The Ambulance Service of NSW has developed two types of care plans to help ambulance staff to make the best decisions in the event of an emergency. Ambulance Care Plans authorise paramedics to provide individually tailored treatment based on the directions documented in their plan by their health practitioner.
Ambulance care plans can also help you and your family prepare for potentially traumatic events before they occur. The plan can be initiated by the individual or any members of their care-team, however final approval and signing prior to submission to NSW Ambulance is the responsibility of the local family GP or palliative care team. Some palliative care teams will routinely discuss ambulance care plans with their patients and ensure an appropriate plan is completed together, but this is not always the case and you may need to instigate the plan yourself. Ideally your GP and your palliative care team will both contribute to your ambulance plan. Once authorised, ambulance care plans are kept by the patient and reviewed annually.
Points to remember
- All ambulance care plans last 12 months - they need to be renewed every year.
- All ambulance care plans must be completed by a medical practitioner (GP and/or palliative care nurse/doctor).
- All ambulance care plans must be endorsed by the NSW ambulance service.
- Keep a copy of your endorsed ambulance care plan somewhere easily accessible at home (i.e. document holder on the back of the front door, on the fridge, on a telephone table)
- Any medications that may be needed for symptom management, but are not routinely kept by ambulance staff, will need to be available for the patient in their home.
- Ambulance staff do not have copies of ambulance care plans, this must be provided to them on arrival. Keeping several copies of the plan, and other appropriate documentation, in your home is advised.
There are 2 different types of Plans:
- Authorised General Care Plans - for people who have disabilities or have medical conditions requiring specific treatment outside the paramedic’s scope of practice or transport to specific destinations for management of their disease or illness.
- Authorised Palliative Care Plans - for people who have a diagnosis of a life-limiting illness and may wish to prescribe treatment for specific symptoms, document resuscitation plans or to guide where they should be admitted if care at home becomes difficult.
Caring for an individual with palliative care needs can be a complex undertaking and an Authorised Palliative Care Plan is an appropriate response for individuals with motor neurone disease. In the after-hours period when sudden changes in health may lead to uncertainty, NSW Ambulance Triple Zero (000) service is commonly a first response. In the absence of detailed clinical knowledge about the patient, the paramedic’s response is protocol based and may suggest a transfer to the hospital emergency department is required, although this is often not the optimal outcome. For a patient with palliative care needs, transfer to hospital may be avoidable if the paramedic has access to a Palliative Care Plan which includes the administration of medications and other actions to relieve and manage symptoms in the home. The Palliative Care Plan allows the paramedic responding to a Triple Zero call to respect the palliative care wishes of the patient and to follow the GP’s advice.
Once you have completed and endorsed your palliative care plan, if the paramedics are called via Triple Zero they are advised that a patient at that address has an Authorised Palliative Care Plan in place. The finer details within the plan are not visible on their system. The patient/person responsible will be required to provide a copy of the endorsed plan to the paramedics when they arrive.
To view or print a copy of a blank ambulance palliative care plan see:
1) NSW AMBULANCE Authorised Palliative Care Plan Adult (Printable Version)