Author Topic: The use of Paramedic by unqualified groups  (Read 7203 times)

Offline excelcare

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The use of Paramedic by unqualified groups
« on: November 20, 2010, 04:08:04 PM »
I have always stood by the use of Paramedic was a fully qualified ambo at Advanced Life Support level and above. Is it wise still assume this is still the case? Please comment!

misterteddy

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Re: The use of Paramedic by unqualified groups
« Reply #1 on: November 20, 2010, 08:51:24 PM »
the term Paramedic in Australia is a bit of a dog's breakfast. There is no legislative protection for the term at all.

It can mean anyone with a Senior First Aid Certificate, through to a Masters Degree depending on what role you have, and in which state and this is perfectly legal. The WA Industrial Paramedic program for instance is only a couple of weeks long, and is enshrined in their legislation.

There is a campaign to have paramedics recognised AND registered, much the same way nurses are, that is being championed by ACAP (www.acap.org.au) that will hopefully enable a minimum set of standards, both in terms of learning qualification, as well as skills maintenance that hopefully will mean in the future, there will be some level of minimum standard attached to the name

There are plenty of legitimate paramedics working outside of the Ambulance Services so this needs to be taken into account. An increasing number are electing to work in the private sector with a far greater clinical exposure than the same old stuff on the road. The other point of note is that in SA the guidelines and therefore treatment options for Paramedics (not ICP/ECPs of course, just your bog standard Paramedic) are way below that of Nurses with a recognised ALS course. A sad state of affairs really.

Hope that answers your question. The ACAP website has a more expansive area  relating to the registration issue which may help too.

Offline boredmatrix

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Re: The use of Paramedic by unqualified groups
« Reply #2 on: November 20, 2010, 11:21:56 PM »


. The other point of note is that in SA the guidelines and therefore treatment options for Paramedics (not ICP/ECPs of course, just your bog standard Paramedic) are way below that of Nurses with a recognised ALS course. A sad state of affairs really.


Care to Enlighten us?

 

Offline disOrderly

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Re: The use of Paramedic by unqualified groups
« Reply #3 on: November 21, 2010, 02:46:54 AM »
Intruiging...

For such a shitty health system, the US has standardized registrations and exams and someone who isn't a Paramedic and calls themselves one is breaking the law by doing so. Silly we don't have this here.
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No Care 1

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Re: The use of Paramedic by unqualified groups
« Reply #4 on: November 21, 2010, 06:01:11 AM »


. The other point of note is that in SA the guidelines and therefore treatment options for Paramedics (not ICP/ECPs of course, just your bog standard Paramedic) are way below that of Nurses with a recognised ALS course. A sad state of affairs really.


Care to Enlighten us?

yes please do...... I'm sorry RN's do a 2 day ALS course and know more than a SAAS para PL3????? nurse cant act on their own they need a order from a Doctor, written , verbal or use a standing order signed by a Doctor. So how do you figure???.

  
« Last Edit: May 02, 2011, 07:29:08 PM by No Care 1 »

misterteddy

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Re: The use of Paramedic by unqualified groups
« Reply #5 on: November 21, 2010, 12:49:39 PM »
firstly, lets put a few things straight. I didn't say that a Nurse doing an ALS course knew more than a Paramedic - please check my wording. I said they were allowed to do more with their knowledge having done the course. Secondly, Nurses operate in exactly the same way we do as Paramedics, they operate on case by case written orders, or standing orders (that don't need referring to the MO); we operate on the same things except we call them Guidelines. They are the same. DR1's signature is on them, we as Paramedics (or ICPs/ECPs or AOs) are using his authority in a standing order - please don't think you have autonomy, you don't.

Next, the ACCCN course is but one version of ALS. You are mostly correct in what it covers. Importantly it provides training in the most common Cardiac Arrest Drugs, Adrenaline, Amiodarone and Atropine. The last 2 are not able to be given by SAAS Paramedics, only ICPs/ECPs. Fancy having a system where your highly trained, university degree qualified Paramedic, can't even follow the Aust Resus Council ALS Cardiac Arrest Guideline. Scandalous really, it goes beyond just dumb. SAAS (and SA Health) are quite happy to allow Paramedics (and even Volunteer AOs)to call an arrest after 10 mins of asystole (flat line on the ECG for the hose draggers following along), but won't even allow a Paramedic to administer the drug of choice for the condition (atropine)....I mean the person is dead, they aren't going to die more! The cynical among us would say that's easier than having to put them in an ICU bed and worry about the $$cost of their recovery, but far be it for me to be cynical about SA Healths motives.  Is it perfect, no, is it 100% clinical efficous - no, nothing is. Is trying it better than watching someone die for the sake of it - ask the relatives. Hopefully Slater and Gordon the lawyer firm read the forum and can apply one of the few benefits of lawyers; change based on punitive damages.

Other ALS courses, such as the UKRC/ARC ALS, ACLS and ATLS courses provide training and assessment in ETI, ETI failure drills and procedures (including needle cric),IO access, pacing and cardioversion, a more comprehensive drug regime,chest decompression and chest drainage tubes among others. Hospital, practice and remote area nurses are approved to use these skills with the authorisation of their Clinical Director (just the same way Paramedics are given an authority to practice)having completed these courses.

ECGs??....sorry, but your bog standard P3 paramedic cant utilise a 12 lead ECG, only a 3 lead, same as your volunteer Cert 2 (albeit better - it's not about the skill remember, just being able to use it). I've had 2 Paramedics not know where to put the V1-6 chest leads. Yes, this basic skill is being rolled out in the current PDWs....hello welcome to 1980, let alone 2010. How the hell do you activate a STEMI notification with a 3 lead as your diagnostic tool.....oh that's right, a Paramedic can't, only an ALS nurse in a rural hospital, an ICP/ECP or an MO can.

Fluid resuscitation is interesting. Can a SAAS P3 cannulate a patient with a 3 day history of fever and no food/water intake for that duration,displaying obvious signs of dehydration and who has a weak thready radial pulse?.....don't think so. They need to consult. When you deliver them to the RAH, u bet they will get IV fluid from the receiving nurse under a standing order.

I'm not having a dip at Paramedics here,far from it just SAAS and its anachronistic muzzling of it's highly qualified staff. Layers of bureaucracy and a metro-centric mentality (where no case is more than 15 mins from hospital)have meant a dilution of the skills Paramedics have been able to utilise throughout the rest of the world, let alone the rest of Australia.  They have the training now (a degree is the standard remember - although large numbers of current SAAS Paramedics don't even have a Diploma), they have the $$ and are close to if not THE highest paid Paramedics in Australia and in fact most of the world, time we got a better bang for our buck as recipients of their knowledge

/rant

Offline excelcare

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Re: The use of Paramedic by unqualified groups
« Reply #6 on: November 21, 2010, 01:01:50 PM »
Hi all, :-D
In my opinion, the term paramedic should be registered and on the AHPRA (Australian Health Professional Registry Authority) register so that it excludes groups like the one here. With the minimum of Diploma Paramedical Science etc. It would clamp down on persons and groups using the name and confusing the public.  :roll:

No Care 1

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Re: The use of Paramedic by unqualified groups
« Reply #7 on: November 21, 2010, 01:16:54 PM »
Oh dear Teddy....

In brief I must make comment about Atropine

Atropine is no longer recommended in cardiac arrest as per the ERC and AHA guidelines and soon to be released ARC guidelines. You may as well inject them with holy water (with the same expected success rate of resuscitation :roll:).

« Last Edit: May 02, 2011, 07:30:08 PM by No Care 1 »

Offline excelcare

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Re: The use of Paramedic by unqualified groups
« Reply #8 on: November 21, 2010, 01:27:39 PM »
No Care 1,
I tend to agree with what you had written about the CCNA ALS Course as I did the same course through the Queen Elizabeth Hospital in August 2004. I was with that group at the time and we got funding to send 4 members to the course. I still have the course notes.

misterteddy

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Re: The use of Paramedic by unqualified groups
« Reply #9 on: November 21, 2010, 03:36:52 PM »
yep I'm aware of the impending changes noCare.....figured I had prattled on enough...if you read the IlCor papers, i reckon it's just ahead of monkey urine - although I can't find the double blind trial reports

- doesnt change any of the other points does it..... surely you would like to be utilising your skills better?
« Last Edit: November 21, 2010, 05:57:55 PM by misterteddy »

Offline disOrderly

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Re: The use of Paramedic by unqualified groups
« Reply #10 on: November 21, 2010, 11:15:28 PM »
Hear, hear teddy!

That is kind of eye opening. It's frustrating seeing things like this, I don't want to be a nurse, I don't want to work in a hospital. I want to work on an Ambulance. If I want the autonomy I ultimately need to be a Dr, but how many Drs work on Ambulances? Pretty much none. If nurses have slightly more autonomy that's great, but they can't work on an Ambulance. So what do I do?

Maybe I be a Paramedic and hope for the best in the future? :)

However, you say the standardisation is the degree? From what I hear, the FUSA degree is pretty shonky, I've had students, paramedics and even one of the lecturers tell me that. The sad thing is, the degree is pretty much run by Paramedics. Why can't they all band together and say: "For so long we have wanted to be recognised as professionals, how about we actually fight for that and make our degree as good as we can and push for change?" From what I have heard, there has been behaviour by teaching staff in the degree which is far from professional. I know that Flinders itself doesn't help the situation at times, but what you guys need to do is band together, push some buttons and get some action moving.

I can see the potential, at least one person here wants to be the best they can be!
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