nd diagnostic tools to identify medical emergencies and to administer the appropriate treatment, including drugs that would normally require a physician order. Credentialing may occur as the result of a State Medical Board examination (U.S.) or the National Registry of Emergency Medical Technicians (U.S.). In England, and in some parts of Canada, credentialing may occur by means of a College of Paramedicine (http://www.britishparamedic.org/). In these cases, paramedics are regarded as a self-regulating health profession. The final common method of credentialing is through certification by a Medical Director and permission to practice as an extension of the Medical Director's license to practice medicine. The authority to practice in this semi-autonomous manner is granted in the form of standing order protocols (off-line medical control) and in some cases direct physician consultation via phone or radio (on-line medical control). Under this paradigm, paramedics effectively assume the role of out-of-hospital field agents to regional emergency physicians, with independent clinical decision-making authority that is typically enjoyed only by expert clinicians within the hospital setting. In some parts of Europe, those in the paramedic role are only permitted to practice many of their advanced skills while assisting a physician who is physically present, except in cases of immediately life-threatening emergencies. In certain other jurisdictions, such as the United Kingdom and South Africa, paramedics may be entirely autonomous practitioners capable of prescribing medications.
In the media[change | edit source]
The 1970s television show Emergency! was a very popular series which centered on the work of paramedics in the Los Angeles County Fire Department, and the staff at the fictional Rampart Emergency Hospital. Emergency! has been widely credited with inspiring many municipalities in the United States to develop their own paramedic programs, and has inspired many to enter the fields of emergency medicine. The show was a top rated program for its entire production run (1972 - 1979), as well as in syndicated television reruns – even inspiring a Saturday morning cartoon series.
Mother, Jugs & Speed is a 1976 comedy film, starring Bill Cosby, Raquel Welch, and Harvey Keitel. The film depicts a private ambulance company struggling to survive in Los Angeles, and, while not necessarily showing the profession in its' most flattering light and taking some real liberties for comedic value, provides a fairly honest illustration of the state of the ambulance industry just prior to its' professionalization as EMS.
Casualty is a long-running BBC television series, depicting the staff of the Accident and Emergency Department of the fictional Holby City Hospital, and the English paramedics who work with them. Provides an interesting, human, and realistic view of English paramedics. The show has been filmed on location in Bristol, England, and has run continuously since the mid 1980s, spinning off another series Holby City and a number of made for television films. It has been described as 'one of Britain's most beloved medical dramas'.
Paramedics is also the name of a show on the Discovery Health Channel, which details the life and work of emergency medical squads in major urban centers in the United States. It is also the name of a 1988 Comedy which highlighted the lighter side of EMS.
Paramedic: On the Front Lines of Medicine (1998), by Peter Canning, is an autobiographical account of a paramedic's first year on the job. Rescue 471: A Paramedic's Stories (2000) is the sequel.
Bringing Out the Dead (1999), directed by Martin Scorsese and starring Nicolas Cage is one of very few films about paramedics. The main character is paramedic Frank Pierce who works in New York's Hell's Kitchen. He's become burned out and haunted by visions of the people he's failed to save including a little girl. The film is based on the novel of the same name by Joe Connelly, a former New York City paramedic.
Into the Breach: A Year of Life and Death with EMS (2002