A paramedic is a specialist healthcare professional who responds to emergency calls for medical help outside of a hospital. Paramedics mainly work as part of the emergency medical services (EMS), most often in ambulances. The scope of practice of a paramedic varies among 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 English-speaking countries, there is an official distinction between paramedics and emergency medical technicians (or emergency care assistants), in which paramedics have additional qualifications and are accountable to a professional regulatory body.
Duties and functions
The paramedic role is closely related to other healthcare positions, especially the emergency medical technician role, with paramedics often being a higher grade role, with more responsibility and autonomy.
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 to support a physician in the field, in a role more akin to a hospital nurse, rather than operating with clinical autonomy.
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 hospitalisation 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.