Paramedics can experience intense pressure when it comes to patient care and getting to incidents in time.
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Now try adding an extra element of being on a cliff face or in a confined space while treating a patient in need - it can be a stressful environment.
But Lithgow's Special Operations Team's (SOT'S) newest recruits Stacey Phillips and Chris Bucholtz are up for the challenge.
The homegrown duo went back to the classroom recently to expand their skills and are now part of the Special Operations Team, working alongside Newcastle's Mitchell Sorby who's also joined the Western crew.
Their news roles mean they're now trained and equipped to safely access and treat patients in isolated, remote or difficult environments, like rugged bushland in the Blue Mountains or out on farmland, that would normally be outside the abilities of regular ambulance operations.
Ms Phillips has been an intensive care paramedic for 13 and-a-half years and said she was excited to have a new set of skills to play with.
"It was just a new opportunity for regional paramedics to kind of expand their skills and bring something more to the community that hasn't previously been offered," she said.
"SOT's only ever really been in Sydney, but this is the first time Special Operations has come to the Western sector."
"It's a nice thing for the town to have this kind of capability here," she said.
Mr Bucholtz has worked for NSW Ambulance as a qualified paramedic for 10 years and said it was great to see a valuable resource available to the Lithgow community.
"It will allow us to assist with cases where the patient is difficult to access and requires specialised skills such as working at heights, in confined spaces or remote area navigation," he said.
"Having this resource based here in Lithgow means we can access our patients quicker and provide the medical care they need, rather than waiting for these resources to arrive from Sydney."
Mr Bucholtz, Ms Phillips and Mr Sorby will be rapid responders and will work closely with the Volunteer Rescue Association (VRA).
Ms Phillips said she was most looking forward to her first abseil, delivering patient care in a "very austere environment".
"You know, it's funny, because you do something like this, you might do a trauma and someone's fallen off a ladder on the ground, and it'll be the same thing, but being on the side of a cliff, it just makes it that much more complicated and a lot more stresses," she said.
"I've done plenty of traumas like this in my life, but when you add the other elements, and the stress factor, your bandwidth just kind of lessens."
The paramedics said things were quiet being Winter but come Summer they're anticipating more call outs.
"It's obviously quiet now because it's Winter and a lot of the National Parks are still closed but come Summer, we will be really busy," Ms Phillips said.
NSW Ambulance inspector Ron Gavin was said Lithgow and Katoomba being the first split SOT station outside of Sydney was a huge benefit to not only the community but also regional paramedics.
"There's also the benefit to the ambulance service, in that local paramedics now have an opportunity to be trained in those advanced skills without having to leave the area," he said.
"I think just in general, that it's very exciting to have it out here. It's a huge step forward for regional where we've typically not had the resources that metropolitan, obviously have."
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