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.