Advanced Practice Paramedic

[rhan101277]

I was looking around online and found that Wake County, NC. has an additional level above paramedic called advanced pratice paramedic. Seems like same thing as advanced practice nurse. Anyhow I found some of their protocols and they do look very progressive. Here are a couple of articles and a link to their protocols

http://www.jems.com/news_and_articles/columns/Bledsoe/Bledsoes_EMS_Scope_of_Practice_Model.html

http://www.wakegov.com/ems/medical/emsprotocols.htm

http://www.wakegov.com/NR/rdonlyres/F6A5BE36-225E-4FC7-8F13-8CC71FD8700C/0/2009protocolupdates.pdf

 

[nomofica]

We have something similar up in Canada. Although, the province I'm in (Alberta) doesn't have a designation above EMT-P, the rest of the country has an ACP (same as EMT-P), and then a more highly-trained designation called a CCP (critical care paramedic).

Ironically, STARS (my province's air ambulance service) only hires CCPs and flight nurses. So if I wanna work with them, I'd have to go out-of-province to get my CCP, then come back home and work.

 

[Dominion]

I only glanced, don't really have time at the moment to really read. It seems like in treatment protocols that they are about on-par with medics here. Our state protocols read somewhat similar except very few services use the state protocols =/

Mostly you'll see that stuff in Rural areas, ESPECIALLY in eastern Ky. I have yet to find a copy of their protocols but I've heard they're doing some pretty crazy crap out that way.

 

[VentMedic]

I was looking around online and found that Wake County, NC. has an additional level above paramedic called advanced pratice paramedic. Seems like same thing as advanced practice nurse. Anyhow I found some of their protocols and they do look very progressive. Here are a couple of articles and a link to their protocols

The APP that Bledsoe is recommending requires a 4 year degree which still falls very short of what an APN has at Masters and with the proposed Doctorate requirement. The difference between nursing and the Paramedic labeling as it exists now is that nursing has established a national standard for training and education for APN/NPs while the Paramedic is still granted the title by however the State, Medical Director and company wants to. Thus, you can now have the APP title and still be a medic mill graduate with just a few extra skills in some places. One could also look at some CCTs and Flight teams to see this now which has done little to boost the image of the Paramedic in some places. When that title is misused you will hear "That's all there is to being an APP, CCP or CCEMT-P?"

Looking over Wake's protocols, they don't appear to be that much different than what a good ALS Paramedic and definitely what CCT/Flight Paramedics should be able to do. Of course, not all CCTs or Flight team Paramedics are are created equal which is where the RN comes in.

For Wake's system they have decided to teach just a handful of Paramedic to do RSI instead of everyone. The other meds that are different for the APP is Oxytocin, Pepcid. procainimide and vasotec in Wake's protocols. Thus, you have a Paramedic driving from scene to scene in a fly car. There are pros and cons to this method in a 911 EMS system. I personally believe to be called progressive all the Paramedics should be well trained to handle these same situations and if more orders are needed they have a med control to contact. Their protocols are not that unique. Sometimes having one "APP" to rush in to save the day does very little for morale among the others and some then become minimalists waiting for the APP to appear. It also puts another emergency vehicle on the road running L&S.