*International Paramedics Day 2023_ Defining “WHAT PARAMEDICS DO*

It is true that the term "paramedic" can sometimes be misunderstood or interpreted differently by individuals based on their understanding or the information they find online, and this can to a great extent be attributed to the historical context of paramedics and the evolving nature of their work which has in no small way contributed to varying definitions.

In the past, paramedics were primarily associated with emergency medical technicians (EMTs) who provided basic life support (BLS) care and transportation to the hospital. However, over time, the role of paramedics has expanded and evolved significantly.

In modern healthcare systems, paramedics are highly trained medical professionals who possess advanced skills and knowledge in prehospital emergency care. They undergo extensive education and certification programs that equip them to provide comprehensive and advanced life support interventions, such as administering medications, performing advanced airway management, interpreting electrocardiograms (ECGs), and conducting critical assessments.

Today's paramedics work collaboratively with other healthcare providers, including physicians and nurses, to deliver timely and effective medical care in emergency situations. They often function as part of a multidisciplinary team and are integral to the continuum of care from the scene of an emergency to the hospital.

It is important to recognize and understand the modern definition and capabilities of paramedics. While historical definitions may still exist, they may not accurately represent the full scope and capabilities of modern paramedics. Seeking reliable sources, such as professional healthcare organizations or reputable educational institutions, can provide a more accurate understanding of the role and responsibilities of paramedics in contemporary healthcare practice.

By acknowledging the advancements and complexities of the modern paramedic profession, we can appreciate the valuable contributions they make in providing critical prehospital care and improving patient outcomes.

The range of work that paramedics can undertake extends far beyond clinical practice. While clinical care remains a core aspect of their role, paramedics also contribute to various other areas within the healthcare field viz;

Research: Paramedics can engage in research activities, conducting studies, participating in clinical trials, and contributing to evidence-based practices. Their frontline experience allows them to gather valuable insights and contribute to advancements in prehospital care and emergency medicine.

Education: Many paramedics play a crucial role in educating future healthcare professionals, including paramedic students, EMTs, and other healthcare providers. They may serve as instructors, clinical preceptors, or faculty members in educational institutions, sharing their expertise and training the next generation of paramedics.

Leadership and Management: Paramedics can pursue leadership and management roles, such as EMS supervisors, operations managers, or directors. In these positions, they oversee the delivery of prehospital care services, coordinate resources, develop protocols, and contribute to the strategic direction of EMS systems.

Specialized Roles: Paramedics can specialize in specific areas of practice, such as critical care transport, flight paramedicine, tactical paramedicine, community paramedicine, or disaster response. These specialized roles require additional training and expertise to address unique patient populations or specific operational needs.

Community Engagement: Paramedics often engage with their communities beyond emergency response. They may participate in public health initiatives, community outreach programs, and health promotion campaigns to enhance community resilience, educate the public on emergency preparedness, and address public health concerns.

The evolving roles and opportunities for paramedics reflect the growing recognition of their diverse skill set and the valuable contributions they can make beyond clinical practice. It is important to appreciate and highlight the breadth of work paramedics undertake in research, education, leadership, and other areas that contribute to the advancement of prehospital care and overall healthcare systems.

While historical definitions may not fully capture the scope of modern paramedic practice, it is essential to recognize that the core role of paramedics still revolves around providing comprehensive care to patients of all ages in various emergency situations.

Paramedics are trained to be versatile and adaptable practitioners capable of managing a wide range of medical emergencies, traumatic injuries, and critical conditions. They possess the knowledge and skills to assess and treat patients across the lifespan, from infants to older adults. This ability to provide care across diverse patient populations and clinical scenarios is a fundamental aspect of their role.

Defining paramedics solely by what they are not can indeed be limiting and less informative. It is more valuable to emphasize what paramedics are, such as highly skilled healthcare professionals specializing in prehospital emergency care. Their unique training and expertise allow them to perform critical interventions, deliver life-saving treatments, and provide essential support during high-stress situations.

To better capture the essence of modern paramedic practice, definitions should focus on the comprehensive and the specialized care they deliver, their role within the healthcare system, and the impact they have on patient outcomes. Acknowledging the breadth of their responsibilities, from clinical care to leadership, education, research, and community engagement, helps paint a more accurate and informative picture of their contributions to healthcare.

As paramedic roles continue to evolve and expand, it is crucial for definitions and perceptions to align with the multifaceted nature of their work. This recognition ensures a better understanding of the vital role paramedics play in emergency medical services and the broader healthcare landscape.

While today’s colloquial definition of the term “paramedic” creates a conflation of paramedic professional titles across different countries. It's however important to recognize that the term "paramedic" can have variations in its meaning and professional requirements depending on the specific jurisdiction.

In some countries, such as the UK, Australia, Canada, and certain states within the US, the term "paramedic" is indeed a protected title. This means that individuals must meet specific educational and certification requirements to legally use the title and practice as a paramedic. Unlike nigeria where some unknown persons with no traceable source of paramedical training are beginning to give themselves the title of paramedics.

It is worth noting that while the term "paramedic" may have variations across countries, the underlying objective of paramedics remains consistent: to provide skilled emergency medical care in prehospital settings. By recognizing and clarifying these variations, we can enhance public awareness and understanding of the paramedic profession as it exists within different jurisdictions.

As paramedicine continues to progress and adapt to changing healthcare needs, it is crucial that the profession is defined by the individuals actively practising within it hence, the need for those within the profession to have a say in defining it.

Paramedics themselves possess unique insights into the breadth and depth of their roles, the challenges they face, and the skills and knowledge required to provide effective prehospital care. Their firsthand experiences and expertise should be considered when shaping the definition and understanding of paramedicine.

By involving paramedics in defining the profession, we can capture the full spectrum of their capabilities, which go beyond historical definitions that focused solely on the setting of practice. This includes not only the varied clinical responsibilities but also the leadership, research, education, and community engagement aspects that paramedics contribute to.

Defining paramedicine based on the input of those who practice it allows for a more comprehensive understanding of the profession's scope and impact. It ensures that the definition aligns with the realities of the field and accurately represents the multifaceted nature of paramedics' work.

By empowering paramedics to contribute to the definition of their own profession, we can foster a sense of ownership and pride within the paramedic community. It also enables ongoing discussions and refinements that reflect the dynamic nature of paramedicine and its continuous growth and advancement.

Incorporating the perspectives and expertise of paramedics in defining the profession can contribute to a more accurate, meaningful, and inclusive representation of paramedicine, ultimately benefiting both the profession and the patients they serve.

When one considers the definition of a ‘paramedic’ as derived from the Paramedicine Delphi Study 2021, one gleans of a definition that captures the evolving nature of paramedicine and acknowledges the diverse range of settings in which paramedics practice. It recognizes that paramedicine extends beyond emergency care and encompasses various clinical and non-clinical roles.

The inclusion of settings like emergency medical services, ambulance services, hospitals, clinics, and non-clinical roles such as education, leadership, public health, and research highlights the expanding scope of paramedicine. It acknowledges the multifaceted nature of paramedic practice and the diverse contributions paramedics make within the healthcare field.

This comprehensive definition reflects the evolving responsibilities and capabilities of paramedics, recognizing their role as healthcare professionals across a range of clinical and non-clinical contexts. It provides a more accurate representation of the profession's scope and aligns with the dynamic nature of paramedicine as it continues to evolve and adapt to changing healthcare needs.

Having a consensus-based definition as derived from the Delphi study signifies that multiple experts and stakeholders within the paramedicine field have come to a shared understanding. Such an inclusive and collaborative approach adds credibility and validity to the definition, ensuring that it reflects the perspectives and insights of those actively involved in the profession.

The Paramedicine Delphi Study 2021's definition provides a valuable reference point for understanding the profession's scope and can serve as a foundation for discussions, research, policy development, and educational curricula related to paramedicine. It contributes to enhancing clarity, promoting professional identity, and supporting the ongoing advancement of the paramedicine field internationally.

Understanding the complex knowledge and skills possessed by paramedics, as well as their broad scope of practice and essential role in the healthcare system coupled with the ability of paramedics to work in unscheduled, unpredictable, and dynamic settings showcases their adaptability and capacity to provide timely and critical care.

The generation and provision of a consensus definition for paramedicine are indeed crucial for the ongoing development and maturation of the discipline. A well-defined and universally accepted definition provides clarity and establishes a common understanding of the profession's scope and purpose. It enables effective communication among healthcare professionals, policymakers, educators, and the public.

A consensus definition also facilitates the establishment of professional standards, regulatory frameworks, and guidelines that support the continued growth and advancement of paramedicine. It ensures that the profession is recognized and valued for the specialized knowledge, skills, and contributions paramedics bring to the healthcare system.

Furthermore, a consensus definition helps to shape education and training programs, ensuring that they align with the evolving demands and expectations of the profession. It aids in the development of competency frameworks and professional development pathways, fostering continuous improvement and ensuring high-quality care delivery.

The provision of a consensus definition reflects the collective expertise and perspectives of paramedics, researchers, educators, policymakers, and other stakeholders involved in the discipline. It demonstrates a shared commitment to advancing paramedicine as a distinct and respected healthcare profession.

Overall, a consensus definition is instrumental in providing a solid foundation for the ongoing development, recognition, and maturation of paramedicine. It serves as a guiding framework that supports the profession's growth, enhances patient care, and strengthens the professional identity and autonomy of paramedics.

As a learned Colleague @george amolo clearly pointed out, there are four pillars within paramedicine: clinical practice, education, leadership, and research. These pillars reflect the multifaceted nature of the paramedic profession and highlight the diverse roles and responsibilities that paramedics undertake beyond clinical care.

Consequently, while historical definitions may not encompass the full scope of paramedic work, it is crucial to recognize and define the profession in a way that reflects the comprehensive contributions paramedics make across these four pillars.

Defining the paramedic profession with a broader perspective acknowledges that paramedics are involved in clinical practice, providing emergency medical care and interventions. However, it also recognizes their roles in education, where they contribute to training and mentoring future paramedics, as well as leadership positions where they guide and shape the direction of paramedicine as a discipline. Additionally, research involvement enables paramedics to contribute to advancing knowledge and evidence-based practices within their field.

By highlighting these four pillars of paramedicine, the definition can encompass the full range of activities and responsibilities that paramedics undertake. This broader definition enables patients, members of the public, and other healthcare professionals to understand and appreciate the diverse expertise and contributions of paramedics.

It is important to emphasize that paramedicine is not solely defined by the presence of an ambulance, blue lights, and red lights. While these visual elements may be associated with the profession, the true essence of paramedicine lies in the specialized knowledge, skills, and dedication of paramedics across clinical practice, education, leadership, and research.

By recognizing and promoting the four pillars of paramedicine in the definition, we can foster a more comprehensive understanding and appreciation for the profession among all stakeholders. This inclusive definition allows for a more accurate representation of the paramedic profession, ensuring that the public and healthcare community have a holistic view of the vital contributions paramedics make beyond the emergency response context.

Yours Sincerely