Paramedic

Paramedics mainly work as part of the emergency medical services (EMS), most often in ambulances.

They can rapidly transport paramedics and other first responders to the scene, carry equipment for administering emergency care and transport patients to hospital or other definitive care.

An early example was the members of the Toronto Police Ambulance Service receiving a mandatory five days of training from St. John as early as 1889.

The service introduced its first paramedics in 1984 (although experiments in pre-hospital advanced life support actually began in 1969).

In English-speaking countries, there is an official distinction between paramedics and emergency medical technicians (or emergency care assistants), in which paramedics have additional qualifications and are accountable to a professional regulatory body.

An emergency care assistant (ECA) is a type of NHS ambulance service worker in the United Kingdom, often used to support paramedics in responding to emergency calls.

This concept developed into the television series Emergency!, which ran from 1972 to 1979, portraying the exploits of this new profession called paramedics.

The series stars Randolph Mantooth and Kevin Tighe as two rescuers, who work jointly as paramedics and firefighters in the Los Angeles metropolitan area.

The show's technical advisor, James O. Page, was a pioneer of paramedicine and responsible for the UCLA paramedic program; he would go on to help establish paramedic programs throughout the US, and was the founding publisher of the Journal of Emergency Medical Services (JEMS).

In the United States paramedics represent the highest practitioner level in this domain.

While doing background research at Los Angeles' UCLA Harbor Medical Center for a proposed new show about doctors, television producer Robert A. Cinader, working for Jack Webb, happened to encounter "firemen who spoke like doctors and worked with them".

Robert A. Cinader (November 10, 1924 – November 16, 1982) was an American television producer best known for his work on two NBC series packaged by actor/producer Jack Webb's Mark VII Limited, Adam-12 and Emergency! The latter show in particular was widely credited by observers as one of the most important efforts to promote the widespread adoption of paramedic services by fire departments and hospitals in the U.S.

During the American Civil War, Jonathan Letterman devised a system of mobile field hospitals employing the first uses of the principles of triage.

In advanced triage systems, secondary triage is typically implemented by emergency nurses, skilled paramedics, or battlefield medical personnel within the emergency departments of hospitals during disasters, injured people are sorted into five categories.

In the United States, a similar system is operated by the National Registry of Emergency Medical Technicians (NREMT), although this is only accepted by forty of the fifty states.

The Registry recognizes four levels of EMS: EMR, EMT, EMT-Advanced, and Paramedic (some states and agencies may have additional certifications such as Critical Care Paramedic, Flight Paramedic, and Community Paramedic).

Paramedics manage and provide medical guidelines in mass casualty incidents.

Initially, the senior paramedic at the scene will be in charge of the incident, but as additional resources arrive, a senior officer or chief will take command, usually using an incident command system structure to form a unified command to run all aspects of the incident.

Paramedics mainly work as part of the emergency medical services (EMS), most often in ambulances.

In English-speaking countries, they are known as emergency medical technicians (EMTs) and paramedics, with the latter having additional training such as advanced life support (ALS) skills.

For instance, in Canada, the province of British Columbia operates a province-wide service (the British Columbia Ambulance Service) whereas in Ontario, the service is provided by each municipality, either as a distinct service, linked to the fire service, or contracted out to a third party.

As of 2018, the BCAS employs 4,750 part-time and full-time paramedics and dispatchers.

As a part of Emergency Medicine Reform in 2017 Ministry of Healthcare introduced two specialties — "paramedic" and "emergency medical technician".

The reforms inaugurated by the publication of "The White Paper" led to higher quality care provided on-scene and in-transit by trained paramedics and EMTs.

In Israel, paramedics are trained in either of the following ways: a three-year degree in Emergency Medicine (B.EMS), a year and three months IDF training, or MADA training.

Although MDA currently staffs approximately 2,000 emergency medical technicians, paramedics and emergency physicians, it still relies heavily on over 15,000 volunteers who serve in both operational and administrative capacities.

In English-speaking countries, there is an official distinction between paramedics and emergency medical technicians (or emergency care assistants), in which paramedics have additional qualifications and are accountable to a professional regulatory body. As a part of Emergency Medicine Reform in 2017 Ministry of Healthcare introduced two specialties — "paramedic" and "emergency medical technician".

An ambulance with only EMTs is considered a Basic Life Support (BLS) unit, an ambulance utilizing AEMTs is dubbed an Intermediate Life Support (ILS), or limited Advanced Life Support (LALS) unit, and an ambulance with Paramedics is dubbed an Advanced Life Support (ALS) unit.

In 1969, the City of Columbus Fire Services joined together with the Ohio State University Medical Center to develop the "HEARTMOBILE" paramedic program under the medical direction of James Warren, MD and Richard Lewis, MD. In 1969, the Haywood County (NC) Volunteer Rescue Squad developed a paramedic program (then called Mobile Intensive Care Technicians) under the medical direction of Ralph Feichter, MD. In 1969, the initial Los Angeles paramedic training program was instituted in conjunction with Harbor General Hospital, now Harbor–UCLA Medical Center, under the medical direction of J. Michael Criley, MD and James Lewis, MD. In 1969, the Seattle "Medic 1" paramedic program was developed in conjunction with the Harborview Medical Center under the medical direction of Leonard Cobb, MD. The Marietta (GA) initial paramedic project was instituted in the Fall of 1970 in conjunction with Kennestone Hospital and Metro Ambulance Service, Inc. under the medical direction of Luther Fortson, MD. The Los Angeles County and City established paramedic programs following the passage of The Wedsworth-Townsend Act in 1970.

He was also instrumental in the development of the Los Angeles County Fire Department's Paramedic program in 1969.

While both of these experiments had certain levels of success, the technology had not yet reached a sufficiently advanced level to be fully effective; for example, the Toronto portable defibrillator and heart monitor was powered by lead-acid car batteries, and weighed around 45 kg.

In the United States, many advanced EMTs and all paramedics are trained to recognize lethal arrhythmias and deliver appropriate electrical therapy with a manual defibrillator when appropriate.

In 1969, the City of Columbus Fire Services joined together with the Ohio State University Medical Center to develop the "HEARTMOBILE" paramedic program under the medical direction of James Warren, MD and Richard Lewis, MD. In 1969, the Haywood County (NC) Volunteer Rescue Squad developed a paramedic program (then called Mobile Intensive Care Technicians) under the medical direction of Ralph Feichter, MD. In 1969, the initial Los Angeles paramedic training program was instituted in conjunction with Harbor General Hospital, now Harbor–UCLA Medical Center, under the medical direction of J. Michael Criley, MD and James Lewis, MD. In 1969, the Seattle "Medic 1" paramedic program was developed in conjunction with the Harborview Medical Center under the medical direction of Leonard Cobb, MD. The Marietta (GA) initial paramedic project was instituted in the Fall of 1970 in conjunction with Kennestone Hospital and Metro Ambulance Service, Inc. under the medical direction of Luther Fortson, MD. The Los Angeles County and City established paramedic programs following the passage of The Wedsworth-Townsend Act in 1970.

A similar situation existed in the Crusades, with the Knights Hospitaller of the Order of St. John of Jerusalem filling a similar function; this organisation continued, and evolved into what is now known throughout the Commonwealth of Nations as the St. John Ambulance and as the Order of Malta Ambulance Corps in the Republic of Ireland and various countries.

A properly positioned tube in the trachea guards the patient's airway and enables the paramedic to breathe for the patient.

Within the UK training is a three-year course equivalent to a bachelor's degree.

The Bachelor of Paramedicine (BScP, BP, BHScP) is a three- to a five-year undergraduate degree that prepares students for a career in paramedicine, paramedic services or emergency medical services.

While doing background research at Los Angeles' UCLA Harbor Medical Center for a proposed new show about doctors, television producer Robert A. Cinader, working for Jack Webb, happened to encounter "firemen who spoke like doctors and worked with them".

Later in the 1971–72 season, Webb and Cinader launched Emergency!, a spin-off of Adam-12, which focused on the fictional Station 51 Rescue Squad of L.A. County Fire Department, which also featured one of the first paramedic units, and its work in conjunction with the emergency department staff of the fictional Rampart General Hospital.

This usually means that paramedics must be registered with the appropriate body in their country; for example all paramedics in the United Kingdom must by registered with the Health Professions Council in order to call themselves a paramedic.

In 1966, a report called Accidental Death and Disability: The Neglected Disease of Modern Society—commonly known as The White Paper—was published in the United States.

The reforms inaugurated by the publication of "The White Paper" led to higher quality care provided on-scene and in-transit by trained paramedics and EMTs.

For instance, in Canada, the province of British Columbia operates a province-wide service (the British Columbia Ambulance Service) whereas in Ontario, the service is provided by each municipality, either as a distinct service, linked to the fire service, or contracted out to a third party.

Firefighters are cross-trained as emergency medical responders, emergency medical technicians, or paramedics.

This research then drove further evolution of the practice of both paramedics and the emergency physicians who oversaw their work, with changes to procedures and protocols occurring only after significant research demonstrated their need and effectiveness (an example being ALS).

In out-of-hospital settings trained emergency medical technicians, paramedics or medics typically provide this level of care.