Rural and Indigenous emergencies

Chapter 44 Rural and Indigenous emergencies



Mark Byrne, Bonita Byrne



RURAL AND REMOTE AUSTRALIA


A doctor providing medical services in a rural or remote area requires a broad skill set with the ability to work independently in a setting with limited or no immediate access to specialist care.


The rural practitioner provides holistic care within a setting that often has unique socio-cultural issues.


Every community is different and local knowledge is essential. What works in location A may not work in location B, so working closely with the community is important.


Australia is a vast country with a relatively small population of 21 million. One-third of Australians live outside urban areas, many in remote, isolated locations. There are recognised differences in health status among rural Australians, compared to their urban counterparts. Despite efforts to bridge these inequalities, access to health services and health professionals for rural Australians is generally poorer.



APPROACH TO THE RURAL PATIENT


The initial approach to the undifferentiated rural patient is the same as if the patient presented to a major tertiary centre. For example, the principle of ‘airway, breathing, circulation’ is fundamental. The provision of services may require adaptation as resources may be limited.


Modern technology does provide many rural sites with video conference facilities which link the rural practitioner with a tertiary hospital and can provide real time, interactive specialist assistance. Ringing for advice and utilising the Internet to gain opinion on ECGs etc is worthwhile.



PATIENT TRAVEL, TRANSPORT AND RETRIEVAL


This has been covered in detail in Chapter 21, ‘Patient transport and retrieval’.


Developing an understanding of who is responsible for the transport and retrieval of patients is essential. Area health services will have a local protocol.


Early planning for patients is important and, if unsure, it is better to discuss the patient early if there are any doubts or perceived management dilemmas.


Each state has provision for financial assistance for people who need to travel long distances to obtain specialist medical or dental treatment that is not available locally. Medical staff have a responsibility to complete documentation associated with travel assistance.



INDIGENOUS PATIENTS



Epidemiology


Indigenous Australians are the most disadvantaged across all socio-economic denominators. These disadvantages stem from colonisation and land dispossession.


Aboriginal health not only includes physical health but also encompasses social, emotional and cultural wellbeing.

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Jun 14, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Rural and Indigenous emergencies

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