Extended Care Paramedic

What is an extended care paramedic?

An extended care paramedic is a relatively new concept in Ambulance and is similar to Paramedic Practitioners in other countries. Basically, the extended care paramedic program was designed to relieve the overburdened emergency departments from their low priority and low acuity patients who could, conceivably be treated safely at home, or in other means, such as extended care paramedics with specialised training is certain areas of hospital care, GPs, Physiotherapists, Community Health and other members of the multidisciplinary health teams. ECPs provide alternate care pathways for patients and assist in reducing unnecessary transport to hospital. Attendance by an ECP reduces the disruption to patients and their carers that is associated with a trip to hospital. If after assessment, the patient still needs to go to hospital, the ECP will arrange this. Patients receive more tailored care and if needed, will be managed in collaboration with other health professionals that are appropriate to their needs.

What states currently use ECPs?

Currently, the Ambulance Service of NSW and the Ambulance Service of South Austalia have implemented Extended Care Paramedic programs. Although, I believe some other Ambulance Services in Australia are currently considering implementing or currently implementing their own extended care paramedic programs.

How is an ECP dispatched?

ECPs generally only attend patients who have made a call to triple zero (000). An ECP may be also be dispatched because requirements through phone consultation or emergency paramedic crew referral.

What equipment and procedures to ECP paramedics perform?

Normal ambulance kits, 12 lead ECG, Point of care testing using i-STAT machine.

ECPs may take blood and test: electrolytes, troponin I, INR, and multiple other blood specimens. Which may be then taken to specified pathology testing companies for processing with a copy of the results sent to the patient’s GP

ECPs may treat multiple injuries and ailments through the skill and use of: Suturing equipment, wound glue and extensive range of wound dressings, plaster of paris for backslabs, ENT assessment – otoscope. Ring cutters for ring removal. ECPs may assess and change Urinary catheters and PEG’s

What extra medications do they have?

Antibiotics, Bronchodilators, puffers, spacers and peak flow meters, analgesics –  including panadeine forte, panaedine, ibrufen, paracetamol, endone, NSAID, Steroids, Antiemetics, Antispasmodic, Antidiarrhoea, Antihistamine, ADT (tetanus vaccine), Gastrolyte and ural.

What cases do ECPs usually spend their day doing?

Wound care including suturing and skin tears, pain management, chronic pain (musculoskeletal) and palliative care patients with break through pain, gastroenteritis – diarrhoea and vomiting, catheter/urinary tract infection/urinary retention,  replacement of urinary catheters – female, male and supra pubic with acute problems (acute and non-acute), rehydration/heat/dehydration, cellulitis, chest infections,  PEG replacements, and epistaxis.

What other health care professionals do ECPs liaise with?

General and other medical practitioners, Community Health, Palliative care services, Carers Respite Centre, Physiotherapists.

This shows the dynamic nature of paramedics and pre-hospital care as a vocation, and is a good exmaple of how these Ambulance Services are improving and furthering their paramedic spectrums through advancements of knowledge and skill bases and responsibilities.