Expanding the role of paramedics

As populations worldwide continue to grow and life expectancy rises, there has been a corresponding demand placed on health care services. Emergency medical services (EMS) in particular have found themselves under increasing pressure, with some ambulance services experiencing a rise in the number of emergency calls received by as much as 8% annually (Department of Health, 2004).

Traditionally, EMS systems have focused on providing patient care for acute illnesses and emergencies. However, studies have suggested that 10–40% of EMS responses are for non-emergent situations (Joint Committee on Rural Emergency Care and National Association of State EMS Officials (JCREC and NASEMSO), 2010). The need for an EMS role, which can improve individual and community health, reduce unnecessary hospitalisations and emergency department visits, and reduce health care costs, has led to the introduction of community paramedic programmes in the United States, Canada, Australia and New Zealand. In the United Kingdom, similar work has been carried out by paramedic practitioners and/or emergency care practitioners, although without the same level of community engagement found in the community paramedic role.

The inaugural meeting of the International Roundtable on Community Paramedicine (IRCP) in 2005 gave the opportunity for the international exchange of ideas on integrating rural EMS providers into rural health care delivery systems (IRCP, 2014). The IRCP has continued to meet annually, promoting the international exchange of information and experience related to the provision of flexible and reliable health care services to residents of rural and remote areas using novel health care delivery models, and acting as a resource to Government agencies, emergency service providers, and others (IRCP, 2014).

In this issue of International Paramedic Practice, O’Meara conducts a scoping review of the emergence of community paramedics and their potential impact. His findings illustrate that although there are few empirical studies on community paramedics, with much of the literature consisting of commentaries and opinion papers, there is still an emerging research literature that is contributing to the development of community paramedicine programme models and the evaluation tools that will contribute to the future evolution of the model.

Also in this issue, Raynovich et al present the findings of a survey of community course offerings and planned offerings sent to every recipient of a standardised community paramedic curriculum. The responses indicated that many community paramedic courses were in the planning stages by programmes that had received the standardised curriculum, both in the United States and Internationally.

Both these papers illustrate the need for further research to examine the impact of community paramedicine, but also highlight the potential of extended scope of practice of paramedics who are based in the community.


Department of Health (2004) Statistical Bulletin Ambulance Services, England 2003–04. DH, London, UK

International Roundtable on Community Paramedicine (2014) IRCP History. http://www.ircp. info (accessed 20 May 2014)

Joint Committee on Rural Emergency Care, National Association of State EMS Officials (2010) Beyond 911: State and Community Strategies for Expanding the Primary Care Role of First Responders. National Conference of State Legislators December 2010

Taken from International Paramedic Practice, published 21 May 2014.

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