RFDS Protocols

Sometime ago I showed you the contents of a Royal Flying Doctor Medical Chests used in remote communities, cattle stations, mining camps and others in remote areas. These items can be ordered by phone by a medical practitioner stating item, number and the drawer it is located in. These chests were put into use in 1939 with orders given by short wave radio and these days mainly by telephone. One of the earliest and longest examples of telehealth.

If a patient needs to be evacuated they have a number of protocols the RFDS follow. The drug and treatment protocols may be a little bit different to what may be used in a hospital as they usually only have to be used for a number of hours until the plane reaches a major centre and medical care.

Below are the protocols in use by RFDS Western Australia (PDF files).

Part 1. Clinical Guidelines June 2008

Part 2. Drug Infusion Guidelines

Part 3. Procedures

Part 4. Standard Drug List

Part 5. Standard Aircraft Minimum Equipment List

There are also a number of Clinical standards for patient transport and aero-medical operations produced by both the RFDS and external organisations that are followed: Standards

RFDS Medical Chest

August 26 2010: This post came about due to a number of enquiries I received from students and researchers enquiring about remote medical chest contents. I was only too happy to write on this topic. Many of the downloads were to university URLs.

However RFDS WA management have asked me to remove the medical chest contents list from this post. Several reasons were given. I do not agree with the reasoning but I have agreed to remove the list in good faith.

Other large organisations specialising in remote health such as Northern Territory Health and Kimberley Aboriginal Medical services do place their remote emergency lists in the public domain.

—————Post dated 16th Sept 2009 begins ——————————

The Royal Flying Doctor Service (RFDS) is a bit of an icon in Australia. It was started in 1928 by the Reverend John Flynn and became a national body in the 1930’s to provide a mantle of safety over the remote parts of Australia. It is now the “largest and most comprehensive aeromedical organisation in the world” (you can read the history of the RFDS here)

P8160042

One of the services it provides to remote communities, cattle stations and other remote workers is the provision of a medical chest.

In Western Australia alone there are over 400 of these medical chests. The RFDS has a special poisons licence to use these chests. The RFDS in turn has has each medical chest registered to a nominated “chest holder”. With the high turnover in staff in remote communities and cattle stations it can be quite difficult in ensuring accountability.

The contents of this Medical Chest are for use at a designated location for a specific project or business undertaking.

P8160043

The chest has a number of trays (A, B, C etc.) and contains a large number of pharmaceutical and non-pharmaceutical items to assist with the treatment of patients in emergency and non-emergency telephone consultations for those living and working in remote areas.

P9140004 Each item is numbered and stored in a nominated tray. In the lid of each chest is a large card with each item, the number and the tray it is to be stored in. The contents of the chest have been standardised across Australia since the 1940’s. An RFDS doctor

P9140007 could then request “I want you to get Item 120 off tray A. It should read Frusemide amps 20mg”

When items are re-ordered they arrive “pre-stickered” with the identifying number already on the item.

This medical chest is a little out of date as the contents P9140003have recently been revised and a new blue stock card issued.

A list of the current items stocked in the medical chest is available here:

RFDS Medical Chest Contents List has been deleted due to supposed “sensitivity” of the items.

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Telehealth in Western Australia

A recent ‘Short Communication‘ to the Rural and Remote Health Journal looked at the results of a very small survey to determine what telehealth needs were most required out bush.

The survey looked at the views of health managers and physicians working in non-metropolitan areas of Western Australia as to what the telehealth priorities were.

While the order of the first four health priorities was different, both groups had the same collective priorities.

Health managers wanted telehealth services (in priority order) for wound care, emergency, psychiatry and ophthalmology. Doctors wanted telehealth mainly for psychiatry (35%), wound care, emergency and ophthalmology.

To have a better sample size I see no reason why remote health services could not have been included. Telehealth is even more important in these areas where in some areas patients can be away for at least a week just to attend a specialist appointment.

In my belief the needs would have been the same, particularly mental health as mental illness is the second largest cause of illness in remote areas of Australia

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