A City Paramedic Goes Remote

· Lived Experience,Professional


Words by Craig Middleton

Recently I was asked to work as a paramedic at a remote mine site in central Australia. While I had previously worked at coal mines and gas projects as a firefighter, this was the first time would work as a remote paramedic.

I arrived in the middle of the Tanami Desert and was surprised to find it was cold. Being a coastal dweller, I was also captivated by the red soil and spinifex for as far as the eye could see. The mine site consisted of an underground mine over 1000 metres deep where rock was crushed and gold extracted using copious amounts of cyanide, and a living area approximately 50 kilometres apart with an accommodation village at each end.

I was soon to discover that the ambulance work I was used to in a metropolitan area, and the private sector work in a remote site varies considerably. Cases included ringworm, muscle strains, foreign body in eye, foreign body in the ear, tooth aches, rashes, plus the obligatory drug test or filling prescriptions of antibiotics . Although the case load was lighter than I was used to, the learning was steep. Supporting me were a team of nurses employed specifically for testing and managing a COVID-19 and Influenza outbreak on-site, plus an on-site medical team who had occasionally been tasked to respond to road crashes on the Tanami Track, as well as transfer patients to Royal Flying Doctor Service (RFDS) fixed wing aircraft.

Prior to this experience, I had worked as a paramedic in a busy metro area. When compared to my previous experiences in the metro environment, I noticed a few differences.

  • Primary care – It came as a surprise how much of the workload involved primary care. As the on-site paramedic, I was the primary response for all medical issues ranging from minor to severe. With that comes extra medications that I had been previously unfamiliar with. While most of these medications were over-the-counter, I also had access to antibiotics that could be administered after approval via phone consult. I had to familiarise myself with a foreign scope of practice and recognise when certain medications could be administered.
  • Tyranny of distance – Further medical assistance was 45-minutes away via road. Any site evacuations needed to be driven to the local airfield and RFDS contacted for transport, which could take several hours depending on operational demand.
  • Resource poor – Typically, two paramedics were stationed at both sections of the mine. However, during this rotation resources were diminished as medical staff were off sick. While staff on-site were first-aid trained, in most cases in most cases I found I was on my own.
  • Case load – For some it may be an attraction, for others a frustration. Typically, low acuity cases predominate the workload, with the occasional high acuity case. Mine sites are, generally, very safety oriented and whilst there is real risk of major incidents due to the hazards on-site, the control measures that are implemented largely negate the risk.
  • Unfamiliar equipment – Different equipment and consumables may take time to grow accustomed to.

It was short term rotation with more learning than I had considered. But it was an amazing clinical experience. If you are considering becoming a resource industry paramedic, my tips would include completing a wound care / suturing course, drug and alcohol specimen collection course, return-to-work course, and mine rescue course.