ems in ireland

[emt_irl]

well ems in ireland is still on its training wheels compaired to you guys in the u.s.. but i thought id share with you guys what its like this side of the atlantic.

the ambulance service is run nationally by the hse which is the public health body and in dublin its part run by them and the dublin fire brigade.

we have 3 levels of training: emt, paramedic and advanced paramedic. they are the practitioner level nationally regged levels. below that courses and skills vary and are responder level like emergency first responce(bls skills and assist emts with initial assesment) and cardiac first responce(cpr and aed).

we also have many private ambulance and volunteer services.. the private and vols do patient transfere work and event cover like concerts and sports etc... but they also are a back up to the emergency services.

if you need the emergency services here you call 999/112

and if you ring for an ambulance this will show up

or this

they are all staffed by paramedic minimum with most these days by advanced paramedics.

our scope of practice would be:

emtatient assesment like bp, spo2 and avpu, bls and semi auto defib, 3 lead ecg, usual first aid, trauma, spinal and 10 drugs(gtn, salbutamol, glucogon, glucose gel, epinephrine, asprin, paracetamol, entanox and under the direction of a regged medical practitioner morphine i.m

paramedic: all of the above but 12 lead ecg more experence in the field, more drugs mainly cardiac and pain releif, superglottic airways

advance paramedic all of above but with more scope of practice, more theory based skill, waay more drugs, intubation, manual defib and more.

i hope to add more to this as i go along but this is the first breif draft

 

[MrBrown]

That is quite interesting, I've had a look around the PHECC site (pheccit.ie)

Looks like you guys have setup a quasi US/UK system in that you have training deliniated to a number of orginisations under a national standard but do not require a University Degree - much like the UK where it's possible to still do the 16 week and 12 week IHCD Technician and Paramedic courses, respectively. Having said that there's not too many places you can still do the Technician course!

I like the look of a national service and what looks like a national patient care guidelines and report form too! That makes sense tho given Ireland is a small country.

As a comparison here is how our levels work:

Ambulance Technician (Diploma): Oxygen, OPA/NPA/LMA, 3 lead ECG, AED, methoxyflurane, aspirin, paracetamol, GTN, salbutamol neb, glucose PO, IM glucagon, ondansetron PO, combat application tourniquet

Paramedic (Bachelors Degree): + IV cannulation, IV fluid and 10% glucose, 12 lead ECG, manual defibrillation and syncronised cardioversion, adrenaline IM/IV, ondansteron IV, naloxone IV/IM/IN, morphine IM/IV. This level is looking to add nationally amiodarone IV for VF/pulseless VT and midazolam IN/IM for seizures.

Intensive Care Paramedic (Post Graduate Diploma): + IO access, transcataneous pacing, endotracheal intubation, cricothyrotomy, atropine IV, amiodarone IV, midazolam IN/IM/IV, ketamine IM/IV/PO, frusemide IV. fentanyl, suxamethonium and vecuronium IV (selected Officers only)

 

[ExpatMedic0]

How long in hours or credits are each level of training?

PS: Super cool looking rigs!

 

[emt_irl]

That is quite interesting, I've had a look around the PHECC site (pheccit.ie)

Looks like you guys have setup a quasi US/UK system in that you have training deliniated to a number of orginisations under a national standard but do not require a University Degree - much like the UK where it's possible to still do the 16 week and 12 week IHCD Technician and Paramedic courses, respectively. Having said that there's not too many places you can still do the Technician course!

I like the look of a national service and what looks like a national patient care guidelines and report form too! That makes sense tho given Ireland is a small country.

As a comparison here is how our levels work:

Ambulance Technician (Diploma): Oxygen, OPA/NPA/LMA, 3 lead ECG, AED, methoxyflurane, aspirin, paracetamol, GTN, salbutamol neb, glucose PO, IM glucagon, ondansetron PO, combat application tourniquet

Paramedic (Bachelors Degree): + IV cannulation, IV fluid and 10% glucose, 12 lead ECG, manual defibrillation and syncronised cardioversion, adrenaline IM/IV, ondansteron IV, naloxone IV/IM/IN, morphine IM/IV. This level is looking to add nationally amiodarone IV for VF/pulseless VT and midazolam IN/IM for seizures.

Intensive Care Paramedic (Post Graduate Diploma): + IO access, transcataneous pacing, endotracheal intubation, cricothyrotomy, atropine IV, amiodarone IV, midazolam IN/IM/IV, ketamine IM/IV/PO, frusemide IV. fentanyl, suxamethonium and vecuronium IV (selected Officers only)

yeah phecc is only a pretty recent thing maybe since the early naughtys(00's) they are the irish version of nremt id say. they make and control our training programs and clinical practice guidelines. and each level is still under development. mainly because we are such a small country it seems to work so far anways. our emt course is currently the only one that doesnt offer a degree, our paramedics and advanced paramedics recieve a degree from the collage its completed with and registery with phecc(pre hospital emergency care council) you can only train as paramedic or advanced if you work for the public services the hse or the d.f.b. but that is changing with time and eventually we hope to have oparamedic level rolled out for private collages etc to teach.

the patient care reports are only a new thing aswell, but thankfully it standardises patient care reporting pre hospital. i think they are great although a little of the big side when fully unfolded.

How long in hours or credits are each level of training?

PS: Super cool looking rigs!

emt is 120 hours classroom work (4weeks) 2 weeks practical placements and have to maintain continous professional development. eg attend confrences, attend phtls/itls course etc

paramedic is a 270 hours course +19 week internship

adv. Paramedic is 35 weeks ontop of your paramedic training


check out www.phecc.ie our ems regulator

and this link explains all our levels and whats involved for each: http://www.phecit.ie/Documents/Home Page/PHECC Responders and Practioners.pdf

 

[ExpatMedic0]

Are your ambulances Automatic or Manual transmission? Do you require a special endorsement or drivers licence to operate one?

 

[emt_irl]

Are your ambulances Automatic or Manual transmission? Do you require a special endorsement or drivers licence to operate one?

some older models are manual as with all vehicle's here, but the newer models like from 2009 up have a auto box as far as im aware.

you you need a full drivers licence at least and complete an emergency driving course also. then some of the newer amgbulances come in over weight and you are required to get a truck licence to drive them also

 

[ExpatMedic0]

Hey I wrote to your national certification body about U.S. Paramedics coming over and got some really good information. If anyones interested Ill copy the email below. It sounds like Ireland accepts the U.S. NREMT so long as your Paramedic program has enough hours and covered the right subjects. I am going to work international right now in the middle east, maybe when I am done I will see if I can check out Ireland, providing there visa process will let me.

____________________________________________

In response to your email, if you are already registered as a Paramedic with the National Registry in the United States you may apply to have your qualifications assessed as equivalent to the Pre-Hospital Emergency Care Council (PHECC) standard and will not have to sit the NQEMT Paramedic exam here.

However, to work as a Paramedic within Ireland you have to be registered with PHECC. As you have done your training outside of Ireland you will have to go through our ‘Assessment of Equivalence’ process as an overseas applicant. I would like to inform you that each application is assessed individually as per our 2007 Education and Training Standards for EMT, Paramedic or Advanced Paramedic. It is not an automatic process to become a PHECC recognised paramedic upon completion of a Paramedic course outside the country, it is based on your education, training and clinical hours in addition to references and good standing status.

The application form and guidelines for its completion are given via our website. I would advise that you read through the guidelines first before completing the application.

As a general summary of the application process (further information available in ‘guidelines’ link above).

Sections 1-5 need to be completed by yourself, to include notarised copies of your diploma/certificate, details of your pre-hospital emergency care course (i.e. the modules/subjects involved and the modules/subjects duration i.e. how many hours), a notarised copy of your passport and the application fee of €230.

Forms A,B,C,D are to be sent out by you and then sent directly back into us.
Form A goes to your pre-hospital emergency care Training Institution.
Form B goes to your most recent and/or relevant Employer.
Form C you post to the relevant authority which recognises that your qualifications enable you to work in the role of EMT, Paramedic, Advanced Paramedic.
Form D is given to the Competent Authority for which can state your ‘Good Standing Status’. If there is no Competent Authority within your country, or if you are not registered with them then Form D is signed by yourself in the presence of a ‘Notary Public’ – it is a solemn declaration that you have not been convicted of a criminal offence.
Please note: An Irish ‘Notary Public’ can be found on www.notarypublic.ie

Should you require any further information please do not hesitate in contacting me.


Marion O' Malley
(on behalf of Anne Keogh)
Clerical Officer,
Pre-Hospital Emergency Care Council,
Abbey Moat House,
Abbey Street,
Naas,
Co. Kildare.
Tel: 045 882042
Fax: 045 882089
www.phecc.ie
email: anne@phecc.ie

 

[MrBrown]

Are your ambulances Automatic or Manual transmission? Do you require a special endorsement or drivers licence to operate one?

You need Categories C1 and D1; I have tried to figure out how to get them but bloody hell it seems to be a process.

 

[Scout]

The C1 and D1 is a HSE requirment.

C1 basicly is down to weight, the tail lift makes them heavy, Also allows you to drive the decon tructs and comms etc.
D1 is for the old ambulances where you could carry more than 8 people.


YOu can drive some on a car licence with no training, thou it is being worked on.

 

[RSquared]

I'm almost amused at this thread because I am DYING to find out information about EMS in Ireland. Ok dying was a tacky way to say that. Currently I'm an EMT-I student in Alberta, Canada (here we are just EMTs, the lower level is EMR, and the higher level is Paramedic). I'm just at the end of my didactic course and am waiting for my practicum placement before I'll have my qualifications. I would love to move to Ireland and do some EMS over there but I'm not too sure what the reciprocity is. When I'm done I'll also have my PHTLS and AMLS, and AHSF CPR prehospital level CPR.

If you could point me in the right direction as to who, or what I could contact for information on how to get certified over there? Or if there are exchange programs? I would greatly appreciate it! I was looking at the Dublin Fire Brigade website and I got the feeling I had to be a firefighter as well as EMT to work in Dublin. Are all departments over there integrated with the fire department? I don't have the guts to be a firefighter, or the muscles.

Any help is appreciated. It's a daunting task to find all of this information, on top of any visas and all of that. But I would love to do some work over there Thank you in advance!

 

[Scott33]

I was looking at the Dublin Fire Brigade website and I got the feeling I had to be a firefighter as well as EMT to work in Dublin.

Most Irish EMT / Paramedics are NOT part of the FD. Dublin FD does have an EMS component, with a dozen or so ambulances, but it is not typical of how the system works elsewhere.

For the rest of Dublin, and the rest of the country, try here for information purposes.

http://www.phecit.ie/DesktopDefault.aspx

Assuming you are a Canadian National and not in possession of an EU passport, you may be eligible for a "working holiday" visa. Whether or not it permits you to work for an National Ambulance Service, I do not know. Therefore, I would suggest sorting the visa side of things out first, or you may not get much further than a ride along on vacation.

http://www.immigrantcouncil.ie/pdf/Working_in_Ireland_May_09.pdf

After you get your visa sorted, you can apply for "Assessment of Equivalence of [your] Professional Qualifications" using this form

http://www.phecit.ie/Documents/Regi...eas/MOM Application Form AoEoQ - Feb 2010.pdf

Note that both applications are completely independent of each other. In other words, even if you were to gain registration with PHECC, it would make no difference as to whether you are eligible for the relevant visa or not.

Good luck. It would be nice to read of someone who has successfully challenged out a foreign system, and actually gone over (to wherever) to work.

Alternatively, get your RN

 

[Scout]

http://www.phecit.ie/Documents/Clin...er - Responder Medication & Skills Matrix.pdf


gives a good run down of the skill for a Paramedic, they would be in the minimum on a front line ambulance, EMT's can do patient transport but there are alot of them now that al the vols are getting this qualification.

So have a read down the list, insure you have a year on the road under you and you should get through. The HSE run most fo the ambulances across the country, DFB is the only fire service to offer an ambulance service. HSE do do work in Dublin too

 

[MrBrown]

Kind of interesting to see that EMTs in Ireland are not taught how to take a GCS or auscultate a chest.

I know the Irish system is still evolving but this list looks both overly complex (three levels of "first responders") and overly restrictive.

 

[Scout]

Shhh.....

With regard to the 3 FR levels, the first is just CPR and AED. The OFA is a normal first aid course. EFR is the typical 6 day FR course.

 

[emt_irl]

in existance anyone can do gcs... id say most emt's know how to do that and oscultate also but technicially we arent allowed!


you would apply to phecc and have to sit some for of conversion exam, but forgien skills do get recognised espicially from the states.

but actually getting work in ems in ireland, its a closed shop. you can only do it with the national ambulance service or the dubin fire brigade.. both public sector and both arent hiring for the forseeable future and each has a long waiting list on the panel already for training.

 

[Scott33]

but actually getting work in ems in ireland, its a closed shop. you can only do it with the national ambulance service or the dubin fire brigade.. both public sector and both arent hiring for the forseeable future and each has a long waiting list on the panel already for training.

Sounds about right. Ambulance work does attract many applicants, and the public sector positions usually come from within, as far as nationality goes. It's the same policy everywhere.

 

[NJmedic3250]

I may have missed it, but if the ambulance service is not run by the local fire department (Dublin Fire Brigade), it's run by a national service?

 

[Scout]

Yup the HSE, health service executive, they run all of the public health services in Ireland

 

[emt_irl]

but in dublin the hse contracted the dublin fire brigade to provide ems in the dublin and greater dublin area along side the hse...

its all a bit mad here being honest

 

[NJmedic3250]

Well I will say from a uniformity standpoint it is a lot less mad than the system we have here in the state of New Jersey. Here, every town/city has it's own BLS ambulance service supplemented by a hospital paramedic service (there are about 30 of these in the state). So I think Ireland has a leg up on that aspect of EMS. Haha