SA-led initiative aims to tackle rural trauma gap

SA is the only state with a coordinated system involving the RG workforce (the RERN).

One of the early drivers of the RERN is Kangaroo Island doctor Tim Leeuwenburg, who said the program came about more than 10 years ago after it was found that a structure for RGs responding to community emergencies was needed.

"Traditionally if a farmer has an accident, people dial 000 and wait for an ambulance to come," he said.

"The problem was the more rural you were, the longer you either waited for the ambulance and then, depending on the injury, a retrieval service - it goes from minutes to hour-long waits, sometimes even days.

"We call this the 'trauma gap' for rural Australians."

Dr Leeuwenburg said that's when they started looking at better use of RGs.

"RGs are often on-call for emergency departments in rural hospitals, but their involvement in pre-hospital emergencies was ad hoc and sporadic," he said.

"But in rural areas, delays by dedicated retrieval services to arrive can be significant when these doctors are already there to help."

This shortfall in service led to the founding of the RERN in SA, which has since equipped about 40 rural doctors with pre-hospital equipment, called 'Sandpiper bags', and training.

"In the past, ambulance bags were used in emergency training, which are helpful," Dr Leeuwenburg said.

"But the idea of a doctor on the scene is to add value, by performing interventions that ambulance workers may not be skilled for.

"These critical care-type interventions could include chest decompression, intravenous access or airway management, administering advanced forms of pain relief, and sometimes life or limb-saving procedures.

"The Sandpiper bags have all the basic equipment a doctor or even a nurse could need on the scene for these interventions."

Dr Leeuwenburg said the Sandpiper bags had successfully been used in Scotland by 1000 rural doctors and nurses since 2001.

"The UK Sandpiper Trust was borne from underlying tragedy," he said.

"Fourteen-year-old Sandy Dickson died in a tragic accident in a remote area and emergency services were unable to respond in a prompt manner.

"The Sandpiper Trust (formed by the Dickson family) raised funds to equip rural clinicians with a standardised 'Sandpiper bag' of essential emergency equipment, while the Scottish arm of BASICS (British Association of Immediate Care Schemes) provided training in pre-hospital care."

Dr Leeuwenburg said they brought the Sandpiper bag concept back to Australia last year and established the Sandpiper Australia charity, with the ultimate goal of equipping RGs nationally.

"There is a demand for this to become more structured and for more appropriate training to be provided," he said.

"Sandpiper Australia aims to provide that."

However plans to take the Sandpiper Australia program national hit a speed bump recently, with country doctors preoccupied by the summer bushfires and then COVID-19.

But Dr Leeuwenburg said this showed the importance of better equipping rural GPs across the country.

"In the aftermath of the bushfires in NSW, Vic and my hometown of Kangaroo Island, it has finally been recognised that disaster and emergency responses need to include and engage with expertise in the local community," he said.

"We are hopeful that state emergency services will begin to understand and integrate the value of the primary care workforce into future disaster plans and preparation.

"We are so excited that the Sandpiper Australia charity is finally established and beginning to raise funds, as we want to see widespread adoption of Sandpiper bags and training in Australia.

"It will present a 'ready-made' solution to rural emergencies, whether that be an isolated vehicle rollover in a remote community, through to state-based responses, such as bushfire, flooding or pandemic.

"We hope to engage with other agencies once COVID-19 restrictions ease."

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