Vol. 11 Issue 1. 2019
The Australian Emergency Services Magazine is a community educational resource dedicated to the recognition and promotion of emergency service personnel, and the awareness of safety measures, for the community, family and individual. We aim to provide relevant and up to date information and advancements within each of the emergency response sectors and first responders.
The Australian Emergency Services Magazine is a community educational resource dedicated to the recognition and promotion of emergency service personnel, and the awareness of safety measures, for the community, family and individual. We aim to provide relevant and up to date information and advancements within each of the emergency response sectors and first responders.
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<strong>Vol</strong> <strong>11</strong> <strong>2019</strong><br />
Inside a<br />
Hospital<br />
Trauma<br />
Unit<br />
SharkSpotter<br />
Drones<br />
& AI<br />
State of the Climate 2018
CONTENTS<br />
3<br />
Editor’s Note<br />
Latest Events<br />
4<br />
5<br />
6<br />
10<br />
14<br />
18<br />
21<br />
23<br />
25<br />
29<br />
32<br />
• <strong>2019</strong> Australian of the Year<br />
• 10 yr Anniversary of 2009<br />
Victorian Bushfires<br />
2018 Weather Wrap up<br />
State of the Climate - CSIRO &<br />
Bureau of Meteorology<br />
Doctors Support Pill Testing at<br />
Music Festivals<br />
Sharkspotter aids Swimmers<br />
Inside a Hospital Trauma Unit<br />
Paramedics Need More Support to<br />
Deal with Trauma<br />
Disease through the Decades<br />
Advances in Forensics<br />
Emergency Contact Information<br />
Cover Image:<br />
Great Ocean Road<br />
Victoria Australia<br />
Island Arch
EDITORS NOTE<br />
FROM THE EDITOR<br />
Happy New Year to all!<br />
A busy start for all our emergency services workers<br />
and volunteers. The incredible heatwaves that<br />
have swept thoughout most of the country kept us<br />
sweltering over the Christmas period and continue<br />
to keep us seeking any way to stay cool. This has had<br />
an effect on our energy usage with Victoria seeing<br />
staggered blackouts to prevent total energy shutdown.<br />
These outages put pressure on older people, business<br />
and care providers such as hospitals and care centres.<br />
The topic of electricity usage, cost and provision<br />
is certainly on the political agenda as it affects our<br />
community and the environment. Lets hope we see<br />
some changes in this arena in the near future.<br />
Congratulations to Dr Richard Harris and Dr<br />
Craig Challen on their shared honour of winning<br />
Australian of the year! A well deserved accolade that<br />
acknowledges the remarkable courage these two men<br />
demonstrated in order to save the lives of others. If<br />
only we could give awards to all of our emergency<br />
service personnel and volunteers who work daily to<br />
protect and care for others in our communities.<br />
Happy Reading!<br />
Emma Parker<br />
Editor<br />
DISCLAIMER<br />
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Australian Emergency Services Magazine<br />
3
LATEST EVENTS<br />
CAVE HEROES SHARE AUSTRALIAN OF THE<br />
The two Australian divers who<br />
gripped the public imagination for<br />
their part in the dramatic rescue of a<br />
Thai boys soccer team have shared the<br />
Australian of the Year award.<br />
Dr Richard Harris, an anaesthetist<br />
from Adelaide and Dr Craig Challen,<br />
a retired vet from Perth, long-time<br />
diving companions, worked as part<br />
of the international team that, against<br />
the odds, brought the 12 boys and<br />
their coach to safety.<br />
The members of the Wild Boars team<br />
entered the caves on June 23 last year,<br />
only to be trapped by floodwater. In<br />
the staged rescue, the last boys and<br />
the coach reached safety on July 10.<br />
The two Australians were preparing<br />
to go on a cave-diving holiday when<br />
their help was sought.<br />
“Richard’s medical experience was key<br />
in the plan to get the children out of<br />
the caves,” the Australia Day Council<br />
said.<br />
“After swimming through the narrow<br />
cave system to assess the health<br />
of those trapped and giving the<br />
medical all-clear for each evacuee, he<br />
administered an anaesthetic to each<br />
to enable their rescue.<br />
“Richard was key to the mission’s<br />
success, remaining in the cave system<br />
until the last evacuee was safe.<br />
“Craig’s technical expertise was<br />
critical to the rescue. He played a<br />
leading role, working 10 to 12 hours<br />
each day in extremely dangerous<br />
conditions to swim the children oneby-one<br />
through the dark and narrow<br />
flooded caves”.<br />
Chair of the council, Danielle Roche,<br />
said that the two men “placed the<br />
safety of others above their own and<br />
inspired hope when hope seemed<br />
lost. Their selflessness, courage and<br />
willingness to help others in a time of<br />
need typifies the Australian spirit.”<br />
In other awards announced at a<br />
ceremony in Canberra on Friday<br />
evening:<br />
The senior Australian of the Year is Dr<br />
Suzanne Packer, 76, from Canberra,<br />
a retired paediatrician. Among her<br />
many activities promoting children’s<br />
health, safety and rights, she has been<br />
involved in child abuse prevention<br />
and an advocate for the importance of<br />
the creation of child-friendly spaces<br />
in hospitals.<br />
The Young Australian of the Year<br />
is Danzal Baker, 22, an Indigenous<br />
rapper, musician and dancer from the<br />
Northern Territory.<br />
“Working across rap, dance, acting<br />
and visual art, Danzal Baker is an<br />
inspiration to indigenous youth,” the<br />
Australian Emergency Services Magazine 4
LATEST EVENTS<br />
10 YR ANNIVERSARY OF 2009<br />
VICTORIAN BUSHFIRES<br />
YEAR <strong>2019</strong><br />
council said. “A multi-talented,<br />
multi-lingual indigenous artist,<br />
Danzal, otherwise known as<br />
Baker Boy, is the first Indigenous<br />
artist to achieve mainstream<br />
success rapping in the Yolngu<br />
Matha language”.<br />
The Local Hero award was<br />
presented to Kate and Tick<br />
Everett from Katherine in the<br />
Northern Territory.<br />
After the death of their teenage<br />
daughter Amy “Dolly” Everett<br />
a year ago, following extensive<br />
bullying, they founded Dolly’s<br />
Dream, to raise awareness about<br />
the devastating impact bullying<br />
can have on children and their<br />
families, The council said the<br />
Everetts’ “non-stop advocacy” had<br />
resulted in governments acting to<br />
prevent childhood bullying.<br />
Michelle Grattan<br />
University of Canberra<br />
First Published on ‘The Conversation’<br />
A state commemoration service in<br />
February will mark ten years since the<br />
2009 Victorian Bushfires.<br />
The anniversary will be a time for<br />
reflection as Victorians remember<br />
the loss of 173 lives. Many more were<br />
injured and lost their homes, and<br />
there was significant damage to public<br />
and private property as a result of the<br />
fire.<br />
The state anniversary<br />
commemoration will be held on<br />
Monday 4 February at the Royal<br />
Exhibition Building in Carlton<br />
Gardens. The event is being held<br />
before the actual anniversary on 7<br />
February to allow for communities<br />
to hold their own events during the<br />
week or spend time together.<br />
Consultations have been undertaken<br />
with survivors and the bereaved<br />
community about the state<br />
anniversary commemoration, and full<br />
details about the event will be released<br />
shortly.<br />
Additional funding has been allocated<br />
to increase mental health and health<br />
support, through existing services,<br />
for bushfire-affected communities<br />
and first responders, and support the<br />
provision of psychological first aid at<br />
Australian Emergency Services Magazine<br />
5<br />
commemorative events.<br />
The Department of Health and<br />
Human Services (DHHS) is providing<br />
extra support to existing, trusted,<br />
local service providers wherever<br />
possible to make sure communities<br />
have access to services which are<br />
tailored to their needs.<br />
These include counselling services;<br />
mental health, alcohol and other<br />
drugs counselling; community<br />
engagement activities; and GP<br />
locums.<br />
People can access these local services<br />
by speaking with their doctor or<br />
mental health professional.<br />
Anyone experiencing problems<br />
or changes in behaviour should<br />
contact their doctor, mental health<br />
professional, or Lifeline on 13 <strong>11</strong> 14<br />
for help and support.<br />
More support services and recovery<br />
advice is available on the DHHS<br />
website.<br />
For updates about the State<br />
anniversary event, please visit the<br />
Victorian Government website
Australian Emergency Services Magazine 6
AUSTRALIA’S 2018 IN WEATHER:<br />
drought, heat and fire<br />
Last year was a time of<br />
exceptional weather and<br />
record-breaking heat<br />
according to the Bureau of<br />
Meteorology’s annual climate<br />
statement, which was released in<br />
January.<br />
The Bureau issued four Special<br />
Climate Statements relating to<br />
“extreme” and “abnormal” heat,<br />
and reported a number of broken<br />
climate records.<br />
One of the headline stories for the<br />
year was drought across eastern<br />
Australia — centred on New South<br />
Wales, but also affecting Victoria,<br />
eastern South Australia and<br />
southern Queensland.<br />
With the whole of NSW declared<br />
in drought during the latter half of<br />
2018, this drought will be recorded<br />
as one of the more significant<br />
in Australia’s history, ranking<br />
alongside the Millennium, 1960s,<br />
World War Two and Federation<br />
Droughts. Of those historic<br />
droughts, only the Millennium<br />
Drought saw similar, accompanying<br />
high temperatures.<br />
The below-average rainfall has<br />
persisted for around two years<br />
across much of NSW and adjacent<br />
regions. The drought conditions<br />
were particularly severe in<br />
the recent spring period, with<br />
low rainfall, persistently high<br />
Australian Emergency Services Magazine<br />
7
temperatures, and record high<br />
evaporation.<br />
This exceptionally dry period<br />
was influenced by sea surface<br />
temperatures to the west of the<br />
continent. Perhaps fortuitously, a<br />
developing El Niño in the Pacific<br />
Ocean failed to mature in the second<br />
half of the year. An El Niño would<br />
have typically exerted a further drying<br />
influence on eastern Australia.<br />
The dry conditions in eastern states<br />
were severe enough to see Australia<br />
record its lowest September rainfall<br />
on record, and the second-lowest<br />
on record for any month — behind<br />
April 1902, during the prolonged<br />
Federation Drought. Over 2018,<br />
Australia’s annual rainfall was<br />
<strong>11</strong>% below average, and the lowest<br />
recorded since 2005, during the<br />
Millennium Drought.<br />
In contrast, above-average rainfall was<br />
recorded across parts of the tropical<br />
north, and most significantly in the<br />
Kimberley, consistent with recent<br />
trends of increasing rainfall in that<br />
region.<br />
The drought conditions were<br />
exacerbated by record or near-record<br />
temperatures across many parts of<br />
the country. It was Australia’s third<br />
warmest year on record, behind<br />
2013 and 2005. Daytime maximum<br />
temperatures were the warmest on<br />
record for NSW and Victoria, and<br />
second-warmest for South Australia,<br />
the Northern Territory and Australia<br />
as a whole.<br />
Persistent dry conditions through<br />
winter are typically associated with<br />
low soil moisture and heatwaves in<br />
the following spring and summer, and<br />
2018 followed this pattern — with<br />
the added contribution of a warming<br />
climate.<br />
The year ended with some recordbreaking<br />
heat events. Perhaps the<br />
most significant of these was the<br />
extreme heat along the central and<br />
northern Queensland coast in late<br />
November and early December,<br />
which saw maximum daytime<br />
temperatures of 42.6 °C in Cairns and<br />
44.9 °C in Proserpine on the 26th of<br />
November.<br />
These temperatures, combined with<br />
persistent dry conditions in the<br />
preceding months, saw catastrophic<br />
fire weather and bushfires along<br />
600km of the Queensland coast, an<br />
event that fire agencies have called<br />
unprecedented for the state.<br />
The year ended with a burst of heat<br />
over the Christmas-New Year period,<br />
with temperatures at least 10 degrees<br />
warmer than average across southern<br />
South Australia, most of Victoria and<br />
southern NSW, leading to Australia’s<br />
warmest December on record.<br />
Karl Braganza<br />
Climate Scientist, Australian Bureau of<br />
Meteorology<br />
First Published on ‘The Conversation’<br />
Australian Emergency Services Magazine 8
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Australian Emergency Services Magazine<br />
9
State of the<br />
Bureau of Meteorology and CSIRO<br />
The Australian Bureau of<br />
Meteorology and CSIRO have<br />
released their fifth biennial State of<br />
the Climate report.<br />
State of the Climate 2018 is the<br />
latest biennial snapshot of climate<br />
change in Australia. It focuses on<br />
observed long-term trends that<br />
are happening now and are likely<br />
to continue into the near future,<br />
as well as significant climate events<br />
that have occurred over the past two<br />
years. These changes are described<br />
through the latest observations from<br />
CSIRO and Bureau of Meteorology<br />
marine, atmospheric and terrestrial<br />
monitoring programs.<br />
The report also summarises<br />
the latest climate research from<br />
Australia and around the world.<br />
This will help inform a range<br />
of economic, environmental<br />
and social risk assessments and<br />
responses by government, industry<br />
and communities.<br />
Multiple lines of evidence show<br />
the climate system changing in<br />
ways that are discernible from<br />
natural variability, and consistent<br />
with a human influence on<br />
Australian Emergency Services Magazine 10
Climate 2018:<br />
climate. These changes are having<br />
an impact on our natural and built<br />
environment.<br />
In particular, climate change is<br />
being felt through an increase<br />
in the frequency and severity of<br />
high-impact weather events such<br />
as heatwaves, extreme fire weather<br />
conditions, coastal inundation and<br />
marine heatwaves. These trends are<br />
projected to continue.<br />
Some of the report’s major findings<br />
are described below.<br />
Passing major milestones<br />
Australia’s average air temperature<br />
has warmed by just over 1degree<br />
since national records began in<br />
1910. Oceans around Australia have<br />
Australian Emergency Services Magazine<br />
<strong>11</strong><br />
also warmed by around 1degree<br />
since 1910.<br />
Atmospheric concentrations of<br />
carbon dioxide are rising globally.<br />
Emissions from the burning of fossil<br />
fuels continue to increase, and are<br />
the main contributor to the rise in<br />
CO₂, with some contribution from<br />
changes in land use.
Atmospheric CO₂ concentrations<br />
measured at Cape Grim, Tasmania<br />
(one of three main global measuring<br />
stations, alongside Mauna Loa,<br />
Hawaii, and Nunavut, Canada), have<br />
persisted at levels above 400 parts<br />
per million (ppm) since 2016. What’s<br />
more, the combined concentration<br />
of all greenhouse gases exceeded the<br />
equivalent of 500 ppm CO₂ in mid-<br />
2018. These milestones haven’t been<br />
crossed for at least 800,000 years, and<br />
likely 2 million years.<br />
Changes in the atmosphere and land<br />
Australia’s warming trend has led<br />
to an increase in the frequency of<br />
extreme heat events. For example,<br />
very high monthly maximum<br />
temperatures that used to occur<br />
around 2% of the time (based on the<br />
average for 1951–80) now happen<br />
about 12% of the time (2003–17).<br />
Other elements of Australia’s climate<br />
have also shown long-term changes.<br />
New analysis techniques now provide<br />
a more detailed picture of changes to<br />
fire weather through time. The annual<br />
total of daily values of the Forest Fire<br />
Danger Index is increasing over large<br />
areas of Australia. Most regions also<br />
saw an increase in the most extreme<br />
10% of fire weather days, and fire<br />
seasons have lengthened.<br />
Rainfall in April–October has been<br />
steadily decreasing in Western<br />
Australia’s Southwest, and has<br />
decreased since the 1990s in southeast<br />
Australia. In contrast, rainfall has<br />
increased in parts of northern<br />
Australia since the 1970s.<br />
The observed long-term reduction<br />
in rainfall across southern Australia<br />
has led to even greater reductions<br />
in streamflow. Long-term average<br />
streamflow has decreased in most<br />
regions of southern Australia, and<br />
increased in regions of northern<br />
Australia.<br />
A warmer atmosphere can hold more<br />
moisture, and this is an important<br />
driver of the observed increase in the<br />
intensity of short-duration rainfall,<br />
sometimes linked to flash flooding.<br />
Southern Australia is projected to<br />
experience decreases in average<br />
rainfall and more time spent in<br />
drought. Meanwhile, most of the<br />
country can expect an increase in<br />
rainfall intensity.<br />
Historically, significant weather and<br />
climate events are often the result of<br />
the combined influence of several<br />
extreme factors at once. Higher<br />
temperatures during periods of<br />
below-average rainfall, for instance,<br />
can exacerbate drought conditions.<br />
Temperature, dryness and wind come<br />
together to create dangerous bushfire<br />
conditions.<br />
Changes in the ocean<br />
The warming in Australia’s oceans<br />
has contributed to longer and<br />
more frequent marine heatwaves –<br />
defined as periods when sea surface<br />
temperatures are much warmer than<br />
average. The world’s oceans are a<br />
crucial moderator of the climate,<br />
taking up more than 90% of the extra<br />
Australian Emergency Services Magazine 12
heat in the system – most of it is<br />
absorbed by the Southern Ocean.<br />
Sea levels continue to rise through the<br />
combined effects of warming oceans<br />
and melting ice from land-based<br />
glaciers and ice sheets. Global average<br />
sea level has risen by more than 20cm<br />
since 1880, but the rate varies from<br />
place to place. About 25% of the CO₂<br />
emitted by human activity diffuses<br />
into the oceans, making them more<br />
acidic in the process.<br />
The past two years, 2016 and 2017,<br />
have seen back-to-back bleaching<br />
events in parts of the Great Barrier<br />
Reef, linked to marine heatwave<br />
events. These changes are very<br />
likely linked to warming oceans,<br />
and primarily driven by the human<br />
influence on the climate.<br />
Well-established scientific theory<br />
and climate model studies both show<br />
that the warming would largely not<br />
have occurred without the increase<br />
in greenhouse gas concentrations.<br />
In addition, the current increase in<br />
temperatures accords with projections<br />
made nearly 30 years ago. Warming<br />
is projected to continue into the<br />
future as the effect of past emissions<br />
continue, and more greenhouse gases<br />
are emitted. Australia is projected to<br />
experience increases in sea and air<br />
temperatures, with more hot days and<br />
marine heatwaves, and fewer cool<br />
extremes.<br />
It takes time for the climate system<br />
to warm in response to increases in<br />
greenhouse gases, and the historical<br />
emissions over the past century have<br />
locked in some warming over the<br />
next two decades, regardless of any<br />
changes we might make to global<br />
emissions in that period. However,<br />
by the mid-21st century, higher<br />
ongoing emissions of greenhouse<br />
gases will lead to greater warming<br />
and associated impacts, and reducing<br />
emissions will lead to less warming<br />
and fewer associated impacts.<br />
State of the Climate 2018 can be read<br />
on either the Bureau of Meteorology<br />
or CSIRO websites. The online report<br />
includes an extensive list of references<br />
and useful links.<br />
Michael Grose<br />
Climate Projections Scientist, CSIRO<br />
Lynette Bettio<br />
Australian Bureau of Meteorology<br />
Traumatic Stress Clinic<br />
Sydney Australia<br />
<br />
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02 8627 3314<br />
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Australian Emergency Services Magazine<br />
13
Doctors Support Pill<br />
Testing at Music<br />
Festivals<br />
Martyn Lloyd Jones<br />
Honorary Senior Lecturer, University of Melbourne<br />
Paul Komesaroff<br />
Professor of Medicine, Monash University<br />
For many years experts in the<br />
field of drug policy in Australia<br />
have known existing policies are<br />
failing. Crude messages (calls for total<br />
abstinence: “just say no to drugs”) and<br />
even cruder enforcement strategies<br />
(harsher penalties, criminalisation of<br />
drug users) have had no impact on<br />
the use of drugs or the extent of their<br />
harmful effects on the community.<br />
Whether we like it or not, drug use<br />
is common in our society, especially<br />
among young people. In 2016 43%<br />
of people aged 14 and older reported<br />
they had used an illicit drug at some<br />
point in their lifetime. And 28% of<br />
people in their twenties said they had<br />
used illicit drugs in the past year.<br />
The use of MDMA (the active<br />
ingredient in ecstasy) is common<br />
and increasing among young people.<br />
In the last three months alone five<br />
people have died as a result of using<br />
illicit drugs at music festivals and<br />
many more have been taken to<br />
hospital.<br />
The rigid and inflexible attitudes<br />
of current policy-makers contrast<br />
dramatically with the innovative<br />
approaches to public health policy for<br />
which Australia was once renowned.<br />
Since the 1970s many highly<br />
successful campaigns have improved<br />
road safety, increased immunisation<br />
rates in children and helped prevent<br />
the spread of blood-borne virus<br />
infections.<br />
The wearing of seatbelts was made<br />
compulsory throughout Australia in<br />
the early 1970s. Randomised breath<br />
testing and the wearing of helmets<br />
by bike riders were introduced in the<br />
1980s. These measures alone have<br />
saved many thousands of lives.<br />
The introduction of needle exchange<br />
and methadone treatment programs<br />
in the late 1980s and, more recently,<br />
widespread access to effective<br />
treatments for hepatitis C have<br />
dramatically reduced the health<br />
burden from devastating infections<br />
such as HIV and the incidence of<br />
serious liver disease.<br />
Each of these programs had to<br />
overcome vigorous and sustained<br />
hostility from opponents who argued<br />
they would do more harm than good.<br />
But in all cases the pessimists were<br />
Australian Emergency Services Magazine 14
Australian Emergency Services Magazine<br />
15
proved wrong. Safety measures on the<br />
roads did not cause car drivers and<br />
bike riders to behave more recklessly.<br />
The availability of clean needles did<br />
not increase intravenous drug use.<br />
Easier access to condoms did not lead<br />
to greater risk taking and more cases<br />
of AIDS.<br />
We believe — along with many other<br />
experts in the field — that as was<br />
the case for these earlier programs,<br />
the evidence presently available<br />
is sufficient to justify the careful<br />
introduction of trials of pill testing<br />
around Australia.<br />
Specifically, we support the<br />
availability of facilities to allow young<br />
people at venues or events where drug<br />
taking is acknowledged to be likely<br />
to seek advice about the substances<br />
they’re considering ingesting.<br />
These facilities should include tests<br />
for the presence of known toxins<br />
or contaminants to help avert the<br />
dangerous effects they may produce.<br />
Such a program should be undertaken<br />
in addition to, and not instead of,<br />
other strategies to discourage or<br />
deter young people from taking illicit<br />
drugs.<br />
Although pill testing has been widely<br />
and successfully applied in many<br />
European countries over a twenty<br />
year period, it has to be admitted<br />
the evidence about the degree of its<br />
effectiveness remains incomplete.<br />
That’s why any program in Australia<br />
should be linked to a rigorously<br />
designed data collection process to<br />
assess its impact and consequences.<br />
However, we do know that the<br />
argument that pill testing programs<br />
will increase drug use and its<br />
associated harms is very unlikely<br />
to be true. Most people seeking<br />
advice about the constituents of their<br />
drugs will not take them if they are<br />
advised that they contain dangerous<br />
contaminants.<br />
And it’s easy to avoid false<br />
reassurances about safety by<br />
careful explanations and detailed<br />
information. The opportunity to<br />
provide face-to-face advice to young<br />
people about the risks of drug taking<br />
is one of the great strengths of pill<br />
testing programs.<br />
Over the last half century we have<br />
learnt public health programs have to<br />
utilise multiple strategies and provide<br />
messages carefully and tailored for<br />
different audiences. What works to<br />
combat the harms associated with<br />
drug-taking in prisons is different<br />
from what works for specific cultural<br />
groups or for young people attending<br />
music festivals.<br />
The available evidence suggests pill<br />
testing is an effective and useful<br />
approach to harm minimisation<br />
in this last group. We believe it has<br />
the capacity to decrease ambulance<br />
calls to festival-goers, help change<br />
behaviour and save lives.<br />
It has taken until now for pill testing<br />
techniques to be developed to a level<br />
where they are able to identify the<br />
constituents in analysed samples<br />
Australian Emergency Services Magazine 16
with sufficient precision, reliability<br />
and speed. These techniques, and the<br />
range of substances for which they<br />
can test, will continue to improve<br />
over time. On the basis of experience<br />
gained in the UK, Europe and<br />
Australia it’s clear pill testing is now<br />
feasible and practicable.<br />
The members of the Australasian<br />
Chapter of Addiction Medicine<br />
within the Royal Australasian<br />
College of Physicians are the main<br />
clinical experts in the field of<br />
addiction medicine in this country.<br />
Together with the Australian Medical<br />
Association and many prominent<br />
members of the community with<br />
experience in this area we feel this<br />
is the time for pill testing to be<br />
introduced, albeit in careful and<br />
controlled circumstances. We believe<br />
this position is also supported by peer<br />
users, concerned families, and past<br />
and present members of police forces<br />
across Australia.<br />
The fact the “War on Drugs” has<br />
failed does not mean we should give<br />
up. There are many new weapons<br />
available to us, as we have learnt<br />
from the successful public health<br />
campaigns of the past. Pill testing will<br />
not abolish all the harms associated<br />
with drug taking, but if handled<br />
carefully, carries the likelihood of<br />
reducing them significantly.<br />
Article first published on ‘The<br />
Conversation’<br />
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Australian Emergency Services Magazine<br />
17
SharkSpotter aids<br />
on Aussie beaches<br />
Nabin Sharma<br />
Senior Lecturer, UTS School of Software, University of Technology Sydney<br />
Michael Blumenstein<br />
Associate Dean Research at the University of Technology Sydney<br />
Australian Emergency Services Magazine 18
swimmers<br />
Four tiger sharks have<br />
now been captured and<br />
killed following two<br />
separate attacks off the<br />
coast of North Queensland in<br />
September last year. Despite<br />
being relatively rare, shark<br />
attacks – or the threat of attacks<br />
– not only disrupt recreational<br />
beach activities, but can affect<br />
associated tourist industries.<br />
Shark nets are a common<br />
solution to preventing shark<br />
attacks on Australian beaches,<br />
but they pose dangers to marine<br />
ecosystems.<br />
Seeking a cost-effective way<br />
to monitor beach safety over<br />
large areas, we have developed<br />
a system called SharkSpotter. It<br />
combines artificial intelligence<br />
(AI), computing power, and<br />
drone technology to identify and<br />
alert lifesavers to sharks near<br />
swimmers.<br />
SharkSpotter was named<br />
the national AI or Machine<br />
Learning Innovation of the Year<br />
at the Australian Information<br />
industry Association (AIIA)<br />
annual iAwards this month.<br />
The project is a collaboration<br />
between the University of<br />
Technology Sydney and<br />
The Ripper Group, which is<br />
pioneering the use of drones –<br />
called “Westpac Little Ripper<br />
Lifesavers” – in the search and<br />
rescue movement in Australia.<br />
A shark spotting drone<br />
SharkSpotter can detect sharks<br />
and other potential threats<br />
using real-time aerial imagery.<br />
The system analyses streaming<br />
video from a camera attached<br />
to a drone (an unmanned aerial<br />
vehicle, or UAV) to monitor<br />
beaches for sharks, issue alerts,<br />
and conduct rescues.<br />
Developed using machine<br />
Australian Emergency Services Magazine<br />
19
learning techniques known as “deep<br />
learning”, the SharkSpotter system<br />
receives streaming imagery from the<br />
drone camera and attempts to identify<br />
all objects in the scene. Once valid<br />
objects are detected, they are put into<br />
one of 16 categories: shark, whale,<br />
dolphin, rays, different types of boats,<br />
surfers, and swimmers.<br />
If a shark is detected, SharkSpotter<br />
provides both a visual indication on<br />
the computer screen and an audible<br />
alert to the operator. The operator<br />
verifies the alert and sends text<br />
messages from the SharkSpotter<br />
system to the Surf Life Savers for<br />
further action.<br />
In an emergency, the drone is<br />
equipped with a lifesaving flotation<br />
pod together with an electronic shark<br />
repellent that can be dropped into the<br />
water in cases where swimmers are in<br />
severe distress, trapped in a rip, or if<br />
there are sharks close by.<br />
A new age of accuracy<br />
The development of SharkSpotter<br />
involved several stages.<br />
Among the most time-consuming<br />
tasks was collecting and annotating<br />
the necessary data. The data were<br />
collected by The Ripper Group by<br />
flying a drone with a camera attached<br />
to it above different Australian<br />
beaches.<br />
We then manually annotated each<br />
video to indicate the specific location<br />
of sharks and other objects. The video<br />
frames and the annotations were<br />
then used to train the deep learning<br />
algorithm to correctly identify and<br />
classify objects.<br />
These advanced machine learning<br />
techniques significantly improve<br />
aerial detection to more than 90%<br />
accuracy. That’s much better than<br />
conventional techniques such as<br />
helicopters with human spotters<br />
(17.1%) and fixed-wing aircraft<br />
spotters (12.5%).<br />
We tested the system at different<br />
Australian beaches to determine the<br />
varying parameters, such as camera<br />
resolution, height above sea level<br />
(which can affect the vision clarity of<br />
drones), speed and flight duration.<br />
After successful trials and fine-tuning<br />
of the system, SharkSpotter was used<br />
across a dozen popular beaches in<br />
New South Wales and Queensland<br />
last summer.<br />
The system was developed to help<br />
Surf Life Savers monitor the beach<br />
more effectively – as opposed to<br />
replacing them – and has been<br />
received positively by end-users and<br />
communities alike, according to a<br />
survey conducted by The Ripper<br />
Group.<br />
Saving lives<br />
In January 2018, the Westpac Little<br />
Ripper Lifesaver was used to rescue<br />
two young swimmers caught in a rip<br />
at Lennox Head, NSW.<br />
The drone flew down the beach<br />
some 800 metres from the lifeguard<br />
station, and a lifesaving flotation pod<br />
was dropped from the drone. The<br />
complete rescue operation took 70<br />
seconds.<br />
We believe SharkSpotter is a win-win<br />
for both marine life and beachgoers.<br />
From a technology perspective, it has<br />
demonstrated how to detect moving<br />
objects in a complex, dynamic marine<br />
environment from a fast-moving<br />
drone.<br />
This unique technology combines<br />
dynamic video image processing AI<br />
and advanced drone technology to<br />
creatively address the global challenge<br />
of ensuring safe beaches, protecting<br />
marine environments, and enhancing<br />
tourism.<br />
The authors would like to<br />
acknowledge the contributions of Dr<br />
Paul Scully Power, co-founder of The<br />
Ripper Group, who partnered in the<br />
development of SharkSpotter.<br />
First Published on ‘The Conversation’
INSIDE A HOSPITAL<br />
TRAUMA UNIT<br />
A look inside our emergency departments<br />
over the holiday period<br />
Simon Hendel<br />
Anaesthesiologist and trauma consultant<br />
Jennifer Jamieson<br />
Trauma Fellow & Emergency Physician<br />
THE NATIONAL TRAUMA RESEARCH INSTITUTE<br />
Australian Emergency Services Magazine<br />
21
As most workers wind down<br />
to enjoy the holidays, staff<br />
in hospital trauma units are<br />
preparing to ramp up. This is because<br />
between November and January,<br />
there is a 25% increase in trauma<br />
presentations. Around 30% of road<br />
fatalities for the year occur during this<br />
period.<br />
A hospital’s trauma unit witnesses the<br />
extreme of physical injury and pain<br />
that occurs over the holiday season.<br />
Here’s a snapshot of what we see.<br />
Inside the trauma unit<br />
The first trauma patient of the day<br />
is handcuffed uncomfortably to a<br />
hospital trolley. He is under arrest<br />
after an early morning brawl at a<br />
nightclub. A deep stab wound to<br />
his leg has damaged the artery. He<br />
is being examined by the on-call<br />
surgeons as two uniformed police<br />
look on.<br />
The decision to take the patient for<br />
surgery is made quickly. Studies in<br />
trauma reception show doctors are<br />
required to make a critical decision<br />
every 72 seconds in the first 30<br />
minutes of a trauma patient arriving<br />
in the emergency department.<br />
Trauma can include broken bones,<br />
head injuries, internal bleeding and<br />
death.<br />
Violence and assaults, including<br />
family violence, often peak around<br />
Christmas and New Year. This is<br />
due to a combination of triggers,<br />
including stretched household<br />
budgets and separated families<br />
coming together.<br />
More people are drinking in the<br />
holidays, and this provides more<br />
opportunities for dangerous<br />
situations. On Christmas day, for<br />
instance, there is a 50% increase in<br />
ambulance attendances for alcohol<br />
intoxication.<br />
In the next bay is an agitated young<br />
man in his late teens. He was weaving<br />
his motorbike in and out of traffic<br />
when he lost control at high speed.<br />
He was rushed to the CT scanner<br />
and, despite wearing a helmet, has<br />
blood inside his skull that needs to be<br />
drained by a neurosurgeon.<br />
Although the patient may survive,<br />
it is still too early to know what the<br />
long-term effects will be. Motorbike<br />
crashes have twice the rate of fatal or<br />
serious injuries compared with cars<br />
comprise 30% of the annual fatality<br />
rate over the summer.<br />
In a neighbouring trauma bay, an<br />
elderly lady has been brought in<br />
after a fall. She is awake but looks<br />
uncomfortable lying flat on her back<br />
with a hard neck collar immobilising<br />
her spine. She slipped and hit<br />
her head while playing with her<br />
grandchildren.<br />
Older people are often in unfamiliar<br />
environments on Christmas day,<br />
visiting friends and family, where<br />
there are more opportunities for<br />
injury.<br />
Two-thirds of female and one-third<br />
of male injury-related deaths occur<br />
in those aged over 65. Falls account<br />
for 73% of cases of major trauma in<br />
patients over 65 years of age.<br />
We hear the sound of a helicopter.<br />
A 4WD has rolled when the driver<br />
swerved at high speed to avoid<br />
another car, smashing head-on into<br />
a tree. He was killed instantly, but<br />
his female passenger survived and is<br />
seriously injured.<br />
Not every hospital has a trauma unit.<br />
In Victoria, where we work, two adult<br />
and one paediatric hospital have been<br />
designated as the state trauma centres:<br />
The Alfred, the Royal Melbourne and<br />
the Royal Children’s Hospital. Patients<br />
with major trauma are usually<br />
transported to one of these hospitals.<br />
The awaiting trauma bay is a hive of<br />
focused preparation as the patient is<br />
wheeled in by the helicopter crew.<br />
The trauma team springs into action<br />
checking the airway, breathing<br />
and circulation. An ultrasound is<br />
performed to identify any internal<br />
bleeding. Chest and pelvis X-rays are<br />
taken from overhead and reveal a<br />
collapsed lung and a crushed pelvis.<br />
In anticipation of ongoing bleeding,<br />
the blood bank has been notified and<br />
a blood transfusion is started to boost<br />
the blood pressure.<br />
As you end your shift, today reminds<br />
you to stay safe over the festive<br />
period. Because Christmas should be<br />
the most wonderful time of the year.<br />
First Published on ‘The Conversation’<br />
Australian Emergency Services Magazine 22
‘BACK TO ALICE’<br />
ROAR19<br />
Rural Outback And Remote Paramedic Conference<br />
If you liked the ROAR2018 program<br />
and experience, or heard the<br />
positive praise of the event from<br />
your colleagues, you won't want to<br />
miss ROAR19 in Alice Springs.<br />
Paramedics Australasia brings you 'Back to Alice' from<br />
10–12 April <strong>2019</strong>. This unique conference builds on<br />
ROAR2018 and provides deep insights into the challenges<br />
and practice of paramedicine in rural and remote<br />
environments. The intensive and stimulating program<br />
will enable delegates to further develop their skills and<br />
resilience, whilst building the courage to move outside<br />
of existing comfort zones.<br />
If you are a paramedic or health professional working in,<br />
or with an interest in, rural, outback and remote locations,<br />
this conference is designed to send you home with a swag<br />
full of skills and inspiration.<br />
The venue will once again be at the beautiful Mercure Alice Springs<br />
Resort, just 20 minutes from Alice Springs airport and a short walk<br />
over the Todd River to the centre of town.<br />
Check your rosters, book your airfares, on‐site accommodation<br />
deals available. Registrations essential with packages starting<br />
from only $60, and close on 27 March <strong>2019</strong>. Discounted rates<br />
for members and Alice Springs hospital staff.<br />
Visit the Paramedics Australasia website<br />
https://paramedics.wildapricot.org/event-3157296<br />
to secure your place.<br />
Enquiries can be directed to:<br />
Cassandra McAllister<br />
e: cassandra.mcallister@paramedics.org<br />
p: +61 408 972 155<br />
WE ARE PLANNING:<br />
• a host of interactive workshops and presentations,<br />
• flexible one, two day or whole conference<br />
registration,<br />
• special rates for PA Members and Alice Springs<br />
hospital staff,<br />
• an incredible welcome BBQ at the Mercure Resort<br />
hosted by Guild Insurance, and<br />
• an absolutely amazing Ooraminna Station<br />
Homestead conference dinner to round off two<br />
jam packed days including hands‐on activities<br />
and super engaging speakers.<br />
PROGRAM HIGHLIGHTS<br />
WILL INCLUDE:<br />
• Resuscitation in resource limited environments<br />
• An exercise in what to pack in your kit<br />
• Situational awareness and personal safety<br />
techniques<br />
• Improvised techniques in remote environments<br />
• Resilience building<br />
• Acute Rheumatic Fever\Rheumatic Heart Disease<br />
– understanding and treating<br />
• Advanced Life Support<br />
• Telehealth<br />
• Medical Retrieval and Consultation Centre<br />
(MRaCC) – 12 months along<br />
• Cultural Safety<br />
• Dialysis in remote communities<br />
• Tribal EMS<br />
• Leadership\career pathways<br />
• Mental Health – signs, symptoms and approaches<br />
in the pre‐hospital environment<br />
• and much, much more......we are still working<br />
on the final details!<br />
WE CAN'T WAIT TO WELCOME<br />
YOU ‘BACK TO ALICE’ IN <strong>2019</strong>!<br />
10–12 APRIL Australian Emergency <strong>2019</strong> Services ALICE Magazine 23 SPRINGS
PARAMEDICS<br />
NEED MORE<br />
SUPPORT TO<br />
DEAL WITH<br />
TRAUMA<br />
Andrea Phelps<br />
A/Director Policy and Service Development, Australian<br />
Centre for Posttraumatic Mental Health,<br />
University of Melbourne<br />
Among all emergency service<br />
workers, paramedics have the<br />
highest rate of PTSD, with an<br />
estimated prevalence of 14.6%. This<br />
compares to 7.3% among firefighters<br />
and 4.7% for police.<br />
While all emergency service<br />
personnel face catastrophic and<br />
stressful events, paramedics<br />
are exposed to these events on<br />
a daily basis. Most of them are<br />
resilient, most of the time, but<br />
traumatic events still take their toll,<br />
particularly when you consider<br />
the cumulative effect of repeated<br />
exposure.<br />
Some cases will slip behind the<br />
professional guard and become<br />
personal. Paramedics working<br />
in small communities are more<br />
likely to know the people they<br />
attend, or know the patient’s family.<br />
And paramedics anywhere can be<br />
confronted with a scene or a patient<br />
that strikes a personal chord for some<br />
reason; the age of a child, the clothes<br />
someone is wearing, the colour and<br />
make of the vehicle. The increasing<br />
incidence of assaults on paramedics<br />
from members of the public adds to<br />
the trauma load.<br />
Paramedics’ mental health can also<br />
be compounded by the very nature of<br />
the job: shift work, fatigue and having<br />
to make critical decisions under time<br />
pressures.<br />
In international studies, the rate<br />
of anxiety among paramedics has<br />
been estimated to be as high as 22%,<br />
depression 10%, and suicidal ideation<br />
10%. This compares to rates in the<br />
general community of 14.4% for<br />
anxiety, 6.2% for depression and 2.3%<br />
for suicidal ideation.<br />
Paramedics’ access to restricted<br />
medical drugs places them in a<br />
unique situation in this regard, and<br />
misuse of restricted medical drugs has<br />
also recently hit the headlines.<br />
In yet unpublished research, we asked<br />
emergency service workers what they<br />
liked most about their job. Most said<br />
it was the satisfaction of knowing they<br />
were doing the job well, making a<br />
positive impact on their communities<br />
and helping people in their hour of<br />
need.<br />
If you’ve encountered a paramedic<br />
on the job, you’ll likely have been<br />
reassured by their cool, calm and<br />
professional demeanour. Paramedics<br />
are well-trained to deal with medical<br />
emergencies and the horrific<br />
Australian Emergency Services Magazine 24
aftermath of accidents and disaster<br />
scenes. Focusing on the job at hand<br />
is an effective way of coping and<br />
keeping an emotional distance from<br />
the event.<br />
Who is at risk?<br />
But how can we predict who will be<br />
resilient and who will develop PTSD<br />
or other post-traumatic mental health<br />
problems? Those who have existing<br />
mental health problems may be more<br />
vulnerable, but this is only a small<br />
part of the answer.<br />
The nature and severity of exposure<br />
to trauma is important. Intentional,<br />
interpersonal trauma such as physical<br />
or sexual assault is more likely to<br />
give rise to PTSD than an accident<br />
or disaster. Prolonged or repeated<br />
trauma is more likely to lead to more<br />
complex symptoms.<br />
But the research tells us this isn’t<br />
the full story. The best predictor of<br />
recovery after trauma is the social<br />
support a person receives after the<br />
event, and whether they have other<br />
life stressors.<br />
In the work context, this means a high<br />
level of organisational support can<br />
buffer the impact of trauma, while a<br />
high level of day-to-day operational<br />
and organisational stress can mean<br />
the person has fewer psychological<br />
resources in reserve to cope with a<br />
particularly traumatic experience.<br />
What needs to be done?<br />
Support from colleagues, as well<br />
as family and friends, is of critical<br />
importance after a traumatic event.<br />
Organisations where staff have<br />
a predictable risk of exposure<br />
to trauma have a responsibility<br />
to build a supportive workplace<br />
culture, have policies and<br />
procedures in place to ensure<br />
support is provided in the<br />
immediate aftermath of trauma,<br />
and staff who need additional help<br />
have early access to best-practice,<br />
evidence-based care with specialist<br />
mental health practitioners. All<br />
emergency service organisations are<br />
working towards these goals.<br />
At a community level, we need<br />
to remember our emergency<br />
service workers put their lives and<br />
wellbeing on the line for the sake<br />
of their communities. Respect and<br />
compassion is the least they should<br />
expect in return.<br />
Australian Emergency Services Magazine<br />
25
DISEASE<br />
THROUGH THE<br />
DECADES<br />
Many diseases develop and become more likely as we age. Here are<br />
some of the most common conditions, and how you can reduce your<br />
risk of getting them as you clock over into a new decade.<br />
In your 40s<br />
Maintaining a healthy weight can<br />
reduce the risk of developing arthritis,<br />
coronary heart disease, and other<br />
common and related conditions,<br />
including back pain, type 2 diabetes,<br />
stroke, and many cancers. But almost<br />
one-third of Australians in their 40s<br />
are obese and one in five already have<br />
arthritis.<br />
From the age of 45 (or 35 for<br />
Aboriginal and Torres Strait<br />
Islanders), heart health checks are<br />
recommended to assess risk factors<br />
and initiate a plan to improve the<br />
health of your heart. This may<br />
include changing your diet, reducing<br />
your alcohol intake, increasing your<br />
physical activity, and improving your<br />
well-being.<br />
Checks to identify your risk of type 2<br />
diabetes are also recommended every<br />
three years from age 40 (or from age<br />
18 for Aboriginal and Torres Strait<br />
Islanders).<br />
If you don’t already have symptoms of<br />
arthritis or if they’re mild, this decade<br />
is your chance to reduce your risk of<br />
the disease progressing. Focus on the<br />
manageable factors, like shedding<br />
excess weight, but also on improving<br />
muscle strength. This may also help<br />
to prevent or delay sarcopenia, which<br />
is the decline of skeletal muscle tissue<br />
with ageing, and back pain.<br />
Most people will begin to experience<br />
age-related vision decline in their 40s,<br />
with difficulty seeing up close and<br />
trouble adjusting to lighting and glare.<br />
A baseline eye check is recommended<br />
at age 40.<br />
Australian Emergency Services Magazine 26
Stephanie Harrison<br />
Azmeraw T.Amare<br />
Jyoti Khadka<br />
Maria Carolina Inacio<br />
Sarah Bray<br />
Tiffany Gill<br />
University of Adelaide<br />
South Australian Health & Medical Research Institute<br />
In your 50s<br />
In your 50s, major eye diseases<br />
become more common. Among<br />
Australians aged 55 and above,<br />
age-related macular degeneration,<br />
cataracts, diabetes-related eye diseases<br />
and glaucoma account for more than<br />
80% of vision loss.<br />
A series of health screenings are<br />
recommended when people turn 50.<br />
These preventive measures can help<br />
with the early detection of serious<br />
conditions and optimising your<br />
treatment choices and prognosis.<br />
Comprehensive eye assessments are<br />
recommended every one to two years<br />
to ensure warning signs are detected<br />
and vision can be saved.<br />
National cancer screening programs<br />
for Australians aged 50 to 74, are<br />
available every two years for bowel<br />
and breast cancer.<br />
To screen for bowel cancer, older<br />
Australians are sent a test in the post<br />
they can do at home. If the test is<br />
positive, the person is then usually<br />
sent for a colonoscopy, a procedure<br />
in which a camera and light look for<br />
abnormalities of the bowel.<br />
In 2016, 8% of people screened had<br />
a positive test result. Of those who<br />
underwent a colonoscopy, 1 in 26<br />
were diagnosed with confirmed or<br />
suspected bowel cancer and one in<br />
nine were diagnosed with adenomas.<br />
These are potential precursors to<br />
bowel cancer which can be removed<br />
to reduce your future risk.<br />
To check for breast cancer, women<br />
are encouraged to participate in the<br />
national mammogram screening<br />
program. More than half (59%) of all<br />
breast cancers detected through the<br />
program are small (less than or equal<br />
to 15mm) and are easier to treat (and<br />
have better survival rates) than more<br />
advanced cancers.<br />
Australian Emergency Services Magazine<br />
27
In your 60s<br />
Coronary heart disease, chronic<br />
obstructive pulmonary disease (a<br />
disease of the lungs that makes<br />
breathing difficult), and lung cancer<br />
carry the biggest disease burden for<br />
people in their 60s.<br />
If you’re a smoker, quitting is the best<br />
way to improve both your lung and<br />
heart health. Using evidence-based<br />
methods to quit with advice from a<br />
health professional or support service<br />
will greatly improve your chances of<br />
success.<br />
The build-up of plaques in artery<br />
walls by fats, cholesterol and other<br />
substances (atherosclerosis) can<br />
happen from a younger age. But<br />
the hardening of these plaques and<br />
narrowing of arteries, which greatly<br />
increases the risk of heart disease and<br />
stroke, is most likely to occur from<br />
age 65 and above.<br />
Exercise protects against<br />
atherosclerosis and research<br />
consistently shows any physical<br />
activity is better than nothing when<br />
it comes to heart health. If you’re not<br />
currently active, gradually build up<br />
to the recommended 30 minutes of<br />
moderate-intensity exercise on most,<br />
preferably all, days.<br />
Other potentially modifiable risk<br />
factors for stroke include high blood<br />
pressure, a high-fat diet, alcohol<br />
consumption, and smoking.<br />
Your 60s is also a common decade<br />
for surgeries, including joint<br />
replacements and cataract surgery.<br />
Joint replacements are typically<br />
very successful, but are not an<br />
appropriate solution for everyone<br />
and are not without risks. After a<br />
joint replacement, you’ll benefit<br />
from physiotherapy, exercise, and<br />
maintaining a healthy weight.<br />
The treatment for cataracts is to<br />
surgically remove the cloudy lens.<br />
Cataract surgery is the most common<br />
elective surgery worldwide, with very<br />
low complication rates, and provides<br />
immediate restoration of lost vision.<br />
In your 70s<br />
Many of the conditions mentioned<br />
above are still common in this decade.<br />
It’s also a good time to consider<br />
your risk of falls. Four in ten people<br />
in their 70s will have a fall and it<br />
can lead to a cascade of fractures,<br />
hospitalisations, disability and injury.<br />
Osteoporosis is one cause of falls.<br />
It occurs most commonly in postmenopausal<br />
women but almost onequarter<br />
of people with osteoporosis<br />
are men. Osteoporosis is often known<br />
as a silent disease because there are<br />
usually no symptoms until a fracture<br />
occurs. Exercise and diet, including<br />
calcium and vitamin D, are important<br />
for bone health.<br />
Older people are also vulnerable to<br />
mental health conditions because of<br />
a combination of reduced cognitive<br />
function, limitations in physical<br />
health, social isolation, loneliness,<br />
reduced independence, frailty,<br />
reduced mobility, disability, and living<br />
conditions.<br />
In your 80s and beyond<br />
Dementia is the second most<br />
common chronic condition for<br />
Australians in their 80s, after<br />
coronary heart disease – and it’s the<br />
most common for people aged 95 and<br />
above.<br />
Many people think dementia is a<br />
normal part of the ageing process, but<br />
Australian Emergency Services Magazine 28
around one-third of cases of dementia<br />
could be prevented by reducing risk<br />
factors such as high blood pressure<br />
and obesity at mid-life.<br />
Early diagnosis is important<br />
to effectively plan and initiate<br />
appropriate treatment options<br />
which help people live well with<br />
dementia. But dementia remains<br />
underdiagnosed.<br />
Around 70% of Australians aged<br />
85 and above have five or more<br />
chronic diseases and take multiple<br />
medications to manage these<br />
conditions. Effective medication<br />
management is critical for people<br />
living with multiple conditions<br />
because medications for one<br />
condition may exacerbate the<br />
symptoms of a different coexisting<br />
condition.<br />
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Australian Emergency Services Magazine<br />
29
ADVANCES IN FORENS<br />
EXPOSE THE NEED FO<br />
GENETIC DATA LEGISL<br />
Australian Emergency Services Magazine 30<br />
Many people first became familiar<br />
with DNA testing through its use<br />
in the OJ Simpson murder trial in<br />
1994. Now, 24 years later, there have<br />
been two dramatic advances in the<br />
capability of forensic genetics that<br />
mark the start of a new era.<br />
The first is the amount of information<br />
we can predict about a person from<br />
DNA found at a crime scene, and<br />
the second is the way police can use<br />
open genealogy databases to identify<br />
people.<br />
But we need to be careful how we use<br />
these new tools. If people lose trust<br />
in how DNA data is used and shared<br />
by police, it could have an adverse<br />
impact on other applications – such<br />
as medical care.<br />
That’s why we’re calling for a Genetic<br />
Data Protection Act to ensure people<br />
have confidence in the way their DNA<br />
is accessed and used.
ICS<br />
R<br />
ATION<br />
We can learn a lot more from DNA<br />
now<br />
Predicting traits from DNA, known<br />
as “DNA phenotyping”, is improving.<br />
Facial prediction, health traits,<br />
predisposition to disease, even<br />
personality traits and things about<br />
our mental health can be predicted<br />
from genetic data. Some researchers<br />
are even considering predicting<br />
propensity to drink or smoke.<br />
Law enforcement agencies around the<br />
world are using these traits to create<br />
predictive DNA “mugshots”, but in<br />
many countries there is no specific<br />
regulation on how and when they<br />
should be incorporated into policing.<br />
And some types of predictions raise<br />
considerable ethical issues.<br />
For example, should it be OK for law<br />
enforcement to predict the mental<br />
health or disease risk of a suspect? If<br />
so, should that information be used<br />
in a trial? If law enforcement predicts<br />
a high risk of a particular disease,<br />
should they be compelled to tell a<br />
suspect or their family?<br />
Separation between databases is<br />
breaking down<br />
You may be familiar with “CODIS”<br />
from CSI, this is the database that<br />
law enforcement has traditionally<br />
used to identify DNA collected at a<br />
crime scene. CODIS has around 17.7<br />
million DNA profiles. There are strict<br />
rules around who can be included in<br />
these databases, and the vast majority<br />
of profiles are from convicted<br />
offenders.<br />
According to best estimates, the<br />
number of people who have taken<br />
genetic ancestry tests is slightly higher<br />
than this, and police have started<br />
using this data as well. The type of<br />
data in CODIS only allows close<br />
Australian Emergency Services Magazine<br />
family matches, but the type of data in<br />
open ancestry databases allows much<br />
deeper relations to be found.<br />
Even if you haven’t participated in<br />
genetic testing or made your genetic<br />
data public, you may have a relative<br />
who has. Currently, law enforcement<br />
is able to identify people based on<br />
matches as distant as third cousins.<br />
On average, people have around<br />
190 third cousins. One estimate<br />
indicates that over 90% of Americans<br />
of European descent already have a<br />
third cousin or higher in the open<br />
genealogy database GEDmatch.<br />
It may take as little as 2% of the<br />
population uploading their DNA data<br />
in a genealogy database for the entire<br />
population to be identified this way.<br />
New statistical methods mean<br />
separations between previously<br />
distinct genetic databases are<br />
disappearing. Traditional forensic<br />
markers can now be cross referenced<br />
to ancestry data, even though they<br />
are completely different types of<br />
genetic data. This means close family<br />
members could be identified across<br />
different databases. These methods<br />
can also be used to re-identify<br />
subjects in medical genetics research<br />
projects.<br />
There has been a lot of public support<br />
for the use of genetic genealogy to<br />
catch serial killers and rapists. In<br />
some cases, people are voluntarily<br />
uploading their data to help these<br />
efforts.<br />
But where should we draw the line?<br />
Should genetic data only be used<br />
in serious crimes, or are we happy<br />
to have a comprehensive system of<br />
genetic surveillance that covers the<br />
entire population?<br />
Private companies are aiding law<br />
enforcement<br />
Both DNA phenotyping and forensic<br />
genealogy – which relies on amateur<br />
genealogists – are now being offered<br />
to law enforcement by private<br />
companies.<br />
31
Parabon, a US-based pharmaceutical<br />
company, has partnered with<br />
armchair genealogist Cece Moore.<br />
She started using genetic genealogy<br />
to find the parents of adoptees<br />
and children born through sperm<br />
donation, but now uses it to catch<br />
criminals.<br />
Parabon also offers facial prediction<br />
services. While the science of facial<br />
prediction from DNA is getting better,<br />
it is still contentious, and several<br />
prominent scientists have cast doubt<br />
on whether Parabon can really do<br />
what it is promising.<br />
Nevertheless, this move out of<br />
government labs and into private ones<br />
raises questions about oversight – and<br />
what exactly is happening to the data<br />
generated.<br />
Genetic data is different from other<br />
kinds of data<br />
Genetic data is highly unique and<br />
can be thought of as a personal 15<br />
million letter pin-code. Since the<br />
code doesn’t just identify us, it also<br />
contains important information about<br />
our disease risk, personality traits<br />
and even our physical features like<br />
our face, it is very difficult to keep<br />
anonymous.<br />
Unlike a credit card we can’t<br />
request a new genome if our data is<br />
compromised. And a stolen credit<br />
card won’t tell a perpetrator anything<br />
about the finances of our family<br />
members.<br />
We understand what happens<br />
if we lose a credit card, but our<br />
understanding of genetic data is still<br />
developing. And we’re likely to see it<br />
put to unexpected uses in the future.<br />
We need a ‘Genetic Data Protection<br />
Act’<br />
Technological advances in genomics<br />
are outpacing public awareness, and<br />
existing legislation doesn’t fit genetic<br />
data well. Under current laws, the lab<br />
that produces the genetic data has<br />
ownership of the record. But if our<br />
genetic data represents a deep part of<br />
the essence of us, it shouldn’t be this<br />
easy for us to give up ownership of it.<br />
We need new ways to protect genetic<br />
data to maintain trust in medical<br />
genomics. Sometimes people need<br />
their genome sequenced for medical<br />
purposes, but they might be reluctant<br />
to consent if trust has broken down<br />
around how genetic data could be<br />
used. That could result in poorer<br />
medical outcomes.<br />
One solution to prevent this is a<br />
specific “Genetic Data Protection Act”,<br />
which would grant people ownership<br />
of their own data. However, it<br />
must be different from standard<br />
property rights: ownership should be<br />
immutable and nontransferable.<br />
The issues around use of our genetic<br />
data are complex, individuals (and<br />
their descendants) must be protected.<br />
Under no circumstances should<br />
it be possible for an individual to<br />
unwittingly sign an agreement that<br />
results in a loss of control of their<br />
genetic data. Legislation is part of<br />
the solution, but education and new<br />
technological solutions will also be<br />
important.<br />
The recent introduction of the<br />
digital My Health Record shows<br />
that Australians care about who is<br />
accessing their sensitive information.<br />
And people are already expressing<br />
unease about the confidentiality of<br />
their genetic data.<br />
We must establish clear boundaries<br />
about how genetic data generated for<br />
medical purposes is used – whether<br />
by police or by any other interested<br />
parties. Giving genetic data the<br />
protection it needs, and making sure<br />
that medical genetic data doesn’t<br />
become a forensic resource will be<br />
crucial to ensure public trust in<br />
medical genetics.<br />
Authors:<br />
Caitlin Curtis<br />
James Hereward<br />
John Devereux<br />
Karen Hussey<br />
Marie Mangelsdorf<br />
University of Queensland<br />
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Australian Emergency Services Magazine 32
BUREAU OF METEOROLOGY<br />
Triple Zero (000) <strong>11</strong>2 From Mobiles<br />
www.triplezero.gov.au<br />
State Emergency Service (SES) 132 500<br />
General Warnings 1900 969 922 www.bom.gov.au<br />
Cyclone Warnings 1300 659 212 www.bom.gov.au/cyclone<br />
Coastal Marine Warnings 1300 360 427 www.bom.gov.au/marine<br />
Tsunami Threat Information 1300TSUNAMI www.bom.gov.au/tsunami<br />
RADIO<br />
EMERGENCY CONTACT INFORMATION<br />
POLICE FIRE AMBULANCE<br />
ABC Local Radio<br />
ABC Local Radio Frequency Finder<br />
Commercial Radio Australia<br />
www.abc.net.au/local<br />
www.abv.net.au/radionational/frequency/<br />
www.commercialradio.com.au<br />
GOVERNMENT/HEALTH/ROADS<br />
Standard Emergency Warning Signal<br />
www.emergencyalert.gov.au<br />
Health & Hospitals 13HEALTH www.health.gov.au<br />
Road Closures 13 19 40 seek local/state road closure info<br />
ELECTRICITY<br />
Energex 13 19 62 www.energex.com.au<br />
Ergon 13 16 70 www.ergon.com.au<br />
PHONE<br />
Telstra 132 203 www.telstra.com.au<br />
Optus 13 13 44 www.optus.com.au<br />
ANIMALS & WILDLIFE<br />
Wildlife Hotline 1300 130 372<br />
RSPCA 1300 852 188<br />
Disease Watch Hotline 1800 675 888<br />
Lost/Missing Animals<br />
Local RSPCA website<br />
CALL 000 IN AN EMERGENCY<br />
Australian Emergency Services Magazine<br />
33
Paramedics Australasia International Conference<br />
PAIC19<br />
BROADENING HORIZONS<br />
28–30 NOVEMBER <strong>2019</strong><br />
Wrest Point • Hobart • Tasmania<br />
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Photo credit: Roger Wong
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Data/Phone Cabling<br />
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Antennas<br />
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Security Systems<br />
C bus Networks<br />
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Australian Emergency Services Magazine<br />
35
APPS TO HELP<br />
YOU IN AN<br />
EMERGENCY<br />
TECHNOLOGY IS FOREVER CHANGING AND IN MOST CASES TRYING<br />
TO IMPROVE OUR ACCESS TO INFORMATION. WE HAVE PUT<br />
TOGETHER THE TOP APPS IN AUSTRALIA THAT ARE FOCUSED ON<br />
KEEPING YOU SAFE AND INFORMED<br />
Fires Near Me App - Developed by the NSW Rural Fire Service it will<br />
provide information about bushfires from participating fire agencies across<br />
Australia. The app finds your location using a map and will give relevant information<br />
around you. It also allows you to choose a location. The app also<br />
provides information on total fire bans.<br />
The Emergency+ app is a free app developed by Australia’s emergency<br />
services and their Government and industry partners.<br />
The app uses GPS functionality built into smart phones to help a Triple Zero<br />
(000) caller provide critical location details required to mobilise emergency<br />
services<br />
Emergency AUS App - delivers warning and incident information issued<br />
by official agencies across Australia. Providing you with real-time access to<br />
official warnings, incident reports and public Sensory Observations to aid<br />
in better decision making during emergencies and disasters. By bringing<br />
together emergency information from over 25 emergency service agencies<br />
and accessing observations submitted by the public<br />
Triple Zero Kids Challenge App - Start playing and learn about what happens<br />
when you call Triple 000. The online game is designed for children of<br />
kindergarten and primary school age and consists of a number of safety scenarios.<br />
The game is available in seven languages including English, Arabic,<br />
Vietnamese, Chinese, Thai, Hindi and Dinka.
TM<br />
KEEP OUR<br />
KIDS SAFE<br />
THIS SUMMER.<br />
The home swimming pool is the most common<br />
location for injury and drowning death for<br />
children under five.<br />
We can all work together to protect children in<br />
our community.<br />
BE A BACKYARD<br />
LIFEGUARD THIS<br />
SUMMER.<br />
To check out how safe your<br />
pool is, pick up a copy of the<br />
pool barrier safety checklist<br />
from this library or download a<br />
copy from our website today.<br />
Closely supervise kids at all times<br />
Learn how to resuscitate<br />
Check your pool barriers meet the current<br />
safety standards<br />
Keep your barriers clear of objects and<br />
plants that kids can use to climb into the<br />
pool area<br />
Teach your kids to swim and be safe<br />
around pools<br />
Ensure your pool gate is shut at all times<br />
SUPPORTED BY<br />
in the Australian Capital Territory<br />
BE A BACKYARD LIFEGUARD | Find out more at www.act.gov.au/backyardlifeguard or call Access Canberra on 13 22 8<strong>1.</strong>
A joint Australian, state and territory government initiative.