Innovative Corrective Services and Ambulance Response Evaluation (ICARE): A Queensland Ambulance and Queensland Corrective Services initiative to improve the management of prisoners with minor orthopaedic injuries.

The Queensland Ambulance Service (QAS) provides out-of-hospital medical services to approximately 900,000 patients annually, and as the publicly funded provider of prehospital emergency care is called to respond to persons incarcerated within correctional facilities. The primary complaint of patients attended by QAS in this setting are minor orthopaedic injuries to the upper arm and hand. In current practice, paramedics provide short-lasting analgesia and temporary limb splinting or bleeding control, before conveying the patient to an emergency department for further management. Transport of patients from correctional facilities to public hospitals is complex, presenting potential risks to staff and the public, and is time consuming and resource intensive. As these injuries are predominately uncomplicated fractures or simple lacerations, it has been postulated these patients may be more appropriately managed by enhancing the care that can be provided onsite by the QAS, with the patient subsequently managed through an outpatient clinic and thereby avoiding an unnecessary presentation to hospital. This project proposes developing a new collaborative treatment pathway involving the QAS, QLD Health and QCS for patients with minor orthopaedic injury. The aim is to reduce unnecessary, time and resource intensive transports to hospital emergency departments for this cohort of patients. Grant funding is sought to undertake an evaluation of this initiative. This model of care provision, if proven effective, could potentially be considered for implementation in other correctional facilities or austere healthcare settings where primary health care resources are stretched, and consequently additional demands are placed on emergency care settings.