Interactions with such persons may occur for a variety of reasons including (but not limited to),
Such encounters are anticipated to be infrequent. Advance Care Directives etc. will normally be in place and communicated.
Deterioration during transport or transfer should attract care and support to ensure the patient is comfortable. Acquire sound information and agree a plan prior to transport. Use the Interfacility Form as necessary.
No special storage of the 'substance' is necessary. However, good practice must include ensuring it is accounted for and included in handover summaries.
Resuscitation efforts or priority diversion to an Emergency Department should not occur in this patient group.
In the extremely rare event that persons may wish to access and take their 'substance' whilst in St John's care, they should not be actively prevented or discouraged from doing so even if there is a conscientious objection. The person should be capable of decision making capacity at that time. The Health Practitioner Advice guidance outlines that persons cannot be denied access to the VAD 'substance'. If asked to aid the person, ambulance clinicians;
If a person has taken the 'substance' and ended their life, there will normally be a contact person present (e.g. family or friend). These individuals are authorised to secure the 'substance' bottles and paraphernalia for safe disposal as outlined here. In other scenarios, follow the advice of Coronials.
Complete your notes in the record as you normally would. Be tactful around how wording around VAD is entered.
It is reasonable to adopt wording to the effect :
I reasonably believe that the person self-administered, or was administered, a voluntary assisted dying substance in accordance with the Voluntary Assisted Dying Act 2019
This wording might provide additional protections under section 115 of the Act.
There are provisions in the act to protect emergency first responders (e.g. Paramedics and Volunteers) who do not administer lifesaving treatment to a patient who has taken the VAD 'substance' to end their life. Transport Officers are also protected persons. This is reflected in Part 8 Sec 115 of the act.
This is outlined clearly in the Information for First Responders advice by WA Health.
A low threshold to call the Clinical Support Paramedic in SOC should be applied whenever there is any uncertainty or unanticipated event