Attention
- Familiarise yourself with the organisations equipment, procedures, check lists and
schedules
- Remote areas use satellite phones, mobile phones and radios. Make sure all staff know
how these work and how to operate them in an emergency
- Practise emergency procedures (mock emergency) so you are all prepared
- Get as many people as possible involved so all know their role
- Being prepared helps staff feel more confident and leads to better care
Portable equipment
Remote Emergency Kit
Essential equipment for emergencies outside the clinic
- Stock for 2–3 casualties. Do not overfill
- Keep all equipment stored together in one place, don't use for other purposes
- Have laminated check lists of contents and adhere to checking and replacement schedules
- Have a notice stored with equipment advising
- What other items to take and where they are stored
- Where emergency medicines are stored (eg fridge, pharmacy)
- Where scheduled medicines are stored (eg safe, secured area)
Suggested Contents
- Clinical protocol manuals (eg CPM, STM, WBM)
- Clipboard with paper, pens and trauma forms
- Triage cards if available
- Airway
- Suction — tubing, connectors
- Yankauer suckers
- Y suction soft flexible catheters — all sizes
- Airways — oropharyngeal, nasopharyngeal, laryngeal mask — all sizes
- Cervical spine collars — all sizes or multi-size, sandbags
- Breathing
- Portable oxygen equipment with tubing
- Bag-valve-masks with oxygen attachment — adult, child, infant sizes
- Stethoscope
- Oxygen masks — adult, child and infant sizes
- Non-rebreather masks — adult and child sizes
- Nebuliser masks — adult and child
- 14G non-retractable cannula for needle decompression
- Circulation
- 2% chlorhexidine in 70% alcohol wipes
- Tourniquet
- IV cannula — 16, 18, 20, 22, 24 gauge
- Intraosseous devices — adult and child
- IV bungs, extension tubing, IV dressings
- Syringes — 10ml, normal saline to flush
- IV giving sets
- Tape
- Crepe bandages and combine dressing
- Trauma scissors
- Small sharps container
- Gadgets
- Pen torch
- BP (sphygmomanometer) with multiple cuff sizes
- O2 sats monitor
- Blood glucose kit
- Suture kit
- Watch with second hand
Extras kits — in separate container
- Medication per organisation policy including needles and syringes to draw up and administer
- PPE — eyewear, masks, gloves, gowns
- Snake bite — heavy weight conforming bandages
- Dressing — dressing packs, skin preparation, slings, safety pins, tape
- Limb splints — all sizes
- Nasogastric — sizes 10Fr, 12Fr, 14Fr, pH paper
- Urinary catheter — sizes 10G, 12G, 14G, drainage bags, lubricant, catheter syringe
- Intubation
- Chest drain
- Birth and resuscitation equipment — see Women's Business Manual
- Defibrillator and monitoring equipment — see Women's Business Manual
Ambulance contents
- Emergency and local contact numbers
- Doctor, retrieval service, ambulance
- Hospital
- Ambulance satellite phone number
- Your mobile phone number
- Your radio call signal
- Local community and regional maps
- Oxygen and suction
- Stretcher with blanket and pillow
- Scoop stretcher and straps
- Tissues
- Vomit bags
- Rubbish bags
- Body bags
- Reflective vests
- Torch and spare batteries
- Hazard triangles
- Drinking water
- Small tarp
Remote clinic emergency area
- Hands free phone, phone numbers for doctor and emergency services
- Clock with second hand
- Freestanding emergency stretcher/bed with IV poles
- 3-drawer emergency trolley
- On top — monitor and defibrillator, sharps container, documentation paperwork, frequent
observations and fluid balance charts
- Drawer 1 — Airway equipment including mini-tracheostomy kit if available
- Drawer 2 — Breathing equipment including non-retractable cannula
- Drawer 3 — Circulation equipment including snake bite bandages and intraosseous devices
- Bottom — reflex hammer, defibrillator supplies including range of BP cuffs and O2 sat finger probes
- PPE
- ECG
- Oxygen and suction equipment (including spanner for changing cylinders)
- POC Test equipment
- Examination light
- BLS and ALS wall charts, paediatric dosing and equipment sizes charts
Responding to remote emergency call-out
When advised of an emergency situation, get all available information before responding — this will guide what and how much equipment to take. Use mnemonic METHANE
to remember important details
- Major incident
- Exact location — which road and how far away, any identifying features nearby (eg 'on
Corrugated Highway, 1km past Mt Lonely turn-off’)
- Type of incident
- Hazards, present and potential (eg chemical/fuel spills, power lines)
- Access to scene
- Number, severity and type of casualties
- Emergency services already present and required
Helpers
- Follow your organisation’s protocols about who to call and what help to take (eg doctor,
police, local emergency services RFDS, St John Ambulance)
- Advise other staff and volunteers if needed — consider
- Someone to come with you possibly in a separate vehicle
- Someone to stand by clinic radio/phone and coordinate communications
- Someone to get clinic ready if you are likely to bring people back
Take
- Helper/s — leave room in ambulance for casualties
- Remote emergency kit
- Medication kit
- PPE kit
- Any other relevant kit
- For safety and comfort consider
- Water
- Insect repellent, sunscreen
- Hat, sturdy footwear, protective clothing
- Snack bar, fruit
Before Leaving
- Check incident location — do you know how to get there
- Check someone knows where you are going, time you expect to arrive (ETA) and when you will call again
- Check vehicle — water, fuel, tools, spare tyres
- Check all required medical emergency equipment on board
- Test phone call/radio check from vehicle
- Clarify who is team leader and helpers role/s
- Consider bathroom break and food
At Scene
- Park as close as safely possible to protect you and the scene
- Switch on hazard warning lights and put on reflective clothing
- If on or near road — ask helper to manage traffic and put out hazard triangles if
available
- Take deep breath, have a good look, work out who is in charge, what has happened and
what your priorities are
Remember: If police/rescue/SES/fire brigade present — they are in charge of scene. Wait for them to declare it safe
for you to approach
- Contact clinic/doctor — quickly tell them exactly where you are, what is happening.
Ask them to pass on to any others responding
- Work out which casualties to triage first (deal with). See — Assessing trauma — primary and secondary survey
- Ask others to help
- Record what you do
- Clear up rubbish — sharps go straight into container
- Carry spare equipment back to make room in ambulance for patients
Follow-up
- Record what you have done in each person's file notes
- Refuel and restock ambulance, restock Remote Emergency Kit
- Have a cup of tea, consider debrief with colleagues and emergency workers
- If you or your colleagues feel upset or traumatised by what you have seen or done
— ask for help from your manager and/or use Bush Support Services 1800 805 391
- Don’t be too hard on yourself. You can only do your best in very difficult circumstances
and learn from the experience
Supporting resources
- Retrieval medicine courses for doctors
- Remote emergency courses for nurses and doctors