Advanced Practice Paramedic

[Just Plain Ruff]

What we should NOT do (as in BC) is get used in nursing homes as muscle and routine bath care moreover as "emergent" IMHO We also need Medical Directors that have not only ER experience but with Community Health, Alberta Health Services and ACoP gets a big phat FAIL in those areas, the 3 wize men concept is all baddness.

nuff said fer now.

cheers

ps I am awaiting a Alphabet course that is entitled ECP ... that's the EXTREME CARE PARAMEDIC

Definately should not be used in nursing homes for lifting or bath care. The minute that happens in the systems I work in is the last day my license will be used. I can understand the occasional need to help the nursing homes with heavy lifting but seriously put a fire truck on that call.

There is already an ECP course, it's called CCEMP or Critical Care paramedic.

[tniuqs]

There is already an ECP course, it's called CCEMP or Critical Care paramedic.

Not up in igloo land ! its called CCP a protected title but yet to be defined .. soo .. dont get me going on that topic PLEASE . Hey and don't rain on my EXTREME CARE PARAMEDIC parade eh .

Point being that the alphabet soup courses and pseudo titles don't mean jack.

[NYCEMS9115]

I did love Alphabet Soup and Alphabet Cereal as a kid. The Alphabet Programs out there are way out of control like a bull running through the streets of Espana. There's so much learning we all must do. I am all for learning but Programs are not readily available for us. Hmmmm, like the CCEMTP and the BS in Paramedics. I can easily get the non required ABC Certifications like PHTLS, PEPP, AMLS, BDLS/ADLS, HAZMAT, PEARS, NRP, & among others but they are $200+ a pop. If they expand the SOP for Paramedics; then let's go.

That being said; Obamacare, Entitlement Programs, and HMOs will cut drastically on services for patients and reimbursements for rendered services. They will continue to battle this in the Senate and the House; all for the sake of Party control come 2012. The APP will save $ on Hospital costs but will it keep the Ambulances afloat? Of course this is all conjecture...

Edited May 26, 2011 by NYCEMS9115

[fiznat]

I sat for a lecture about this from the guy running the program during the last JEMS conference. I don't remember every detail, but I remember him mentioning:

-APPs do 100% followup on every refusal in their system. That means that APPs are calling these patients, and sometimes visiting, to make sure not only that they understood what the refusal meant, but also that they're doing OK and know how to get help if they need it. As I recall they also offer advice on how to streamline care (IE 911 isn't always the best option).

-APPs have a slightly advanced scope of practice which I believe centers around cardiac arrest resuscitation. They respond to every code and do RSI, induced hypothermia, etc. They also serve as extra hands and I believe "run" the code to ensure optimum care.

-Psychs. My impression was that they skip the ER and go to a facility or somehow streamline that process.

All in all I remember thinking that it was an interesting take on EMS, but not something I would personally ever want to do. Although I do agree somewhat with the dogma that EMS must stick to "emergency" care, I think we would be mindful of the fact that it was partially through this kind of expansion of scope that got nurses to where they are today. I don't think anyone would disagree that EMS could very much benefit from a similar maturation...

[Kiwiology]

All Ambulance Officers here regardless of practice level can leave people at home, do alternate referrals etc but our Extended Care Paramedic you are able to write simple antibiotics and one or two other things sort of like Emergency Care Practitioner in the UK except we didn't make a mess of it.

[zippyRN]

All Ambulance Officers here regardless of practice level can leave people at home, do alternate referrals etc but our Extended Care Paramedic you are able to write simple antibiotics and one or two other things sort of like Emergency Care Practitioner in the UK except we didn't make a mess of it.

ECP was made a mess of in the Uk for 2 reasons

1. trying to introduce it at a time when

a. the pointless metric was almighty - and there was not enough ring fenced funding

b. when there was a shortage of Paramedics at the time so to extract them for ECP training was a difficulty... ( the irony being that many of the Nurses who could have been appointed if the Services had all followed the original 'rules' were already doing part or all the ECP skills)

2. too many services just advertised internally rather than recruiting across professions and services - which led to the wrong people in the role in some places- as an easy way to either get off a truck or get up a band

[NYCEMS9115]

I asked Chief Kirkwood about the APP through an email. He quickly replied with:

"Advanced Practice Paramedic is a local program - something that we designed to meet the unique needs of our community. While we will share anything that we do with anybody, I personally hope that it never becomes a state certification, or anything like it, because the needs of every community are so very different. This is a place for state EMS regulations to "get off the back" of the local community and let us innovate.....

We select experienced medics who are excellent clinicians, who have excellent customer service skills, and we put them through a 300 hour training program that is focused on working with and building relationships with public health, mental health crisis, detox, crisis intervention team police officers, and of course on the things we want them to do to mitigate falls, help families of deceased, care for diabetics, etc.

I hope that helps. Take care.....

Skip Kirkwood, M.S., J.D., EMT-P, EFO, CMO

Chief, Emergency Medical Services Division

Wake County Department of Emergency Medical Services

331 S. McDowell Street

Raleigh, NC 27601

(919) 856-6026 (office)

(919) 625-0053 (cell)

(919) 856-6209 (fax)

skip.kirkwood@wakegov.com

www.wakegov.com/ems"

City members email him with any questions...

[paramedicmike]

I think any program that measures its training in terms of hours is suspect from the beginning.

[fiznat]

It also makes me cringe when people refer to patients as "customers."

[Kiwiology]

Patients cringe whenever Kiwi comes to treat them too ... hmm, perhaps it is somehow related?