A paramedic

Paramedic

A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...

 in Australia

Australia

Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

 is a health care professional who responds to and treats all types of medical and trauma emergencies outside of a hospital

Hospital

A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

 setting before and during transportation to an appropriate medical facility. Paramedics also work in the inter-facility transport environment where a paramedic will continue or upgrade medical care to a higher level while transporting a patient from one healthcare facility to another. Paramedics usually transport patients to a hospital-based emergency department

Emergency department

An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...

, but paramedics can treat patients out of the hospital setting and then not transport the patient to the hospital (e.g. a paramedic gives a diabetic patient 50% dextrose in water). In Australia, use of the term "paramedic" is not restricted, registered or licensed. There are currently substantial efforts in Australia to change this situation, most notably through Paramedics Australasia. Prior to the 1990s most paramedics were known as "ambulance officers".

Definition of a paramedic (Australian Council of Paramedicine)

"A Paramedic is a specialist health care professional who responds to requests for assistance and attends people suffering acute

Acute (medicine)

In medicine, an acute disease is a disease with either or both of:# a rapid onset, as in acute infection# a short course ....

 health crises of any nature. Paramedics provide health assessment

Health assessment

A health assessment is a plan of care that identifies the specific needs of the client and how those needs will be addressed by the healthcare organization or skilled nursing facility....

, initial diagnosis

Diagnosis

Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...

, design a treatment

Therapy

This is a list of types of therapy .* Adventure therapy* Animal-assisted therapy* Aquatic therapy* Aromatherapy* Art and dementia* Art therapy* Authentic Movement* Behavioral therapy* Bibliotherapy* Buteyko Method* Chemotherapy...

 plan and manage the patient’s crisis. The Paramedic may provide adequate treatment that may resolve the crisis and may or may not refer the patient onto another health professional

Health care provider

A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....

. The Paramedic may continue treatment and provide patient transfer to an appropriate health care facility for ongoing referral and patient care."

Education & training

The Australian government regulates the training of all of those involved in emergency care by means of a series of numbered certificates, intended to provide a relatively common level of competencies. Many individuals possessing Certificates I-III may work in industrial first aid, for commercial first aid companies, or as non-emergency transporters. Certificate IV is the basic life support level which is regarded as the minimum entry level for emergency work in most statutory ambulance services.

First responder

Recently a new national certificate, Certificate II in Emergency Medical Response has been endorsed. The term is non-specific and is used by private first aid companies, volunteer organisations and workplaces to describe many levels of advanced first aid training.

Patient transport officers

Patient transport officers must, at a minimum, complete a course of training that will earn them a nationally recognised Certificate III in Non-Emergency Patient Transport.

Ambulance transport officer/attendant

Generally speaking, the statutory ambulance services in Australia require training to a Certificate IV level as the entry level for basic life support providers. The one exception to this is the State of Queensland, which still permits entry at the Certificate I level, or at Certificate IV. Though in other states like Victoria a Diploma of Paramedical Science (Ambulance), is required to transport more acute patients. This is possible with in either the state run ambulance service (AV), or with in some of the private ambulance transport companies.

Paramedic

Paramedics in Australia are all educated to advanced life support Level (ALS

Advanced Life Support

Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...

). The base qualification for a paramedic is a Bachelor's degree (in Health Science, Paramedic Science, Emergency Health or Paramedicine

Paramedicine

Paramedicine is the unique domain of practice that represents the intersection of health care, public health, and public safety. While discussed for many years, the concept of paramedicine was first formally described in the EMS Agenda for the Future. Paramedicine represents an expansion of the...

) or a post Graduate Diploma

Graduate Diploma

A Graduate Diploma is generally a postgraduate qualification, although some graduate diplomas involve the study of undergraduate level courses...

 (pre-Masters

Master's degree

A master's is an academic degree granted to individuals who have undergone study demonstrating a mastery or high-order overview of a specific field of study or area of professional practice...

 - for health professionals converting to paramedicine). Some paramedic degrees are dual, that is with another discipline, for example Bachelor of Paramedicine/Bachelor of Nursing.

In some states, paramedics can still undergo an in-service (post employment) diploma or Advanced Diploma level of education. Post-employment training is slowly being phased out in most states of Australia. Victoria and South Australia have completely ceased all in-service education with other states gradually reducing post-employment training as the supply of Graduate Paramedics from Universities meets Industry demands. Generally and increasingly, the standard for entry into practice requires graduation

Graduation

Graduation is the action of receiving or conferring an academic degree or the ceremony that is sometimes associated, where students become Graduates. Before the graduation, candidates are referred to as Graduands. The date of graduation is often called degree day. The graduation itself is also...

 from a university

University

A university is an institution of higher education and research, which grants academic degrees in a variety of subjects. A university is an organisation that provides both undergraduate education and postgraduate education...

.

Intensive care or Mobile intensive care ambulance (MICA) paramedic

Intensive care

Intensive care medicine

Intensive-care medicine or critical-care medicine is a branch of medicine concerned with the diagnosis and management of life threatening conditions requiring sophisticated organ support and invasive monitoring.- Overview :...

 (IC) paramedics, or Mobile Intensive Care Ambulance

Mobile Intensive Care Ambulance

Australian Mobile Intensive Care Ambulances are well-equipped ambulances staffed by highly trained paramedics dispatched to emergency situations where patients require a higher level of care than a regular ambulance can provide.- MICA Paramedics :...

 (MICA) paramedics, have completed post-graduate education that allows them to have a primary role of supporting paramedics by providing in-field stabilisation and mobile intensive care. Graduates have completed a university-level post-graduate diploma in Intensive Care Paramedical Practice, Emergency Health (MICA Paramedic) or equivalent in addition to their base qualification and graduate (internship) program.

Clinical scope of practice

Please note that these terms and qualifications

Professional certification

Professional certification, trade certification, or professional designation, often called simply certification or qualification, is a designation earned by a person to assure qualification to perform a job or task...

 vary slightly between states. These are the minimum qualifications, but some states require more advanced training to hold these positions. For example, in Victoria

Victoria (Australia)

Victoria is the second most populous state in Australia. Geographically the smallest mainland state, Victoria is bordered by New South Wales, South Australia, and Tasmania on Boundary Islet to the north, west and south respectively....

, "Ambulance Transport Attendants" (ATA) (who primarily work for non-emergency private companies) are now required to hold a Diploma

Diploma

A diploma is a certificate or deed issued by an educational institution, such as a university, that testifies that the recipient has successfully completed a particular course of study or confers an academic degree. In countries such as the United Kingdom and Australia, the word diploma refers to...

, and the term "Ambulance Paramedic" (Victoria) can also be referred to as "Advanced Care Paramedic" (Queensland

Queensland

Queensland is a state of Australia, occupying the north-eastern section of the mainland continent. It is bordered by the Northern Territory, South Australia and New South Wales to the west, south-west and south respectively. To the east, Queensland is bordered by the Coral Sea and Pacific Ocean...

).

First responder

In some locations, volunteer first responders are used by ambulance services to begin basic treatment before a paramedic arrives. Their training is a high standard of advanced first aid

First aid

First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...

. In some states volunteer "Ambulance

Ambulance

An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...

 Officers" have similar training to First Responders.

Patient transport officer

Patient transport officers (PTOs), or ambulance transport officers, provide non-emergency patient transport. PTOs provide a pre-booked, non-urgent service that includes home to hospital and hospital to hospital transfers. In some states, PTOs may occasionally be required to act as first responders to emergencies. This is usually limited to situations where it would take significantly longer for paramedics to arrive at the scene than a nearby patient transport crew, or patients that are assessed to be low-risk and require a low level of care in transit.

Ambulance officer / Ambulance transport attendant

This is the basic level of pre-hospital emergency care. These paramedics hold a Certificate IV Health Care (Ambulance) (previously known as Certificate IV in Emergency Care), or equivalent, and are trained in basic life support skills. Meanwhile, in Queensland, ambulance officers hold only Certificates I-IV in Basic Emergency Care. In Queensland, when entering the ambulance service, workers can enter at Certificate I Level and can work towards a new certification every year or, with the completion of a Bachelor degree

Bachelor's degree

A bachelor's degree is usually an academic degree awarded for an undergraduate course or major that generally lasts for three or four years, but can range anywhere from two to six years depending on the region of the world...

 in paramedics, can enter as a level V paramedic.

Paramedic

Paramedics practice includes all components of the basic life support

Basic life support

Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...

 level and the further enhancement of IV canulation, drug therapy

Medication

A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

 (oral, intramuscular injection

Intramuscular injection

Intramuscular injection is the injection of a substance directly into a muscle. In medicine, it is one of several alternative methods for the administration of medications . It is used for particular forms of medication that are administered in small amounts...

 (IM), intravenously

Intravenous therapy

Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...

 (IV), narcotic

Narcotic

The term narcotic originally referred medically to any psychoactive compound with any sleep-inducing properties. In the United States of America it has since become associated with opioids, commonly morphine and heroin and their derivatives, such as hydrocodone. The term is, today, imprecisely...

 pain relief, anti-emetics

Antiemetic

An antiemetic is a drug that is effective against vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer....

, cardiac arrest, respiratory drugs, etc.), fluid resuscitation

Fluid replacement

Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced via oral administration , intravenous administration, rectally, or hypodermoclysis, the direct injection...

, advanced airway management

Airway management

In cardiopulmonary resuscitation, anaesthesia, emergency medicine, intensive care medicine and first aid, airway management is the process of ensuring that:# there is an open pathway between a patient’s lungs and the outside world, and...

 (usually a laryngeal mask airway

Laryngeal mask airway

The laryngeal mask airway is a supraglottic airway device invented by Archie Brain, a British anaesthetist.-Description:Laryngeal masks consist of a tube with an inflatable cuff that is inserted into the pharynx. Laryngeal mask airways come in a variety of sizes ranging from large adult to infant...

 [LMA], or endotracheal intubation and Cricothyroidotomy

Cricothyrotomy

A cricothyrotomy is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by a foreign body, angioedema, or massive...

 in Western Australia) and the maintenance of infusions. Paramedics perform extensive physical assessment, blood examinations (e.g. random glucose test

Random glucose test

Random glucose test is a blood sugar test taken from a non-fasting subject.This test, also called random blood glucose , assumes a recent meal and therefore has higher reference values than the fasting glucose test.-Reference values:...

), interpret electrocardiogram

Electrocardiogram

Electrocardiography is a transthoracic interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the outer surface of the skin and recorded by a device external to the body...

s (ECG), SpO2, temperature, and provide care for a range of patients from the new born

Infant

A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...

 to the elderly

Old age

Old age consists of ages nearing or surpassing the average life span of human beings, and thus the end of the human life cycle...

.

Intensive care or Mobile intensive care ambulance (MICA) paramedic

IC or MICA paramedics are able to practice intensive care procedures such as endotracheal intubation, surgical airways, rapid sequence intubation

Rapid sequence induction

Rapid Sequence Induction is a medical procedure involving the expeditious induction of general anesthesia and subsequent intubation of the trachea. RSI is generally used in an emergency setting or for patients who have an increased risk of aspirating stomach contents into the lungs...

 (RSI), nasotracheal intubation, chest tube insertion, and drug infusions (e.g. Adrenaline

Epinephrine

Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...

, Salbutamol

Salbutamol

Salbutamol or albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It is marketed as Ventolin among other brand names....

, sedation

Sedation

Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure...

, thrombolytics

Thrombolytic drug

Thrombolytic drugs are used in medicine to dissolve blood clots in a procedure termed thrombolysis. They limit the damage caused by the blockage of the blood vessel.-Uses:...

 etc.). IC or MICA paramedics practice under clinical practice guidelines independently of medical control. The Council of Ambulance Authorities is currently lobbying for an expanded scope of practice to permit more primary care by advance care paramedics, including the role of paramedic as independent practitioner.

Rescue or Special Operations paramedic

Some ambulance services employ paramedics specially trained in rescue or special operations techniques. Officers can be trained in areas such as road crash rescue, vertical rescue, confined space

Confined space rescue

Confined space rescue is a subset of technical rescue operations that involves the rescue and recovery of victims trapped in a confined space or in a place only accessible through confined spaces, such as underground vaults, storage silos, storage tanks, or sewers.Confined space rescues can be...

 and trench rescue

Trench rescue

Trench rescue is a specialized form of rescue, a subset of confined space rescue. Trench rescue involves shoring up the sides of a trench, and digging a trapped worker out of a collapsed ditch. Trench rescue is one of the most dangerous rescue operations to complete....

. They learn navigation

Navigation

Navigation is the process of monitoring and controlling the movement of a craft or vehicle from one place to another. It is also the term of art used for the specialized knowledge used by navigators to perform navigation tasks...

 skills, four wheel driving, urban search and rescue

Urban search and rescue

Urban search and rescue involves the location, extrication, and initial medical stabilization of victims trapped in confined spaces due to natural disasters, structural collapse, transportation accidents, mines and collapsed trenches.USAR teams in different countries may be organised in a...

, and chemical biological and radiological procedures.

Flight paramedic

Flight paramedics work on fixed wing

Fixed-wing aircraft

A fixed-wing aircraft is an aircraft capable of flight using wings that generate lift due to the vehicle's forward airspeed. Fixed-wing aircraft are distinct from rotary-wing aircraft in which wings rotate about a fixed mast and ornithopters in which lift is generated by flapping wings.A powered...

 and helicopter

Helicopter

A helicopter is a type of rotorcraft in which lift and thrust are supplied by one or more engine-driven rotors. This allows the helicopter to take off and land vertically, to hover, and to fly forwards, backwards, and laterally...

 aircraft in many states, performing both emergency and routine transport operations. They are generally considered to be extremely highly trained in emergency medical care, but also aviation medicine

Aviation medicine

Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or persons involved in spaceflight...

, rescue and aviation emergencies. In some states this role is performed by a Flight Nurse or Flight Doctor with specialist qualifications in Intensive Care or Emergency Medicine who is then supported by a Flight Paramedic who is usually credentialed at IC or MICA level.

Employment

Paramedics are employed by various public and private service providers. The state run ambulance services are activated by the 000

000 emergency

Triple Zero is the primary national emergency number in Australia. The Emergency Call Service is operated by Telstra a condition of its telecommunications licence, and is intended only for use in life-threatening or time-critical emergencies...

 or 112 for mobile phone

Mobile phone

A mobile phone is a device which can make and receive telephone calls over a radio link whilst moving around a wide geographic area. It does so by connecting to a cellular network provided by a mobile network operator...

s) emergency number. Paramedics may respond to medical incidents in a conventional ambulance, sedan, 4WD, rescue vehicle, helicopter, fixed-wing aircraft, motorcycle

Motorcycle

A motorcycle is a single-track, two-wheeled motor vehicle. Motorcycles vary considerably depending on the task for which they are designed, such as long distance travel, navigating congested urban traffic, cruising, sport and racing, or off-road conditions.Motorcycles are one of the most...

 or even bicycle

Bicycle

A bicycle, also known as a bike, pushbike or cycle, is a human-powered, pedal-driven, single-track vehicle, having two wheels attached to a frame, one behind the other. A person who rides a bicycle is called a cyclist, or bicyclist....

 or foot

Walking

Walking is one of the main gaits of locomotion among legged animals, and is typically slower than running and other gaits. Walking is defined by an 'inverted pendulum' gait in which the body vaults over the stiff limb or limbs with each step...

 at large public gatherings. There are also private transport ambulances which are crewed by Patient Transport Officers (or sometimes Ambulance Attendants and/or nurses). They generally transport non-emergency patients between hospitals and other health settings such as nursing home

Nursing home

A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...

s. In Australia paramedic salaries can range anywhere from unpaid volunteer positions to over $100,000 a year, depending on location, experience, supervisory responsibilities and overtime.

Professional organisations

Paramedics Australasia (PA) is the professional college for paramedics and ambulance personnel. Industrial representation varies from state to state, the paramedic unions in Australia include the Ambulance Employees of Australia (AEA) which represents paramedics from Queensland, Victoria and Western Australia

Western Australia

Western Australia is a state of Australia, occupying the entire western third of the Australian continent. It is bounded by the Indian Ocean to the north and west, the Great Australian Bight and Indian Ocean to the south, the Northern Territory to the north-east and South Australia to the south-east...

. The [Health Services Union] is another in the industrial field.

The Emergency Medical Services Protection Association (EMSPA) represents a new chapter in Legal and Industrial representation and protection for Paramedics and employees. EMSPA is a professional organisation representing nearly 2000 paramedics in New South Wales, Queensland, and Victoria in industrial and other work-related matters. Established in 2005 by Ambulance Officers seeking improved representation on employment-related matters this association has been extremely successful in representing the rights and entitlements of Ambulance Officers since its inception and as a result continues to grow in membership numbers.

External links

• National Registry of Emergency Medical Technicians
• National Association of Emergency Medical Technicians
• NHTSA Emergency Medical Services National Page