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Advanced Practice Paramedic Training Expands Emergency Medical Services

By Sally Delacruz


In most large urban areas people pay little attention to the constant background noise of ambulance sirens until they actually need an emergency service. Acute medical situations happen at all hours, and citizens have come to rely on well-trained personnel to treat them on site, as well as en route to the hospital. The people who make this service possible save hundreds of lives each year, making a strong case for advanced practice paramedic programs.

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.

That was an era when car wrecks killed more people than wars, making the need for expanding those services seem obvious. When funding began in the 1970s, it laid the groundwork for the current network response structure. At that time, the goal was formally stated as being a speedy response to a crisis, care as needed for those who are affected, and medical support while en route to a hospital emergency room.

Today, the same front lines are manned by two different levels of personnel. Emergency medical technicians (EMTs) are considered to be entry level workers, and comprise the largest group of responders. Training for this position is extensive and comprehensive, and they are often the first to arrive at the scene. Both basic and intermediate level EMT technicians, however, are prevented from taking certain actions.

An actual paramedic performs similar functions, but without as many restrictions. They are not considered doctors, but have been formally trained in anatomy, physiology, and cardiology, and are knowledgeable in the latest techniques for resuscitating and saving the lives of people having heart attacks. They routinely administer intravenous solutions, know how to clear air pathways, and can inject medications.

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.

More education and higher certification levels can prevent many emergencies before they happen. Besides answering crisis calls, these upper-level paramedics would also visit patients in their homes, assist in educating people about their conditions, and helping to monitor the diseases that most often need acute care, such as heart failure, diabetes, and asthma. This practice also frees additional workers for actual emergency response.

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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