Paramedic

From Wikipedia, the free encyclopedia

A Paramedic is a specialized health care professional who responds to medical and trauma emergencies in the pre-hospital (out-of-hospital) environment, provides emergency treatment and, when appropriate, transports a patient to hospital for further assessment or follow-up care. Paramedics may also work in a hospital emergency department alongside nurses and doctors.

Paramedics are employed by a variety of different agencies: by government (as part of a public hospital system, as a separate ambulance/paramedic service, or sometimes, especially in the United States, as part of a fire department or county ambulance service) or by private sector organizations (private hospitals, private ambulance companies). Paramedics also work in other settings (e.g., emergency departments, hospital inpatient units, medical clinics, doctors' offices, oil rigs, steel mills, and casinos). Depending on the system, paramedics may work with either another paramedic or less highly trained staff known as an ambulance driver or an ambulance attendant (in most countries) or EMTs (in the US UK). In Canada, Paramedics are highly trained and work only with a Paramedic of the same level or higher. In Canada there are 3 levels of Paramedics.

Historically, paramedics have functioned under the authority and indirect supervision of a physician, both through standing protocols (off-line medical control) or through direct physician consultation via phone or radio (on-line medical control). In many modern jurisdictions this "medical control" has been deemphasized or eliminated as paramedicine matures into a stand-alone profession.

Contents 1 Skills performed by paramedics in the U.S. 2 In the media 3 See also 4 References 5 External links

[edit] Skills performed by paramedics in the U.S.

Some of the many skills performed (as permitted by local protocol):

• Basic Life Support
• Advanced Cardiac Life Support - ACLS
• Pediatric Advanced Life Support - PALS
• Prehospital Trauma Life Support - PHTLS or Basic or Advanced Trauma Life Support - BTLS or ATLS
• Provide advanced cardiac care, including:
  • Manual defibrillation;
  • Synchronized cardioversion;
  • Transcutaneous pacing;
  • Electrocardiogram monitoring and interpretation, including 12-lead ECG;
• Provide basic and advanced airway management, including:
  • Visualize the airway by use of the laryngoscope and remove foreign bodies with Magill forceps;
  • Perform endotracheal and nasotracheal intubation, (including use of the Eschmann catheter);
  • Perform retrograde intubation;
  • Perform Rapid Sequence Intubation (generally known as RSI);
  • Perform surgical cricothyroidotomy;
  • Perform needle cricothyrotomy/transtracheal jet insufflation;
• Establish vascular access for medication administration and fluid resuscitation via several routes:
  • Peripheral intravenous cannulation;
  • Intraosseous cannulation (placement of needle into marrow space of a large bone), by hand, with a drill or spring-loaded device;
• Utilize noninvasive diagnostic devices such as pulse oximetry and capnography;
• Perform needle thoracotomy for tension pneumothorax;
• Administer medications via intramuscular, subcutaneous, intravenous, sublingual, endotracheal, rectal, oral, intranasal, intraosseous and buccal routes
• Use of glucometry for diabetic patients
• Obtain venous blood samples
• Ventilator and IV pump management

Paramedics administer a variety of emergency medications; the individual medications vary widely based on medical director preference, local standard of care, and state law. These drugs range from calcium channel blockers that slow the heart rate to sympathomimetics like dopamine for severe hypotension (low blood pressure). They may also administer elective medications such as those which relieve pain or decrease nausea and vomiting. Nitroglycerin, aspirin, and morphine may be administered for chest pain. Other medications are used to treat cardiac conditions such as a myocardial infarction and various dysrhythmias.

[edit] In the media

The 1970's television show Emergency! was a very popular series which centered around the work of paramedics in the Los Angeles County Fire Department, and the staff at the fictional Rampart Emergency Hospital. Emergency! has been widely credited with inspiring many municipalities to develop their own paramedic programs, and has inspired many to enter the fields of emergency medicine. The show was a top rated program for its entire production run (1972 - 1979), as well as in syndicated television reruns -- even inspiring a Saturday morning cartoon series.

Paramedics is also the name of a show on the Discovery Health Channel, which details the life and work of emergency medical squads across the country. It is also the name of a 1988 Comedy which highlighted the lighter side of EMS.

Paramedic: On the Front Lines of Medicine (1998), by Peter Canning, is an autobiographical account of a paramedic's first year on the job. Rescue 471: A Paramedic's Stories (2000) is the sequel.

Bringing Out the Dead (1999), directed by Martin Scorsese and starring Nicholas Cage is one of very few films about paramedics. The main character is paramedic Frank Pierce who works in Gotham's Hell's Kitchen. He's become burned out and haunted by visions of the people he's failed to save including a little girl.

Parts of Third Watch (1999) were devoted to adventures of the fictional 55th precinct FDNY EMS unit, created by ER executive producer John Wells.

Saved (2006), a television series centered around paramedic Wyatt Cole (Tom Everett Scott), his partner, and their chaotic lives on and off the job.

[edit] See also

• Paramedics in Canada
• Paramedics in France
• Paramedics in Germany
• Paramedics in the United States of America
• Paramedics in the United Kingdom
• Paramedics in Australia
• Paramedics in Turkey

[edit] References

• American Heart Association (Jan. 2006)
• Meisel, Zachary (2005-11-08). Ding-a-Ling-a-Ling— Ambulances can be dangerous places.. Slate. Washington Post.Newsweek Interactive Co. LLC. Retrieved on 2007-01-25.
• Tribute to R Adams Cowley, M.D.. University of Maryland Medical Center. Retrieved on 2005-12-30.

[edit] External links

• National Registry of Emergency Medical Technicians
• National Association of Emergency Medical Technicians
• Nationwide Directory of Paramedic Schools