Support The QAS was initially divided into six operational regions across Queensland, until the Northern Region was split to form 'Far Northern Region'. This model reflected a similar structure in the then Queensland Fire and Rescue Authority. In 2012, the QAS Structural Reform Report, a comprehensive review of QAS operations, lead to a restructure of operations, and a decentralisation of control to local networks. Instead of large regions, the service would be divided into fifteen geographical local ambulance service networks (LASNs) aligning with Queensland health and hospital service networks. A sixteenth network was established as state operations centres, with the existing seven communications centres to become operations centres, reporting directly to a central assistant commissioner. The LASNs vary in size according to population and stations, and are categorised from Category 1 (largest) to Category 5 (smallest). The categorisation simply reflects their size and gives a foundation for staffing allocation and command structure.
Local ambulance service networks Category 1 (General Manager – Assistant Commissioner) • Metro North • Metro South
Category 2 (General Manager – Assistant Commissioner) • Cairns • Darling Downs • Gold Coast • Sunshine Coast • Townsville
Category 3 (Director – Chief Superintendent) • Central Queensland
Category 4 (Director – Chief Superintendent) • Mackay • West Moreton • Wide Bay
Category 5 (Executive Manager – Superintendent) • Cape York and Torres Strait • Central West • North West • South West
State Operations – Assistant Commissioner • Seven Operations Centres (Cairns, Townsville, Rockhampton, Maroochydore, Toowoomba, Brisbane, Southport)
Headquarters There are five key central office commands that divisions report to: • Office of the Commissioner • Office of the Deputy Commissioner State LASN Operations • Office of the Deputy Commissioner Service Planning and Performance • Office of the Deputy Commissioner Corporate Services • Office of the Medical Director These commands, plus some additional senior staff, form the Central Office Senior Executive (COSE), which in turn report to the QAS Board of Management (BoM).
Clinical operations Following a redesign in 2014, the overall clinical governance of the service is ensured by the director of clinical quality and patient safety, currently filled by Chief Superintendent Tony Hucker ASM. The office ensures that patient care services provided by officers of the Queensland Ambulance Service are delivered at a consistently high standard, and that current clinical research is included within contemporary practice. The office also responsible for QAS Policy on Staff Health and Wellbeing and setting medical priorities for ambulance resource dispatch. There are a small number of medical officers, with the team led by Medical Director Dr Stephen Rashford ASM FACEM, who also holds the rank of deputy commissioner. Ambulance operations of the Queensland Ambulance Service are performed predominantly by its own operational staff. QAS operational staff include student paramedics, advanced care paramedics (ACPs), critical care paramedics (formerly known as intensive care paramedics), patient transport officers (PTOs) and emergency medical dispatchers (EMDs). In addition to this, critical care paramedics possess a graduate diploma in intensive care paramedic practice, or very commonly a master's degree in emergency health. ACPs and CCPs attend medical, surgical and trauma emergencies. Patient transport officers possess a Certificate III in non-emergency patient transport or equivalent, and provide non-emergency patient transport services. Emergency medical dispatchers have completed a Certificate III in ambulance communications (call taking) and a Certificate IV in ambulance communications (dispatch) or equivalent. EMDs receive emergency calls and direct ambulance services to the emergency, and advise callers in performing first aid until the ambulance arrives on scene. ACPs are competent in many emergency medical skills, including airway management (
oropharyngeal and
nasopharyngeal airway, oropharyngeal suctioning,
laryngoscopy and Magill's forceps,
laryngeal mask airway,
intermittent positive pressure ventilation), cardiac management (cardiac monitoring – basic
ECG interpretation and 12-lead ECG,
manual defibrillation), drug/fluid administration (
intramuscular injection,
intravenous cannulation,
fluid replacement), and the administration of basic and advanced drugs (
aspirin,
glucose,
glyceryl trinitrate,
adrenaline,
morphine,
fentanyl, etc.). Critical care paramedics typically respond when an advanced level of clinical practice is required. In some areas, they will respond as a single officer in units known as 'pods'(priority only dispatch). CCP pods operate around the state, focused on metropolitan, major regional centers, or where a rescue helicopter is located. These ambulances are not equipped to transport patients, but contain much of the same equipment as a regular ambulance, as well as advanced equipment. CCPs are competent in all ACP procedures, as well as advanced emergency medical skills, such as
endotracheal intubation,
synchronised cardioversion,
transcutaneous cardiac pacing, continuous positive airway pressure ventilation
CPAP, decompression of
tension pneumothorax, extra-jugular venous cannulation, procedural sedation (
midazolam,
ketamine, and
droperidol.), pre-hospital thrombolysis (
tenecteplase), pre-hospital direct referral to primary
PCI,
intraosseous access, as well as the administration of advanced drugs (
atropine,
heparin,
ketamine,
benztropine,
magnesium, etc.). In addition to standard CCP skills, officers on the High Acute Response Unit (HARU) perform general anaesthesia via
Rapid Sequence Induction, with the additional use of
rocuronium and
propofol, transfuse packed red blood cells, perform chest thoracostomy, and carry some additional pharmacology specific to major trauma such as
TXA. As of 2018, there are HARU units located at Brisbane and the Gold Coast ==Vehicles==