Paramedic
A paramedic is a healthcare professional trained in the medical model, whose main role has historically been to respond to emergency calls for medical help outside of a hospital. Paramedics work as part of the emergency medical services, most often in ambulances. They also have roles in emergency medicine, primary care, transfer medicine and remote/offshore medicine. The scope of practice of a paramedic varies between countries, but generally includes autonomous decision making around the emergency care of patients.
Not all ambulance personnel are paramedics, although the term is sometimes used informally to refer to any ambulance personnel. In some English-speaking countries, there is an official distinction between paramedics and emergency medical technicians, in which paramedics have additional educational requirements and scope of practice.Functions and duties
The paramedic role is closely related to other healthcare positions, especially the emergency medical technician, with paramedics often being at a higher grade with more responsibility and autonomy following substantially greater education and training. The primary role of a paramedic is to stabilize people with life-threatening injuries and transport these patients to a higher level of care. Due to the nature of their job, paramedics work in many environments, including roadways, people's homes, and depending on their qualifications, wilderness environments, hospitals, aircraft, and with SWAT teams during police operations. Paramedics also work in non-emergency situations, such as transporting chronically ill patients to and from treatment centers and in some areas, address social determinants of health and provide in-home care to ill patients at risk of hospitalization.
The role of a paramedic varies widely across the world, as EMS providers operate with many different models of care. In the Anglo-American model, paramedics are autonomous decision-makers. In some countries such as the United Kingdom and South Africa, the paramedic role has developed into an autonomous health profession. In the Franco-German model, ambulance care is led by physicians. In some versions of this model, such as France, there is no direct equivalent to a paramedic. Ambulance staff have either the more advanced qualifications of a physician or less advanced training in first aid. In other versions of the Franco-German model, such as Germany, paramedics do exist. Their role is very similar to the role of paramedics in the Anglo-American model with an advanced scope of autonomy and practice, and the added element of emergency physician backup, either virtually or on scene with a rapid response vehicle / helicopter. The role of paramedics in Germany has evolved from support to physicians in the field to the central role in pre-hospital emergency care.
The development of the profession has been a gradual move from simply transporting patients to hospital, to more advanced treatments in the field. In some countries, the paramedic may take on the role as part of a system to prevent hospitalization entirely and, through practitioners, are able to prescribe certain medications, or undertaking 'see and refer' visits, where the paramedic directly refers a patient to specialist services without taking them to hospital.Occupational hazards
Paramedics are exposed to a variety of hazards such as lifting patients and equipment, treating those with infectious disease, handling hazardous substances, and transportation via ground or air vehicles. Employers can prevent occupational illness or injury by providing safe patient handling equipment, implementing a training program to educate paramedics on job hazards, and supplying PPE such as respirators, gloves, and isolation gowns when dealing with biological hazards.
Infectious disease has become a major concern, in light of the COVID-19 pandemic. In response, the U.S. Centers for Disease Control and Prevention and other agencies and organizations have issued guidance regarding workplace hazard controls for COVID-19. Some specific recommendations include modified call queries, symptom screening, universal PPE use, hand hygiene, physical distancing, and stringent disinfection protocols. Research on ambulance ventilation systems found that aerosols often recirculate throughout the compartment, creating a health hazard for paramedics when transporting sick patients capable of airborne transmission. Unidirectional airflow design can better protect workers.
To further safeguard paramedics, incorporating evidence-based strategies for managing chemical exposures and environmental risks is crucial. Agencies such as OSHA, WHO and NIOSH offer comprehensive guidelines that highlight the integration of safety protocols, technological advancements, and procedural innovations to enhance paramedic safety and well-being.Physical injuries
Paramedics are widely recognized to face high risks of physical injuries in their line of work. More than 22,000 EMS providers visit the emergency room each year for work-related injuries. Some physical injuries encountered when providing healthcare services include lifting injuries, back strains, and needlestick incidences. Injuries such as sprains and strains mostly occur in the back and neck, and injuries are most prevalent while responding to 911 calls, which include patient care and transport. These injuries are prevalent but not impossible to overcome; they require preventive measures to minimize the chance of them happening. Safe lifting techniques and patient-handling equipment are major factors in reducing paramedics' physical injury risk. Workers with less than 10 years' experience are most at risk, pointing to the need for targeted prevention strategies for newer employees. By employing the proposed measures to reduce physical injuries, it will be possible to mitigate the hazards faced by paramedics, to help paramedics stay safe while rendering the most needed services.Infectious diseases
The risk of contracting infectious diseases is common in the paramedic profession. The COVID-19 pandemic strengthens the necessity of following safety protocols. Preventive measures for healthcare workers from needlestick injuries and infectious disease is critical. Including, the immediate disposal of sharps in puncture-resistant containers and wearing appropriate personal protective equipment and strict adherence to post-exposure protocols, enhances safety. Additionally, staying updated with vaccinations, including those for flu, COVID-19, Hepatitis B. Furthermore, adhering to infection control practices, such as hand hygiene, environmental cleaning, and specialized control programs, are vital for preventing infections like MRSA, TB, and COVID-19. Personal Protective Equipment usage in implementation and vaccination compliance are effective transmission reduction measures for infectious diseases among paramedics. Exposures to blood pathogens and body fluids through incidents, for example, needlestick injuries which jeopardizes paramedics at risk of infectious diseases such as Hepatitis B, and Hepatitis C, and HIV affecting around 6,000 EMS workers. This realization strengthens the need for science-based methods in preventing the occupational risks posed by infectious diseases with a foregrounding of the role of preventative measures geared towards protecting the health of paramedic professionals and, at the same time, the community.Chemical exposures
Paramedics encounter daily risks associated with handling hazardous chemicals. As a result, they must understand how to deliver care safely to remain protected in the service provision. They need to remain cautious for them to stay safe in the process of providing care. There are numerous associated risks from chemical exposures in prehospital settings. The use of PPE and standard precautions are necessary to prevent harmful exposures for paramedics. Desirable implementation of the ordered processing of hazardous material and the proper decontamination process are effective strategies in combating hazard risk. Such steps are necessary to ensure fewer cases of health hazards to paramedics.Environmental and operational hazards
Paramedics are confronted with many challenges exhibited in the form of environmental and operational risks, primarily during transportation. These transportation-related hazards should be considered and addressed in prehospital care. Slips, trips, and falls; motor vehicle incidents; and violence or assaults have huge impact on paramedics' occupational hazards, resulting to thousands of paramedics impacted annually. Vehicle safety features need to be known by paramedics, and so must undergo exhaustive emergency driving training, which looks into curbing the provisions that are the peril of transportation. Paramedics are frequently assaulted by patients or bystanders affecting around 2,000 EMS workers annually, which further hammers the need for training on de-escalation. NIOSH and the Department of Homeland Security have conducted ambulance crash testing, resulting in the development of 10 test methods published by the Society of Automotive Engineers to reduce and eliminate crash-related injuries to EMS workers. Through effective training, the threat cases are more likely to be mitigated, and the paramedics will have a better chance to provide services as required.Protective measures and equipment
One way of ensuring paramedics work at optimal efficiency is to provide them with protective equipment and gear to mitigate the possible risks when executing their duties. PPE keeps paramedics' occupational risks low. Examples of PPEs include gloves, masks, and gown or specific clothing; they protect workers from physical, biological, and chemical hazards. The different types of PPE include respiratory, eye, face, and hand protection. Under respiratory protection, paramedics can use N95 masks to filter airborne contaminants. Chemical splashes are also a common hazard faced by paramedics, where safety goggles can be used for eye protection. Underhand protection, paramedics can employ gloves mainly to curb burns. One of the principles of PPE is that choices should be guided by specific risks associated with various emergencies, which warrant different PPE requirements.