The Experience

Registrars

What’s the job like?

The com­bi­na­tion of pathol­o­gy and geog­ra­phy presents a unique chal­lenge and our retrieval doc­tors need to be able to man­age a broad range of crit­i­cal ill­ness in a remote envi­ron­ment. The one ser­vice cov­ers all age groups and presentations. 

Tele­phone advice is avail­able from the retrieval con­sul­tants, who work close­ly with inten­sive care, pae­di­atric and obstet­ric spe­cial­ists as required. 

In 6 months, you are like­ly to under­take around 100 cas­es, including:

  • Lots of severe sep­sis, includ­ing patients requir­ing crit­i­cal inter­ven­tions such as intubation.
  • Up to 20% pae­di­atric patients, pre­dom­i­nant­ly with res­pi­ra­to­ry, GI tract and soft tis­sue infections.
  • Trau­ma — such as motor vehi­cle acci­dents on remote highways.
  • Missed dial­y­sis with pul­monary oede­ma / hyperkalaemia.
  • Car­diac dis­ease — such as acute coro­nary syn­dromes, rheumat­ic heart dis­ease and valvu­lar disease.
  • Obstet­ric emer­gen­cies such pre­ma­ture labour.
  • Psy­chi­atric and behav­iour­al emer­genices requir­ing seda­tion for safe transport.

We are also respon­si­ble for the inter-hos­pi­tal trans­fer of patients to ter­tiary ser­vices. This means a min­i­mum trans­port time of 5 hours to ter­tiary hos­pi­tals with defin­i­tive care options such as angiog­ra­phy, neu­ro­surgery or cardiothoracics.

In addi­tion to the day-to-day job, retrieval doc­tors are ros­tered to pro­vide med­ical sup­port for some major sport­ing events in the region, includ­ing the Finke Desert Race and Run Lara­p­in­ta.

Retrieval Doc­tor Requirements

  • You must be at min­i­mum senior reg­is­trar in the last two years of a train­ing pro­gramme (ACEM, CICM, ANZ­CA, ACCRM, RACGP).
  • Desir­able crit­i­cal care expe­ri­ence of at least: 
    • 6 months in an Emer­gency Department, 
    • 6 months in an Inten­sive Care Unit, and 
    • 3 months in Anaes­thet­ics
  • The abil­i­ty to be the clin­i­cal lead, work­ing with a flight nurse or para­medic, pro­vid­ing crit­i­cal care to patients in remote settings.
  • Excel­lent com­mu­ni­ca­tion and team­work skills.
  • The abil­i­ty to work safe­ly and sen­si­tive­ly in com­plex cross cul­tur­al environments.

What’s a typ­i­cal day?

We oper­ate a flex­i­ble rota cov­er­ing four shifts, pro­gress­ing through days, evenings then nights.

After being acti­vat­ed for a task, the retrieval doc­tor may be asked to liaise with the remote clin­ic staff to reassess the patient’s cur­rent state. The doc­tor then meets the flight nurse and pilot at the hangar to col­lect any addi­tion­al kit before fly­ing out to the remote airstrip. The vast major­i­ty of clin­ics are with­in 1 hours flight time, with a few up to 2 hours away. There’s nor­mal­ly a short jour­ney by 4WD to the clin­ic at the oth­er end, although some jour­neys may be as long as 40 min­utes from the air­port to clin­ic. Once in the clin­ic, you then assess and treat the patient as required to sta­bilise them for safe trans­fer on the return leg to hospital.

The retrieval doc­tor will also under­take road retrievals with St John Ambu­lance para­medics, par­tic­u­lar­ly in sit­u­a­tions where the patient is less than 150km away (or 2 hours dri­ving time), where there is no suit­able airstrip, or the sit­u­a­tion requires an urgent response and no oth­er assets are available.

The sec­ond day shift doc­tor is avail­able for inter-hos­pi­tal trans­fers. The flight times alone are 3 – 4 hours one-way, so a sin­gle return trip takes an entire shift.

Retrieval reg­is­trars will be ros­tered to sup­port shifts in the con­sul­ta­tion cen­tre in order to gain an appre­ci­a­tion for the logis­tics required to do the job. Any giv­en day can have mul­ti­ple patients simul­ta­ne­ous­ly across a large area and the retrieval doc­tors must pri­ori­tise patients whilst fac­tor­ing in aspects such as trans­fer times, day-only airstrips, weath­er, demands on indi­vid­ual crews, pilot hours and how to make the best use of the resources and assets avail­able. Although chal­leng­ing, this can be one of the most sat­is­fy­ing ele­ments of the job.

If not tasked to fly, there are oppor­tu­ni­ties for up-skilling (for exam­ple, with anaes­thet­ics lists) and ambu­lance observ­er shifts. Retrieval doc­tors also con­tribute to the growth of the ser­vice, under­tak­ing rel­e­vant qual­i­ty improve­ment activ­i­ties such as audits.