Paramedic - Knowledge

921:, most of whom were Black. New York City's Saint Vincent's Hospital developed the United States' first Mobile Coronary Care Unit (MCCU) under the medical direction of William Grace, MD, and based on Frank Pantridge's MCCU project in Belfast, Northern Ireland. In 1967, Eugene Nagle, MD and Jim Hirschmann, MD helped pioneer the United States' first EKG telemetry transmission to a hospital and then in 1968, a functional paramedic program in conjunction with the City of Miami Fire Department. In 1969, the City of Columbus Fire Services joined with the Ohio State University Medical Center to develop the "HEARTMOBILE" paramedic program under the medical direction of James Warren, MD and Richard Lewis, MD. In 1969, the Haywood County (NC) Volunteer Rescue Squad developed a paramedic program (then called Mobile Intensive Care Technicians) under the medical direction of Ralph Feichter, MD. In 1969, the initial Los Angeles paramedic training program was instituted in conjunction with Harbor General Hospital, now 1350: 173:, 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 (typically an emergency department). 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 (a practice known as community paramedicine). 305: 754: 589:, which should provide a compelling reason to implement preventive mental health measures within this profession. Moreover, there is an extra risk for CVDs because of the heaviness of emergency response operations. There is a need to emphasize cancer risk and the importance of constant exploration and individualized prevention patterns. Besides, there is the cumulative effect of fatigue, violence, and trauma on the health of paramedics. As a result, there is a need for systematic monitoring and preventive measures in health among paramedics. It is necessary to study long-term health risks for paramedics and apply a prophylactic approach to maintaining the health state of healthcare professionals. 2404: 1234:(HCPC), and in order to qualify for registration you must meet the standards for registration, which include having a degree obtained through an approved course. The change of entry requirements does not affect currently registered Paramedics, some of whom will still only have their entry qualification, but it is common for Paramedics to continue to progress through "top up" courses, for instance, to work towards a Bachelors of Science degree. This has led to Paramedics holding a wide range of qualifications, with some qualifications (such as master's degrees in Advanced or Paramedic Practice) being a pre-requisite for paramedic prescribing. 565:, are some of the mental health issues paramedics are likely to get exposed to due to their nature of work as compared to the general population. Stable support systems that may include peer counselling and the availability of mental health resources become essential in building the resilience of paramedic professionals. Peer counselling programs appear to be an effective stress management strategy for paramedics. Taking part in open discussions with other peers who understand what the employee is going through determines the necessary supportive grounds that facilitate managing and processing feelings related to this work. 862: 1250:

assessment) in order to use the title "specialist". There are also now a growing number of these advanced paramedics who are independent and supplementary prescribers. There are also 'Critical Care Paramedics' who specialise in acute emergency incidents. In 2018, the UK government changed legislation allowing Paramedics to independently prescribe, which will open new pathways to Paramedics to progress into. This came into force on 1 April 2018, but did not immediately affect practice as guidance was still being written.

1076:. Comparisons have been made between Paramedics and nurses; with nurses now requiring degree entry (BSc) the knowledge deficit is large between the two fields. This has led to many countries passing laws to protect the title of "paramedic" (or its local equivalent) from use by anyone except those qualified and experienced to a defined standard. This usually means that paramedics must be registered with the appropriate body in their country; for example all paramedics in the United Kingdom must by registered with the 991:, which ran from 1972 to 1977, portraying the exploits of this new profession called paramedics. The show gained popularity with emergency services personnel, the medical community, and the general public. When the show first aired in 1972, there were just six paramedic units operating in three pilot programs in the whole of the US, and the term paramedic was essentially unknown. By the time the program ended in 1977, there were paramedics operating in all fifty states. The show's 180:. 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 49: 1172:

towards a university degree-based program. The province of Ontario announced that by September 2021, the entry level primary care paramedic post-secondary program would be enhanced from a two-year diploma to a three-year advanced diploma in primary care paramedicine. Resultantly, advanced care paramedics in Ontario will require a minimum of four years of post-secondary education and critical care paramedics will require five years of post-secondary education.

1135: 765: 228: 1048: 224:. 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. 1289:, or anatomy and physiology courses from an accredited college or university. Paramedics in some states must attend up to 50+ hours of ongoing education, plus maintain Pediatric Advanced Life Support and Advanced Cardiac Life Support. National Registry requires 70 + hours to maintain its certification or one may re-certify through completing the written computer based adaptive testing again (between 90 and 120 questions) every two years. 906:, the US government moved to develop minimum standards for ambulance training, ambulance equipment and vehicle design. These new standards were incorporated into Federal Highway Safety legislation and the states were advised to either adopt these standards into state laws or risk a reduction in Federal highway safety funding. The "White Paper" also prompted the inception of a number of emergency medical service (EMS) 447:, 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. 1401:, firefighters have been offered free paramedic training. There are also many paramedics who volunteer for backcountry or wilderness rescue teams, and small town rescue squads. In the specific case of an ambulance service being maintained by a fire department, paramedics and EMTs may be required to maintain firefighting and rescue skills as well as medical skills, and vice versa. In some instances, such as 1647: 1155:, in 1972. The program, which intended to upgrade the then mandatory 160 hours of training for ambulance attendants, was found to be too costly and premature. The program was abandoned after two years, and it was more than a decade before the legislative authority for its graduates to practice was put into place. An alternative program which provided 1,400 hours of training at the 469: 1373:, and the transfer of critical care patients between facilities. While some jurisdictions still use physicians, nurses, and technicians for transporting patients, increasingly this role falls to specialized senior and experienced paramedics. Other areas of specialization include such roles as tactical paramedics working in police units, marine paramedics, hazardous materials ( 1643:. The specific medications they are permitted to administer vary widely, based on local standards of care and protocols. For an accurate description of permitted drugs or procedures in a given location, it is necessary to contact that jurisdiction directly. A representative list of medications may commonly include: 1245:. This is a fully autonomous role, and such senior paramedics are now working in hospitals, community teams such as rapid response teams, and also in increasing numbers in general practice, where their role includes acute presentations, complex chronic care and end of life management. They work as part of the 891:. Key factors contributing to victim survival in transport to definitive care such as a hospital were identified as comprehensive trauma care, rapid transport to designated trauma facilities, and the presence of medical corpsmen who were trained to perform certain critical advanced medical procedures such as 1095:

Physicians began to take more interest in paramedics from a research perspective as well. By about 1990, the fluctuating trends began to diminish, being replaced by outcomes-based research. This research then drove further evolution of the practice of both paramedics and the emergency physicians who

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and skill set has existed in a state of flux. Requirements often originated and evolved at the local level, and were based upon the preferences of physician advisers and medical directors. Recommended treatments would change regularly, often changing more like a fashion than a scientific discipline.

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who often possessed the only local transport allowing a passenger to lie down. In most cases these ambulances were operated by drivers and attendants with little or no medical training, and it was some time before formal training began to appear in some units. An early example was the members of the

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were typically determined by local medical directors based primarily on the perceived needs of the community along with affordability. There were also large differences between localities in the amount and type of training required, and how it would be provided. This ranged from in-service training

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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

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In many localities, paramedics operate as a direct extension of a physician medical director and practice as an extension of the medical director's license. In the United States, a physician delegates authority under an individual state's Medical Practice Act. This gives a paramedic the ability to

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trained its first group internally, before the process spread across the country. By 2010 the Ontario system involved a two-year community college based program, including both hospital and field clinical components, prior to designation as a Primary Care Paramedic, although it is starting to head

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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

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team including Doctors, Nurses, physician Associates, Physiotherapists, Associate Physicians, Health Care Assistant and Clinical Pharmacists. Paramedic Practitioners also undertake examinations modelled upon the MRCGP (a combination of applied knowledge exams, clinical skills and work place based

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Paramedics are employed by a variety of different organizations, and the services they provide may occur under differing organizational structures, depending on the part of the world. A new and evolving role for paramedics involves the expansion of their practice into the provision of relatively

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still occurs in some jurisdictions, it has become increasingly rare. Day-to-day operations largely moved from direct and immediate medical control to pre-written protocols or standing orders, with the paramedic typically seeking advice after the options in the standing orders had been exhausted.

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Changes in procedures also included the manner in which the work of paramedics was overseen and managed. In the early days medical control and oversight was direct and immediate, with paramedics calling into a local hospital and receiving orders for every individual procedure or drug. While this

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under the medical direction of Leonard Cobb, MD. The Marietta (GA) initial paramedic project was instituted in the Fall of 1970 in conjunction with Kennestone Hospital and Metro Ambulance Service, Inc. under the medical direction of Luther Fortson, MD. The Los Angeles County and City established

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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

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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

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Lindsley, William G.; Blachere, Francoise M.; McClelland, Tia L.; Neu, Dylan T.; Mnatsakanova, Anna; Martin, Stephen B.; Mead, Kenneth R.; Noti, John D. (2019-10-22). "Efficacy of an ambulance ventilation system in reducing EMS worker exposure to airborne particles from a patient cough aerosol

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As described above, many jurisdictions have different levels of paramedic training, leading to variations in what procedures different paramedics may perform depending upon their qualifications. Three common general divisions of paramedic training are the basic technician, general paramedic or

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services after the end of World War II. Training was frequently conducted internally, although national levels of coordination led to more standardization of staff training. Ambulance services were merged into county-level agencies in 1974, and then into regional agencies in 2006. The regional

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provides global views by laying international standards to protect the well-being of the staff involved in the healthcare provided, irrespective of whether it is an emergency or routine operation. Such regulatory bodies, as the ones promoting national and global safety standards, ensure that

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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

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and clinical hours for a paramedic program of 1,500 or more hours of classroom training and 500+ clinical hours to be accredited and nationally recognized. Calendar length typically varies from 12 months to upwards of two years, excluding degree options, EMT training, work experience, and

1192:. They operate in MED evac and ambulances. They are legalized under the 1976 Doctors Ordinance (Decree). In a 2016 study at the Ben Gurion University of the Negev it was found that 73% of trained paramedics stop working within a five-year period, and 93% stop treating within 10 years. 1071:

The variations in educational approaches and standards required for paramedics has led to large differences in the required qualifications between locations—both within individual countries and from country to country. Within the UK training is a three-year course equivalent to a

954:. It would take several more years before these technologies drifted through to civilian applications. In North America, physicians were judged to be too expensive to be used in the pre-hospital setting, although such initiatives were implemented, and sometimes still operate, in 2420:(off-line medical control) and direct physician consultation via phone or radio (on-line medical control). Under this paradigm, paramedics effectively assume the role of out-of-hospital field agents to regional emergency physicians, with independent clinical decision. 516:

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.

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Throughout the 1970s and 1980s, the paramedic field continued to evolve, with a shift in emphasis from patient transport to treatment both on scene and en route to hospitals. This led to some services changing their descriptions from "ambulance services" to

1027:, was instrumental in organizing emergency health services in southern California earlier in his career during the 1970s, in the paramedic program in Pittsburgh, and had a substantial role in the founding of the paramedic programs in Toronto and 1146:

While the evolution of paramedicine described above is focused largely on the US, many other countries followed a similar pattern, although often with significant variations. Canada, for example, attempted a pilot paramedic training program at

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motorized ambulances started to be developed, but once they proved their effectiveness on the battlefield during the war the concept spread rapidly to civilian systems. In terms of advanced skills, once again the military led the way. During

184:. 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 1396:

for their area, although this employer could itself be working under a number of models, including a specific autonomous public ambulance service, a fire department, a hospital based service, or a private company working under contract. In

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prerequisites. It is required to be a certified Emergency Medical Technician prior to starting paramedic training. Entry requirements vary, but many paramedic programs also have prerequisites such as one year required work experience as an

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In some cases paramedics may gain further qualifications to extend their status to that of a paramedic practitioner or advanced paramedic, which may allow them to administer a wider range of drugs and use a wider range of clinical skills.

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Associated technologies also rapidly evolved and changed, with medical equipment manufacturers having to adapt equipment that worked inadequately outside of hospitals, to be able to cope with the less controlled pre-hospital environment.

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advanced technician, and advanced paramedic. Common skills that these three certification levels may practice are summarized in the table below. The skills for the higher levels automatically also assume those listed for lower levels.

406:. 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 1349: 3299:

Tamminga, Sietske J; Emal, Lima M; Boschman, Julitta S; Levasseur, Alice; Thota, Anilkrishna; Ruotsalainen, Jani H; Schelvis, Roosmarijn MC; Nieuwenhuijsen, Karen; van der Molen, Henk F (2023-05-12). Cochrane Work Group (ed.).

2839:"Interim Recommendations for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points/Emergency Communication Centers (PSAP/ECCs) in the United States During the Coronavirus Disease (COVID-19) Pandemic" 2562: 1108:, to changes in drug protocols. As the profession grew, some paramedics went on to become not just research participants, but researchers in their own right, with their own projects and journal publications. In 2010, the 845:

to perform the advanced procedures. While both of these experiments had certain levels of success, the technology had not yet reached a sufficiently advanced level to be fully effective; for example, the Toronto portable

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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

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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.

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The provision of municipal ambulance services and paramedics, can vary by area, even within the same country or state. For instance, in Canada, the province of British Columbia operates a province-wide service (the

750:. After returning home, some veterans began to attempt to apply what had they had seen on the battlefield to their own communities, and commenced the creation of volunteer life-saving squads and ambulance corps. 661:

Throughout the evolution of pre-hospitalization care, there has been an ongoing association with military conflict. One of the first indications of a formal process for managing injured people dates from the

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These early developments in formalized ambulance services were decided at local levels, and this led to services being provided by diverse operators such as the local hospital, police, fire brigade, or even

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in 1970. Other cities and states passed their own paramedic bills, leading to the formation of services across the US. Many other countries also followed suit, and paramedic units formed around the world.

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Verbeek, Jos H; Rajamaki, Blair; Ijaz, Sharea; Sauni, Riitta; Toomey, Elaine; Blackwood, Bronagh; Tikka, Christina; Ruotsalainen, Jani H; Kilinc Balci, F Selcen (2020-04-15). Cochrane Work Group (ed.).

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In places where paramedics are recognised health care professionals registered with an appropriate body, they can conduct all procedures authorised for their profession, including the administration of

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level prior to commencing employment was then tried, and made mandatory in 1977, with formal certification examinations being introduced in 1978. Similar programs occurred at roughly the same time in

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Paramedics work in various settings including NHS and Independent Ambulance Providers, Air Ambulances, Emergency Departments and other alternative settings. Some paramedics have gone on to become

192:) 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. 2416:

practice within limited scope of practice in law, along with state DOH guidelines and medical control oversight. The authority to practice in this manner is granted in the form of standing orders

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by injection in emergency situations, and pharmacists' mates on warships were permitted to do even more without the guidance of a physician. The Korean War also marked the first widespread use of

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Paramedicine continues to grow and evolve into a formal profession in its own right, complete with its own standards and body of knowledge, and in many locations paramedics have formed their own

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in local systems, through community colleges, and up to university level education. This emphasis on increasing qualifications has followed the progression of other health professions such as

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Fratta, Kyle A.; Levy, Matthew J.; Brothers, James M.; Baer, Gamaliel D.; Scharf, Becca; Fratta, Kyle A.; Levy, Matthew J.; Brothers, James M.; Baer, Gamaliel D.; Scharf, Becca (2020-09-12).

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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

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Charlier, Bruno; Coglianese, Albino; De Rosa, Federica; De Caro, Francesco; Piazza, Ornella; Motta, Oriana; Borrelli, Anna; Capunzo, Mario; Filippelli, Amelia; Izzo, Viviana (2021-01-14).

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In some areas, paramedics are only permitted to practice many advanced skills while assisting a physician who is physically present, except for immediately life-threatening emergencies.

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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.

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offer comprehensive guidelines that highlight the integration of safety protocols, technological advancements, and procedural innovations to enhance paramedic safety and well-being.

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Durham, Mark; Westhead, Pete; Griffiths, David; Lyon, Richard; Lau-Walker, Margaret (2020). "Prehospital neuromuscular blockade post OHCA: UK's first paramedic-delivered protocol".

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offer paramedic programs and two-year associate degrees, a handful of universities also offer a four-year bachelor's degree component. The national standard course minimum requires

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The early technicians with limited training, performing a small and specific set of procedures, has become a role beginning to require a foundation degree in countries such as

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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.

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and there is now a significant standardization of training and skills. The UK model has three levels of ambulance staff. In increasing order of clinical skill these are:

3542:"The effects of emergency medical service work on the psychological, physical, and social well-being of ambulance personnel: a systematic review of qualitative research" 137:

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

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While there are varying degrees of training and expectations around the world, a set of skills practised by paramedics in the pre-hospital setting commonly includes:

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Some paramedics have begun to specialize their practice, frequently in association with the environment in which they will work. Some early examples of this involved

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Expanded resuscitation skills including supraglottic airway placement, monitoring of capnography, administration of epinephrine/adrenaline (in some jurisdictions).

3117:"Work-related posttraumatic stress disorder in paramedics in comparison to data from the general population of working age. A systematic review and meta-analysis" 3467:"Factors Influencing Use of Personal Protective Equipment Among Emergency Medical Services Responders During the COVID-19 Pandemic: A Retrospective Chart Review" 4204: 2756:"Which extended paramedic skills are making an impact in emergency care and can be related to the UK paramedic system? A systematic review of the literature" 2520: 1003:

and responsible for the UCLA paramedic program; he would go on to help establish paramedic programs throughout the US, and was the founding publisher of the

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options. Paramedic education programs typically follow the U.S. NHTSA EMS Curriculum, DOT or National Registry of EMTs. While many regionally accredited

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By the early 1960s experiments in improving medical care had begun in some civilian centres. One early experiment involved the provision of pre-hospital

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injuries, it will be possible to mitigate the hazards faced by paramedics, to help paramedics stay safe while rendering the most needed services.

1324: 879:—was published in the United States. This paper presented data showing that soldiers who were seriously wounded on the battlefields during the 722:

While civilian communities had organized ways to deal with prehospitalisation care and transportation of the sick and dying as far back as the

200:, or undertaking 'see and refer' visits, where the paramedic directly refers a patient to specialist services without taking them to hospital. 54: 3777: 1230:

degree in Pre-Hospital Care or Paramedic Science. As the title "Paramedic" is legally protected, those utilising must be registered with the

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In Israel, paramedics are trained in either of the following ways: a three-year degree in Emergency Medicine (B.EMS), a year and three months

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framework for paramedics is highly dependent on the overall structure of emergency medical services in the territory where they are working.

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pandemic strengthens the necessity of following safety protocols. Preventive measures for healthcare workers from needlestick injuries and

3179:"Causes of stress and poor wellbeing among paramedic students in Saudi Arabia and the United Kingdom: a cross-cultural qualitative study" 3065:"Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff" 358: 3733: 2478: 217: 2377:), fracture/dislocation reduction, umbilical venous access, chemically facilitated extrication, emergency surgical procedures such as 1405:, a fire department may provide emergency medical services, but as a rapid response or rescue unit rather than a transport ambulance. 3802: 2699:"Veränderungen und Entwicklungen in der präklinischen Notfallversorgung: Zentrale Herausforderungen für das Rettungsdienstmanagement" 268:

Paramedics are widely recognized to face high risks of physical injuries in their line of work. More than 22,000 EMS providers visit

4492: 3684: 541:. The psychological aspect is intertwined with the nature of the paramedics' work. Exposure to traumatic events such as accidents, 504:. The different types of PPE include respiratory, eye, face, and hand protection. Under respiratory protection, paramedics can use 2823: 985:, happened to encounter "firemen who spoke like doctors and worked with them". This concept developed into the television series 149:

of a paramedic varies between countries, but generally includes autonomous decision making around the emergency care of patients.

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across the US including paramedic programs. The success of these units led to a rapid transition to make them fully operational.

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Svenson, James; Biedermann, Marc (2011). "Ketamine: a unique drug with several potential uses in the prehospital setting".

2649: 1109: 4089: 4485: 4420: 3759: 3002:"Occupational Injury Claims Related to Patient Lifting and Moving in a Safety-Oriented Emergency Medical Services Agency" 2429: 1550: 1231: 1077: 4395: 1798:

used to reduce the irritability or agitation of patients, to relieve symptoms of seizure, or provide procedural sedation

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each year for work-related injuries. Some physical injuries encountered when providing healthcare services include

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Intravenous fluids, dextrose infusion (hypoglycemia), and symptom relief medications such as ondansetron (nausea),

1328: 293: 2615: 2488: 1259: 929:, MD and James Lewis, MD. In 1969, the Seattle "Medic 1" paramedic program was developed in conjunction with the 914: 753: 456: 145:. They also have roles in emergency medicine, primary care, transfer medicine and remote/offshore medicine. The 4468: 3408:

Reichard, Audrey A.; Marsh, Suzanne M.; Tonozzi, Theresa R.; Konda, Srinivas; Gormley, Mirinda A. (2017-07-04).

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Lawn, Sharon; Roberts, Louise; Willis, Eileen; Couzner, Leah; Mohammadi, Leila; Goble, Elizabeth (2020-07-03).

2403: 922: 711: 699: 586: 574: 530: 3880: 427:, primarily during transportation. These transportation-related hazards should be considered and addressed in 3928: 2164: 1542: 1442: 1438: 1378: 1060: 630: 477: 411: 370: 334: 4025: 3241:"Chemical Risk in Hospital Settings: Overview on Monitoring Strategies and International Regulatory Aspects" 2863: 4816: 4572: 4562: 1332: 1286: 1220: 702:

filling a similar function; this organisation continued, and evolved into what is now known throughout the

170: 154: 121: 31: 1080:(HCPC) in order to call themselves a paramedic. In the United States, a similar system is operated by the 4760: 4678: 4650: 4640: 4635: 4567: 4539: 2614:. Health Resources and Services Administration, Office of Rural Health Policy. March 2012. Archived from 1241:, a role that practices independently in the pre-hospital environment in a capacity similar to that of a 455:

have conducted ambulance crash testing, resulting in the development of 10 test methods published by the

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administration by nasal cannula, rebreathing and non-rebreathing mask, positive pressure ventilation by

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and temporary. In time, however, these arrangements began to formalize and become permanent. During the

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occurring only after significant research demonstrated their need and effectiveness (an example being

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Emergency medical services (EMS) personnel deliver emergency medical treatment before hospital arrival

4547: 2014: 1393: 930: 817:". These innovations would not find their way into the civilian sphere for nearly twenty more years. 638: 606: 373:

usage in implementation and vaccination compliance are effective transmission reduction measures for

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and strict adherence to post-exposure protocols, enhances safety. Additionally, staying updated with

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The role of a paramedic varies widely across the world, as EMS providers operate with many different

3601:"Exploring factors associated with paramedic work-related psychological injury through data linkage" 3351:"Driving the ambulance: an essential component of emergency medical services: an integrative review" 2252:

Low-risk and immediate requirements, e.g., aspirin and nitroglycerin (chest pain), oral glucose and

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Today, university qualifications are expected for paramedics, with the current entry level being a

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McCann-Pineo, Molly; Li, Timmy; Barbara, Paul; Levinsky, Brian; Berkowitz, Jonathan (2022-05-05).

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to evacuate the wounded from forward positions to medical units, leading to the rise of the term "

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Metcalf, Matthew (2018). "Ketamine administration by HART paramedics: a clinical audit review".

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had a better survival rate than people who were seriously injured in motor vehicle accidents on

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among paramedics. Exposures to blood pathogens and body fluids through incidents, for example,

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evidence-based approaches reinforce adherence to their occupational health being safeguarded.

4529: 4198: 4186: 2468: 1743: 1454: 1181: 1101: 855: 4370:

American Sirens: The Incredible Story of the Black Men Who Became America's First Paramedics

1417:, the service is provided by each municipality, either as a distinct service, linked to the 4645: 4608: 3718:

Division of Medical Sciences, Committee on Trauma and Committee on Shock (September 1966),

2515: 2463: 2458: 2026: 1273: 1129: 1113: 1073: 538: 526: 525:

Paramedic are involved in challenging professions and can be subject to different kinds of

509: 269: 240: 197: 2173:

Expanded drug therapy options (epinephrine, anti-arrhythmics), ECG interpretation, manual

2090:

Assessment (rate, effort, symmetry, skin color), obstructed airway maneuver, supplemental

423:

Paramedics are confronted with many challenges exhibited in the form of environmental and

8: 4780: 4587: 4094: 2417: 2356:, point-of-care blood chemistry interpretation (glucose, lactate, hemoglobin, troponin). 2227: 2138: 1957: 1842: 1759: 1601: 1597: 1568: 1559: 1504: 1492: 1227: 1097: 975: 695: 542: 444: 403: 318: 185: 134: 3442: 3409: 3326: 3301: 3213: 3178: 3151: 3116: 2428:, and are personally answerable to a regulator. For example, in the United Kingdom, the 2407:

Paramedics load an injured woman into an air ambulance after a head-on collision in the

1866:

and aspirin are used to treat cardiac ailments such as angina and myocardial infarctions

4770: 4698: 4524: 4321: 4243: 3576: 3541: 3499: 3385: 3350: 3302:"Individual-level interventions for reducing occupational stress in healthcare workers" 3273: 3240: 3089: 3064: 3036: 3001: 2924: 2805: 2782: 2755: 2731: 2698: 2370: 2151: 2042: 1853: 1525: 1515:

airway adjuncts, and manual removal of obstructions via direct laryngoscopy and use of

1465: 1354: 1242: 917:

was the first civilian emergency medical service in the United States to be staffed by

814: 773: 739: 735: 707: 634: 378: 326: 292:

mostly occur in the back and neck, and injuries are most prevalent while responding to

281: 161:), in which paramedics have additional educational requirements and scope of practice. 3985: 2806:"Emergency medical services workers: how employers can prevent injuries and exposures" 2697:

Lauer, Daniel; Bandlow, Stephan; Rathje, Maik; Seidl, Andreas; Karutz, Harald (2022).

235:

To further safeguard paramedics, incorporating evidence-based strategies for managing

4775: 4755: 4739: 4729: 4670: 4383: 4373: 4325: 4313: 4278: 4235: 4178: 3628: 3620: 3581: 3563: 3504: 3486: 3447: 3429: 3390: 3372: 3331: 3278: 3260: 3218: 3200: 3156: 3138: 3094: 3041: 3023: 2928: 2916: 2908: 2787: 2736: 2718: 2186: 2167:, basic airway adjuncts, suctioning, BVM ventilation, semi-automatic defibrillation. 2131: 1949: 1896: 1717: 1583: 1469: 1366: 1277: 1156: 1152: 1068:, which also progressed from on the job training to university level qualifications. 992: 978: 926: 896: 892: 621:

hazards are managed by operating under the guidelines and recommendations offered by

618: 554: 497: 432: 407: 213: 146: 4247: 3688: 2975: 169:

The paramedic role is closely related to other healthcare positions, especially the

4665: 4592: 4305: 4270: 4227: 4170: 3612: 3571: 3553: 3494: 3478: 3437: 3421: 3380: 3362: 3321: 3317: 3313: 3268: 3252: 3208: 3190: 3146: 3128: 3084: 3080: 3076: 3031: 3013: 2900: 2813: 2777: 2767: 2726: 2710: 2510: 2223: 1943: 1731: 1398: 1269: 1185: 1164: 1024: 907: 781: 769: 757: 424: 289: 273: 3660: 3425: 3177:

Alzahrani, Adnan; Keyworth, Chris; Wilson, Caitlin; Johnson, Judith (2023-05-05).

2904: 4765: 4708: 4693: 4655: 4472: 4231: 4190: 3482: 2315: 1953: 1880: 1805: 1485: 1418: 1374: 1264:

In the United States, the minimum standards for paramedic training is considered

947: 683: 614: 610: 562: 501: 493: 297: 236: 4309: 4274: 4060: 2772: 2641: 3558: 3466: 3367: 3195: 3133: 2754:

Evans, Rachel; McGovern, Ruth; Birch, Jennifer; Newbury-Birch, Dorothy (2012).

2714: 2408: 2339: 2311: 2284: 2272: 2174: 2159: 2095: 2075: 2062: 1857: 1849: 1751: 1689: 1546: 1516: 1512: 1496: 1477: 1446: 743: 723: 513: 505: 189: 4424: 4387: 3616: 3410:"Occupational Injuries and Exposures among Emergency Medical Services Workers" 2432:

regulates paramedics and can censure or strike a paramedic from the register.

597:

The regulatory guidelines are fundamental in eliminating occupational risk in

4795: 4625: 4477: 4402: 4317: 4282: 4239: 4174: 3624: 3567: 3490: 3433: 3376: 3264: 3204: 3142: 3027: 2912: 2818: 2722: 2280: 2237: 2215: 2208: 2058: 1863: 1823: 1573: 1508: 1450: 996: 959: 951: 950:

technologies were more advanced, particularly due to initiatives such as the

851: 847: 629:, targeting the healthcare industry especially. These include properly using 550: 485: 3600: 789:

receiving a mandatory five days of training from St. John as early as 1889.

549:

are some of the factors undermining the psychological health of paramedics.

4734: 4688: 4552: 4519: 4182: 4007: 3632: 3599:

Kearney, Jason; Muir, Carlyn; Smith, Karen; Meadley, Ben (September 2023).

3585: 3508: 3451: 3394: 3335: 3282: 3256: 3222: 3160: 3098: 3045: 2920: 2791: 2740: 2335: 2299: 2241: 2144: 2107: 2019: 1917: 1773: 1712: 1535: 1521: 1382: 1304: 1000: 798: 663: 598: 489: 354: 330: 3722:, Washington, D.C.: National Academy of Sciences-National Research Council 2583: 573:

The long-term health risks that need to be observed by the paramedics are

227: 3018: 2505: 2397: 2378: 2346: 2331: 2319: 2257: 2231: 2147: 2127: 1967: 1963: 1939: 1921: 1913: 1831: 1827: 1755: 1747: 1725: 1667: 1640: 1627: 1623: 1531: 1473: 1461: 1052: 1028: 880: 793: 786: 386: 382: 350: 338: 277: 48: 4465: 3720:

Accidental Death and Disability: The Neglected Disease of Modern Society

3646: 1942:(organophosphates), sodium bicarbonate (tricyclic antidepressants), and 1596:, and recognition of and procedures for obstetrical emergencies such as 871:

Accidental Death and Disability: The Neglected Disease of Modern Society

585:

risk. There are a variety of challenges paramedics encounter, including

512:. Chemical splashes are also a common hazard faced by paramedics, where 4630: 2382: 2364:

Splinting of bone fractures, uncomplicated and complicated childbirth.

2123: 2068:

Use of supraglottic airway devices such as the I-Gel or King-LT airway

1971: 1900: 1884: 1870: 1813: 1809: 1739: 1708: 1700: 1593: 1589: 1554: 1481: 1370: 1265: 1134: 1088: 987: 918: 884: 841:, which was staffed by a regular ambulance crew, along with a hospital 810: 802: 764: 687: 4339: 4074: 2007:

Emergency Medical Technician - United States (120-200 hrs. education)

1211:

ambulance services, most often trusts, are under the authority of the

4703: 4613: 2303: 2295: 2291: 2261: 2204: 2134:, basic shock management and hypothermia prevention, pelvic binding. 1927: 1892: 1888: 1838: 1801: 1791: 1787: 1783: 1704: 1696: 1681: 1663: 1655: 1300: 1207: 1047: 982: 943: 675: 667: 342: 181: 142: 108: 1059:

The training, knowledge-base, and skill sets of both paramedics and

381:

which jeopardizes paramedics at risk of infectious diseases such as

220:

and other agencies and organizations have issued guidance regarding

4713: 2537: 2500: 2374: 2276: 2265: 2253: 2189:

electrodes and ability to transmit to hospital for interpretation.

2082:(in some jurisdictions), use of magill forceps, airway suctioning. 1981: 1935: 1795: 1779: 1769: 1735: 1721: 1685: 1677: 1673: 1579: 1386: 1281: 1104:). Such changes affected everything from simple procedures such as 806: 691: 546: 480:

keeps paramedics’ occupational risks low. Examples of PPEs include

436: 366: 346: 322: 3956: 4109: 2703:

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz

1772:(often D50W, a solution of 50% dextrose in water), used to treat 1659: 1564:

Administration of emergency drugs/medications (see section below)

1414: 1168: 1160: 1065: 888: 834: 830: 826: 679: 558: 440: 27:

Healthcare professional who works in emergency medical situations

4401:. National Highway Traffic Safety Administration. Archived from 3238: 1015:

magazine creation resulted from Page's previous purchase of the

674:

and providing some form of care. Such individuals, although not

353:. Furthermore, adhering to infection control practices, such as 3803:"HCPC - Health and Care Professions Council - Protected titles" 2753: 2091: 1975: 1931: 1763: 1646: 1613: 1353:

Firefighter paramedics assist a simulated burn victim during a

1312: 1084:, although this is only accepted by forty of the fifty states. 955: 842: 747: 727: 671: 582: 285: 212:

Infectious disease has become a major concern, in light of the

3176: 1188:

training. Paramedics manage and provide medical guidelines in

4362:

Coach and horses: my history in the ambulance dispute 1989/90

4061:"Paramedic Schools in Oregon with Training Program Overviews" 3464: 3298: 2889: 2473: 2111: 1724:, also known as anticholinergic drugs, used to speed up slow 974:

Harbor Medical Center for a proposed new show about doctors,

481: 3115:

Hoell, Andreas; Kourmpeli, Eirini; Dressing, Harald (2023).

2106:

Decompression of tension pneumothorax by needle or incision

2065:

airway adjuncts, manual removal of obstructions, suctioning

1845:

used to treat conditions such as asthma and acute bronchitis

1507:

insertion, manual repositioning, sterile suctioning, use of

609:

provide specific guidelines. For example, in United States,

592: 4445: 4295: 4090:"Salaries, Strong Recruitment Ease Area Paramedic Shortage" 2563:"Salaries, Strong Recruitment Ease Area Paramedic Shortage" 2101: 1650:

A paramedic preparing an intravenous infusion for a patient

1607: 1311:, and increasingly in Canada and parts of the U.S. such as 971: 1639:

Paramedics carry and administer a wide array of emergency

1082:

National Registry of Emergency Medical Technicians (NREMT)

468: 402:

Paramedics encounter daily risks associated with handling

4046: 3407: 2864:"First Responders, Law Enforcement & Public Services" 2010:

Emergency Medical Responder - Canada (80 hrs. education)

1105: 633:, handling hazardous substances, and adequately managing 390: 333:

in puncture-resistant containers and wearing appropriate

3881:"NHS England » Prescribing training for paramedics" 3857:"HCPC - Health and Care Professions Council - Standards" 3539: 3061: 730:

between 1598 and 1665, such arrangements were typically

418: 4455: 4450: 3598: 3524: 2696: 2584:"What's the Difference Between an EMT and a Paramedic?" 2352:

Advanced assessment, 4 and 12-lead ECG interpretation,

1576:

management, including immobilization and safe transport

1315:, where a degree is required for entry level practice. 1308: 1116:

for physicians who work in emergency medical services.

4460: 3778:"Study in Ben Gurion University with Magen David Adom" 3114: 2999: 2944: 1856:

used to treat inflammatory respiratory conditions and

1670:, used to relieve pain or decrease nausea and vomiting 1087:

As paramedicine has evolved, a great deal of both the

820: 520: 4456:

National Association of Emergency Medical Technicians

4423:

University of Maryland Medical Center. Archived from

4254: 2810:

National Institute for Occupational Safety and Health

2521:

National Association of Emergency Medical Technicians

3929:"Independent Prescribing | Professional Development" 2048:

Advanced Care Paramedic - Canada (4 yr. education)

2032:

Primary Care Paramedic - Canada (2-3 yr. education)

603:

Occupational Safety and Health Administration (OSHA)

463: 4075:"MOH order from 09.08.2017 р. № 918" 1362:basic primary health care and assessment services. 1096:oversaw their work, with changes to procedures and 4451:National Registry of Emergency Medical Technicians 4289: 2976:"Emergency Medical Services Workers | NIOSH | CDC" 2940: 2938: 2526:National Registry of Emergency Medical Technicians 1206:In the United Kingdom, ambulances were originally 833:, Northern Ireland, in 1966. This was repeated in 714:in the Republic of Ireland and various countries. 4260: 4203:: CS1 maint: DOI inactive as of September 2024 ( 4000:"Emergency Medical Technician-Paramedic - CAAHEP" 3734:"1967-Metro Ambulance Service (Atlanta, Georgia)" 2893:Journal of Occupational and Environmental Hygiene 1528:to relieve pneumothorax and pericardial tamponade 1202:Emergency medical personnel in the United Kingdom 837:, Canada in 1968 using a single ambulance called 4793: 4077:(in Ukrainian). www.apteka.ua. November 1, 2017. 3649:. Occupational Safety and Health Administration. 2290:Significantly expanded drug list, most commonly 1988: 1385:, oil and mineral exploration teams, and in the 970:While doing background research at Los Angeles' 858:, and weighed around 45 kilograms (99 lb). 492:or specific clothing; they protect workers from 258: 2935: 2345:More detailed physical assessment and history, 1766:. These are often known as "vasoactive" agents. 1392:The majority of paramedics are employed by the 4507: 4461:NHTSA Emergency Medical Services National Page 3348: 2192:Twelve lead ECG monitoring and interpretation 2038:Paramedic - United States (1-2 yr. education) 1622:Surgical procedures such as field amputation, 1331:introduced two specialties — "paramedic" and " 1138:Firefighters assist while paramedics from the 746:employing the first uses of the principles of 568: 55:Australian Capital Territory Ambulance Service 4493: 3832:"Entry requirements and training (paramedic)" 3349:Becker, Julia; Hugelius, Karin (2021-12-18). 1460:Patient assessment, including acquisition of 865:EMTs caring for a collapsed woman in New York 2672:"Befugnisse: Was darf ein Notfallsanitäter?" 934:paramedic programs following the passage of 805:battlefield medics administered painkilling 4211: 4160: 2114:, use of mechanical transport ventilators. 1816:, used when an emergency procedure such as 717: 678:, were probably among the world's earliest 321:is common in the paramedic profession. The 4500: 4486: 4161:De Backer D (2011). "Treatment of shock". 2868:Centers for Disease Control and Prevention 2843:Centers for Disease Control and Prevention 1695:Beta and calcium channel blockers such as 1338: 218:Centers for Disease Control and Prevention 47: 4087: 3575: 3557: 3498: 3441: 3384: 3366: 3325: 3272: 3212: 3194: 3150: 3132: 3088: 3035: 3017: 2817: 2781: 2771: 2730: 1634: 593:Regulatory guidelines and recommendations 2402: 2391: 1645: 1348: 1133: 1055:indicate the changing nature of the job. 1046: 860: 763: 752: 467: 303: 226: 4367: 4217: 3647:"Chemical Hazards and Toxic Substances" 3306:Cochrane Database of Systematic Reviews 3069:Cochrane Database of Systematic Reviews 2041:Intensive Care Paramedic - Australia ( 1491:Airway management techniques including 1034: 942:In the military, however, the required 203: 164: 14: 4794: 4067: 3520: 3518: 2970: 2968: 2966: 2964: 2962: 2960: 2958: 2956: 2642:"Community Paramedics: Redefining EMS" 2639: 2578: 2576: 2260:(anaphylaxis or respiratory failure), 1421:, or contracted out to a third party. 329:is critical. Including, the immediate 312: 222:workplace hazard controls for COVID-19 4578:Advanced emergency medical technician 4481: 4150:from the original on 22 October 2021. 3736:. National EMS museum. Archived from 3471:Western Journal of Emergency Medicine 3294: 3292: 3234: 3232: 3172: 3170: 3110: 3108: 3057: 3055: 2885: 2883: 2279:), and non-narcotic pain management ( 2211:injection of a limited list of drugs 2036:Advanced Life Support (ALS) Provider 1457:, and administration of cardiac drugs 1005:Journal of Emergency Medical Services 690:. A similar situation existed in the 575:Post Traumatic Stress Disorder (PTSD) 457:Society of Automotive Engineers (SAE) 419:Environmental and operational hazards 397: 2126:using direct and indirect pressure, 2022:- United States (3-6 mo. education) 1424: 1268:, but many colleges offer paramedic 1110:American Board of Emergency Medicine 1061:emergency medical technicians (EMTs) 965: 410:in prehospital settings. The use of 263: 3515: 2953: 2861: 2836: 2640:Hilton, Michael (7 February 2018). 2573: 2430:Health and Care Professions Council 1834:, used to sedate combative patients 1707:used to slow down excessively high 1567:Bleeding control and management of 1232:Health and Care Professions Council 1078:Health and Care Professions Council 821:Pre-hospital emergency medical care 521:Mental health and stress management 371:Personal Protective Equipment (PPE) 335:personal protective equipment (PPE) 111:; hospital; pre-hospital; transport 24: 4396:"National Scope of Practice Model" 4354: 3289: 3229: 3167: 3105: 3052: 2880: 2057:Assessment, manual repositioning, 2005:Basic Life Support (BLS) Provider 1582:management, including assessment, 1411:British Columbia Ambulance Service 25: 4833: 4439: 4421:"Tribute to R Adams Cowley, M.D." 4088:McCaffrey, Raymond (2008-04-04). 3245:Journal of Public Health Research 2826:from the original on Apr 5, 2023. 1488:interpretation (glucose, lactate) 1195: 1142:load a patient into an ambulance. 925:, under the medical direction of 464:Protective measures and equipment 3525:U.S fire administration (2022). 2652:from the original on Dec 2, 2020 2543:List of EMS provider credentials 2484:Paramedics in the United Kingdom 1837:Respiratory medications such as 1472:acquisition and interpretation, 1429: 1253: 787:Toronto Police Ambulance Service 656: 601:; authoritative bodies like the 443:have huge impact on paramedics' 4332: 4154: 4126: 4110:"Clinical Operating Guidelines" 4102: 4081: 4053: 4039: 4014: 3992: 3970: 3945: 3921: 3897: 3873: 3849: 3824: 3795: 3770: 3752: 3726: 3711: 3702: 3677: 3653: 3639: 3592: 3533: 3458: 3401: 3342: 2993: 2945:US fire administration (2022). 2855: 2489:Paramedics in the United States 2078:(surgical airway), delayed and 1984:to control post-partum bleeding 1818:rapid sequence intubation (RSI) 1260:Paramedics in the United States 915:Freedom House Ambulance Service 607:World Health Organization (WHO) 453:Department of Homeland Security 4822:Occupational safety and health 4812:Protective service occupations 3953:"Our Mission | NHTSA EMS" 3318:10.1002/14651858.CD002892.pub6 3081:10.1002/14651858.CD011621.pub4 2830: 2798: 2747: 2690: 2664: 2633: 2601: 2555: 712:Order of Malta Ambulance Corps 700:Order of St. John of Jerusalem 682:by default, being required to 579:cardiovascular diseases (CVDs) 531:post-traumatic stress disorder 415:health hazards to paramedics. 13: 1: 4298:Journal of Paramedic Practice 4263:Journal of Paramedic Practice 4220:Journal of Paramedic Practice 3933:www.collegeofparamedics.co.uk 3909:www.collegeofparamedics.co.uk 3687:. Toronto EMS. Archived from 3426:10.1080/10903127.2016.1274350 2905:10.1080/15459624.2019.1674858 2548: 2287:, ketorolac, acetaminophen). 2165:Cardiopulmonary resuscitation 1989:Skills by certification level 1869:Diuretic medications such as 1630:(if trained and credentialed) 1543:positive pressure ventilation 1443:cardiopulmonary resuscitation 1439:Advanced cardiac life support 1379:Heavy Urban Search and Rescue 1344: 1221:emergency medical technicians 284:incidences. Injuries such as 259:Types of Occupational Hazards 243:is crucial. Agencies such as 155:emergency medical technicians 4802:Emergency medical responders 4573:Emergency medical technician 4563:Emergency medical dispatcher 4372:. New York: Hachette Books. 4232:10.12968/jpar.2018.10.10.430 3760:"Emergency Medical Services" 3483:10.5811/westjem.2022.2.55217 3183:BMC Health Services Research 2195:Advanced ECG interpretation 1924:used for nausea and vomiting 1862:Cardiac medications such as 1692:, used to treat severe pain. 1333:emergency medical technician 1287:emergency medical technician 171:emergency medical technician 122:Emergency medical technician 32:Emergency medical technician 7: 4761:Critical emergency medicine 4679:Kendrick extrication device 4651:Nontransporting EMS vehicle 4641:Light horse field ambulance 4568:Emergency medical responder 4344:www.paramedicultrasound.com 4310:10.12968/jpar.2020.12.5.202 4275:10.12968/jpar.2011.3.10.552 4047:"National Registry of EMTs" 4022:"National Registry of EMTs" 2773:10.1136/emermed-2012-202129 2678:(in German). 4 January 2024 2676:Notfallsanitäter-Aktuell.de 2442: 2330:Basic physical assessment, 1668:paracetamol (acetaminophen) 1586:, and dislocation reduction 760:paramedics training in 1931 742:devised a system of mobile 569:Health risks and monitoring 431:. Slips, trips, and falls; 10: 4838: 4509:Emergency medical services 4466:College of Paramedics (UK) 3605:Journal of Safety Research 3559:10.1186/s12888-020-02752-4 3414:Prehospital Emergency Care 3368:10.1186/s12873-021-00554-9 3196:10.1186/s12913-023-09374-y 3134:10.3389/fpubh.2023.1151248 3121:Frontiers in Public Health 2760:Emergency Medicine Journal 2715:10.1007/s00103-022-03588-x 2479:Paramedics in South Africa 2411:region of Ontario, Canada. 2359: 2325: 2247: 2214:limited list of drugs for 2198: 2180: 2177:, intubation, ultrasound. 2157: 2117: 2085: 2052: 1541:Oxygen administration and 1342: 1318: 1257: 1247:allied health professional 1199: 1140:Toronto Paramedic Services 1127: 1042:emergency medical services 936:The Wedsworth-Townsend Act 923:Harbor–UCLA Medical Center 649: 645: 394:same time, the community. 188:backup, either virtually ( 139:emergency medical services 39:Paramedic (disambiguation) 36: 29: 4748: 4722: 4664: 4601: 4548:Certified first responder 4538: 4515: 3617:10.1016/j.jsr.2023.05.012 2385:(in some jurisdictions). 2222:, intravenous injection ( 2015:Intermediate Life Support 1600:, cord presentation, and 1394:emergency medical service 1325:Emergency Medicine Reform 1217:emergency care assistants 1175: 1123: 931:Harborview Medical Center 869:In 1966, a report called 159:emergency care assistants 115: 100: 95: 85: 75: 67: 62: 46: 4558:Emergency care assistant 4340:"Prehospital Ultrasound" 4175:10.2143/ACB.66.6.2062611 3978:"Degree Programs in EMS" 3708:Br Heart J 1986;56:491-5 2819:10.26616/NIOSHPUB2017194 2609:"Community Paramedicine" 2080:rapid sequence induction 1909:ventricular fibrillation 1875:congestive heart failure 1592:, including assessment, 1501:rapid sequence induction 1017:PARAMEDICS International 718:Early ambulance services 664:Imperial Legions of Rome 652:History of the ambulance 317:The risk of contracting 216:. In response, the U.S. 30:Not to be confused with 4807:Health care occupations 4368:Hazzard, Kevin (2022). 4364:. Glantaff House, 2010. 4177:(inactive 2024-09-12). 3529:. Emmitsburg, MD: FEMA. 2454:Paramedics in Australia 2426:prescription medication 2334:, history taking, lung 2072:Endotracheal intubation 2025:Paramedic - Australia ( 1905:ventricular tachycardia 1877:and severe hypertension 1339:Structure of employment 1239:Paramedic Practitioners 1213:National Health Service 1190:mass casualty incidents 856:lead-acid car batteries 704:Commonwealth of Nations 472:EMS workers wearing PPE 433:motor vehicle incidents 308:A paramedic wearing PPE 135:healthcare professional 3685:"Toronto EMS: History" 3355:BMC Emergency Medicine 3257:10.4081/jphr.2021.1993 2412: 2308:neuromuscular blockers 1901:abnormal heart rhythms 1758:(low blood pressure), 1651: 1635:Emergency Pharmacology 1618:mass casualty incident 1383:offshore oil platforms 1358: 1329:Ministry of Healthcare 1143: 1056: 1051:Bicycle paramedics in 866: 829:care by physicians in 776: 761: 473: 341:, including those for 309: 232: 4530:Advanced life support 4143:. 13 September 2018. 3251:(1): jphr.2021.1993. 2569:on September 8, 2011. 2516:Health care providers 2474:Paramedics in Ireland 2469:Paramedics in Germany 2448:Paramedics by country 2406: 2392:Medicolegal authority 2268:(narcotic overdose). 2249:Drug types permitted 1649: 1455:transcutaneous pacing 1441:, or ACLS, including 1352: 1345:Paramedics by country 1137: 1050: 864: 767: 756: 510:airborne contaminants 471: 307: 230: 141:(EMS), most often in 4646:Motorcycle ambulance 4609:Air medical services 4163:Acta Clinica Belgica 3661:"Health emergencies" 3527:EMS Safety Practices 3019:10.7759/cureus.10404 2947:EMS Safety Practices 2464:Paramedics in France 2459:Paramedics in Canada 2200:Drug administration 2130:, wound packing and 2096:bag valve mask (BVM) 1658:medications such as 1381:, and paramedics on 1357:mass casualty drill. 1130:Paramedics in Canada 1114:medical subspecialty 1035:Evolution and growth 686:wounds and complete 527:psychological stress 445:occupational hazards 379:needlestick injuries 204:Occupational Hazards 165:Functions and Duties 37:For other uses, see 4817:Medical credentials 4781:Wilderness medicine 4588:Emergency physician 4446:National EMS Museum 4134:"Medical Directive" 4095:The Washington Post 2590:. 18 September 2014 2327:Patient assessment 2182:Cardiac Monitoring 2139:fluid resuscitation 1998: 1843:ipratropium bromide 1602:placental abruption 1598:breech presentation 1560:Fluid resuscitation 1505:supraglottic airway 1493:tracheal intubation 1294:professional bodies 1228:Bachelor of Science 999:, was a pioneer of 976:television producer 873:—commonly known as 696:Knights Hospitaller 543:medical emergencies 404:hazardous chemicals 375:infectious diseases 319:infectious diseases 313:Infectious Diseases 241:environmental risks 186:emergency physician 4771:Emergency medicine 4699:Spinal precautions 4525:Basic life support 4471:2020-05-13 at the 4360:Conaghan, Joseph. 3885:www.england.nhs.uk 2862:CDC (2020-04-30). 2837:CDC (2020-02-11). 2621:on August 24, 2020 2413: 2371:butterfly stitches 2361:Other procedures. 2152:pericardiocentesis 2054:Airway management 1997: 1854:methylprednisolone 1652: 1526:pericardiocentesis 1468:, history taking, 1466:chest auscultation 1403:Los Angeles County 1359: 1278:community colleges 1243:nurse practitioner 1223:, and paramedics. 1149:Queen's University 1144: 1057: 867: 777: 762: 740:Jonathan Letterman 736:American Civil War 708:St. John Ambulance 635:workplace violence 553:issues, including 474: 408:chemical exposures 398:Chemical Exposures 331:disposal of sharps 327:infectious disease 310: 270:the emergency room 237:chemical exposures 233: 196:prescribe certain 53:Paramedics of the 4789: 4788: 4776:Military medicine 4756:Aviation medicine 4740:Search and rescue 4730:Ambulance station 4379:978-0-306-92607-5 3807:www.hcpc-uk.co.uk 2389: 2388: 2145:Intraosseous (IO) 2132:hemostatic agents 2027:Bachelor's Degree 1958:hemorrhagic shock 1930:for a variety of 1897:magnesium sulfate 1848:Steroids such as 1776:(low blood sugar) 1718:Parasympatholytic 1616:of patients in a 1470:electrocardiogram 1464:, physical exam, 1425:Scope of practice 1367:aviation medicine 1274:bachelor's degree 1157:community college 1153:Kingston, Ontario 1074:bachelor's degree 993:technical advisor 979:Robert A. Cinader 966:Public notability 927:J. Michael Criley 913:Founded in 1967, 897:airway management 893:fluid replacement 782:funeral directors 768:Ambulance of the 425:operational risks 264:Physical injuries 214:COVID-19 pandemic 147:scope of practice 127: 126: 16:(Redirected from 4829: 4666:Casualty lifting 4593:Medical director 4502: 4495: 4488: 4479: 4478: 4435: 4433: 4432: 4416: 4414: 4413: 4407: 4400: 4391: 4348: 4347: 4336: 4330: 4329: 4293: 4287: 4286: 4258: 4252: 4251: 4215: 4209: 4208: 4202: 4194: 4158: 4152: 4151: 4149: 4138: 4130: 4124: 4123: 4121: 4120: 4106: 4100: 4099: 4085: 4079: 4078: 4071: 4065: 4064: 4057: 4051: 4050: 4043: 4037: 4036: 4034: 4033: 4024:. Archived from 4018: 4012: 4011: 4006:. Archived from 3996: 3990: 3989: 3984:. Archived from 3974: 3968: 3967: 3965: 3964: 3955:. Archived from 3949: 3943: 3942: 3940: 3939: 3925: 3919: 3918: 3916: 3915: 3901: 3895: 3894: 3892: 3891: 3877: 3871: 3870: 3868: 3867: 3853: 3847: 3846: 3844: 3843: 3828: 3822: 3821: 3819: 3818: 3809:. Archived from 3799: 3793: 3792: 3790: 3789: 3780:. Archived from 3774: 3768: 3767: 3756: 3750: 3749: 3747: 3745: 3740:on 14 April 2013 3730: 3724: 3723: 3715: 3709: 3706: 3700: 3699: 3697: 3696: 3681: 3675: 3674: 3672: 3671: 3657: 3651: 3650: 3643: 3637: 3636: 3596: 3590: 3589: 3579: 3561: 3537: 3531: 3530: 3522: 3513: 3512: 3502: 3462: 3456: 3455: 3445: 3405: 3399: 3398: 3388: 3370: 3346: 3340: 3339: 3329: 3296: 3287: 3286: 3276: 3236: 3227: 3226: 3216: 3198: 3174: 3165: 3164: 3154: 3136: 3112: 3103: 3102: 3092: 3059: 3050: 3049: 3039: 3021: 2997: 2991: 2990: 2988: 2987: 2972: 2951: 2950: 2949:. MD, USA: FEMA. 2942: 2933: 2932: 2887: 2878: 2877: 2875: 2874: 2859: 2853: 2852: 2850: 2849: 2834: 2828: 2827: 2821: 2802: 2796: 2795: 2785: 2775: 2751: 2745: 2744: 2734: 2694: 2688: 2687: 2685: 2683: 2668: 2662: 2661: 2659: 2657: 2637: 2631: 2630: 2628: 2626: 2620: 2613: 2605: 2599: 2598: 2596: 2595: 2580: 2571: 2570: 2565:. Archived from 2559: 2511:Flight Paramedic 2256:(hypoglycemia), 2228:intravenous drip 2002:Treatment issue 1999: 1996: 1944:hydroxocobalamin 1732:Sympathomimetics 1538:(IO) cannulation 1480:, point-of-care 1270:associate degree 1165:British Columbia 1025:medical director 770:Magen David Adom 758:German Red Cross 637:. Moreover, the 529:, for instance, 508:masks to filter 502:chemical hazards 429:prehospital care 87:Activity sectors 51: 44: 43: 21: 4837: 4836: 4832: 4831: 4830: 4828: 4827: 4826: 4792: 4791: 4790: 4785: 4766:Diving medicine 4744: 4718: 4709:Vacuum mattress 4694:Scoop stretcher 4668: 4660: 4656:Water ambulance 4636:Combination car 4597: 4534: 4511: 4506: 4473:Wayback Machine 4442: 4430: 4428: 4419: 4411: 4409: 4405: 4398: 4394: 4380: 4357: 4355:Further reading 4352: 4351: 4338: 4337: 4333: 4294: 4290: 4269:(10): 552–556. 4259: 4255: 4226:(10): 430–437. 4216: 4212: 4196: 4195: 4159: 4155: 4147: 4141:AustinTexas.gov 4136: 4132: 4131: 4127: 4118: 4116: 4108: 4107: 4103: 4086: 4082: 4073: 4072: 4068: 4059: 4058: 4054: 4045: 4044: 4040: 4031: 4029: 4020: 4019: 4015: 3998: 3997: 3993: 3976: 3975: 3971: 3962: 3960: 3951: 3950: 3946: 3937: 3935: 3927: 3926: 3922: 3913: 3911: 3903: 3902: 3898: 3889: 3887: 3879: 3878: 3874: 3865: 3863: 3861:www.hcpc-uk.org 3855: 3854: 3850: 3841: 3839: 3830: 3829: 3825: 3816: 3814: 3801: 3800: 3796: 3787: 3785: 3776: 3775: 3771: 3758: 3757: 3753: 3743: 3741: 3732: 3731: 3727: 3716: 3712: 3707: 3703: 3694: 3692: 3683: 3682: 3678: 3669: 3667: 3659: 3658: 3654: 3645: 3644: 3640: 3597: 3593: 3538: 3534: 3523: 3516: 3463: 3459: 3406: 3402: 3347: 3343: 3312:(5): CD002892. 3297: 3290: 3237: 3230: 3175: 3168: 3113: 3106: 3075:(4): CD011621. 3060: 3053: 2998: 2994: 2985: 2983: 2974: 2973: 2954: 2943: 2936: 2899:(12): 804–816. 2888: 2881: 2872: 2870: 2860: 2856: 2847: 2845: 2835: 2831: 2804: 2803: 2799: 2752: 2748: 2709:(10): 987–995. 2695: 2691: 2681: 2679: 2670: 2669: 2665: 2655: 2653: 2638: 2634: 2624: 2622: 2618: 2611: 2607: 2606: 2602: 2593: 2591: 2582: 2581: 2574: 2561: 2560: 2556: 2551: 2445: 2394: 2369:Wound closure ( 2316:tranexamic acid 2043:Master's Degree 2017:(ILS) Provider 1991: 1962:Broad spectrum 1954:tranexamic acid 1881:Antiarrhythmics 1806:succinylcholine 1637: 1486:blood chemistry 1432: 1427: 1369:and the use of 1347: 1341: 1321: 1262: 1256: 1204: 1198: 1178: 1132: 1126: 1037: 968: 948:miniaturization 904:The White Paper 902:As a result of 876:The White Paper 854:was powered by 823: 744:field hospitals 720: 659: 654: 648: 595: 571: 563:substance abuse 523: 466: 421: 400: 315: 266: 261: 206: 167: 118: 105: 103: 88: 78: 77:Occupation type 58: 57:during training 42: 35: 28: 23: 22: 15: 12: 11: 5: 4835: 4825: 4824: 4819: 4814: 4809: 4804: 4787: 4786: 4784: 4783: 4778: 4773: 4768: 4763: 4758: 4752: 4750: 4749:Related fields 4746: 4745: 4743: 4742: 4737: 4732: 4726: 4724: 4720: 4719: 4717: 4716: 4711: 4706: 4701: 4696: 4691: 4686: 4681: 4675: 4673: 4662: 4661: 4659: 4658: 4653: 4648: 4643: 4638: 4633: 4628: 4623: 4622: 4621: 4611: 4605: 4603: 4599: 4598: 4596: 4595: 4590: 4585: 4580: 4575: 4570: 4565: 4560: 4555: 4550: 4544: 4542: 4536: 4535: 4533: 4532: 4527: 4522: 4516: 4513: 4512: 4505: 4504: 4497: 4490: 4482: 4476: 4475: 4463: 4458: 4453: 4448: 4441: 4440:External links 4438: 4437: 4436: 4417: 4392: 4378: 4365: 4356: 4353: 4350: 4349: 4331: 4304:(5): 202–207. 4288: 4253: 4210: 4169:(6): 438–442. 4153: 4125: 4114:www.google.com 4101: 4080: 4066: 4052: 4038: 4013: 4010:on 2015-07-08. 4004:www.caahep.org 3991: 3988:on 2015-06-26. 3969: 3944: 3920: 3896: 3872: 3848: 3836:Health Careers 3823: 3794: 3769: 3751: 3725: 3710: 3701: 3676: 3652: 3638: 3591: 3546:BMC Psychiatry 3532: 3514: 3477:(3): 396–407. 3457: 3420:(4): 420–431. 3400: 3341: 3288: 3228: 3166: 3104: 3051: 2992: 2952: 2934: 2879: 2854: 2829: 2797: 2766:(7): 594–603. 2746: 2689: 2663: 2632: 2600: 2572: 2553: 2552: 2550: 2547: 2546: 2545: 2540: 2534: 2533: 2529: 2528: 2523: 2518: 2513: 2508: 2503: 2497: 2496: 2495:Related fields 2492: 2491: 2486: 2481: 2476: 2471: 2466: 2461: 2456: 2450: 2449: 2444: 2441: 2409:Kawartha Lakes 2393: 2390: 2387: 2386: 2367: 2365: 2362: 2358: 2357: 2350: 2343: 2340:pulse oximetry 2328: 2324: 2323: 2312:blood products 2288: 2285:methoxyflurane 2273:dipenhydramine 2269: 2264:(asthma), and 2250: 2246: 2245: 2235: 2212: 2201: 2197: 2196: 2193: 2190: 2183: 2179: 2178: 2175:defibrillation 2171: 2168: 2162: 2160:Cardiac arrest 2156: 2155: 2142: 2135: 2120: 2116: 2115: 2104: 2099: 2088: 2084: 2083: 2076:cricothyrotomy 2069: 2066: 2063:nasopharyngeal 2055: 2051: 2050: 2034: 2012: 2003: 1990: 1987: 1986: 1985: 1980:Hormones like 1978: 1960: 1950:Blood products 1947: 1925: 1911: 1899:used to treat 1878: 1867: 1860: 1858:adrenal crisis 1850:hydrocortisone 1846: 1835: 1824:Antipsychotics 1821: 1799: 1777: 1767: 1752:cardiac arrest 1744:norepinephrine 1729: 1715: 1693: 1690:methoxyflurane 1671: 1636: 1633: 1632: 1631: 1620: 1611: 1606:Management of 1604: 1587: 1577: 1571: 1565: 1562: 1557: 1547:bag-valve-mask 1539: 1529: 1519: 1517:magill forceps 1513:nasopharyngeal 1497:cricothyrotomy 1489: 1478:pulse oximetry 1458: 1447:defibrillation 1431: 1428: 1426: 1423: 1340: 1337: 1320: 1317: 1258:Main article: 1255: 1252: 1200:Main article: 1197: 1196:United Kingdom 1194: 1177: 1174: 1128:Main article: 1125: 1122: 1036: 1033: 981:, working for 967: 964: 958:countries and 822: 819: 724:bubonic plague 719: 716: 666:, where aging 658: 655: 647: 644: 594: 591: 570: 567: 522: 519: 514:safety goggles 465: 462: 420: 417: 399: 396: 314: 311: 265: 262: 260: 257: 205: 202: 178:models of care 166: 163: 125: 124: 119: 116: 113: 112: 106: 101: 98: 97: 93: 92: 89: 86: 83: 82: 79: 76: 73: 72: 69: 65: 64: 60: 59: 52: 26: 9: 6: 4: 3: 2: 4834: 4823: 4820: 4818: 4815: 4813: 4810: 4808: 4805: 4803: 4800: 4799: 4797: 4782: 4779: 4777: 4774: 4772: 4769: 4767: 4764: 4762: 4759: 4757: 4754: 4753: 4751: 4747: 4741: 4738: 4736: 4733: 4731: 4728: 4727: 4725: 4721: 4715: 4712: 4710: 4707: 4705: 4702: 4700: 4697: 4695: 4692: 4690: 4687: 4685: 4682: 4680: 4677: 4676: 4674: 4672: 4667: 4663: 4657: 4654: 4652: 4649: 4647: 4644: 4642: 4639: 4637: 4634: 4632: 4629: 4627: 4626:Ambulance bus 4624: 4620: 4617: 4616: 4615: 4612: 4610: 4607: 4606: 4604: 4600: 4594: 4591: 4589: 4586: 4584: 4581: 4579: 4576: 4574: 4571: 4569: 4566: 4564: 4561: 4559: 4556: 4554: 4551: 4549: 4546: 4545: 4543: 4541: 4537: 4531: 4528: 4526: 4523: 4521: 4518: 4517: 4514: 4510: 4503: 4498: 4496: 4491: 4489: 4484: 4483: 4480: 4474: 4470: 4467: 4464: 4462: 4459: 4457: 4454: 4452: 4449: 4447: 4444: 4443: 4427:on 2006-07-18 4426: 4422: 4418: 4408:on 2021-03-24 4404: 4397: 4393: 4389: 4385: 4381: 4375: 4371: 4366: 4363: 4359: 4358: 4345: 4341: 4335: 4327: 4323: 4319: 4315: 4311: 4307: 4303: 4299: 4292: 4284: 4280: 4276: 4272: 4268: 4264: 4257: 4249: 4245: 4241: 4237: 4233: 4229: 4225: 4221: 4214: 4206: 4200: 4192: 4188: 4184: 4180: 4176: 4172: 4168: 4164: 4157: 4146: 4142: 4135: 4129: 4115: 4111: 4105: 4097: 4096: 4091: 4084: 4076: 4070: 4062: 4056: 4048: 4042: 4028:on 2016-08-10 4027: 4023: 4017: 4009: 4005: 4001: 3995: 3987: 3983: 3982:www.naemt.org 3979: 3973: 3959:on 2015-08-14 3958: 3954: 3948: 3934: 3930: 3924: 3910: 3906: 3900: 3886: 3882: 3876: 3862: 3858: 3852: 3837: 3833: 3827: 3813:on 2016-10-20 3812: 3808: 3804: 3798: 3784:on 2018-01-21 3783: 3779: 3773: 3765: 3761: 3755: 3739: 3735: 3729: 3721: 3714: 3705: 3691:on 2010-12-26 3690: 3686: 3680: 3666: 3662: 3656: 3648: 3642: 3634: 3630: 3626: 3622: 3618: 3614: 3610: 3606: 3602: 3595: 3587: 3583: 3578: 3573: 3569: 3565: 3560: 3555: 3551: 3547: 3543: 3536: 3528: 3521: 3519: 3510: 3506: 3501: 3496: 3492: 3488: 3484: 3480: 3476: 3472: 3468: 3461: 3453: 3449: 3444: 3439: 3435: 3431: 3427: 3423: 3419: 3415: 3411: 3404: 3396: 3392: 3387: 3382: 3378: 3374: 3369: 3364: 3360: 3356: 3352: 3345: 3337: 3333: 3328: 3323: 3319: 3315: 3311: 3307: 3303: 3295: 3293: 3284: 3280: 3275: 3270: 3266: 3262: 3258: 3254: 3250: 3246: 3242: 3235: 3233: 3224: 3220: 3215: 3210: 3206: 3202: 3197: 3192: 3188: 3184: 3180: 3173: 3171: 3162: 3158: 3153: 3148: 3144: 3140: 3135: 3130: 3126: 3122: 3118: 3111: 3109: 3100: 3096: 3091: 3086: 3082: 3078: 3074: 3070: 3066: 3058: 3056: 3047: 3043: 3038: 3033: 3029: 3025: 3020: 3015: 3012:(9): e10404. 3011: 3007: 3003: 2996: 2981: 2977: 2971: 2969: 2967: 2965: 2963: 2961: 2959: 2957: 2948: 2941: 2939: 2930: 2926: 2922: 2918: 2914: 2910: 2906: 2902: 2898: 2894: 2886: 2884: 2869: 2865: 2858: 2844: 2840: 2833: 2825: 2820: 2815: 2812:. July 2017. 2811: 2807: 2801: 2793: 2789: 2784: 2779: 2774: 2769: 2765: 2761: 2757: 2750: 2742: 2738: 2733: 2728: 2724: 2720: 2716: 2712: 2708: 2705:(in German). 2704: 2700: 2693: 2677: 2673: 2667: 2651: 2647: 2643: 2636: 2617: 2610: 2604: 2589: 2585: 2579: 2577: 2568: 2564: 2558: 2554: 2544: 2541: 2539: 2536: 2535: 2531: 2530: 2527: 2524: 2522: 2519: 2517: 2514: 2512: 2509: 2507: 2504: 2502: 2499: 2498: 2494: 2493: 2490: 2487: 2485: 2482: 2480: 2477: 2475: 2472: 2470: 2467: 2465: 2462: 2460: 2457: 2455: 2452: 2451: 2447: 2446: 2440: 2437: 2433: 2431: 2427: 2421: 2419: 2410: 2405: 2401: 2399: 2384: 2380: 2376: 2372: 2368: 2366: 2363: 2360: 2355: 2351: 2348: 2344: 2341: 2337: 2333: 2329: 2326: 2321: 2317: 2313: 2309: 2305: 2301: 2297: 2293: 2289: 2286: 2282: 2281:nitrous oxide 2278: 2274: 2270: 2267: 2263: 2259: 2255: 2251: 2248: 2243: 2239: 2238:Infusion pump 2236: 2233: 2229: 2225: 2221: 2217: 2216:intramuscular 2213: 2210: 2209:intramuscular 2206: 2202: 2199: 2194: 2191: 2188: 2185:Placement of 2184: 2181: 2176: 2172: 2169: 2166: 2163: 2161: 2158: 2153: 2149: 2146: 2143: 2140: 2136: 2133: 2129: 2125: 2121: 2118: 2113: 2109: 2105: 2103: 2100: 2097: 2093: 2089: 2086: 2081: 2077: 2073: 2070: 2067: 2064: 2060: 2059:oropharyngeal 2056: 2053: 2049: 2046: 2044: 2039: 2035: 2033: 2030: 2028: 2023: 2021: 2016: 2013: 2011: 2008: 2004: 2001: 2000: 1995: 1983: 1979: 1977: 1974:for cases of 1973: 1969: 1965: 1961: 1959: 1955: 1951: 1948: 1945: 1941: 1937: 1933: 1929: 1926: 1923: 1919: 1915: 1912: 1910: 1906: 1902: 1898: 1894: 1890: 1886: 1882: 1879: 1876: 1872: 1868: 1865: 1864:nitroglycerin 1861: 1859: 1855: 1851: 1847: 1844: 1840: 1836: 1833: 1829: 1825: 1822: 1819: 1815: 1811: 1807: 1803: 1800: 1797: 1793: 1789: 1785: 1781: 1778: 1775: 1771: 1768: 1765: 1761: 1757: 1753: 1749: 1745: 1741: 1737: 1733: 1730: 1727: 1723: 1720:drug such as 1719: 1716: 1714: 1710: 1706: 1702: 1698: 1694: 1691: 1687: 1683: 1679: 1675: 1672: 1669: 1665: 1661: 1657: 1654: 1653: 1648: 1644: 1642: 1629: 1625: 1621: 1619: 1615: 1612: 1609: 1605: 1603: 1599: 1595: 1591: 1588: 1585: 1581: 1578: 1575: 1574:Spinal injury 1572: 1570: 1566: 1563: 1561: 1558: 1556: 1552: 1548: 1544: 1540: 1537: 1533: 1530: 1527: 1523: 1520: 1518: 1514: 1510: 1509:oropharyngeal 1506: 1502: 1498: 1494: 1490: 1487: 1483: 1479: 1475: 1471: 1467: 1463: 1459: 1456: 1452: 1451:cardioversion 1448: 1444: 1440: 1437: 1436: 1435: 1430:Common skills 1422: 1420: 1416: 1413:) whereas in 1412: 1406: 1404: 1400: 1395: 1390: 1388: 1384: 1380: 1376: 1372: 1368: 1363: 1356: 1351: 1346: 1336: 1334: 1330: 1326: 1323:As a part of 1316: 1314: 1310: 1306: 1302: 1297: 1295: 1290: 1288: 1283: 1279: 1275: 1271: 1267: 1261: 1254:United States 1251: 1248: 1244: 1240: 1235: 1233: 1229: 1224: 1222: 1218: 1214: 1209: 1203: 1193: 1191: 1187: 1184:training, or 1183: 1173: 1170: 1166: 1162: 1158: 1154: 1150: 1141: 1136: 1131: 1121: 1117: 1115: 1111: 1107: 1103: 1099: 1093: 1090: 1085: 1083: 1079: 1075: 1069: 1067: 1062: 1054: 1049: 1045: 1043: 1032: 1030: 1026: 1023:, the show's 1022: 1018: 1014: 1010: 1006: 1002: 998: 997:James O. 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