Each year, societies spend millions to protect people, infrastructure, flora, fauna and cultural assets from the threat of potential fire. Yet in the last 6 months across Australia, many of these defences have been pierced as a new reality exerts itself upon Australian communities, emergency services workers, and paramedics.
Since November, 2019, what started as a series of bushfires across the north-eastern areas of Australia has evolved into a national bushfire crisis of unprecedented scale and impact. This crisis has seen more than 7.7 million hectares of land burned, thousands of homes destroyed and dozens of people killed, including many firefighters.
On a personal level in my hometown of Port Macquarie, communities experienced the unnerving spectacle of blood-orange skies during the day as bushfires surrounded the town; they experienced the falling of ash and burnt leaves from the sky, like an eerie type of confetti, and they waded through the smoke which plummeted the air quality to levels worse than New Delhi and Beijing (Rubbo and Wellauer, 2019).
Such experiences have been visited upon town after town, and at times upon the major cities, as bushfires have marched across the now dry Australian continent. Yet these grim settings serve only as a backdrop to the incredible work carried out by fire-fighters, paramedics and other emergency agencies as they work together to save lives and assist community wellbeing during a national bushfire crisis.
Times of protracted crisis often result in communities pulling together. The same commitment seems evident among emergency services personnel when they are faced with unprecedented challenges and threats. In fact, the current events in Australia have reminded me of the remarkable interagency cooperation which springs to life within a crisis. For example, in some of the eight States and Territories of Australia, the mutual respect between fire and paramedic agencies is so great that fire fighters will embed a paramedic colleague within each of their teams when they travel to another jurisdiction. Simple measures such as this point to a deep underlying trust and mutual respect. This notion of inter-professional cooperation reflects a core recommendation of the recent report by Wales and Stiles (2019: 27), which also recommends a seamless, patient-centred approach in the rescue and ongoing care of burn survivors.
In light of these developments, it seems timely that in this edition of JPP, Matthew Metcalf explores prehospital burn management practices, particularly as they relate to prophylactic endotracheal intubation for patients with suspected airway burns. In undertaking this review, Metcalf outlines why he supports recommendations for high-specificity criteria to guide decision making in this important area.
When I reflect on this article and the circumstances which I have observed in Australia over the past 6 months, two thoughts come to mind. First, I am reminded that when agencies and professional disciplines work together, achievements are always greater than the sum of their parts. Second, even within the most collaborative partnership, paramedics have an immutable role: to continuously develop our expertise as paramedics, to research every facet of our practice and to share our findings.