Thursday, June 12, 2014

Advanced Practice Paramedic Training Benefits Emergency Medical Response

By Sally Delacruz


The distant wail of ambulance sirens is an unremarkable phenomenon in most big cities, but the assistance they provide is anything but routine. A critical medical situation can happen at any hour, and citizens rely on emergency medical technicians for on-site treatment and transport to a hospital. The trained workers who make this possible save multiple lives each year, and reflect a growing need for advanced practice paramedic services.

In earlier times there were few options for treating victims in the field. Even as recently as the 1960s, only a few locations had actual published lists of the standards and practices required and allowed for emergency personnel, and prior to cell phones some ambulances did not even have mobile 2-way radio. First responders were Red Cross certified, but received little classroom medical training.

During that period auto accidents killed more people than wars, and the need for advanced field treatment specialists with advanced emergency training became obvious. By the 1970s funding was established, and the current network of services had begun to coalesce. The goal was was to respond quickly to a crisis, providing care both at that location and in an ambulance en route to an emergency room.

Today there are two primary categories of personnel working on the front lines. EMT (Emergency Medical Technicians) are the most common, and are considered to the be entry level technicians. Training is comprehensive and extensive, and these individuals are often the first to arrive. Both basic and intermediate EMT personnel can help patients up to a specific point, but cannot inject medications or break skin.

Paramedics perform similar tasks, but their scope of practice is far less restricted. Although not actually doctors, they have received additional training in cardiology, physiology and anatomy, in addition to the latest field emergency medical procedures used to resuscitate heart attack victims. They are authorized to clear airways, administer intravenous solutions, and inject drugs. Many began as EMTs.

The current emergency system is light years ahead of the old, but is still retains the same structure. There is a genuine need for another level of expertise in the field, and extending the training and capabilities of paramedics is considered a logical next step. The concept was actually conceived many years ago, but was dropped for various reasons, including political and hierarchical concerns.

This additional level of training actually helps prevent emergencies. Besides performing standard crisis work, these paramedics are also able to more readily make home visits that involve patient education and monitoring, helping to control serious conditions that often lead to a crisis, such as asthma, diabetes, or heart failure. This not only helps prevent emergencies from developing, but also frees personnel to treat other life-threatening occurrences.

Creating these positions not only fills a service gap, but also opens up a career pathway for interested paramedics. Because there has traditionally been no room for advancement, paramedics have increasingly abandoned emergency specialties in favor of actual hospital positions. Retaining the best and brightest field responders not only helps those in need, but also improves the overall system.




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