I’ve seen the future, brother…

Shock
Gut Check. It’s been over a year since I posted “Do we need paramedics?” . The recent decision of the London Ambulance Service in England to remove endotracheal intubation from paramedic protocols will prove to be an interesting case study. Buckman has also proselytized on his blog about how many patients we encounter in the prehospital environment do not need Advanced Life Support.

Over the next year the need for paramedics in the prehospital setting will be tested. I did not say if paramedics will be needed on ambulances. Despite the sinking feeling that all our fancy skills will be taken from us, paramedics will always be needed to transport patients between facilities (unless they just hire all nurses to replace medics, but that’s not cost effective). The ICU transports, patients on ventilators and transports from rural emergency departments to definitive care facilities will still require ALS (even if all we do is some hand holding and equipment gazing). Keep your eyes on the news coming from London Ambulance Service.

Where will paramedics be in the future?  I believe that the future of paramedicine is in public health. The community paramedic program is where we are headed. A few agencies with the vision have already started employing preventative medicine. Western Eagle County Ambulance District in Colorado have just completed the didactic portion of their community paramedic program. Wake County EMS in North Carolina are using Advanced Practice Paramedics. Learn more about Community Paramedics and the International Roundtable on Community Paramedicine.

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About Joel

I am a paramedic, firefighter and I work for an organ procurement organization. All stories related to work have been altered to HIPPA standards and for the protection of those involved. The personal stories are different. Photography, flying, aviation, hiking, camping, travel, geocaching, amateur radio are a few of my hobbies.
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2 Responses to I’ve seen the future, brother…

  1. Buckman says:

    Kind of sad since you just got your cert from one of my classes, eh? Oh well. What are you going to do? I think you are on to something though. I have been thinking lately that the national certifications should change. There should be one EMT cert that is somewhere between EMT and Paramedic. And there should be a new Transport/Community Medic that has a VERY different education and a very different job description. But I haven’t worked out the kinks and haven’t posted. So lately I am just driving around never using my skills.

    • rescuemonkey says:

      Sad? Or was I better prepared for the world of prehospital medicine? I believe that many EMS personnel will achieve this reality as well. Paramedics are better utilized filling in the gaps of general practice medicine. The Community Paramedic program is the future of our profession. Doctors are unwilling to treat patients at their homes, unwilling to treat patients under their care in Nursing Homes.

      Agencies providing 911/999 service will still need to have a few paramedics for the rare times we can make a difference. The best use of Paramedics in a 911 service is to have them in Rapid Response cars (like the UK system) triaging the PTs and making transport decisions. EMT-A with a EMT-B can do the transports. Train the medics like Physician’s Assistants & allow them to treat common problems on the scene. Chris Kaiser over at lifeunderthelights.com has a few good posts about the educational needs of paramedics in the future.

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