Paramedics serve an important role in emergency medical services, providing pre-hospital treatment and stabilization for individuals experiencing illness or injuries. They are often the first healthcare professionals to arrive at an emergency scene, making rapid assessments and initiating medical care. Their goal is to stabilize patients before transport to a hospital.
Scene Safety and Assessment
Upon arrival, paramedics assess the scene for safety, identifying potential hazards like unstable structures, downed power lines, chemical spills, or active violence. They observe the environment for clues indicating danger, such as unusual odors or suspicious activity, before approaching the patient. Wearing personal protective equipment, such as gloves and goggles, is standard to prevent infection and ensure safety. This assessment also helps determine the number of patients and the nature of illness or injury.
Initial Patient Evaluation and Life Support
Once the scene is safe, paramedics conduct a rapid primary assessment to identify life-threatening issues. This assessment systematically checks the patient’s airway, breathing, and circulation (ABCs). They determine responsiveness and assess airway patency. If the airway is compromised, interventions like a head-tilt chin-lift or jaw thrust maneuver may be performed, and an airway adjunct inserted if necessary.
Breathing is evaluated by observing the rate, depth, and symmetry of respirations, with supplemental oxygen or assisted ventilations provided if breathing is inadequate. Paramedics also assess circulation by checking for a pulse, noting its rate and quality, and observing skin color, temperature, and moisture. Any severe external bleeding is identified and controlled immediately to prevent further blood loss. Simultaneously, paramedics gather initial information from the patient, if conscious, or from bystanders, including the chief complaint and a brief history of the event. This rapid evaluation allows for prompt initiation of life-saving interventions, such as cardiopulmonary resuscitation (CPR) or defibrillation if indicated.
Advanced Medical Care and Transport Readiness
Following the primary assessment and stabilization of immediate life threats, paramedics conduct a more detailed secondary assessment. This involves a thorough head-to-toe physical examination to identify additional injuries or medical conditions. Vital signs, including heart rate, blood pressure, respiratory rate, oxygen saturation, and temperature, are measured and documented to provide a comprehensive picture of the patient’s status. They also gather a more in-depth patient history, including allergies, medications, past medical history, last oral intake, and events leading to the current situation, often using mnemonics like AMPLE.
Based on their findings, paramedics administer advanced medical care, which can include intravenous fluid administration, medication administration for specific conditions like cardiac events or severe allergic reactions, and pain management. For trauma patients, stabilization techniques such as splinting fractures and immobilizing the spine are performed. Patient packaging and securing for transport are important steps. Patients are carefully moved onto a stretcher and secured, ensuring their comfort and minimizing movement that could exacerbate injuries during the ambulance ride. Equipment for ongoing care during transport, such as oxygen, monitoring devices, and intravenous drips, is prepared and secured.
On-Scene Documentation and Handover
During and after patient care on scene, paramedics document all findings, interventions, and patient information. This documentation includes details of the scene, the patient’s initial presentation, all assessments performed, treatments administered, and the patient’s response to those treatments. Accurate and complete records are important for continuity of care and for legal and administrative purposes.
Before arriving at the hospital, paramedics provide a pre-arrival notification to the receiving emergency department. This communication alerts hospital staff about the incoming patient, their condition, and any specialized care they might require, such as for stroke, heart attack, or trauma. This allows the hospital to prepare the necessary space, equipment, and medical team, streamlining the patient handover process. Upon arrival at the emergency department, a formal verbal handover occurs, where paramedics provide a concise yet comprehensive report to the hospital staff, ensuring a smooth transition of care. This structured handover includes the patient’s identification, chief complaint, relevant history, assessment findings, treatments given, and the patient’s current status.