Paramedic (not fireline qualified)

The Paramedic provides emergency medical services (EMS) at the medical unit and/or other incident locations as requested by the Incident commander or representative.

Introduction

The Paramedics primary focus is to provide advanced emergency medical care for injured and sick persons.  The position has the knowledge associated with, and is expected to be competent in all of the skills of the EMT, and AEMT.  A Paramedic completes a more thorough course of education, which in some states requires the completion of an Associate’s degree.  The paramedic has an in-depth understanding of human anatomy, physiology and pathophysiology which allows them to perform more advanced skills and a broader spectrum of medications than either an EMT or AEMT.  These skills carry a greater risk for the patient if improperly or inappropriately performed, are more difficult to attain and maintain competency in, and require significant background knowledge in basic and applied sciences.

While all Paramedics receive essentially the same training, the specific procedures that each individual Paramedic is authorized to perform varies depending on the Paramedic’s scope of practice.  A Paramedic’s scope of practice contains only those procedures for which he or she is educated, certified (by passing an exam), credentialed (medical director grants “permission” to practice), and licensed by a state to perform.  Therefore, the scope of practice of a Paramedic will vary by individual.

Skills, Knowledge, and Abilities

The following are the minimum psychomotor skills of the Paramedic:

• Airway and Breathing
  • Performs endotracheal intubation
  • Performs percutaneous (not to include ‘surgical’ access using a scalpel) cricothyrotomy
  • Decompresses the pleural space of the chest cavity
  • Performs gastric decompression
  • Monitors and interprets Patient oxygen and carbon dioxide levels
• Pharmacological interventions include
  • Inserts an intraosseous (IO) cannula
  • Enteral and parenteral administration of approved prescription medications
  • Accesses indwelling catheters and implanted central IV ports for fluid and medication administration
  • Administers medications by intravenous (IV), intraosseous, intramuscular, intranasal, sublingual, and subcutaneous routes
  • Maintains an infusion of blood or blood products
• Medical/Cardiac Care
  • Performs cardioversion, manual defibrillation, and transcutaneous packing
  • Performs and interprets the results of Electrocardiogram (EKG) including 12-lead

Position Knowledge and/or Requirements

• Current Paramedic license (must be issued by the Paramedic’s home-state EMS licensing authority)
• Introduction to ICS (I-100)
• NIMS:  An Introduction (IS-700)
• No physical fitness level has been established for this position

Other Training Supporting Development of Knowledge and Skills

• Firefighter Training (S-130)
• Annual Fireline Safety Refresher (RT-130)
• Introduction to Wildland Fire (S-190)
• Human Factors in the Wildland Fire Service (L-180)
• Intermediate Wildland Fire Behavior (S-290)
• Basic Air Operations (S-270)
• Helicopter Crewmember (S-271)
• Advanced Cardiac Life Support (if not required for state/agency licensure)