Since a string of bushfires sparked by drought and record-high temperatures began ravaging Australia in the summer of 2019, fire and EMS services have ramped up their operations to protect their people and land from some of the country’s worst fires yet. Nearly 27.2 million acres have been burned, and 33 lives have been lost, four being firefighters.1 EMS World spoke with Justin Dunlop, acting Director of Emergency Management of Ambulance Victoria, an EMS organization serving the state of Victoria, about managing this ongoing disaster.
How did Ambulance Victoria prepare for and respond to the bushfires?
The bushfires in Victoria’s far east and northeast were the largest emergency ever faced by the state. It saw the premier declare a state of disaster for the first time in Victoria. In the days leading up to the fires, Ambulance Victoria (AV) was predominantly engaged in relocating vulnerable members of the community in hospitals and aged-care facilities in the danger zone. During the peak of the fires, many of our paramedics and volunteer community officers elected to remain and shelter alongside their communities as fire services provided support and protection. AV provided representatives in up to 19 fire control centers across the state during the peak of the fire, in addition to resourcing its own ambulance emergency operations center that coordinated the statewide ambulance response from its Melbourne base.
We also provided extra paramedics in isolated areas, and the state government funded medical officers and an Australian Defence Force medical team. These measures were designed to allow local crews to get some respite but also to support local health services during periods of stress. Paramedics also provided health assessments during the eventual large-scale evacuation of these isolated communities, facilitated by the Australian Army and Royal Australian Navy. The Air Ambulance Victoria base in Melbourne was used as a receiving station for those that needed to be evacuated by the Navy’s air assets.
Special arrangements were put in place to ensure the safety of ambulance crews dispatched to medical calls in potential fire areas. When a call came in from a fire ground, we would contact the relevant fire control center and check the local conditions. If the fire controller identified the area as unsafe, alternative safe options were investigated, and in rare cases advice was provided on what to do when an ambulance could not attend.
How have AV’s operations continued in areas unaffected by the fires?
The smoke generated by the fires affected air quality across the state. People were advised to wear P2/N95 face masks when required to work outdoors during the peak smoke period. On the worst day we saw a 51% increase in ambulance calls for cases of breathing problems. More generally, our work continued as normal across the state. Fortunately there were only a small number of burn patients, including some firefighters. The more serious cases required AV’s helicopter emergency medical service (HEMS) transport back to the state burns services in Melbourne.
What are your greatest challenges managing the fires?
The greatest challenge during these fires has been gaining access to isolated communities. The ongoing fires and damage to roads meant a number of ambulance crews were isolated with their communities for several days—in one case for several weeks. A number of methods were used to move and exchange crews, including ‘wet’ escort, in which a firetruck escorts an ambulance as it moves through a fire ground, air transport of crews by the Australian Defence Force, and water transport of crews by Victorian water police.
How have the fires impacted your providers personally?
Unfortunately, some of our paramedic and volunteer community officers lost homes, livestock, and businesses while supporting their local communities during the fires. Many have been working long hours in trying conditions. It is a true testament to their commitment but comes at a personal cost. Our plans recognize this, and an organizational recovery plan was developed early during the emergency. Internal ambulance recovery managers have been appointed in a range of areas, and peer support and psychological counseling commenced early and remain ongoing.
Through past fires and the current fires, what best practices has your agency learned regarding the role of EMS in wildfire management?
The 2009 ‘Black Saturday’ fires, which claimed 173 lives, are still a recent memory and invite comparison in Victoria. While the current fires consumed far more of Victoria’s landscape than in 2009, the work done by all emergency services, including ambulance, have meant that communities are better informed and supported when it comes to responding to bushfires. This has resulted in far fewer injuries and deaths.
Since the 2009 ‘Black Saturday’ bushfires, Ambulance Victoria has been working to improve access to patients inside fire grounds and other emergencies. Having a well-understood internal agency plan on how to deal with these situations is important. Engagement with other agencies to provide a joint understanding of the issues which can lead to a multiagency approach is invaluable and was demonstrated during these fires.
1. BBC News. Australia fires: A visual guide to the bushfire crisis. (2020). Retrieved from https://www.bbc.com/news/world-australia-50951043
Valerie Amato, NREMT, is the assistant editor of EMS World. Reach her at email@example.com.