by Dr. Adrian Cohen

published in the Autumn 2011 edition of the Australasian Mine Safety Journal

A complete emergency response capability is having the security of knowing that any and all emergencies at your site can be handled to the satisfaction of: the injured party, their colleagues, management, stakeholders, regulators and the community.

This is summed up by the words “best practice”.

The key to best practice in emergency response is recognising and implementing acceptable standards. Where this is accomplished in terms of emergency response, it is also generally the case that overall costs for maintaining this capability are lowered, training needs decreased, the management are protected from OHS and legislative standpoints and production is quarantined from threat: since ERT activities can occur with full-time, experienced career professionals, not with miners who have other tasks and responsibilities.

For the last 50 years, mine rescue has been evolving and coming to terms with the expectations of our modern age. Televised real-life rescues, reality television shows, ‘larger than life’ film and TV productions and community expectation that ‘city-style’ services be available in remote areas and offshore, fuel the need for mine management to be 100% certain that they can respond appropriately RIGHT NOW.

Similarly, the long-anticipated OHS Harmonisation and attendant scrutiny, fines and conceivably individual criminal prosecution and jail-time means that everyone from the board room down to the boiler room, including managers, need to critically review the standard of systems, personnel and equipment involved in emergency response activities and ask the hard questions:

• Is it good enough in 2011 to use anything less than advanced life support paramedics, career professionals with on-road experience putting in IVs, giving narcotics, dealing with major trauma, heart attacks and spinal injuries?
• Is best practice reflected in a range of personnel drafted from various backgrounds assembled into a volunteer ER team on the day?
• Is it sufficient to ‘desktop exercise’ your ER plan once a year then put it back in the cupboard?
• Is there a different standard permitted for small mines compared to ‘the big guys’?
• Do our current emergency response capabilities fully mitigate our obligations as an employer?

Regulators and coroners alike operate under consistent principles which place the burden on operators to understand best practice and adhere to it. Knowledge of the law and of industry standards and the latest developments is expected, and mine safety managers are expected to ensure adequate Risk Management strategies are in place and ensure that they are functional.

• “We’re too small for that” is not an acceptable excuse
• “That’s OK for the ‘big states over east’ but we’re different” is not an acceptable excuse
• “They didn’t have that at my last job” is not an acceptable excuse
• “We didn’t budget for it” is not an acceptable excuse

So what can be considered to be best practice in emergency response?

Looking at the two key elements, medical and rescue, the first important paradigm is that these two areas should be integrated, exactly as occurs in urban areas with ambulance and fire service.

But rather than risk denuding the local region of community-based services, it should be entrenched that resource companies, either individually or collectively, provide dedicated, full-time professional emergency response services to meet their duty of care, and ultimately their legal obligations.

To date, the word ‘paramedic’ and the level of their training and experience have been ill-defined. Anyone with basic ambulance service training, or a 7-10 day ’EMT‘ course on top of a first aid certificate could claim to be a paramedic, because there was no accepted definition.

However, in 2010, the Emergency Services Registry of Australasia (www.esra.com.au) was created to provide a reliable and consistent framework to credential paramedics and other rescue personnel.

The Best Practice standard for providing the higher-level interventions required on a mine site should be Advance Life Support or Intensive Care Paramedic (being able to put in IV medications and fluid, give drugs and perform advanced airway maintenance) represented by a minimum ESRA Level IV Paramedic.

For rescue, the standards have already been set under the Public Safety and Resource Industry Training packages: nationally accredited qualifications which by definition cross borders and disciplines.

The elements which are required include:

• RIIERR201A Conduct Fire Team Operations
• PUAFIR207B Operate Breathing Apparatus Open Circuit
• PUASAR004B Undertake Vertical Rescue
• PUASAR002A Undertake Road Accident Rescue

In terms of true integration, it makes sense for paramedics to have training in these disciplines too, and for emergency services officers to have paramedical training (well above first aid level) to be able to work as part of a cohesive team for the benefit of the patient.

A model of rescue-trained advanced care paramedics, and paramedically trained emergency services officers provides a integrated emergency response capability which not only ticks all the boxes, but covers all the bases, ultimately costs less, manages and mitigates mine management risk and protects the production capability of the enterprise.

In this case, Best Practice also equals win-win.

reproduced with permission from APRS Pty. Ltd