Talk:Paramedic

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There are three types of medical emergency workers in regards to ambulances. Everyone must start out as an EMT-Basic (emergency medical tech) They must learn basic life support, basic airway management, bleeding control, splinting, basic anatomy and physiology, scene management and safety, ambulance operations, basic pharmacology, vital sign taking and physical and history patient assessment. In some states, the EMT-B learns IV therapy and AED. They say that a good paramedic was always a good EMT-B first.

The next Level is an EMT-Intermediate. All the skills as an EMT-B plus advanced airway management, EKG interpretation, and multiple drugs including cardiac drugs.

The highest step is EMT-P or Paramedic. The bottom line is more experience, extensive knowledge about medical trauma situations and the human body. As well as more training for many more drugs. In some states, the Paramedic can take more classes and become a critical care paramedic for interfaculty transfer of very sick patients.

WASTREL 09:56, 23 March 2006 (UTC)

Contents 1 Cleanup 2 List? 3 International bias 4 Paramedics in Canada and worldwide 5 Removed some stuff 6 I'm removing this 7 In the U.K. ... 7.1 Paramedics in the UK 7.2 Qualifications 7.3 Employment 7.4 Professional Organizations 7.5 Sources 8 Acts Allowed 9 Difference Between an EMT and Paramedic 10 More U.S. centrisism 11 Golden Rod of Asclepius 12 History of Paramedicine 13 Canada section citation tags 14 Quebec prehosipital setup 15 Lead

[edit] Cleanup

This article has long sections on Germany and Canada. As discussed above, as a layperson I have a hard time determining if and how a paramedic differs from an EMT. Doubtless this varies from country to country, but this article does not explain those differences adequately. This needs attention from a subject-matter expert. Cleduc 2 July 2005 21:19 (UTC)

Now, there is a very profound difference between Paramedics (EMT-P) and the typical EMT. Of course this article is somewhat lacking, and following some other things I will make an effort to revise this article to explain this difference. As it stands, Paramedic does need its own section, because it is a lot more complicated than EMT.

WASTREL 09:55, 23 March 2006 (UTC)

[edit] List?

Does anyone think a list of famous paramedics would be useful? Just a quick bit of research on Wikipedia shows Ernest Hemingway, E. E. Cummings, John Dos Passos, John Howard Lawson, and Archibald MacLeish (to list only the American writers born in the 1890s) were all "ambulance drivers". The list could be interesting. LizardWizard 21:52, July 10, 2005 (UTC)

---

There's a difference between "ambulance driver" and modern paramedic, and while this might have been a term given to figures such as Ernest Hemingway in their time, their role would more appropriately be termed "ambulance driver" or "emt", as they were not trained (even for lack of technology) in most of the applications in which EMT-P are trained.

-LoL WASTREL 09:55, 23 March 2006 (UTC)

and you can add Walt Disney and Walt Whitman to the list of wartime "ambulance drivers"

---

Someone's added a new list of possible skills, which is fine, but it needs a lot of cleanup and needs to be better described as possibilities for skills a paramedic MAY be allowed to perform. If this is going to be a main page with links to descriptions of the roles paramedics have in various countries, it may even be useful in generating some interest in which options are common in different places. Still, at the moment, it reads like a resume. catseyes 10:42, 26 November 2006 (UTC)

[edit] International bias

This article is very US-centric, what a paramedic does in the US should not be listed in this "paramedic" area. --jbignell 16:35, 20 February 2007

This article is very US-centric, and this should be pointed out, or preferably corrected to include information about other countries. For example, I think no other country calls it's paramedics "NREMT-P"s, and in France, ambulance drivers are just that -- they have no/minimal medical training, even in urban environments. --me_and 16:35, 31 July 2005 (UTC)

They are called "NREMT-P"s because they are certified through the National Registry of Emergency Medical Technicans as Paramedics. Now, be aware that not all Paramedics are certified through the NREMT-P. For example, many of the Paramedics in King County are not NREMT-Ps, although they are EMT-Ps through what is typically considered the best paramedic program in the world. -LoL

Actually, in much of Europe, there are doctors and nurses on the ambulances. I've seen literature (but can't quote it directly off the top of my head) that says that American paramedics (including Canadians) have much better patient outcomes than most or all of those systems. --catseyes 03:56, 1 November 2005 (UTC)

In Canada (at least Alberta) a paramedic is a level of EMT, we have 3 levels for pre-hospital care emergency workers, Emergency Medical Responder (EMR), Emergency Medical Technician "Ambulance" (EMT-A), and Emergency Medical Technician "Paramedic" (EMT-P) depending on level of training, now common usage does use "EMR" "EMT" "Paramedic" but technically Paramedic is an "EMT-P" Green1 23:33, 15 December 2005 (UTC)

All depends on perspective really. In Australia a Paramedic can have the most basic of skills, Semi-automatic defibrillation, S/l GTN, and the like or the most advanced skills such as rapid sequence intubation, cricothyrotomy, Decompress Tension Pneumothorax, etc. So the term in Australia is almost meaningless, especially as private providers with dubious qualifications can call themselves a paramedic. Add in the out of date references, and parochial dialgue this is not a very good article. Long story short...this article should be removed, my humble opinion of course.--Paradimn 09:35, 19 December 2005 (UTC)

Perhaps the majority of this article should be under the title of 'Paramedic in the US' and then 'Paramedic' should be a page with a brief description of what a Paramedic generally does, and links to country-specific pages. (Iburneditdown 11:32, 5 January 2006 (UTC))

I agree. See Paramedics_in_Canada. Andrewjuren 23:26, 12 January 2006 (UTC)

I've removed the External links, since they were all specific to paramedics in Canada and already linked on the Paramedics in Canada page. Also, removed the {{cleanup-date}} and {{globalize}} tags, since they are no longer applicable. Andrewjuren 19:33, 8 March 2006 (UTC)

I think that recent changes and the branching of pages for paramedics of different nationalities has actually done quite a lot to make this page more internationally oriented. Perhaps with the addition of comments that explain just how restricted the skills of paramedics are in some places (from what I understand, very minimal skills are required to be called a paramedic in parts of Canada and Australia, to give examples) we could remove the national bias tag? --catseyes 22:08, 19 February 2007 (UTC)

I added the section on South Africa to promote the diversity, eventhough South Africa operates much as the UK with clinicians (ECP) rather than technicians (Paramedics). Princeattractive (talk) 05:16, 21 January 2008 (UTC)

[edit] Paramedics in Canada and worldwide

As a so called "paramedic" in the province of manitoba i have something i would like to add, the term paramedic has been used quite liberaly although it is supposed to mean the highest level of care and traning availible in pre-hospital care. if going by the standards of say texas department of state health services manitoba has no paramedics even though my skill level EMR (Emergency Medical Responder) is considerd to be a paramedic in manitoba. skill levels as low as this should not be considerd paramedics. ambulance officers or ambulance attendants, yes. paramedics no. the term paramedic should only apply to EMT3-P's or EMT-P's. the paramedic page on wikipedia should only deal with the EMT3-P or EMT-P levels. anything else should be called what it is. EMT's whether it be a EMT-1,2,3 or EMT-A,B,I or whatever you call them should have their own catagories and it should be made clear that the lower levels are NOT paramedics. since laypeople are not neccesarily familiar with the different standards it might be adivsable to simply have a paramedic wiki with links to the other skill levels making it clear there is a differance. infact, not every province in canada even calls themselves paramedics, and alberta is not the only one. ontario has AEMCA's[i am making a minor correction] Paradimn, you are partily correct, as i am partily wrong. the A-EMCA testing standatd is a reletivly new advent. older ontario EMCA's were exactly that EMCA's. the term EMT or Paramedic was not part of their title, indeed, their uniforms used to have their service patch and the title EMCA emergency medical care attendant. no paramedic or EMT patch

TheRenaissanceMan 06:54, 18 January 2006 (UTC)L James EMR (not 

paramedic)

- not true(above - statements written by Manitoba EMR)) a-emca in ontario is merely the testing level and the certifications through base hospital are primary care, advanced care and critical care paramedics. Critical care paramedic falls in a level above all of these including EMT-P

The article does a good job of discribing paramedics in the US. I agree with the comments that it should be balanced with international material.

The additional comments in the article do little to aid clarification. In Australia it is not usual practice to start out as an "EMT-B" we don't use that term. In fact it is possible to commence day one as a "paramedic" after gaining a degree from a university this is not a reflection on north American paramedics (with whom I have worked) simply a different way of labelling the people who work on and in ambulances. The term paramedic in the international context does not describe the level of care able to be provided by the caregiver..--Paradimn 10:40, 17 February 2006 (UTC)

In Ontario we use the following classification. PCP -Primary Care Paramedic, ACP - Advanced Care Paramedic , and CCP - Critical Care Paramedic. We do not call ourselves A-EMCA's... —Preceding unsigned comment added by 192.234.223.100 (talk) 17:30, 29 March 2008 (UTC)

[edit] Removed some stuff

I removed this list and the following text. The list was unneccisary and the text read like a child's book and wasn't too useful.

Dependent on local protocol and medical director approval, paramedics can administer most of the following medications: - *adenosine - *albuterol - *aminophylline - *amyl nitrite - *acetylsalicylic acid - *atropine - *calcium chloride - *dextrose 50% - *diazepam - *diltiazem - *diphenhydramine - *epinephrine - *etomidate - *furosemide - *glucagon - *glyceryl trinitrate - *isoetharine - *isoproterenol - *lidocaine - *magnesium sulfate - *metoprolol - *morphine - *naloxone - *norepinephrine - *oxytocin - *pancuronium - *phenobarbital - *procainamide - *promethazine - *sodium bicarbonate - *sodium nitrite - *sodium thiosulfate - *succinylcholine

Unencyclopedic section, feel free to cleanup and reinsert - A Paramedic isn’t just an ordinary doctor it’s much much more!

- Paramedics are the first people at the scene of an accident. They are like ‘mini doctors’ that drive ambulances, boats and fly helicopters! - - A paramedic is also called a ‘medical technician’, which means a person who may be called to any number of settings in an emergency situation. - - Being a paramedic is not all exciting and good. A paramedic must be brave and strong having to put up with some pretty tough stuff. - For example, they see people who are very sad or people who have damaged body parts but apart from that it must be great! - A paramedic has a huge responsibility. People trust paramedics with their lives! - In other words, dealing with life and death! - - When a paramedic gets to the emergency scene he/she must treat the patient first. Then the paramedic will keep looking after the patient until they reach hospital. After that they must tell a doctor about the condition/s of the patient. - A paramedic must be prepared for any emergency situation. - - A paramedic always works with a partner. They take turns of driving the ambulance. Another part of a paramedic’s job is to check if they have the right medicine in the ambulance. They also keep in touch with an ambulance communication centre. An ambulance communication centre is where a more experienced paramedic gives medical advice over the phone. - - Paramedics have to go through lots of training to get to the level where you can drive ambulances at over 100kph when the speed limit is 80kph. Landing in helicopters in snow or in tight spaces or most importantly knowing how to help other people is a major responsibility. - - There are many different types of paramedics. - These include: - Emergency Preparedness Coordinator - (EPC’s) are paramedics that have more training than other normal paramedics, which gives them the ability to handle more dangerous situations and very bad injuries. - Patient Transport Services Staff (PTS’s) are people who are training to become a paramedic. PTS’s have first aid training, they also have specialist driving skills and are able to handle basic life support. - - The highest level of being a paramedic is being an EMT. EMT stands for Emergence Medical Treatment. - An EMT can get to the level where the lead missions or become an Instructor! - An EMT has more levels than one, there can be up to four levels called: EMT, EMT-2, EMT-3 and EMT-4! - - An EMT trained paramedic needs excellent eye-sight and be able to carry heavy loads, such as a patient in a stretcher. - - The lowest level of being a paramedic is called a ‘first responder’ they know all the basic medical stuff so all the pro’s don’t get called out to the easy emergencies where if a major injury happens, they can help. - All emergency services (Fire, Police and Rescue) have the first responder level. - - - A paramedic gets special passes to go places where you can’t go. For example, going in the mine where the trapped miners in Tasmania or standing at the side of a race track and much, much more! - - Paramedics go to about 5- 10 accidents a day. - - Paramedics have ‘shifts’ which means paramedic might work from 12:00am-12:00pm and then another paramedic might come and take over and go from 12:00pm-12:00am and then switch over in a cycle. - - A paramedic not only helps people but also educates the community by visiting schools and doing first aid courses. - - A paramedic is a very important person who never gives up!

If you want to salvage some of that and put it back in feel free --Crucible Guardian 22:44, 9 June 2006 (UTC)

[edit] I'm removing this

"an example would be usually going to Krispy Kreme but instead going to Dunkin Donuts because they have a coupon."

I'm removing this as it is obviously stupid. 172.191.102.217 21:03, 2 July 2006 (UTC)

[edit] In the U.K. ...

... paramedics on the whole do not:

• "derive the legal ability to provide advanced life support care through a medical doctor's license", they are legally autonomous practitioners, registered with the state,
• perform "synchronized cardioversion", "transcutaneous pacing", "transtracheal jet insufflation", "surgical cricothyroidotomy", "rapid sequence endotracheal intubation", "IV pump management", and "gastric suction",
• administer "calcium channel blockers" or "dopamine",
• "provide care under protocols written by physicians, which guide clinical decisions," rather they follow guidelines derived from best practice as agreed by a national clinical committee,
• do not work in "critical care inpatient units".

but they do

• Administer thrombolitic drugs to reduce the effects of myocardial infarctions.

And that's just one country's differences. I agree that this article needs a complete review to ensure it reflects the international nature of the role. The entry for ambulance has lots of useful bits of info for the task at hand.

Here's my entry...

[edit] Paramedics in the UK

In the United Kingdom the term paramedic is protected by law and only applies ambulance practitioners who are able to achieve and maintain strict standards established by a statutory body. The Health Professions Council (H.P.C) requires paramedics to enter on to a register before being allowed to work autonomously. It sets the profession’s standards of proficiency and expects registrants to work by codes of ethics, conduct and performance.

Paramedics are expected to work using the clinical standards set by their employers. These vary throughout the country but increasingly are being brought into line with national guidelines. The Joint Royal Colleges Ambulance Liaison Committee, a collection of professionals from the U.K.’s medical, nursing, and ambulance communities, have produced these guidelines bi-annually since 2000. This group reviews its advice based on the principles of evidence based medicine and best practice.

Unlike other countries, there is only one legal level of practitioner. However, many paramedics have undertaken further training or higher educational programmes in order to work as advanced practitioners. Community paramedics and emergency care practitioners vary in the scope of their practice throughout the country but can be found offering unscheduled care in the community in lieu of G.P. visits.

[edit] Qualifications

Traditionally the only route to becoming a paramedic was to join an NHS ambulance service and work towards the position from non-emergency patient transport roles through to the emergency division. After qualifying and working as an ambulance technician for a period, it was possible to internally apply for paramedic training. Although offered at ambulance service training departments, the curriculum and certification were awarded by a private company called IHCD. Such paramedic training was usually a 10 week course with some of this time spent in a hospital operating theatre, assisting the anaesthetist. Completion of the course allowed the paramedic to register with the then legislative body (state registration).

It was nearly impossible for non-NHS employees to access such courses, and many private ambulance companies provided their own training. However, lack of recognition by the regulatory body for such training created a problem. This was compounded by paramedical staff leaving the armed forces found their training unrecognised. Eventually the term paramedic was used by variety of people with varying levels of ability. After the incorporation of the H.P.C. the paramedic became legally defined and private and military ambulance staff were given an opportunity to have their training and experience reviewed (grand parenting) against the new standards. This allowed many to register.

Eventually the IHCD began to accredit non-NHS training establishments, alowing them to teach their ciriculum. In the mid 1990s some universities started to offer paramedicine diplomas and degrees, in association with local Ambulance Trusts. These incorporated the IHCD ciriculum and allowed registration. Later, the HPC and British Paramedic Association defined the educational standards required to register, removing the requirement for the IHCD material to be the core of such programmes. Only recognised courses will lead to registration however.

The higher educational route is still considered controversial, with some more experienced ambulance staff arguing that such a fast-track approach misses the experience of PTS where recruits learn vital interpersonal skills.

[edit] Employment

The NHS employs the majority of paramedics, usually in the role of clinical lead on accident and emergency ambulances. However, some are employed by the NHS in providing other services such as G.P. practice based roles, community unscheduled care provision, and within minor injury units. Private sector paramedics are often found providing medical services at large public events, at remote industrial sites, as lectuers and trainers, or increasingly as contractors working on behalf of the NHS in accident and emergency work.

[edit] Professional Organizations

The British Paramedic Association is the paramedic's professional body in the U.K. It was formed relatively soon after the H.P.C.'s incorporation but only due to Government pressure rather than peer demand. It was the only profession regulated by the H.P.C. without such a body and this situation was deemed unallowable. It was important the profession could maintain self regulation responsibilities for standards and education. At the time paramedics were still struggling with what it mean to be a professional rather than a vocational worker and the B.P.A. was eyed with some suspicion. As a consequence membership is still relatively small compared to the body of the profession as a whole. It does not offer industrial relations or other services normally associated with trade unions.

[edit] Sources

HPC http://www.hpc-uk.org/aboutregistration/professions/paramedics/

IHCD http://www.edexcel.org.uk/subjects/a-z/ihcd/

Ambulance Service Association http://www.asa.uk.net/document_archive/073-049_amb_careers_broch.pdf

British Paramedic Association http://www.britishparamedic.org/

[edit] Acts Allowed

Scope2776 07:37, 30 December 2006 (UTC) I'm pretty sure retrograde intubation is not an act allowed by paramedics here in the united states, this should be removed if unsupported and erroneous.

There are a FEW jurisdictions that allow it. Not many, but someone was obviously making a list of everything they could find. I'm trying to think of ways to emphasize the fact that many jurisdictions allow very few of the things in the sample list, and in places like Australia, you can be called a paramedic with essentially no training (as compared to many other countries). If you have any suggestions, please let me know.--catseyes 19:47, 16 April 2007 (UTC)

[edit] Difference Between an EMT and Paramedic

Scope2776 08:44, 9 January 2007 (UTC)I was also wondering if we should add a section about the differences between an EMT and Paramedic, the public may be confused about this and may be looking to wikipedia for an answer!

Since this is the parent, worldwide article, I think the sentence lumping EMTs together with Ambulance Drivers and Ambulance Attendents and "other lesser trained personel" should cover it, since we only use call them EMTs here in North America. I think that the Paramedics in the United States of America article does have a good explanation of the difference. --Elipongo ^{(Talk|contribs)} 08:52, 9 January 2007 (UTC)

[edit] More U.S. centrisism

"Paramedics are employed by a variety of EMS systems, which may be fire-based (a part of the fire department), private, or municipal third-service (city or county). "

How about regional too... and municipal could be changed to public sector to reflect other country's ways of service provision.

Don't forget 'Third Watch' from the media section: http://www.imdb.com/title/tt0197182/?fr=c2l0ZT1kZnx0dD0xfGZiPXV8cG49MHxrdz0xfHE9dGhpcmQgd2F0Y2h8ZnQ9MXxteD0yMHxsbT01MDB8Y289MXxodG1sPTF8bm09MQ__;fc=1;ft=21

Or Trauma http://www.imdb.com/title/tt0405602/?fr=c2l0ZT1kZnx0dD0xfGZiPXV8cG49MHxrdz0xfHE9dHJhdW1hfGZ0PTF8bXg9MjB8bG09NTAwfGNvPTF8aHRtbD0xfG5tPTE_;fc=13;ft=45;fm=1 http://www.bartsandthelondon.org.uk/news/story.asp?id=132&section_id

I think the problem is that this article doesn't make it clear that it is for the international meaning of Paramedic and not for just the USA or elsewhere. That should be clearly stated somehow in the opening of the article. Also, instead of simple links under *See also* I think each country should get a short paragraph headed by the *Main* template linked to the main article on that country. That should clear up confusion and keep this article in a proper worldview. I'll put it on my list of project to do, if no one else gets to it first! --Elipongo ^{(Talk|contribs)} 16:34, 5 January 2007 (UTC)

[edit] Golden Rod of Asclepius

In Denmark paramedics have started to use a special version of the classic Star of Life, where the Rod of Asclepius has been added a golden color. But is this only a national phenomenon or has it been seen other places?

See commons:Image:Roskilde I2 right.jpg and commons:Image:Star of life gold.svg. --|EPO| ^da: 20:21, 11 July 2007 (UTC)

It's not unprecedented. The NREMT has a golden Rod of Asclepius on some of the pins they sell to registrants [1]. Cheers! —Elipongo (Talk contribs) 22:02, 20 July 2007 (UTC)

Cool to know. The "paramedic" concept is still relative new in Denmark and is starting to grow during these years. But would like know if you have seen it on e.g. vehicles, clothes or papers rather than pins, which strictly spoken are merely ornaments. --|EPO| ^da: 08:56, 21 July 2007 (UTC)

I spotted a golden snake on the Rod of Asclepius of a local ambulance and I took a snapshot of it... Image:South Windsor Connecticut ambulance.JPG. So I guess it's not just a phenomenon of Denmark. Cheers! —Elipongo (Talk contribs) 20:23, 10 August 2007 (UTC)

Cool to know it is actually being used "out there" - thanks for the image. --|EPO| ^da: 10:32, 11 August 2007 (UTC)

[edit] History of Paramedicine

I recommend some sort of historical section. Remember not to limit it to United States...unless that is where it truly started. —Preceding unsigned comment added by AnthonyM83 (talk • contribs) 04:38, 6 December 2007 (UTC)

[edit] Canada section citation tags

1. If your going to reference a journal such as New England Journal of Medicine, please provide a full citation.

2. I would be willing to place money that there are American paramedic services that are allowed to reroute to a cardiac center without going to online medical control. Hospital notification [e.g. "We're 10 minutes out from your facility with a STEMI"] doesn't count. JPINFV (talk) 05:15, 27 March 2008 (UTC)

Actually no. Ottawa was the first Paramedic Service to have a STEMI protocol( where the medics interrupt the 12-Lead, diagnose the STEMI, and decide on their own to transport to a Heart institute to a cath lab. It is slowly being implemented around the world. Its saving lives and I hope all services can get it.

Heres your reference NEGM article.:

http://content.nejm.org/cgi/content/short/358/3/231

http://cardiology.jwatch.org/cgi/content/full/2008/116/1 —Preceding unsigned comment added by 99.241.180.108 (talk) 14:13, 27 March 2008 (UTC)

Reply to deleted comment: I am not deleting them, only changing them to reference tags. It is the preferred style over inline links as they had been put in. If you look at the bottom under the References heading they are still there Jons63 (talk) 14:27, 27 March 2008 (UTC)

Thanks, :) —Preceding unsigned comment added by 1972MGB72 (talk • contribs) 14:31, 27 March 2008 (UTC)

I have no problem if Ottawa was the first, but the current edition states that they are the only service in the world. Actually, New York City's EMS region allows paramedics to reroute to the nearest cath lab (http://www.nycremsco.org/images/articlesserver/General%20Operating%20Procedures%20January%202008%20v010108b.pdf) page 11. Again, it's one thing to say "first" and a complete other thing to say "only." Either way, it doesn't belong on Wikipedia without a reference. Furthermore, plenty of American paramedics operate under standing orders. The sentence "...unlike American Paramedics [sic]" is patently false. Also, paramedic is not capitalized when used in this sense. JPINFV (talk) 17:28, 27 March 2008 (UTC)

But do NYC Paramedics need to talk to a physician first and send the 12-Lead for interuptation by a physician? —Preceding unsigned comment added by 1972MGB72 (talk • contribs) 18:16, 27 March 2008 (UTC)

Not according to the protocol I posted. Admittedly I don't work in New York. This still does not solve the problem with there being no reference for Ottawa being the first service to do prehospital 12-leads with medic interpretation. JPINFV (talk) 18:27, 27 March 2008 (UTC)

There are still alot of American services that have to contact a physician before giving any medications. I know Florida still runs like this, so I am not patently false.

Yes. Implying that ALL US paramedics need to call for orders is patently false. Even LA County is no longer working under the same situation shown in "Emergency!" JPINFV (talk) 18:28, 27 March 2008 (UTC)

I stand by what I have stated, alot of services still run like this. Heck there are still volunteer medics in the US, not sure if they have any medical backgrounds. —Preceding unsigned comment added by 1972MGB72 (talk • contribs) 19:10, 27 March 2008 (UTC)

It doesn't matter what you stand by, it matters what you can verify. You can hold any beliefs that you want, but that doesn't mean it gets included onto Wikipedia. The simple fact is that there are services in the US that use 12 leads based on the medic's judgment (avoid the fire based EMS systems) and there are plenty of services that either use either complete standing orders or a combination of standing/online orders. JPINFV (talk) 19:17, 27 March 2008 (UTC)

I am not doubting what you are stating, but you are not proving me wrong :). I know that US medics have full ACLS, and CCP's and have 12-lead training. Never once did I say that the US didnt. I didnt know that Fire base medic programs arent as advanced as pure medic based programs in the US. Is that true ? —Preceding unsigned comment added by 1972MGB72 (talk • contribs) 19:43, 27 March 2008 (UTC)

My point was that the original phrasing used the "only" and the section about "US Paramedics call for orders" (without any qualifications such as "some") was false. As far as fire-based, I'll contact you via talk page since it's starting to get a bit off topic. JPINFV (talk) 20:02, 27 March 2008 (UTC)

[edit] Quebec prehosipital setup

The section about Quebec is wrong in the article. It says "In many parts of Europe and in the Canadian province of Quebec (which follows the French system), a different paradigm is used for prehospital care in which doctors, nurses and occasionally medical students function as prehospital providers, either in conjunction with or instead of paramedics." The Quebec system only provides level 1 paramedics on the field. As stated here http://www.spll.ca/ambufonctions.htm here http://www.paramedicduquebec.org/node/33 and here http://www.urgences-sante.qc.ca/indexx.asp?page=58 . The actual Quebec system is not based on the french system in no way. That would be a misunderstanding. The presence of doctor in prehospital set is only a byproduct of the level 2 paramedic project in Montreal. It is an exeption and it is not permenant but it is a educationnal purpose until the student achives automnomy. I think the paragraph speaking about Quebec should be simply taken out since it is unaccurate.

--Arkar1984 (talk) 04:25, 15 April 2008 (UTC)

Cool. I suggest you be bold and edit it. Just include any references you have. -JPINFV (talk) 04:57, 15 April 2008 (UTC)

In so I was. I took out the part and if I get the time I will suggest a more accurate comment for Quebec. --Arkar1984 (talk) 00:17, 16 April 2008 (UTC)

Its too bad Quebec is so far behind in pre hospital medicine, when the rest of the country is making great grounds. Hopefully your system will change. —Preceding unsigned comment added by 99.241.180.108 (talk) 17:07, 24 April 2008 (UTC)

[edit] Lead

Ok, an anonymous/IP address editor keeps adding the following to the lead. "Furthermore, they often express frustration at being prejudiced by their phyisican colleagues who, due to higher degree of training and clinical expertese, are less inclined to take into significant consideration the medical advice provided by the paramedic." In doing so, he keeps removing a citation needed tag. I have numerous problems with it.

1. The lead is the wrong place to add the information. things like this need to be in it's own category, not integrated into the lead. See wp:lead.

2. The wording is highly POV. I highly doubt that doctors are highly "prejudiced" (a word that carries a very negative connotation) against paramedics. Are some? Sure. As a whole? No. It's like saying a teacher is prejudiced against her pupils because the teacher has more training and education.

3. It is something that is sweeping and needs to be sourced, per WP:verify.

4. The removal of a citation needed without addressing the need for a citation (stand alone issue).

Comments? JPINFV (talk) 23:24, 18 May 2008 (UTC)