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Certified Paramedic

A Paramedic is a “Health Care Professional who responds to requests for help from people who are suffering an acute health crisis of any nature.” This includes providing health assessment, initial treatment, transport to hospital, and sometimes treatment on scene that allows the patient to remain at home.  

A paramedic needs to be well versed in many kinds of medical treatment. Many paramedics are trained in emergency surgery techniques, especially given the unpredictability of such operations in the field. 

The Paramedic must have excellent judgment and be able to prioritize decisions and act quickly in the best interest of the patient, must be self disciplined, able to develop patient rapport, interview hostile patients, maintain safe distance, and recognize and utilize communication unique to diverse multicultural groups and ages within those groups. Must be able to function independently at optimum level in a non-structured environment that is constantly changing. Paramedics have fulfilled prescribed requirements by a credentialing agency to practice the art and science of out-of-hospital medicine in conjunction with medical direction. Through performance of assessments and providing medical care, their goal is to prevent and reduce mortality and morbidity due to illness and injury. Paramedics primarily provide care to emergency patients in an out-of-hospital setting. Paramedics have completed well over 1300 hours of training, classroom, field internship, and clinical rotations before being allowed to test for their certification.  Then, and only then will they be allowed to practice in the field setting, often times being supervised closely for a period of time.

The Paramedic must not only be knowledge about medications but must be able to apply this knowledge in a practical sense. Knowledge and practical application of medications include thoroughly knowing and understanding the general properties of all types of drugs including analgesics, anesthetics, anti-anxiety drugs, sedatives and hypnotics, anti-consultants, central nervous stimulants, psychotherapeutics which include antidepressants, and other anti-psychotics, anti-cholerginics, muscle relaxants, anti-dysrhythmias, anti-hypertensive, anticoagulants, diuretics, bronchodilators, opthalmics, pituitary drugs, gastro-intestinal drugs, hormones, antibiotics, anti-fungals, anti-inflammatories, serums, vaccines, anti-parasitic, and others. The Paramedic is personally responsible, legally, ethically and morally for each drug administered, for using correct precautions and techniques, observing and documenting the effects of the drugs administered, keeping one' own pharmacological knowledge-base current as to changes and trends in administration and use, keeping abreast of all contraindications to administration of specific drugs to patients based on their constitutional make-up, and using drug reference literature. The responsibility of the Paramedic includes obtaining a comprehensive drug history from the patient that includes name of drugs, strength, daily usage and dosage. The paramedic must take into consideration that many factors, in relation to the history given, can affect the type medication to be given. For example, some patients may be taking several medications prescribed by several different doctors and some may lose track of what they have or have not taken. Some may be using, Non-prescription/over the counter drug. Awareness of drug reactions and the synergistic effects of drugs combined with other medicines and in some instances, food, are imperative. The paramedic must also take into consideration the possible risks of medication administered to a pregnant mother and the fetus; keeping in mind that drugs may cross the placenta.

The Paramedic must be cognizant of the impact of medications on pediatric patients based on size and weight, special concerns related to newborns, geriatric patients and the physiological effects of aging such as the way skin can tear in the geriatric population with relatively little to no pressure. There must be an awareness of the high abuse potential of controlled substances and the potential for addiction, therefore, the Paramedic must be thorough in report writing and able to justify why a particular narcotic was used and why a particular amount was given. The ability to measure and re-measure drip rates for controlled substances/medications is essential. Once medication is stopped or not used, the Paramedic must send back-unused portions to proper inventory arena.

The Paramedic must be able to make accurate independent judgments while following oral directives. The ability to perform duties in a timely manner is essential, as it could mean the difference between life and death for the patient. The Paramedic must be able to apply basic principles of mathematics to the calculation of problems associated with medication dosages, perform conversion problems, differentiate temperature reading between centigrade and Fahrenheit scales, be able to use proper advanced life support equipment and supplies (i.e. proper size of intravenous needles) based on patient' s age and condition of veins, and be able to locate sites for obtaining blood samples and perform this task, administer medication intravenously, administer medications by gastric tube, administer oral medications, administer rectal medications, and comply with universal pre-cautions and body substance isolation, disposing of contaminated items and equipment properly. The paramedic must be able to apply knowledge and skills to assist overdosed patients to overcome trauma through antidotes, and have knowledge of poisons and be able to administer treatment. The paramedic must be knowledgeable as to the stages drugs/medications go through once they have entered the patient's system and be cognizant that route of administration is critical in relation to patient's needs and the effect that occurs. The Paramedic must also be capable of providing advanced life support emergency medical services to patients including conducting of and interpreting electrocardiograms (EKGs), electrical interventions to support the cardiac functions, performing advanced endotracheal intubations in airway management and relief of pneumothorax and administering of appropriate intravenous fluids and drugs under direction of off-site designated physician. Paramedics and  
                           
Anatomy and Physiology

Anatomy is the study of the structures associated with the human body. Physiology is the study of the function of each of these structures. The human body is often thought of as a complicated machine. In order for the machine to work, it must have all of its parts but in addition each of these parts must function optimally. If organs or organ systems are not functioning properly, then the patient is described as having disease.

For a specific example: Some patients have a thinning (weakening) spot in the wall of an artery. This is referred to as an aneurysm. The blood in arteries is under very high pressure. This pressure becomes even greater when we are undergoing activity such as exercise. If the wall of the artery is weak and the pressure on the blood increases too much, then the vessel may rupture (burst aneurysm) and the patient may bleed to death.

The structure (vessel wall) has changed so that the artery can no longer carry out its function (containing the blood).

You want to provide the patients the best care possible. Most often your patients will have a disease or sudden illness. Diseases are often a result of an abnormality in the anatomy and physiology of a structure. With a car, you can’t understand how to fix an engine if you don’t know how it works. The same is true with your patients. You can’t really understand how to treat them or why the treatments work the way they do, if you don’t understand how the affected body system normally functions. Patients need to understand their diseases. In order to help them understand what is going wrong, you have to first understand how a particular organ is supposed to work. In addition, you will need to be able to explain this to the patients in a way that they can understand. Organ systems are so interconnected that a disease in one system may produce a symptom in another system. Without seeing the normal interconnected function, you cannot fully understand the disease. If you don’t understand all of that well you will not be able to explain it to your patient and execute the correct interventions.
 

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