PRIME ends 24-hour medical emergency care

Raglan will lose its round-the-clock emergency service when PRIME (Primary Response in Medical Emergency) ends this weekend, even though one of its volunteers says there is now a need for it more than ever.

The PRIME programme, which is administered by St John in life-threatening cases, especially when the ambulance response time has been delayed, will finish up its 24-hour service in Raglan on Sunday, just before the busy Easter weekend, because it doesn’t have the number of volunteers it needs to operate safely or to give full assistance when needed.

PRIME volunteer Mark Reynolds, who is a nurse educator in critical care at Waikato District Health Board, says with several people leaving the service at the same time it is unable to continue delivering a 24-hour operation. However, PRIME will continue to operate from West Coast Health during office hours.

“There aren’t enough people to provide 24/7 emergency cover and certainly Raglan needs that,” says Mr Reynolds.

With more people coming to Raglan in the weekends there are more chances of drownings, car crashes, heart attacks or any other events requiring a “high level of emergency care”.

PRIME was started in 2008 by West Coast Health Charitable Trust to provide extra backup to St John Ambulance and other emergency responders. The service had eight doctors and nurses on its roster, while St John has one paid staff member working the ambulance service weekdays during office hours, and volunteers that work the weekends.

“We all did a special course that gave us the same skill set as an intensive care paramedic,” says Mr Reynolds, of the PRIME volunteers. “We had the authority to operate at that level so we could give drugs and do advanced life-saving procedures. It has definitely happened, there have been cases where we have done things that have saved lives.”

In comparison, an ambulance officer’s role is to administer pre-hospital emergency care.

Mr Reynolds says while St John does an excellent job, there are “many gaps” in St John’s Raglan roster, and there are times when the Raglan ambulance is already on a call so one needs to be sent from Hamilton or Ngaruawahia.

“You are going to get an ambulance but it may take 30 or 40 minutes,” Mr Reynolds says.

“It feels to me like they need more (volunteers).”

He says he was rostered to work PRIME on the first weekend of March and attended two callouts – the Raglan ambulance was unavailable for both.

He says about 40 percent of the callouts in Raglan in 2015 were unattended by Raglan ambulance.

St John district operations manager Stuart Cockburn would not say how many volunteers it had on its books for Raglan, but says they always need more.

The St John service relies on government funding, which is currently under review.

“It is St John’s understanding that the loss of the PRIME service in Raglan is only temporary. St John believes that we have sufficient resources available to continue to provide a high level of service to Raglan and surrounding communities.

“In the past year, St John attended 766 incidents in the Raglan area, of which 483 were outside normal business hours; the PRIME service attended 70 incidents, with 58 of those occurring outside normal business hours.”

Mr Cockburn says that while the contribution of PRIME in Raglan is important, there is also a memorandum of understanding with the fire service to attend life-threatening incidents, and there are other resources it can draw on.

“For all life threatening and time critical incidents St John dispatches multiple resources immediately – this includes ambulances from within the Waikato, New Zealand Fire Service co-response and helicopter response to high acuity incidents.”

Raglan Volunteer Fire Brigade chief fire officer Kevin Holmes says if the Raglan ambulance is busy, the fire service can get to an incident straight away and start CPR.

“Our ambulance isn’t always going to be there all the time … from the time someone puts in a call we can be on the road in five minutes.”

The fire trucks carry a defibrillator, oxygen and first aid kits, and firefighters are trained in defib use, oxygen therapy, CPR and first aid (above the level given in workplace training).

“We tend to respond to cardiac arrest but also attend other events, to make an assessment and provide first aid. It also provides assurance to those waiting for the ambulance.”

He says the PRIME volunteers have been really good to work alongside.

“They come to everything, from medical to motor vehicle crashes.

“While waiting for an ambulance it is good to have people with medical skills.”

Inger Vos

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