Would love to see this in the US....

[akflightmedic]

but will not happen anytime soon, until we get our act together, increase education standards and get out from other public service agencies.

There is no source attached to this snippet, so if anyone has more info, please link it.

Paramedic diagnosis could ease ER congestion - Canada

The head of the Alberta College of Physicians and Surgeons says allowing paramedics to diagnose patients could help overcrowding in emergency rooms.

Under the planned provincial takeover of ambulance services next April, paramedics would decide whether a patient should be dealt with in an urgent care centre or on site.

College registrar Dr. Trevor Theman says if paramedics can help those patients get care in some other way and take the burden off the emergency department, then it's a good thing.

He says every ambulance service in the province works under medical direction, usually an on-call emergency room physician.

[akroeze]

You know the more I hear about Alberta the more I'm considering moving there. I really like how medics there are independent practitioners.

[BEorP]

You know the more I hear about Alberta the more I'm considering moving there. I really like how medics there are independent practitioners.

The other major factor being that there are actually jobs there...

[Arizonaffcep]

but will not happen anytime soon, until we get our act together, increase education standards and get out from other public service agencies.

There is no source attached to this snippet, so if anyone has more info, please link it.

Paramedic diagnosis could ease ER congestion - Canada

The head of the Alberta College of Physicians and Surgeons says allowing paramedics to diagnose patients could help overcrowding in emergency rooms.

Under the planned provincial takeover of ambulance services next April, paramedics would decide whether a patient should be dealt with in an urgent care centre or on site.

College registrar Dr. Trevor Theman says if paramedics can help those patients get care in some other way and take the burden off the emergency department, then it's a good thing.

He says every ambulance service in the province works under medical direction, usually an on-call emergency room physician.

In Southern AZ, as long as you have a good rapport with the hospital staff, you can let them know if the "patient is triage-able," meaning they are ok for triage instead of straight to and ED room. EMS is not allowed to transport patients to anywhere but an ED (from a 911 based call).

[Fox800]

At my gig we decide where the patient goes as well (ER vs. triage) but that isn't anywhere near the level of autonomy that the Alberta paramedics have in this case.

[JPINFV]

but will not happen anytime soon, until we get our act together, increase education standards and get out from other public service agencies.

Is there any developed country that's behind us in terms of prehospital care? Here's a study out of the UK.

Effectiveness of emergency care practitioners working within existing emergency service models of care

Suzanne Mason1, Colin O’Keeffe1, Patricia Coleman1, Richard Edlin2, Jon Nicholl1

1 Health Services Research, School of Health and Related Research, University of Sheffield, Sheffield, UK

2 Sheffield Health Economics Group, School of Health and Related Research, University of Sheffield, Sheffield, UK

Correspondence to:

Correspondence to:

Dr S Mason

Health Services Research, School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield S1 4DA, UK;s.mason@sheffield.ac.uk

Background: An emergency care practitioner (ECP) is a generic practitioner drawn mainly from paramedic and nursing backgrounds. ECPs receive formal training and extended clinical skills to equip them to work as an integral part of the healthcare team working within and across traditional boundaries of emergency and unplanned care. Currently, ECPs are working in different healthcare settings in the UK.

Objectives: (1) To evaluate appropriateness, satisfaction and cost of ECPs compared with the usual service available in the same healthcare setting, (2) to increase understanding of what effect, if any, ECPs are having on delivery of health services locally and (3) to evaluate whether ECP working yields cost savings.

Methods: Using a mixed-methods approach, data were collected quantitatively and qualitatively from three different types of health provider setting where ECPs are operational, in three areas of England. Data were collected by sending two questionnaires to each patient eligible to be seen by an ECP, at 3 and 28 days after presentation; telephone interviews were conducted with a sample of staff that included ECPs, other health professionals and stakeholders (eg, managers) in each of the three settings; and routine data were analysed to provide a perspective on costs.

Results: After adjusting for age, sex, presenting complaint and service model, some differences in the processes of care between the ECPs and the usual providers in the three settings were observed. Overall, ECPs carried out fewer investigations, provided more treatments and were more likely to discharge patients home than the usual providers. Patients were satisfied with the care received from ECPs, and this was consistent across the three different settings. It was found that ECPs are working in different settings across traditional professional boundaries and are having an impact on reconfiguring how those services are delivered locally. Costs information (based on one site only) indicated that ECP care may be cost effective in that model of ECP working.

Conclusion: Care provided by ECPs appears to reduce the need for subsequent referral to other emergency and unscheduled care services in a large proportion of cases. We found no evidence that the care provided by an ECP was less appropriate than the care by the usual providers for the same type of health problem.

Emergency Medicine Journal 2007;24:239-243;

http://emj.bmj.com/cgi/content/abstract/24/4/239

/me still has to read this one. I ended up picking up an old JEMS at my new job while waiting for a call and felt like I was getting dumber as I read it. So I went to school and printed out a bunch of articles from EMJ.

[ERDoc]

It sounds like we are getting closer and closer to putting PAs in the field. Why not?

[HellsBells]

You know the more I hear about Alberta the more I'm considering moving there. I really like how medics there are independent practitioners.

Lets not get ahead of ourselves quite yet. This is the proposed model coming forth in April, and nobody knows exactly what things are going to look like yet. There has been a lot of talk about increasing the autonomy of paramedics here, but little actual detail an how that is going to be achieved. Obviously there is going to have to be some changes in training, protocols, and in the whole concept of medical direction as we know it

Check out this thread for more info... Alberta Takes a Huge Step Forward

[akroeze]

The other major factor being that there are actually jobs there...

That too...

Being unemployed is starting to really hurt.

[mobey]

http://www.inews880.com/Channels/Reg/Local...aspx?ID=1049128

Head of Alberta doctors' group supports more responsibility for paramedics

8:14PM

Click here to email Chris Gardner

12/28/2008

The head of the Alberta College of Physicians and Surgeons supports a proposal by Alberta's health minister to allow paramedics increased responsibility for patient care.

Under the planned provincial takeover of ambulance services next April, paramedics could soon be diagnosing patients to determine whether they require a trip to an emergency room.

Health Minister Ron Liepert says it will be up to paramedics to determine if a patient can be dealt with in an urgent care centre or on site. Alberta College of Physicians and Surgeons registrar Dr. Trevor Theman says it makes sense.

He says it could help prevent the unnecessary crowding of emergency rooms.

Theman says in Calgary in particular, there are some patients who are going to emergency departments because they can't get in to see a family doctor. (The Canadian Press, Calgary Sun, ccg)