Expanding Indigenous Cardiovascular Education & Healthcare In Rural & Remote Australia

Dr Sarah Edwards1, Mr Nicholas Dutton1

1NSW Ambulance



Cardiovascular health outcomes for the indigenous population, especially in rural and remote areas, continues to lag behind the rest of the population in Australia. This remains a significant challenge for the health system. NSW Ambulance has committed to a program that delivers culturally safe healthcare advice and education in rural & remote NSW.

Aim of the project:

NSW Ambulance established the Aboriginal Cardiac Education Program in 2010.

The program aims to deliver a targeted health promotion program to raise awareness of acute cardiac events and Acute Coronary Syndrome, specifically:

  • To increase knowledge of the signs and symptoms of heart attacks
  • To raise awareness of the importance of calling Triple Zero (000)

A gap analysis involving engagement with local elders and Aboriginal Medical Services at the time was conducted. Expansion of the scope of the program to raise awareness of cardiovascular disease in a broader context was identified as an area of improvement as well as strengthening the core message of cardiovascular health.

The educational content of the program has been expanded to include:

  • Rheumatic Heart Disease
  • Stroke
  • Diabetes

The program has been supported by the introduction of new protocols for clinical staff e.g. Acute Rheumatic Fever released in 2018.


Analysis of the program shows an increase in participants accessing the program and an increased demand for sessions in 2017 and 2018. Event numbers have increased from 9 in 2014 to over 40 in 2018 (and is on track to grow even more in 2019).


Significant health disparities still exist for Aboriginal and Torres Strait Islander peoples.  It is essential that healthcare providers undertake continuous quality and service improvement to close the gap between Aboriginal and non-Aboriginal peoples.


Nick Dutton is the Paramedic Cardiovascular Advisor with NSW Ambulance in charge of the operational education and clinical support for NSW Ambulance clinicians, including Acute Coronary Syndromes. Other cardiovascular emergencies focused on including out of hospital cardiac arrest (OHCA) and CVA.

He is an operational Paramedic qualified as both an Intensive Care Paramedic (ICP) & Extended Care Paramedic (ECP) with 14 years’ experience.

Prior to joining NSW Ambulance Nick worked as an ICP (MICA Paramedic) with Ambulance Victoria (AV) for 7 years.

He has previously held roles as an Educator at the NSW Ambulance Education Centre and a Paramedic Clinical Instructor with AV.

His interests involved Paramedic management of ACS (including systems of care in ACS, 12 lead ECG & Paramedic initiated thrombolysis) and Paramedic management of OHCA.

Nick has a Bachelor of Education from Wollongong University, a Graduate Diploma of Emergency Health (MICA Paramedic) and a Masters of Paramedic Practice (Critical Care Paramedic) from Edith Cowan University