Paramedicine

“Paramedics commonly facilitate medical decisions at an emergency scene and during transport. Paramedics work in a variety of specialty care settings including but not limited to ground and air ambulances, occupational, in hospital, and community settings. Academic preparation enables paramedics to use a wide range of pharmacology, airway, and monitoring devices as well as to utilize critical thinking skills to make complex judgments such as the need for transport from a field site, alternate destination decisions, the level of personnel appropriate for transporting a patient, and similar judgments.” (National EMS Scope of Practice Model 2019)

· Use sound judgment to perform patient assessments and therapeutic procedures and modalities.

· Use critical thinking skills to assess and treat patients in emergency settings and to communicate effectively in a healthcare setting.

· Pass the National Registry of EMT's paramedic practical and written examination.

· Demonstrate the personal and professional ethics and interpersonal skills that are expected in the workplace.

· Be aware of drug reactions and the synergistic effects of drugs combined with other medicines and in some instances, food.

· Be aware of the possible risks of medication administered to a pregnant mother and the fetus, keeping in mind those drugs may cross the placenta.

· Be cognizant of the impact of medications on pediatric patients based on size and weight, special concerns related to newborns and geriatric patients, and the physiological effects of aging such as the way skin can tear in the geriatric population with relatively little to no pressure.

· Be aware of the high abuse potential of controlled substances and the potential for addiction, be able to thoroughly report writing and to justify why a particular narcotic was used and why a particular amount was given.

· Have the ability to measure and re-measure drip rates for controlled substances and medications.

· Be able to apply basic principles of mathematics to the calculation of problems associated with medication dosages, perform conversion problems, and differentiate temperature readings between centigrade and Fahrenheit scales.

· Be able to use proper advanced life support equipment and supplies based on patient's age and condition of veins.

· Be able to locate sites for obtaining blood samples and perform this task.

· Be able to administer medication intravenously, administer medications by gastric tube, administer oral medications, administer rectal medications, and comply with universal precautions and body substance isolation, disposing of contaminated items and equipment properly.

· Be able to apply knowledge and skills to assist overdosed patients to overcome trauma through antidotes and have knowledge of poisons and be able to administer treatment.

· Be knowledgeable as to the stages drugs/medications go through once they have entered the patient's system.

· Be cognizant that the route of administration is critical in relation to patient's needs and the effect that occurs.

· Be capable of providing advanced life support emergency medical services to patients, including conducting of and interpreting electrocardiograms (EKGs), electrical interventions to support the cardiac functions, performing advanced endotracheal intubations in airway management and relief of pneumothorax and administering appropriate intravenous fluids and drugs under direction of an off-site designated physician.

· Remain calm when working in difficult and stressful circumstances and capable of staying focused while assuming the leadership role inherent in carrying out the functions of the position.

· Have good judgment along with advanced knowledge and technical skills to direct other team members to assist as needed.

· Deal with adverse and often dangerous situations, which include responding to calls in districts known to have high crime and mortality rates.

· Have self-confidence and a desire to work with people.

· Have solid emotional stability, a tolerance for high stress, and the ability to meet the physical, intellectual, and cognitive requirements demanded by this position.

· Have good physical stamina, endurance, and body condition that would not be adversely affected by frequently having to walk, stand, lift, carry, and balance weight that is at times in excess of 125 pounds.

· Have motor coordination because over uneven terrain, the well-being of the patient, paramedic and other workers must not be jeopardized.

· Be flexible to meet the demands of the ever-changing emergency scene. When emergencies exist, the situation can be complex and care of the patient must be started immediately.

· Use advanced training and equipment to extend emergency physician services to the ambulance.

· Make accurate independent judgments while following oral directives.

· Perform duties in a timely manner is essential, as it could mean the difference between life and death for the patient.

· Use telephone or radio dispatch for coordination of prompt emergency services.

· Accurately discerning street names through map reading and correctly distinguishing house numbers or business addresses.

· Concisely and accurately describing orally to dispatchers and other concerned staff one's impression of a patient's condition as the paramedic works in emergency conditions where there may not be time for deliberation.

· Be able to accurately report orally and in writing all relevant patient data. At times, reporting may require a detailed narrative on extenuating circumstances or conditions that

go beyond what is required on a prescribed form. In some instances, the paramedic may be required to enter data on a laptop while riding in an ambulance.

· Use verbal skills and reasoning skills.