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Authors

Jennifer Short

Abstract

The role of the paramedic During the 1950s and 1960s ambulance services aimed to provide a quick response and speedy transportation. Over the past ten years the role of the paramedic has become more diffuse. A tripartite emphasis on access, stabilisation and transport can be discerned.

Source of the push for an expanded role of the paramedic It is possible to discern two sources pushing for an expanded role for the paramedic:

• The first source of the push for an expanded role can be identified as coming from paramedics themselves.

• The second source of the push for an expanded role for the paramedic can be seen to be coming from health care payers.

Constraints A number of constraints diminish the likelihood of the expansion of the current role of the paramedic. • Doctors may baulk at delegating any additional tasks to mid-level practitioners (paramedics).

• Nurses may identify that proposals for an expanded role for the paramedic are redundant because they mimic existing public health and community nurse roles.

• In a period of health care reform focused on cost containment it is particularly difficult to justify any expansion of a currently existing role. The exception may be an expanded role associated with implementing some form of economic discrimination within the emergency medical system.

Opportunities Despite the existence of constraints, significant opportunities exist which strengthen the likelihood of the expansion of the current role of the paramedic. • Given the current emphasis on cost containment, paramedics could expand their current role by performing the role of "Gatekeeper" with respect to access to health care facilities. • In rural areas, paramedics could take on the role of "Out Of Hospital Emergency Care Provider". • Paramedics can perform the role of "Quality Assurance Assessor". • The role of "Researcher" can be undertaken by paramedics. • Paramedics have the potential to fulfil the role of "Community Educator".

Conclusion Within a health care system characterised by an overriding emphasis on the necessity to contain costs and to use resources efficiently, the desire to expand the role of the paramedic appears fraught with difficulty. It can be argued however, that by expanding the role of the paramedic in order to fill current health care system deficiencies, patient care will benefit, whilst at the same time, greater levels of efficiency and effectiveness will be achieved.

* Within this paper, the term "paramedic" is used in the generic sense. That is, it is inclusive of more specialised terms such as Qualified Ambulance Officer, Advanced Life Support Officer, Mobile Intensive Care Ambulance Officer, etc.

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