South Australia Ambulance Service on high demand
By Nichole Bastian, South Australia Ambulance Service
Bushfires can start suddenly and destroy lives and properties without warning.
Tens of thousands of lightning strikes sparked dozens of bushfires across a drought-affected state in late December 2019, amid catastrophic and dangerous fire conditions warnings that left the S.A. Ambulance Service on high alert.
On one dramatic day, more than 800 firefighters tackled at least 120 blazes across the state, the majority of which were sparked by electrical storms.
Amid hot, dry, and windy conditions, authorities were facing at least four major blazes on the Eyre Peninsula, Kangaroo Island, Adelaide Hills, and the southeast of SA, which collectively burnt through thousands of hectares of scrub, forests, and paddocks.
The men and women who responded to the fires, which have destroyed more than 160 homes, 500 vehicles, 250,000 hectares (617,763 acres) of land, and 43,000 livestock, have come from all walks of life, and all corners of the state including our own staff.
The Country Fire Service (CFS), Metropolitan Fire Service, SAAS, Australian Defence Force Reservists, State Emergency Service as well as volunteers from overseas and interstate provided much need support in fighting these fires.
These fires impacted people, pets, livestock, and our unique wildlife, including the already struggling koala population.
Witnesses were shocked by a scorched landscape of scarred trees, ash-coloured earth, and animal carcasses, stating that the damage to the island was hard to describe. “The scenes were nothing short of apocalyptic.”
The severity and extent of the fires, concentrated in the island’s biodiversity-rich western region, have prompted ecologists to express grave fears for the future of some of Kangaroo Island’s unique and endangered wildlife.
The fires started with lightning strikes in the Flinders Chase National Park, which has been devastated and the farming and tourism industries badly affected. Twenty-four people have been injured on Kangaroo Island and two killed. Residents were finally able to return to their homes after being given clearance by the emergency services. More than 215,000 hectares (531,217 acres—almost two-thirds of the island—has been burned since Dec. 20, 2019.
The national community has been shocked and saddened by the scale of destruction on Kangaroo Island, not only has there been tragic loss of life, families have lost homes and properties, people have lost businesses, vineyards, livestock, and, for some, their livelihoods.
More than 60 homes have been destroyed and at least 10 other buildings have been significantly damaged or left without power and water.
Lightning storms moved across Eyre Peninsula from late Dec. 29, 2019, through the following day with lightning strikes linked to several fires reported before 6 a.m.
The Eyre Peninsula fire, which was sparked by lightning at Miltalie on the northwest outskirts of Cowell, 106 kilometers (65 miles) southwest of Whyalla, destroyed a power station, cutting electricity to at least 25,000 people at one stage.
More than 10,000 homes and businesses on South Australia’s Eyre Peninsula and West Coast were without power after strong winds fanned dust storms and bushfires across the state.
Fires were also burning on Eyre Peninsula and in the southeast of the state where more than 8,000 hectares (19,768 acres) have been blackened since a blaze broke out several days previously.
A cool change moving across the state was expected to bring some relief, but instead brought dust storms and lightning, increasing the fire risk.
On the Nullarbor Plain, bushfire and smoke forced the closure of 400 kilometers (248 miles) of the Eyre Highway between a small roadhouse community and the historic mining town of Norseman, bringing the main transport route from South Australia to West Australia to a grinding halt for a period of two weeks.
The fire, which has been burning at the Higginsville mine site since Dec. 16, 2019, has blackened more than 148,000 hectares (365,715 acres) of land and is being fought by 81 firefighters.
The Adelaide Hills fires, which started at Cudlee Creek, burned east as far as the Bremer Valley at Harrogate some 60 kilometers (37 miles) away before a wind change pushed it to the north and northwest.
The Cudlee Creek fire, which also resulted in a loss of life, stock, wildlife, and property has left deep scars which will take months, if not years to recover. Eighty-seven homes have been lost and more than 23,000 hectares (56,834 acres) had been burnt.
With determination and courage, firefighters eventually got on top of a flare-up at Mount Torrens inside the Cudlee Creek fireground, more than 10 days after that deadly blaze was sparked.
As a massive firefront bore down on the quaint village of Lobethal, the town’s beloved and traditional Christmas lights display was cancelled with fears for property and lives.
More than 500 firefighters and aerial bombers were required to tackle the wall of flames ahead of an expected cool change later that day.
Firefighters commented that difficult terrain and catastrophic conditions meant the fire was unlikely to be controlled within a short timeframe.
Thick smoke from this and the Kangaroo Island fire blanketed Adelaide’s central business district as the toll from the state’s bushfire crisis continues to grow, making the city’s air quality among the worst in the world.
Emergency services were inundated with Triple 0 calls from Adelaide residents as thick smoke from the bushfires blanketed the city causing health issues, such as shortness of breath.
The water supply to some parts of the Adelaide Hills, including Lenswood, Lobethal, and Woodside, were affected as fires impacted pumping operations.
SAAS Bushfire Fire Ground Response
Supporting the public and emergency services is no mean feat and, hence, on the operational front, incident managers and five strike teams were sent to critical sites such as Kangaroo Island, around 50 people in total. These teams have played an important role in providing additional support to the local crews.
One of the heartening aspects of our involvement was seeing SAAS people working in partnership with other emergency and health services. For example, CFS personnel have been driving to remote properties to deliver food drops to people who wouldn’t leave their properties in case they need to defend them against fire. Our SAAS members travelled in convoy with the CFS to proactively offer treatment and welfare checks. One on occasion we used a video call to complete a clinical assessment of one resident farmer who was unable to leave his property and we were unable to get access to him due to the fireground.
Working closely with the major hospitals and local health and mental health providers, we were able to identify those who were most vulnerable in the community and organize follow-up care, a much-needed priority for our staff.
Due to the significant fire risk during this period, we worked to ensure our crews and residents were safe. We were able to conduct welfare checks for people in their homes in and around the areas impacted by the high number of fires with the support of the CFS.
Questions and Answers
Describe the SAAS service area.
More than 1,500 volunteer ambulance officers provide services to the smaller regional parts of the state, while another 1,100 operational staff direct services in the metropolitan area and larger regional areas. The Emergency Operations Centre (EOC) response area covers 1.7 million people in a land area of 983,482 square kilometers (611,107 square miles).
Are calltakers and dispatchers cross-trained and how is the staffing allocated during a major event such as the bushfires?
The EOC staff is engaged in the specific portfolios. Some hold dual qualifications and Authority to Practice in both calltaking and dispatch. SAAS calls upon the expertise of staff to participate in the Incident Management Team as subject matter experts in calltaking and dispatch during major incidents such as the recent bushfires. This means that staff can dedicate their efforts to the specific incident and be responsive to the ever-changing information as it occurs.
Are there accommodations at the center if it’s necessary to rotate existing staff?
We do not have accommodation on site for staff. We roster staff to the major incident some weeks in advance wherever possible to allow for fatigue management and recovery away from the workplace. We prefer staff to be at home with their families so do not need on-site accommodation.
Did the call volume increase during the most recent bushfires?
The calltakers received a significant increase in calls that were attributed not only to the bushfires but to the extreme hot weather that was experienced across the state, with temperatures peaking at 107.4 degrees Fahrenheit (41.9 Celsius).
Additional staff was rostered to support callers and allow staff to manage fatigue and, in some cases, the personal impact of the fires. A number of our staff had property damaged or completely destroyed.
Do you train specifically for events such as these?
Yes. We train staff for participation in major incidents and have robust procedures in place to manage the increase in workload and particularly how to notify callers that there will be a delayed response due to safety concerns for the responding crews.
What calls are prevalent for ambulances due to bushfires?
We primarily receive calls from people suffering from smoke inhalation, burns, and general medical. It was not unusual to receive some trauma-related calls from those attempting to flee the fire and from our firefighting colleagues who received injuries in the carriage of their duties.
Why were these calls considered worse than those since Black Saturday?
Note: Black Saturday was a series of bushfires burning across Victoria on Saturday, Feb. 7, 2009. Similar to the recent fires, extreme weather conditions contributed to the fires. The fires resulted in 173 fatalities.
Not worse, but for longer duration and just as intense. Whilst every area was an area of concern, the fires on Kangaroo Island created some logistical challenges due to the location and access. At one point there was consideration given to a total evacuation of the island including the local hospital and nursing home.
Do calltakers provide dispatch life support (can they advise people what to do, such as how to escape a fire but not sheltering in place)?
The Emergency Medical Dispatch Support Officers (EMDSOs) follow the scripting in the Medical Priority Dispatch System™ (MPDS®) and, fortunately, we do not receive calls direct to ambulance for people trapped in a fire zone. We do, however, advise callers that there may be a delayed ambulance response if we cannot safely access the area. The advice our firefighter colleagues provide is dependent on the location and specifically if the caller is trapped inside a building or in an area they cannot escape such as a vehicle.
What techniques do calltakers use to keep callers calm?
The EMDSOs are excellent in using repetitive persistence techniques as well as significant reassurance. They are aware these situations are highly emotive and about the patient/caller in what can be highly emotive and quickly changing incidents that the EMDSOs need to be adaptive to.
How do the centers keep up with the fires since they must change daily (daily briefings, for example)?
In major incidents such as the recent bushfires, SAAS stands up an Incident Management Team (IMT) to ensure we deliver the best possible ambulance service to communities in South Australia. The IMT prepare briefings several times during the day and has a direct link to the statewide Emergency Management Centre where we have a SAAS liaison officer in place as a representative with the other emergency service and health departments.
The ‘good news’ calls during this period (babies born, cardiac arrest saves, and good news related to people helping those affected by the fires)?
The staff at SAAS are extraordinarily resilient. Some of our colleagues who lost homes, business, and farming property, including wildlife, continued to come to work to support their teammates and provide service to the community. This includes staff in the emergency operations center who offered to come to work on days off to assist in the extreme workload.
From the start of the bushfire events in SA in 2019 until the declared end of the incident, SAAS continued to respond to the entire range of requests for service including the acutely unwell and childbirth deliveries at homes.
On the evening of Dec. 20, 2019, during one of the significant escalating for the fires in the hills to the east of Adelaide, we received a call to a farmer in cardiac arrest. The community and surrounding district were completely isolated by fire with no road access in or out for paramedics. This is how the event transpired:
- The EMDSOs and EMDs worked together to respond volunteer ambulance officers who were in the impacted community.
- The EMDSOs provided pre-arrival instructions for about 20 minutes before the arrival of volunteers. The team on the ground confirmed there was good quality CPR in place prior to their arrival and were able to shock the patient into a very slow rhythm.
- The EMDs looked at all available options and, ultimately, worked with the fire service to respond with a helicopter and that crew had to coordinate with aerial firefighting aircraft and fire weather to access the property.
The intensive care paramedics stabilized the patient and his condition was stable on arrival at hospital.
Nichole Bastian is Operations Manager/Statewide Services, for the South Australia Ambulance Service, Government of South Australia.