Do You Want the Coolest Job There is in Health Care?
By Chris Reynolds- CEM, REMT-P
Battalion Chief – Tampa, FL, USA

We’ve all watched television programs depicting the action in emergency rooms. From the television drama, “ER” to the Discovery Channel’s “Trauma Life in the ER”, they all conjure up an image of excitement and fast action. The month of May is EMS Month, so take a moment and reflect upon the significance of emergency medical services in your community.

What is a Paramedic?

A Paramedic is a highly trained and skilled medical professional who is educated to carry out some of the duties of a nurse or physician. Paramedics can examine, evaluate and treat patients with equipment and medications usually only found in the emergency department of a hospital. Paramedics are typically utilized as emergency care practitioners on rescue units, but their scope is expanding to many other areas. Some of these include industry, elementary and high schools, colleges, hospitals, doctor’s offices and emergency departments. More challenging and higher paid positions include working in specialty areas such as cruise ship medical departments, off shore oil drilling platforms, helicopter or fixed wing medical transport and hyperbaric oxygen chambers. Often they are the sole or highest trained medical provider in these areas. The origin of the word paramedic may have come from the military, where highly trained medics parachuted into emergency areas. Today the term is used to signify personnel who function as subsidiaries or supplements to Physicians. The prefix para is now taken to mean “closely resembling; beside,” and medic is taken to mean “the Physician”.

A Paramedic works beside and/or resembles the physician. Many of the procedures and medications administered by the Paramedic are ordered and supervised by a physician. This may be through direct supervision or remotely using telephone, radio or pre-established written orders. The Paramedic is a confident leader who can accept the challenge and high degree of responsibility entailed in the position. The Paramedic has excellent judgment and is able to prioritize decisions and act quickly in the best interest of the patient. They are self disciplined, able to develop patient rapport, interview hostile patients, maintain safe distance, and recognize and utilize communication unique to diverse multicultural groups and ages within those groups.

Most importantly, the Paramedic is able to function independently at optimum level in a non-structured environment that is constantly changing. The responsibility of the Paramedic includes obtaining a comprehensive drug history from the patient that includes names of drugs, strength, daily usage and dosage. The Paramedic must take into consideration that many factors, in relation to the history given, can affect the type medication to be given. For example, some patients may be taking several medications prescribed by several different doctors and some may lose track of what they have or have not taken. Some may be using non-prescription/over the counter drugs. Awareness of drug reactions and the synergistic effects of drugs combined with other medicines and in some instances, food, is imperative. The Paramedic must also take into consideration the possible risks of medication administered to a pregnant mother and the fetus, keeping in mind that drugs may cross the placenta. The ability to measure and re-measure drip rates for controlled substances/medications is essential. Among the many medications he or she must know, include analgesics, anesthetics, anti-anxiety drugs, sedatives and hypnotics, anti-convulsants, central nervous stimulants, psychotherapeutics which include antidepressants, and other anti-psychotics, anticholerginics, cholergenics, muscle relaxants, anti-dysrythmics, anti-hypertensives, anticoagulants, diuretics, bronchodilators, opthalmics, pituitary drugs, gastrointestinal drugs, hormones, antibiotics, antifungals, antiinflammatories, serums, vaccines, anti-parasitics, and others.

The Paramedic must be able to apply basic principles of mathematics to the calculation of problems associated with medication dosages, perform conversion problems, differentiate temperature reading between centigrade and Fahrenheit scales, be able to use proper advanced life support equipment and supplies ( i.e. proper size of intravenous needles ) based on patient’s age and condition of veins, and be able to locate sites for obtaining blood samples and perform this task, administer medication intravenously, administer medications by gastric tube, administer oral medications, administer rectal medications, and comply with universal precautions and body substance isolation, disposing of contaminated items and equipment properly. The Paramedic must also be capable of providing advanced life support emergency medical services to patients including conducting of and interpreting electrocardiograms (EKGs), electrical interventions to support the cardiac functions, performing advanced endotracheal intubations in airway management and relief of pneumothorax and administering of appropriate intravenous fluids and drugs under direction of off-site designated physician.

The Paramedic is a person who must not only remain calm while working in difficult and stressful circumstances, but must be capable of staying focused while assuming the leadership role inherent in carrying out the functions of the position. Good judgment along with advanced knowledge and technical skills are essential in directing other team members to assist as needed. The Paramedic must be able to provide top quality care, concurrently handle high levels of stress, and be willing to take on the personal responsibility required of the position. This includes not only all legal ramifications for precise documentation, but also the responsibility for using the knowledge and skills acquired in real life threatening emergency situations. Paramedics provide the most extensive pre-hospital care and may work for fire departments, private ambulance services, police departments or hospitals.

The Paramedic must be flexible to meet the demands of the ever-changing emergency scene. When emergencies exist, the situation can be complex and care of the patient must be started immediately. In essence, the Paramedic in the EMS system uses advanced training and equipment to extend emergency physician services to a community. Many large cities and counties use firefighter/paramedics. This adds an extra dimension to the career field by utilizing one highly trained individual to do the arduous and difficult tasks as a firefighter in addition to the paramedic duties.

So, as EMS Week comes around the corner, remember the men and women who make up the most important link in the Emergency Medical System chain the firefighter/paramedics.

The Author: Chris Reynolds is a Battalion Chief and paramedic with Hillsborough County Fire Rescue in the Tampa Bay area of Florida. He holds a Masters Degree in Public Administration and Bachelors in Public Safety. He is a Certified Emergency Manager (CEM) and a Captain in the United States Air Force Reserve. Chief Reynolds has the distinction of supervising the busiest engine companies and rescues in the Tampa Bay area. Stop by and visit his wonderful website at …

Thanks Chris for writing this interesting and informative article for us. And thank you for your dedication to your community, profession & to the USAF. ~ CN ~

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