The RFDS in WA
Our Retrieval Service
We operate a dedicated medical retrieval service which covers 98% of Western Australia and extends from Rottnest Island off the coast of Perth to the Indian Ocean territories of Christmas and Cocos Islands. All but those mainland locations within approximately 80km of Perth access the service for medically supervised transport. The state has a highly centralised hospital system with no intensive care facilities outside of the metropolitan area of Perth in the south of the state. Long distance transport over distances of up to 2,000km is considered normal.
Our service operates a statewide 1800 number which is accessible by any health service or member of the community outside of the metropolitan area. It is not promoted within the metropolitan area. Our philosophy is to have every air evacuation call handled by an experienced retrieval doctor so that the best decisions are made for every air transport and a high level of advice is immediately available to callers.
We have been fortunate over the past two decades to have developed a single number, single call, single agency service where the clinical, aviation, engineering and communications functions are integrated into one operation. The system has the capacity to talk to multiple teams from multiple locations to ensure the best response for urgent patients and to achieve maximum utilisation of assets across the state. For example, it is not uncommon to have medical teams deployed from all five facilities at once with critical care transfers; or even to have multiple teams in the south of the state undertaking a number of fixed wing and rotary retrievals concurrently. Multiple teams from multiple locations can also be tasked to mass casualty incidents as an extension of our normal coordination practices.
Over 9,000 transports are undertaken each year. Approximately 80% of evacuation requests are received from country hospitals, with the remaining 20% being primary requests from locations without medical practitioners. Only stretcher cases and those requiring ongoing treatment in flight are accepted for interhospital air transport.
Primary evacuations often involve undifferentiated cases, as adequate pre-flight information is not usually available from callers. Primary evacuations are authorised by an RFDS doctor and directed to the nearest suitable hospital. Interhospital transfers are referred to us by country doctors. Patients are taken to the nearest suitable hospital. Interhospital transfers are referred to us by country doctors. Patients are taken to the nearest suitable regional or tertiary hospital, able to provide definitive care, as agreed between all clinicians involved.
At present, roughly 55% of transports are medical retrievals requiring a retrieval doctor and flight nurse team. The balance are conducted by our flight nurses alone, under medical direction, with written treatment orders and in-flight satellite telephone communication. For example, each of the 4-500 emergency obstetrics transports each year are managed by our flight nurses alone (all of whom are registered midwives) with satellite phone support in flight.
Our workload continues to rise with the increasing population and economic activity in rural and remote parts of the state. A narrated overview of how our system works, based on a recent conference presentation, can be viewed here.