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Title : What emergency services learnt from the Bourke St attack
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What emergency services learnt from the Bourke St attack

Related Story: The lives changed forever by a moment on Bourke Street

One year ago, intensive care paramedic Andrew Burns was doing training exercise on how Ambulance Victoria would deal with mass casualties at a major event.

As the training session finished, alerts about an incident on Melbourne's busy Bourke Street began flooding in.

At first there was very little information available to emergency services: a car had mounted the footpath, multiple people had been hurt, and shots had been fired.

While hurrying to the scene, Mr Burns also faced a personal conflict.

"Right at that time my twins, who were 15 at the time, were having their first day on their own in the city with their mates," he said.

"And my immediate thought was 'where are my children?'"

The scene at Bourke Street is something that will stay with the seasoned ambulance officer.

"It's so hard to describe. In my over 20 years in this job I've never seen anything like it, I hope I never see anything like it again," he said.

"It was absolute chaos because three city blocks have been completely shut with this sort of horror. There were just broken people everywhere, and all on one side of the road.

"All you're hearing is sirens, you're hearing a lot of human misery because people are screaming in pain, so it was like a war, it was like a combat scene."

'Nightmare' to manage response

Responding to mass casualties is all part of the job for paramedics, and in many ways Bourke Street was just like another day at work.

But the nature of Bourke Street presented unique challenges, as the injured were spread out over three city blocks — an area spanning about 700 metres.

Ambulance Victoria's State Health Commander Paul Holman said paramedics rose to the challenge.

"Every patient got a paramedic in a quick amount of time, was treated and transported to hospital, job done," Mr Holman said.

A debrief after the event led to 32 findings about how to respond better to similar events in future.

"With these type of incidents, we think we're going to see more of this type of thing. We need to learn from it, we need to get it better, because it's all about saving lives."

Twenty-five people were sent to trauma centres around the city.

The Alfred Hospital, in Melbourne's south, treated seven patients.

Doctor Carl Luckhoff said from a medical point of view, treating patients was not much different than any other day in a busy emergency department.

But he said there was a palpable anxiety among the public and staff.

"I think what made Bourke Street quite unique was that it was the first time something like that had occurred," Dr Luckhoff said.

"We learn a little bit from every event that you go through. Unfortunately, as sad as it is, you get better with it each time."

Sadly, practice makes perfect

For police, any review into their operations on the day will be a long time coming, with a looming criminal trial and a coronial inquest.

But there were immediate and visible changes after the tragedy.

Concrete blocks moved into the CBD in the aftermath; slowly, they are being replaced with metal bollards and strategically-placed benches and planter boxes.

Across the city, 95 CCTV cameras are being fitted with emergency alert speakers, so police can advise the public if an incident is underway.

Assistant Commissioner Stephen Leane said there have been other, less obvious changes as well.

"We've changed our response so there are more police on the streets of Melbourne today than there were on January 20 last year," he said.

"We've got more general police out and about in full uniform being visible, in addition to that, we've got critical incident response teams which we've shaped and refocused.

"Behind the scenes, we've done a lot of training with our staff in regard to what their vehicle can do and withstand if it's rammed by another vehicle."

Assistant Commissioner Leane said in the case of another event, their objective would be to bring it to a conclusion as quickly as possible.

"And we realise that means we have to put our police in harm's way," he said.

"Our police understand that, they've been trained and they understand that issue, so I think we'll be in a much better position to respond."

Emergency services faced an early test of their responsiveness, with another vehicle attack near Flinders Street station in December.

Police and ambulance said they were faster and more organised.

"Unfortunately through practice you get better at it, much, much better at it," Assistant Commissioner Leane said.

"We worked through a range of issues through Bourke Street, and [Flinders Street] was much more seamless.

"Our response was instantaneous … the responding police were there within moments so I think that demonstrates we've got a capacity, but we have to be vigilant.

"We're already better prepared, and I think Flinders Street demonstrated that.

"Every patient was treated and transported within 30 minutes, and that was 16 patients."

Urban design expert at the Designing Out Crime Research Centre, Douglas Tomkin, said Australia needed a national, unified response to security measures.

"There's no mechanism like there is say in the UK to bring all the different parties together and come to joint solutions," he said.

"Of course nothing is perfect and there's no way we could ever say that we can prevent such an attack, but we can do an awful lot."

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