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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.
[1] Paramedicine represents an expansion of the traditional notion of
emergency medical services
as simply an emergency response system. Paramedicine is the totality
of the roles and responsibilities of individuals trained and
credentialed as EMS practitioners. These practitioners have been
referred to as various levels of Emergency Medical Technician (EMTs).
[2] In the United States
paramedics
represent the highest practitioner level in this domain. Additional
practitioner levels in this domain within the U.S. include Emergency
Medical Responders (EMRs), Emergency Medical Technicians (EMTs) and
Advanced Emergency Medical Technicians (AEMTs).
[3]
Paramedicine is a
health profession
focused on assisting individuals, families, and communities in
attaining, re-attaining, and maintaining optimal health, often following
acute or sudden onset of medical or traumatic events. Paramedicine is
practiced predominantly in the out of hospital setting. The practice of
paramedicine is based on the sciences of human
anatomy,
physiology, and
pathophysiology.
The goal of paramedicine is to promote optimal quality of life, as
defined by persons and families, throughout their life experiences, from
birth to care at the end of life.
The practice of paramedicine includes tasks such as independent
decision making, often in the face of incomplete, ambiguous and
conflicting information. Examples of such decision making include
response readiness, scene management, patient assessment, clinical
problem solving, emergency vehicle operations, leadership, planning,
therapeutic communications, disposition decisions, patient education and
resource coordination. The practice of paramedicine involves the
application of concepts of medical care under challenging, uncontrolled,
and austere conditions.
[citation needed]
In addition to the independent portion of practice, paramedicine
involves the performance of medical skills and tasks which are regulated
by law. In the United States such regulated tasks (i.e. starting an
IV,
administering a medication, performing invasive tasks, etc.), the
practice of paramedicine is performed under the direction of a licensed
physician (MD/DO). In some states, such as Texas, a paramedic is
considered an unlicensed assistive personnel in the clinic, hospital or
out-patient care setting, whilst in the United Kingdom, paramedics have
complete autonomy, and can practice as independent clinicians, able to
confirm death, administer controlled drugs and prepare treatments for
patients as they deem fit. UK paramedics practice under their own
licence, as regulated by the
Health and Care Professions Council [4]
Various governments have different rules regulating the overall
responsibility, delegation of tasks and the role of the paramedic
outside of the field.
Paramedicine is based on the emerging concept of paramedic theory
which is the study and analysis of how the three pillars of paramedicine
(health care/medicine, public health, and public safety) interact and
intersect. As stated in the IoM Report EMS at the Crossroads (2006),
EMS is currently highly fragmented and largely separated from the
overall health care system.
[5]
A major emphasis of paramedic theory is the integration of emergency
medical services, both intra-professionally and extra-professionally.
Intra-professional integration is the study of resource allocation,
distribution, deployment and efficiency. Extra-professional study
involves the integration of EMS with the nation's existing (and future)
emergency care and health care system.
Other areas of inquiry in paramedic theory are: emergency
response, response planning, community education, transport medicine,
disaster preparedness/response,
emergency management,
pandemic and
epidemic, emergency response planning, special operations, medical aspects of rescue, etc.
See also
Paramedicine is the unique domain of practice that represents
the
intersection of health care, public health, and public safety...
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