About paramedics
Saving lives by restoring a heart beat, delivering medication to reverse a diabetic coma or re-opening airways in an asthmatic child are some of the call paramedics see on a daily basis. One becomes a paramedic to help people. Below are FAQ (frequently asked questions) that we hope, will answer the question: "What is it like to be a paramedic?" Most of the questions below have been gathered from emails and telephone messages we've received at the Ottawa Paramedic Service.
Tell me about the training involved in becoming a paramedic.
All Primary Care Paramedics are graduates of a two-year post-secondary para-medicine diploma program. Their education is focused on all aspects of pre-hospital emergency medical assessments and delivery of sophisticated in-field treatments for medical and traumatic emergencies. The curriculum is heavily focused on acute medical assessments and rapid medical treatment for all medical and traumatic related emergencies.
Program studies include; pharmacology, human biology, psychopathology, crisis intervention and, medical-legal issues, patient care procedures, patho-physiology, patient care practical laboratory, computer skills, communications skills, professional and leadership skills and emergency vehicle operations.
Upon graduation of the 2-year post-secondary diploma program, students must write a 6-hour long provincial exam. Successful candidates are awarded the provincial A-EMCA (Advanced Emergency Medical Care Assistant) certification, which permits full or part-time employment anywhere in Ontario.
What about training for Advanced Care Paramedics?
Advanced Care Paramedics possess an additional year of post-secondary medical education and allows for the delivery of delegated medical acts that can otherwise only be legally provided by a provincially certified medical physician. With a number of life-saving medications at their disposal, advanced care paramedics have the ability to stop seizure activity, reverse a diabetic coma, return the heart to its normal rhythm, open airways for the asthmatics and assure that the effects of an anaphylactic reaction does not result in the loss of life.
Is there any continuing education for paramedics?
The Province of Ontario mandates that all paramedics undergo yearly continuing medical education, ensuring the highest quality of pre-hospital emergency medical care and treatment. Primary care Paramedics must undergo 40 hours per year and 80 hours per year for Advanced Care Paramedics. At the Ottawa Paramedic Service we employ Clinical training Officers who are tasked, in part with providing yearly educational sessions for all levels of paramedics.
What makes a good paramedic?
It's difficult to give a clear image of what it takes to be a good paramedic. People who are injured or gravely ill call paramedics because they find themselves in an urgent situation, so compassion and care are probably the biggest assets one could possess. Paramedics are required to be understanding and cool-headed. Also, medicine is a challenging field. New treatments and new medical protocols are continuously being developed. Paramedics must be in good physical state; lifting injured people from turned over vehicles or carrying them long flights of stairs places heavy demands on the body.
How long are shifts?
Most shifts with the Ottawa Paramedic Service are 12 hours long, with some shifts 10 or 8 hours in duration. Shift starts are staggered to allow for the efficient coverage of paramedics crews for the city. Most shift patterns follow a "two days on then three days off, followed by three days on, then two days off" pattern. Twelve-hour shifts will rotate through several weeks of days then switch to nights following the same pattern. Ten-hour shifts patterns will see paramedics work 4-day workweeks only resulting in one day off during a week (which changes from week to week). Usually only senior Paramedics are allocated these shifts. The Ottawa Paramedic Service has formed a committee that manages schedules and shift patterns. This committee was created and is managed by front-line paramedics.
What types of calls do you do?
One thing that attracts people to this field is the range of medical calls you will do during your shift. The inability to predict the emergency you'll be handling in the next few minutes makes this an exciting career. One minute you may be holding a newborn that you've helped deliver, while, perhaps, an hour later, consoling a grieving widow.
The greatest majority of calls are for medical type emergencies; abdominal pain, cardiac related chest pains, strokes, difficulty breathing. Then there are also calls for traumatic injuries from car collisions, falls and sports related injuries. These injuries range from fractures to legs, arms, and pelvis, hips or head injuries.
Paramedics also transfer critically and non-critically injured people from one medical facility to another.
How are calls received and dispatched?
All emergency calls are received through the 9-1-1 Centre. This centre, located at the Ottawa Police headquarters on Elgin Street, will direct calls for emergency medical illnesses and injuries to the Ottawa Paramedic Service Central Ambulance Communications Centre. Communications Officers will quickly confirm location of the call and will ask key questions that enable them to determine the medical nature of the emergency and assign the call a priority.
Call priorities are:
CODE 4: Life threatening call Life and /or limb threatening in nature.
CODE 3: Urgent call Non-life threatening, however, call is of serious enough in nature
CODE 2: Scheduled call Generally non-urgent/non-life threatening
CODE 1: Deferrable call Non-urgent/non life threatening calls
Once the priority is assigned to the call, selection of the most appropriate vehicle is made and the crew informed of the call's nature and location.
Tell me about the work that Paramedics do when they arrive at the patient.
Upon arriving at the location of a call, paramedics will make an initial assessment of the medical state of the patient, starting with the ABC's; Airway, Breathing and Circulation. Level of consciousness, breathing, pulse/heart rates and external bleeding are all assessed and treated at this time. Then paramedics move on to collect medical history of the event that led them to call. Further tests and assessments may also be made, while the other paramedic gathers information like; medications, allergies and prior hospital visits. Should the call point towards a cardiac emergency, a cardiac monitor is applied for the capture of a 4-lead and then 12-lead electrocardiogram. A blood oxygen saturation level is also acquired. The cardiac monitor used by the Ottawa Paramedic Service is the Zoll M Series monitor, capable of 4 or 12 lead electrocardiogram, external pace making capability, blood oxygen saturation reading, manual and semi-automatic defibrillation and cardio-conversion capabilities.
Further treatments and medication will be administered based on the nature of the medical emergency.
Generally speaking, what is the most critical medical emergency paramedics respond to?
Cardiac-respiratory arrest calls are by far, the most demanding calls in terms of utilization of resources and time. Paramedics will commence CPR (as quickly as possible), insert a tube directly in the lungs, apply the cardiac monitor and deliver defibrillation shocks to the heart and insert an intravenous line that enables delivery life-saving drugs in an attempt to restart the heart. Calls of this nature typically take double the time of a normal call.
Sounds like you must almost constantly stay in contact with doctors?
No. Paramedics have the education and the certification of a medical authority that enables them to practice paramedicine. They have intensive education and yearly re-certification that maintains the paramedics' high level of skills for all situations of medical emergencies. At times calls are made to an on-call emergency room physician in order to deviate from normal medical protocol.
I suppose there is a lot of paperwork?
Yes. For all assessments and treatments provided, paramedics must complete an Ambulance Call Report; basically, a medical chart that denotes assessment findings, lists of medications taken by the patient, prior medical history, treatments delivered and other medical procedures done on the patient. Additional reports must also be completed for unusual occurrences, such as accidents or lost/broken equipment. These documents can be used for administrative, clinical, legal and research purposes.
Who insures that Paramedics have done a good job on a patient?
There are several independent groups that insure that the quality of care provided by our paramedics is done to the highest degree possible. Internally, the Ottawa Paramedic Service Performance Management Group assures that charts are entered in a database system, audits on Ambulance Call reports; and monitors that a high quality of care was delivered to patients. Independent from the service is a medical authority for all paramedics (the Ottawa Base Hospital Program) that also review Ambulance Call Reports. Thirdly, the Ontario Ministry of Health and Long Term Care Ambulance Services Branch also possesses the authority to investigate calls paramedics have done.
Should it be found that medical protocols have not been followed paramedics are asked to explain their actions. At times, corrective action is taken in the form of re-education. We take the responsibility of delivering high-quality emergency medicine to the residents and visitors of the city of Ottawa extremely seriously. The medicine delivered by our Paramedics has to be world-class with no exception.
What choices of career advancements are there at the Ottawa Paramedic Service?
Many. As a front-line paramedic, you may advance your career in several different directions. This service requires Paramedic Team Leaders who are Advanced Care Paramedics that provide on-street administrative and operational support to all paramedics, Quality Review Officers insure that clinical protocol and skills are at the highest possible level, Clinical Training Officers prepare and deliver on-going education for all paramedics.
Paramedics can also expand on their abilities by being part of Ottawa Paramedic Service's Special Operations Units.
Tell me more about these units?
The Ottawa Paramedic Service Special Operations Section administers special teams of paramedics including a Bike Unit, Tactical Unit and the Marine Unit. Using specialized equipment and focused medical training, the Special Operations units have the ultimate goal of reducing response times for the delivery of specialized advanced, and in the case of our Special Operations units-focused, medical treatment.
More information on these Special Units can be found in the Special Operation section of this site.
What responsibilities do Paramedics have upon completing of their work day?
When returning to our main facility paramedics must collect and submit all relevant paperwork and sign-in assigned vehicle.
What about cleaning and restocking?
The Ottawa Paramedic Service employs Equipment and Supply Technicians whose role is to clean and restock all Paramedic Units prior to deployment. They also maintain preventative maintenance schedules and perform required repairs on patient care equipment.
Why employ Equipment and Supply Technicians?
The Ottawa Paramedic Service recognizes that paramedics' work time is best spent providing patient care. Equipment and Supply Technicians assures that paramedics' time is spent on the street providing life-saving treatments to those who need it.
