework, this is the training I'd received, which equipped me with skills to manage emergencies until more qualified medical help arrives.

In the case of our poor couple who've come a gutsa in the motorbike accident, a police officer can:

• Secure the accident scene for safety. (Park your marked car with lights flashing, across the road and control traffic)
• Conduct a primary assessment for life-threatening conditions. (Look for red stuff and poking out bones - then competently get on the radio to tell someone bad stuff has happened and help is needed)
• Perform CPR and basic airway management if required. (Yes this is true)
• Control bleeding using direct pressure, bandages, or tourniquets. (Debatable depending on the level of proficiency achieved in their course)
• Protect the victim from the elements to prevent shock. (Yes this is true)

However, despite their training, these officers face several limitations. They cannot:

• Administer advanced airway management if the patient's condition worsens. (Potentially a jaw thrust at most)
• Provide advanced pain relief or other critical medications. (This is very true)
• Perform invasive procedures. (Again correct)
• Make comprehensive assessments or clinical judgments. (They do quiet often scream down the line for a Paramedic from St John's NT to get there ASAP to help)

Their main role then (beyond traffic control) is to provide immediate life-saving measures and stabilise a patient until paramedics arrive. Which in my case at this stage of my career may have included a fair bit of gawking and looking on in dismay.

Degree-qualified paramedics arrive (thank god), traffic control's well in hand, but it's time for the real life-saving to begin, stand back 5-0!

Thankfully the green overalls (degree-qualified paramedics) from St John's NT Ambulance Service have a vastly different scope of practice. Upon arriving at the scene of the motorbike crash, a paramedic can:

• Perform an advanced patient assessment, including vital signs and detailed physical examinations.
• Administer a wide range of medications, including pain relief, cardiac medications, and other emergency interventions.
• Use advanced airway management techniques, such as intubation or administering oxygen therapies.
• Initiate intravenous (IV) lines for fluid or medication administration.
• Use cardiac monitors to identify and treat life-threatening cardiac arrhythmias.
• Make autonomous decisions about patient care and the need for medical evacuation, whether by road or air.

The paramedic's advanced training allows them to identify and manage complex medical issues that are beyond the scope of first aid.

Which right now as the situations unfolding is pretty critical, because as you'll remember from the big red line on the map, there isn't a decent hospital closer than Alice Springs and that's about 700km's by road or 5-7 hours drive depending on traffic, road conditions, lights and sirens and weather.

Medi-vac is about the only option here and now

The difference in care between an advanced first aid-trained police officer and a paramedic becomes starkly apparent. I'm stood holding a space blanket over a patient while the Paramedics are acting almost like JTAC's calling in a Royal Flying Doctor Service aircraft to drop in on the Stuart Highway (sure there's some coordination here with the cops as we keep the road clear) but you get the picture by now of the value in having this level of training rapidly deployable in an emergency.

You get what you get, you don't get upset.

Bringing it back to the profession and private industry now. If the choice is made to go remote without serious medical intervention skills or qualifications, the consequences can accumulate rapidly when/if your principal or patients deteriorate due to .....anything.

While the first aid capabilities of operators with their relevant and helpful courses are invaluable for that immediate first response, especially given the vast responsibilities they cover for their principals, their skills are not a substitute for the comprehensive care provided by a real paramedic or better yet a remote wilderness qualified doctor.

Here's a spotlight on the Panoptic Solutions medical director, Dr. Kieran McCarthy , he holds a Fellowship of the Royal Australian College of General Practitioners, a Masters of Public Health

That mad Emu on the Stuart Highway hopefully highlights the importance of each role and the need for real medical support in remote areas. For those who live, work, or travel through such isolated regions, understanding the limitations of first aid and the capabilities of paramedics can have a serious effect.

Panoptic Solutions - Australia & Asia Security & Risk Management are a highly experienced security, risk management and medical support company that provide bespoke solutions to the needs of our clients as they travel and explore Asia and the Pacific regions of the world.

Want to know more? Contact us here or email at [email protected]

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Image obtained from Dailymail