hythmics), ECG interpretation (may be limited to Lead II) Semi-automatic or manual defibrillator||Expanded drug therapy options, ECG interpretation (12 Lead), manual defibrillator, synchronized mechanical or chemical cardioversion, external pacing of the heart|
|Cardiac Monitoring||Cardiac monitoring and interpretation of ECGs||12-lead ECG monitoring and interpretation||18-lead ECG monitoring and interpretation|
|Drug administration||Limited oral, limited aerosol, limited injection (usually IM)||Intramuscular, subcutaneous, intravenous injection (bolus), IV drip||per ETT, per rectal tube, per infusion pump|
|Drug types permitted||Low-risk/immediate requirements (e.g. ASA (chest pain), nitroglycerin (chest pain), oral glucose (diabetes), glucagon (diabetes), epinephrine (Allergic Reaction), ventolin (Asthma)). Note: Some jurisdictions also permit naloxone (Narcotic Overdose), nitrous oxide (for pain); considerable variation by jurisdiction||Considerable expansion of permitted drugs, but still typically limited to about 20, including analgesics (narcotic or otherwise) (for pain), antiarrhythmics (irregularities in heartbeat), major cardiac resuscitation drugs, bronchodilators (for breathing), vasoconstrictors (to improve circulation), sedatives||Dramatically expanded (up to 60) drug list, Note: In some jurisdictions advanced levels of paramedics are permitted to administer any drug, as long as they are familiar with it. Note: In some jurisdictions certain types of advanced paramedics have limited authority to prescribe.|
|Patient assessment||Basic physical assessment, 'vital' signs, history of general and current condition||More detailed physical assessment and history, auscultation, interpretation of assessment findings, ECG interpretation, glucometry, capnography, pulse oximetry||Interpretation of lab results, interpretation of chest x-rays, interpretation of cranial CT scan, limited medical diagnosis (e.g. rule out fracture using Ottawa Ankle Rules)|
|Wound management||Assessment, control of bleeding, application of pressure dressings and other types of dressings||Wound cleansing, wound closure with Steri-strips, suturing|
Skills common to all EMTs and Paramedics[change | edit source]
- Spinal injury management, including immobilization and safe transport.
- Fracture management, including assessment, splinting, traction splints where appropriate.
- Obstetrics, assessment, assisting with uncomplicated childbirth, recognition of and procedures for obstetrical emergencies, such as breech presentation, cord presentation, placental abruption.
- Management of Burns, including classification, estimate of surface area, recognition of more serious burns, treatment.
- Assessment and evaluation of general incident scene safety.
- Effective verbal and written reporting skills (Charting).
- Routine medical equipment maintenance procedures.
- Routine radio operating procedures.
- Triage of patients in a mass casualty incident.
- Emergency vehicle operation.
Medications administered[change | edit source]
Paramedics in most jurisdictions administer a variety of emergency medications; the individual medications vary widely, based on physician medical director preference, local standard of care, and law. These drugs may include Adenocard (Adenosine), which will slow the heart for a short period of time, and Atropine, which will speed a heartbeat that is too slow. The list may include sympathomimetics like dopamine for severe hypotension (low blood pressure) and cardiogenic shock. Diabetics often benefit from the fact that paramedics are able to give D50W (Dextrose 50%) to treat hypoglycemia (low blood sugar). They can treat crisis and anxiety conditions; some may also be permitted to perform rapid sequence inductionRSI, a rapid way of obtaining an advanced airway with the use of paralytics and sedatives, using such medications as Versed, Ativan, or Etomidate, and paralytics such as succinylcholine, rocuronium, or vecuronium. Paramedics in some jurisdictions may also be permitted to sedate combative patients using antipsychotics like Hald