RRESS Guidelines Frequently Asked Questions

According to the CSCF, Level 2 emergency care “provides basic resuscitation and limited stabilisation, including short-term assisted ventilation prior to transfer to higher level service”

If a HHS determines the RRESS guidelines do not suit their rural and remote facility ,with Level 1 or 2 emergency care services, then with approval from the local Quality, Safety and Risk unit and the Executive Director of Medical services, the HHS can develop emergency services resourcing documents appropriate to their rural and remote facilities. In these instances the HHS are responsible for all Statewide governance expectations including document control, review, renewal and approval

Large metropolitan hospital emergency departments are well resourced to deal with frequent acute presentations 24 hours a day. In less populated rural and remote communities, resourcing of small health facilities reflects the limited number of acute presentations
Subsequently, the vast variety of specific resuscitation, airway support, IV access or monitoring trolleys found in large emergency departments are not suitable for rural and remote facilities limited by serviceable population, space, workforce, isolation, clinical capability and costs
To support the broadest and most efficient emergency capability of rural and remote facilities, Statewide emergency and retrieval specialists determined that the following systems be implemented as a minimum:

• A resuscitation trolley with enough basic resources to support advanced cardiopulmonary resuscitation
• Adjunct emergency procedural kits to compliment the resuscitation trolley with systems targeted resources e.g. complex circulation emergencies or imminent birth and obstetric emergencies
• An emergency response pack to take when responding to an acute incident beyond the doors of the facility with or without specific emergency procedural kits

First and second line medicines are stored in the bottom drawer because in the event of an emergency it is easier to relocate the medicines than to relocate equipment held in the top drawers. To aid quick relocation, medicines can be stored in an appropriately sized container.

Yes. Facility managers must ensure the storage of resuscitation trolley medicines, kept in an emergency room complies with the Medicines and Poisons Act 2019 which requires:

• All Schedule 4 (S4) Restricted medicines are secure from public access i.e. locked away, that signage indicates restricted public access to the emergency area and all staff actively monitor the approved restriction
• All Schedule 8 (S8) Controlled medicines be stored in a S8 safe and

Resuscitation trolley compartments containing S4 medicines can be secured with a single use locking tag system which will alert clinicians to any tampering of contents. The choice of tag system:

• Is at the discretion of the governing HHS
• Should be easily identifiable with a serial number
• Should be easily removed in the event of an emergency and
• Should be checked daily, with serial numbers recorded next to the clinician signature

Yes. Local alteration, but not removal, of resuscitation trolley, emergency procedural kits or emergency response pack contents is acceptable after consultation with and approval by the local Director of Medical Services and Quality, Safety and Risk unit. In instances of content alteration the HHS are responsible for all changes including Statewide governance expectations including document control, review, renewal and approval of those items added or altered

Items can be obtained from local stores departments, pharmacy or pathology, using normal ordering processes. To support rural and remote facilities, a regularly updated S4HANA ordering spreadsheet is available for use.

In two ways:

• Checking contents daily against the RRESS checklists.
• Conduct auditing for checking compliance every 6 months at a local level and regularly by the local Quality, Safety and Risk Unit at discretionary periods.

See the relevant RRESS Guideline (not checklist) for detailed checking requirements

No. If a HHS determines the RRESS guidleines do not suit their rural and remote facility requirements then, with approval from the local Quality, Safety and Risk unit and the Executive Director of Medical services, the HHS can develop emergency services resourcing documents appropriate to their rural and remote facilities with Level 1 and 2 emergency services. In these instances the HHS are responsible for all Statewide governance expectations including document control, review, renewal and approval.

No. QAS will respond to acute incidents.

As a standard expectation, Yes. Occasionally, there is a variation in your QAS Service Level Agreement (SLA). In general, QAS will supply the vehicle as well as vehicle equipment e.g. stretcher, traction splints, while the Hospital and Health Service will supply consumables i.e. the resources found in the ERPs. If you are unsure, your QAS SLA that will be available from your local HHS Quality, Safety and Risk Team or Contract department.

The review of these documents are undertaken every 2-3 years by an expert Reference Group with broad experience in rural and remote environments, retrieval medicine and supporting rural networks, by an open, Statewide EOI process. Members usually include representation from:

• Rural and remote clinical staff
• Aeromedical Retrieval and Disaster Management Branch, (RSQ/TEMSU)
• Australasian College for Emergency Medicine (ACEM)
• Australian College of Rural and Remote Medicine (ACRRM)
• Broad HHS clinical staff
• Queensland Ambulance Service (QAS)
• Royal Flying Doctor Service, Queensland Section (RFDS)
• Directors of Pharmacy

Every 2-3 years. Urgent changes can be made if a risk assessment, or a coroners or ombudsman determination identifies a quality or safety issue

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