Author Topic: first-aid training  (Read 26382 times)

Offline Robert-Robert34

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Re: first-aid training
« Reply #25 on: January 03, 2009, 08:04:15 PM »
CFS & SES could provide back up medical support for SAAS cause sometimes even volunteer SAAS stations cant even raise a crew resulting in waiting for a paramedic crew to respond from else where

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Offline boredmatrix

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Re: first-aid training
« Reply #26 on: January 03, 2009, 10:25:30 PM »
CERT teams have been revamped - and SAAS has recently introduced a Cert II course as either a pre-cursor to the Cert IV course, or the vol's can stay at that level (personal choice).

 Elements of the cert IV course all revolve around treating the patient appropriately, within a protocol system and then taking said patient to hospital.  Cert II course is more around stabilising the patient to wait for transport by the crew in a BWT. (or should that be now BGAFYT??) 

I'm all for the community getting a first response of some description, but the differing elements of the communities safety shouldn't all be coming out of the same pot....it gets too messy! - kinda like trying to make an omelette and jam at the same time....it will look bad and taste even worse....


Offline chook

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Re: first-aid training
« Reply #27 on: January 04, 2009, 08:03:41 AM »
Boardy how long would Cert II take to complete in a perfect world? Similar to a combined senior first aid occupational first aid?
Yep Pip you could be right, move forward to 2012 - volunteer SAAS stations closed due to a) lack of crew b) cost cutting(don't have to provide buildings, vehicles, equipment as CFS/SES now provides a first response capability).MVA, local brigade responds(crew of 4 as its harvest time), on arrival discovers several persons trapped with significant injuries, back up 3/4 of an hour away, significant risk of fire due to fuel leak - how does the crew do all of the tasks required? Remember that golden hour rule?
Or what happens when the same crew, is busy fighting a major wild fire?
I still think that all emergency responders should be able to provide first aid, but becoming a community response team is a fairly big step. By the way NSW SES does provide those teams in the remote north west (mainly in the indigenous communities), however ambulance services are a fair distance away. Seems to work well, but.
cheers
Ken
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Offline Robert-Robert34

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Re: first-aid training
« Reply #28 on: January 04, 2009, 08:38:39 AM »
Maybe CFS & SES could introduce Cert II as a training course for all of those volunteers who dont have RCR training but want to provide first aid care to casualties until Ambos arrive
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Offline Robert

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Re: first-aid training
« Reply #29 on: January 04, 2009, 12:53:41 PM »
I believe CFS doing EMR would be very valuable to the community.  Its not hard to do basic life support, such as put oxygen on a patient, posture a patient, do CPR , put on an AED push analyse and follow the prompts etc.
Statistics have concluded that patients that have CPR initiated within seven minutes (Basic life support) and paramedic treatment (IV Drugs, advance Airway Management, cardiac ECGs etc) within ten minutes have a much lower mortality rates.
 As we know this is not new, the MFB have done EMR since 1998 and they have had some very good saves…..
At the end of the day the fire service is going to be responded if an ambulance is not available. (Just look at last week when a CFS brigade got responded to a cardiac case)
So why not have the extra bit of training and the equipment. (some CFS brigades already have this)
You are only talking a 4 hour advance resuscitation course, an extension of senior first aid…not a 12 month volunteer cert 4 courses or a 4 year paramedic uni degree….

Offline boredmatrix

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Re: first-aid training
« Reply #30 on: January 04, 2009, 02:16:26 PM »
Boardy how long would Cert II take to complete in a perfect world? Similar to a combined senior first aid occupational first aid?


In the perfect world - the Cert II should take about 8 weeks to do.....


in SAAS's current education delivery shambles it's taking more like 6 months......

...and then they have to implement think tanks to try and brainstorm ways of retaining volunteers....while the answer stares them in the face....

Offline Pipster

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Re: first-aid training
« Reply #31 on: January 04, 2009, 02:26:15 PM »
Boardy how long would Cert II take to complete in a perfect world? Similar to a combined senior first aid occupational first aid?
Yep Pip you could be right, move forward to 2012 - volunteer SAAS stations closed due to a) lack of crew b) cost cutting(don't have to provide buildings, vehicles, equipment as CFS/SES now provides a first response capability).MVA, local brigade responds(crew of 4 as its harvest time), on arrival discovers several persons trapped with significant injuries, back up 3/4 of an hour away, significant risk of fire due to fuel leak - how does the crew do all of the tasks required? Remember that golden hour rule?
Or what happens when the same crew, is busy fighting a major wild fire?
I still think that all emergency responders should be able to provide first aid, but becoming a community response team is a fairly big step. By the way NSW SES does provide those teams in the remote north west (mainly in the indigenous communities), however ambulance services are a fair distance away. Seems to work well, but.
cheers

I don't disagree...but note, the symbol  :evil:, at least in my postings, means I'm taking the [email protected], even if just a little bit......

To expand a little on my posting, there are many areas where any SAAS coverage is a long way away (eg an hour or more).   Having some people within that community, willing & able to provide some first response function, is not a bad concept.

Pip

« Last Edit: January 04, 2009, 05:18:25 PM by Pipster »
There are three types of people in the world.  Those that watch things happen, those who make things happen, and those who wonder what happened.

Offline chook

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Re: first-aid training
« Reply #32 on: January 04, 2009, 03:18:26 PM »
Duely noted Pip :wink:
Robert it is a very long bow to compare MFB to CFS (as you know so I wont both to point out the differences).
From a community point of view re-suss,AED etc would be a waist of time (it would take longer than 4 minutes to get a crew on the road) & by that stage its too late as you know.
However CERT would be good in the areas mentioned PIP (areas where the first SAAS crew is an hour or so away).
However considering the course is eight weeks long, do you really think the tiny CFS crews in those areas would really be bothered?
Think about it, most of the populated areas of the state are already covered (even if it is with vollie crews) so now is it still a good idea?
And what about skills maintanance? Lots of questions, but I guess if you guys want to do it good luck to you.
Ken
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Offline Robert

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Re: first-aid training
« Reply #33 on: January 04, 2009, 04:22:56 PM »
However CERT would be good in the areas mentioned PIP (areas where the first SAAS crew is an hour or so away).
However considering the course is eight weeks long, do you really think the tiny CFS crews in those areas would really be bothered?

Chook I don't you think u fully understand what cert covers, we don't need to be teaching Firefighters/CFS 1st responders how to do urgent Ambulance driving, manually handling, stress management, GRN training OHS etc
Just basic life support

Think about it, most of the populated areas of the state are already covered (even if it is with vollie crews)

dont think you can say that, area coverage is rubbish sometimes.... many times I have driven cat 2 cases, up to 50min away because volly team, have no crew or are out on another case,
I have used CFS oxygen many times at MVA, as I wait for the Ambulance to arrive.
« Last Edit: January 04, 2009, 04:25:12 PM by Robert »

Offline chook

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Re: first-aid training
« Reply #34 on: January 04, 2009, 05:26:00 PM »
No Robert, I do understand - you used the MFB as example, proper help for them is minutes away not an hour plus.
Here is a real incident for you to ponder - MVA one male occupant, friends start CPR. Emergency services arrive - initial one under manned CFS, one SAPOL officer mean time more friends arrive (teenages & twenty odd year olds about 30 of them).
Rescue (undermanned) arrives with SAAS. Patient not responding (nil heartbeat, nil breathing)crowd getting anxious, additional rescue requested (crowd control as scene getting ugly), additional SAAS arrive to assist SAAS & rescue work on PT.
After 20 or so minutes work stopped, crowd gets very upset. Additional SAPOL arrive - total time elapsed about 35 - 40 minutes.
Now the SAAS Crew had all of the machines that go beep, vials of adrenaline, heaps of experience. Still to no avail!
So
1) as CFS does not cover the requirements of CERT, how would you have coped?
2)How long would you have worked on the guy? remember you don't have the machines.
3)What about his very angry mates?
I was very involved with this one (holding his arm while they pumped adrenaline into him, watching the machine & keeping an eye on my other crew member until another unit arrived), & I too have held the the PT body parts, Iv's, & other paraphernalia that SAAS work with on many occasions & believe that you would need to know more than basic life support.
Otherwise the public would have great expectations of what you can do, which would not be filled.
Therefore yes CFS needs senior firstaid for all members, maybe with an add on O2 AED module for self help, however if you want to be ambo's then IMHO you would need to do the CERT course with RPL for GRN & other modules if they match the SAAS requirement (after some of my dealings with CFS non rescue crews at messy MVA's stress management, manual handling & general OHS wouldn't be a bad idea either).
So Robert I do understand, just don't agree with you :wink:
cheers
Ken
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Offline Baxter

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Re: first-aid training
« Reply #35 on: January 04, 2009, 06:52:36 PM »
For the contry bumpkin all this talk of cert this cert that and IMHO I just don't get. So guys why can't we apply the good old KISS principle (Keep it simple for sanity). Then there the other principle don't go putting all your eggs in one basket. As soon as one organisation is able to do the job of the other then the other will surely go. As government keep on going on about duplication blah blah blah and how it can save us dollars.

OK the ambo is about 50 mins away train the crew on the ground look after the patent and keep them alive till that ambo arrives. We don't need to be trained to perform the duties of para medico's or the ambo's just simple first aiders as some help or assistance to the ambo crew will be better than none.

Those that in Adelaide I hope would have enough nonce to go let put this out to the troop on the ground for feedback so that they feel they are a part of it not something that is being prescribed onto them. Maybe working in collaboration with the ground troops and engaging them properly would be the first step. Give it to us a draft discusion paper with the problem outlined and a range of solution options let that be the discussion to begin with.
keep it simple for sanity skes please

Offline JC

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Re: first-aid training
« Reply #36 on: January 04, 2009, 07:08:03 PM »
I agree with chook in saying being cert trained is alot more than just AEDs & O2, if you at an MVA and SAAS know your Cert trained and your assisting them they WILL expect you to know exactly what they want & where to get it when they ask for it. It is a big ask training wise to expect a cfs brigade to keep there skills upto scratch on top of all there other training, Full time guys yep no probs, they can spend 1/2 a day training on it every but for the Vols its asking to much i believe.

But just to add all cfs vols should be trained in AED & O2, and all appliances should carry it.
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Offline bittenyakka

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Re: first-aid training
« Reply #37 on: January 04, 2009, 07:15:43 PM »
Chook we are talking about CFS (and just to through it out there SES too?) becoming a First responder to medical cases. Not a replacment to SAAS.

So it sounds like your horrible RCR scenario was just bad in every way.

But lets say in an area SAAS can't clear a crew or the crew is a fair distance and there is a CFS Truck sitting in station doing jack all like lots do. Why not make the CFS truck respond and have given the crew some increased first responder training.

Now If there is a job like an MVA CFS will still be sent as Fire cover/ rescue and SAAS will go as "saas"?. But the CFS crews will be better able to deal with any medical stuff.

So the only real difference will be that CFS brigade will be responding to a few more jobs which they currently don't go to.



Yep Pip you could be right, move forward to 2012 - volunteer SAAS stations closed due to a) lack of crew b) cost cutting(don't have to provide buildings, vehicles, equipment as CFS/SES now provides a first response capability).MVA, local brigade responds(crew of 4 as its harvest time), on arrival discovers several persons trapped with significant injuries, back up 3/4 of an hour away, significant risk of fire due to fuel leak - how does the crew do all of the tasks required? Remember that golden hour rule?
Or what happens when the same crew, is busy fighting a major wild fire?
I still think that all emergency responders should be able to provide first aid, but becoming a community response team is a fairly big step. By the way NSW SES does provide those teams in the remote north west (mainly in the indigenous communities), however ambulance services are a fair distance away. Seems to work well, but.
cheers

At the moment many of these current resources would be involved in fighting the fire, If vollie SAAS stations are closed whats to say those members haven;t joined the CFS to do the medico stuff?

just adding my thoughts Does it make sense ?

yakka

Offline Alan J

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Re: first-aid training
« Reply #38 on: January 04, 2009, 11:18:28 PM »
To those that know about SAAS stuff and medico stuff. How many hours of training would a CFS member really need to be of serious use in a first responder scenario? I ask this from the point of view that i would welcome the idea (for discussion etc) of CFS doing some first responder work but Don't want to do a SAAS uni degree.

When I investigated this a couple of years ago, SAAS required at least 8 or so members
to do about 120hrs training up-front with ongoing requirement of maybe 30hrs/year.

This thing MrTeddy presents looks like we would be -only- turned out to collapse, short-of-
breath, & chest pains, not trauma or other medical as existing CFS/SES first-responders.only

Therefore SFA + AED + O2 is all that's required, which makes it a lot more accessible
to mere mortals.
« Last Edit: January 05, 2009, 08:35:21 AM by Alan J »
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Offline Robert

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Re: first-aid training
« Reply #39 on: January 04, 2009, 11:31:59 PM »
No Robert, I do understand - you used the MFB as example, proper help for them is minutes away not an hour plus.
1) as CFS does not cover the requirements of CERT, how would you have coped?
2)How long would you have worked on the guy? remember you don't have the machines.
3)What about his very angry mates?

Chook the MFB was an example of Firefighters with basic life support training can make a difference.(oxygen advance resus & AED) believe it or not some CFS stations can have a truck on scene within 7 seven minutes, even if its a quick attack (only need two ppl).
If you look at malleefire post,  he has got it spot on, "keep it simple" basic training to keep the patient alive until the SAAS resource arrives (oxygen advance resus & AED) its about getting some basic life saving medical care to a patient as early as possible.

and your "real incident" sounds like your patient was in trauma cardiac arrest and only about 3% of theses patient actually survive no matter what treatment you give or level of training. theses patient need to be in a operating theater.

again I question why CERT training for CFS vols??? how would this have helped in your incident? compared to Advance resus and AED training????

Offline chook

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Re: first-aid training
« Reply #40 on: January 05, 2009, 08:06:18 AM »
Robert - the PT  concerned had massive internal injuries, which in normal circumstances work would have stopped far earlier (angry mates made this decision harder). My point was what if you can't keep someone alive until SAAS arrives? SFA does not cover that senario, because it assumes that help is minutes away.
CERT was mentioned in a previous post, "we can assist when SAAS is not available".

Malleefire - totally agree which is what I have already said "SFA with the O2 AED modules", and not get responded to medical emergencies - then when you are responded to a task & discover a medical emergency at the scene you can provide some assistance until SAAS arrives. However be aware you may not get as many saves as you may think.
Yakka - if I was a SAAS vollie I wouldn't cross over, why would I want to be bothered doing fire stuff when I joined an ambulance service. Same if I was in SES rescue & it was closed & handed to CFS I for one wouldn't bother - more training, different rules etc.
Again responding to some task thats are a SAAS responsibility could be the thin edge of the wedge & from the initial phonecall to crew on scene would be far longer than 4 minutes (000 call "can I have an ambulance Uncle Joe's collapsed - SAAS comms can't raise a crew, contacts Adelaide fire, they find the appropriate crew & set off the pagers) more like 8 - 10 minutes before a truck is rolling.
But as I said previously, if this is what you guys want to do - so be it & good luck with it. Just hope that its what you are really after.
cheers
Ken
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Offline Alan J

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Re: first-aid training
« Reply #41 on: January 05, 2009, 08:55:42 AM »
G'day Ken
for this thing to work, I think paging would have to be handled from SAAS comms.
The two or so minutes needed to transfer the call & data to MFS is too long.
I theorise that SAAS would have to maintain its own database of pager numbers
of willing persons for each suburb/township/locality, & page them directly on
receipt & dispatch of original call.

I further theorise that we would be looking at a totally different style of response to the crew-based system we currently use.  It takes too long for most of us to get a truck on the road ex-station - park car, unlock door, open roller-
door, extract truck, wait for additional crew, close & lock doors behind & drive
off... 

More likely that the kit would be expected to be kept near the station access door - pull up out front, grab kit & use own car to location. Any further than 1
or 2 km, & the gear will arrive well outside the 4 minute target anyway.
Full crew not required.
Yellows not required - medical PPE in kit.
Truck not required (not for initial response anyway).

Whether SAAS would want/need to know that a CFR is responding is questionable.
Response phone call burns valuable time.  Possibly they would hope to be still
talking to the caller when a CFR arrives & makes presence known.

That is before we get into any Workers Comp issues for CFRs...

cheers
Alan J.
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Offline mattb

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Re: first-aid training
« Reply #42 on: January 05, 2009, 09:02:53 AM »
Quote
Robert it is a very long bow to compare MFB to CFS (as you know so I wont both to point out the differences).

You can exchange MFB for CFA now, the CFA have been running a trial EMR system for at least 12 months now in certain areas. From what I understand selected CFA vollies that choose to be part of the program are given an extensive training program from the Ambulance service, the brigade is kitted out with an AED, 02 and extensive first aid / trauma kit.

The brigade is responded via pager to any CAT1 (non breathing / non responsive) jobs where an ambulance is unlikely to be on scene within a certain time (7 mins sounds familiar). If the CFA brigade are closer or can reasonably be expected to be there first they go. Normally it is just two vollies in a command car or Quick Attack, however I think a few brigades may be using their pumper (as part of the trial they wanted to evaluate different combinations of response)

Initial trial results have shown many positive patient outcomes with a few good saves. The downside is obviously more work for some vollies (training / re-cert and calls) and exposure to some of the more nasty jobs (deceased children, lots of drug overdoses etc). However all the vollies are given the facts about what they can expect and what is involved before they sign up to the program.

The community is the winner out of the whole program so it has got to be a good thing. I think the trial is still underway but the word is that they can expect to see the program rolled out further across the service in the coming year.

If it can work in Victoria why wouldn't it work here, the CFA and CFS are very similar organisations, surely it is worth a look at and possibly a trial of some sort.

Offline chook

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Re: first-aid training
« Reply #43 on: January 05, 2009, 10:30:41 AM »
Thanks guys - good points.
Matt that sounds more like a CERT program, going on what some of the guys have said they don't want to do that level of training. The bit about messy cases is what I was trying to get at. Very different to what most vollies are used to (we can fix/stop anything), this comment applies to SES as well as CFS (normally among the younger group until they have experienced the feeling of a "not good outcome"). And a good example of this is when a search goes bad, Casualties dying at scene etc. Just for your info the new basic rescue module has/had a triage subject (from SAAS) & that is a confronting experience (I was criticized for black tagging someone even though their outlook was next to hopeless - the comment from the other participants was "you aren't a doctor" my reply was "then why are we doing this then?). So when it comes to medical emergency stuff I tend to leave it to the professionals. Interestingly the NSW version of the course doesn't have that subject in it, so I'm not sure why SA bothered (caused a lot of intense discussion).
But if the CFA trial works & there are enough CFS volunteers (and its not a short cut program as has been suggested by some), then I guess it may be a good idea bearing in mind the list of potential negative outcomes (including a reduction in CFS members) then good luck with it.
As I said some NSW SES units are CERT units & it works for them. But its not like on TV :-D
Anyway I think I have exhausted my thoughts on this.
cheers
Ken
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Offline joff

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Re: first-aid training
« Reply #44 on: January 05, 2009, 10:54:19 AM »
Hi Guys

All you need for this program to work is as Robert said advance resus and the use of AED with maybe OP airways put in there. The MFB has had over 100 saves now since starting the program and for those fearing the rise in calls or the difficulty of training  do not stress. The MFB and CFA vols are at times lucky to attend 1 EMR call a month and sometimes you may get a run of them, it is on for CAT 1 cases where an ambulance is more then 7 minutes from the scene, most of the time your called off the job or only assist with compressions. This program is vital to get resources to these incidents quicker to make a difference.

Joff

Offline Pipster

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Re: first-aid training
« Reply #45 on: January 05, 2009, 02:38:49 PM »
There is also the consideration of the current skills of people you have within the CFS brigade.....my own has a Nurse, Intensive Care Paramedic and former Ambulance Officer.  The wife of one of my members is a doctor, and is willing to come out to crashes etc with CFS, in her capacity as a doctor.   It is not a quantum leap for those people to undertake first response work!

As for bad outcomes - you can get that without being a first responder!

However, you need to look at your members, and who is able to deal with those bad outcomes, and who may not....no difference in attitude to being a first responder and being the first one on a fire appliance, going to a nasty crash.

And of course, not everyone wants to be a first responder.  But there are people out there who may do - and who are not currently living in an area where a SAAS first responder system exists....

Pip
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Offline chook

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Re: first-aid training
« Reply #46 on: January 06, 2009, 05:14:35 PM »
Just a correction, I said remote areas in NSW - Cowra is not exactly remote
Ten volunteers from the Gooloogong SES Unit have graduated as Community First Responders.
 On Tuesday evening, 16 December, ten volunteers from the Gooloogong Unit of the NSW State Emergency Service took part in a special Graduation Ceremony, where they graduated as ‘Community First Responders’ with the Ambulance Service of NSW.

The Graduation Ceremony was held at the Log Cabin in Gooloogong, and was attended by the Director General of the NSW State Emergency Service, Mr Murray Kear and Mr Denis Beavan, Divisional Manager Southern Division from the Ambulance Service of NSW.  Also in attendance was the Mayor of Cowra Council, Cr Bill West along with the Senior Management of the Ambulance Service and the State Emergency Service, and families and friends of the Gooloogong SES Unit members and members of the Gooloogong community.

The Gooloogong SES Unit is the eleventh Unit from the NSW State Emergency Service to become accredited as Community First Responders with the Ambulance Service of NSW.

Source NSWSES
Thats another woops from me :oops:
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Ken
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Offline bajdas

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Re: first-aid training
« Reply #47 on: January 07, 2009, 04:32:39 PM »
...for this thing to work, I think paging would have to be handled from SAAS comms. The two or so minutes needed to transfer the call & data to MFS is too long. I theorise that SAAS would have to maintain its own database of pager numbers of willing persons for each suburb/township/locality, & page them directly on receipt & dispatch of original call.....

Wouldn't this scenario be fixed by SACAD when any ESO ComCen can dispatch any resource using the 'closest most appropriate' rules & the same database/system ?
Andrew Macmichael
lives at Pt Noarlunga South.

My personal opinion only.

Offline Alan J

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Re: first-aid training
« Reply #48 on: January 07, 2009, 05:56:43 PM »
Wouldn't this scenario be fixed by SACAD when any ESO ComCen can dispatch any resource using the 'closest most appropriate' rules & the same database/system ?

All hail the Great & Mystical SACAD, Bringer of Order & Prosperity to the Great
Unwashed, Deliveror of ESOs from Confusion & Pointlessness, Defender of The Free,
& Bum-Coverer for The Minister.   :-D  :evil:

A little bird told me the other week that SAPol dispatch system already ticks most, if
not all of the SACAD boxes... multi-incident, multi-agency, multi dispatch centre,
resource tracking, full property database & Lands Dept interworking, & etc etc. 
Already working, already paid for, implementable for modest additional cost in weeks,
not years. 

I know not the truth or otherwise of this.  Anyone here think they know different ?

cheers
Alan J.
Cherry Gdns CFS

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Offline boredmatrix

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Re: first-aid training
« Reply #49 on: January 07, 2009, 08:59:42 PM »
meh - taxi's and RAA have had these systems for years.....

Government departments dont give a scheiße about efficient systems if it means it's going to cost a lot of money to set it up..hence we're still in the dark ages

SAAS response times will never get any better until something happens.....in the meantime...people will die because we have a government (and former CEO) who sat on their hands trying to save the mighty $$$ to keep the man happy!

TWATS

 

anything