Helsinki Committee for Human Rights

 

 

 

 

 

 

 

 

Paramedic

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.

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.

Throughout the evolution of pre-hospitalisation 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 Imperial Legions of Rome, where aging Centurions, no longer able to fight, were given the task of organizing the removal of the wounded from the battlefield and providing some form of care. Such individuals, although not physicians, were probably among the world's earliest surgeons by default, being required to suture wounds and complete amputations. A similar situation existed in the Crusades, with the Knights Hospitaller of the Order of St. John of Jerusalem filling a similar function; this organisation continued, and evolved into what is now known throughout the Commonwealth of Nations as the St. John Ambulance and as the Order of Malta Ambulance Corps in the Republic of Ireland and various countries.

As a result of The White Paper, 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) pilot units across the US including paramedic programs. The success of these units led to a rapid transition to make them fully operational.

The training, knowledge-base, and skill sets of both paramedics and emergency medical technicians (EMTs) were typically determined by local medical directors, what it was felt the community needed, and what was affordable. 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 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 nursing, which also progressed from on the job training to university level qualifications.

As paramedicine has evolved, a great deal of both the curriculum 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. Associated technologies also rapidly evolved and changed, with medical equipment manufacturers having to adapt equipment that worked adequately outside of hospitals, to be able to cope with the less controlled pre-hospital environment.

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 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.

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 IDF training, or MADA training. Paramedics manage and provide medical guidelines in mass casualty incidents. 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.

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 aviation medicine and the use of helicopters, 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 (Hazmat) teams, Heavy Urban Search and Rescue, and paramedics on offshore oil platforms, oil and mineral exploration teams, and in the military.

 

 

 

 

 

 

 

 

www.helsinski.org.rs | biserkos@eunet.rs

 

 

 

 

 

 

 

 

U.S. HELSINKI COMMISSION TO HOLD HEARING ON HUMAN TRAFFICKING AND TRANSNATIONAL ORGANIZED CRIME

November 2, 2011

10:00 a.m. - 11:30 a.m.

Please join the Commission on Security and Cooperation in Europe for a hearing that explores the nexus between Transnational Organized Crime and Human Trafficking.

Organized Crime has evolved to meet the challenges of globalization and modern technology. In this evolution major international criminal organizations and smaller highly specialized groups of criminal entrepreneurs have found new ways to expand their operations and exploit human beings into slavery. To meet these challenges new national and international strategies have been placed into action, but their results remain to be seen. This continues the Helsinki Commission’s hearing series on new fronts in human trafficking. This hearing will focus on: (1) the evolving nature of Transnational Organized Crime, (2) the role of major international organized crime groups and smaller organized criminal syndicates in human trafficking, (3) identified trends, and (4) strategies to combat these organizations and prevent the trafficking of human beings.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copyright * Helsinki Committee for Human Rights 2011