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History and Evolution of Paramedic Practice in Australia

History of Australian ambulance services – where and why did ambulance services start in Australia?

An ambulance is a service provided by the state, private system, country, or any society. It refers to a response that is needed in emergency cases such as accidents. It has two main functions, including that it provides assistance in the need of an accident or any emergency case of a paramedical function, and it provides a transport service to the patients who need to reach the hospitals, and it transporting the patients from one place to another. There are several ambulance services working in Australia, in which the Ambulance service Australia is the prominent one. Ambulance Service Australia provides its service for patient transfers as well as it is available for certain events such as Motorsport, festivals, and certain equestrian events. It provides onsite first response and also pre-hospital care at every level and it includes the intensive care paramedics. The pre-hospital is required when the patients need immediate care after an accident or in an emergency situation. Ambulance services are no doubt important and significant for the countries, but in the past, there were so many such services available, and different options were required in the past histories. In this paper, the past, present, and future perspectives of ambulance care services are discussed and explored in detail.

What services were there for people who were sick and injured before the introduction of ambulance services?

In the past ancient times, when ambulance services were not introduced, people used different methods and techniques in their emergency situations. In ancient times, people used carts to transport patients from one place to the hospitals or any medical care center. Ambulance services started in 1487 during the Siege of Malaga. It was the time when Spanish forces acted against the Emirate of Granada. Due to the passage of time, and technological advancements, modern ambulance services are introduced in the 19 and 20th centuries.

In the ambulance service in the history, people used carts for the transfer of their patients. It was two-wheeled carts, which were also used to transfer goods from one place to another. It was the one that needed human effort, and human were the ones who moved the carts with their hands. Later, humans started to use animals with their carts for quicker services so that patients could transfer from one place to another within less time. The first ambulance was developed in France in the late 18th century. It was developed by Dominique-Jean Larrey, who was a surgeon and worked in the Napoleon Army. The reason behind it was that the wounded soldiers who were fighting in the war needed medical assistance, but due to the lack of ambulance services, most of them died on the way to get some assistance. The purpose of ambulance creation was to provide quick and fastest assistance and immediate aid so that no one could lose his life due to the lack of services. Larry designed a cart, which was a horse-driven carriage, and it included some medical doctors who provided immediate care to the patients.

What was the role and scope of practice (abilities) of the “stretcher bearer” in the early years of paramedic practice?

In the past, the stretcher bearer was the one who carried the stretcher. A stretcher was used to shift patients from one place to another. The stretcher bearer carried the stretcher and mostly needed the assistance of another person during the process. In the past centuries, stretcher-bearers were used in the situation of wars and in emergency times when a serious and critical condition of the patients was noted after a disaster. The stretcher bearers have several qualities such as the men who were physically strong were used as stretcher bearers so that they could easily carry or move the stretcher with patients on them. Moreover, in the war and military campaigns, stretcher-bearers were trained in a specified way so that they could at least able to provide quick first-aid assistance to the patients. The abilities of the stretcher bearer include their training in first aid, and on the battlefield, they approach quickly to the patients needed their assistance.

Evolution of paramedic practice – how and why has paramedic practice evolved in Australia?

A paramedic is a person who is appropriately trained to provide medical assistance in any medical emergency situation. A paramedic is responsible for providing quick care to patients who need to get to the hospital as soon as possible, and need a stabilization situation before the ambulance shifts them to the hospital. The role of any paramedic is linked with the role of ambulance services. The abilities and capabilities of the paramedic include their training and their qualities to provide quick care to the patients. A paramedic role is evolving in the current modern world due to the advanced technological machinery and systems of the world. The paramedics are trained in a specified way, and they are linked with the health care services. Paramedics belong to public safety as well as the healthcare system because they provide their services to save people as well as provide them with needed assistance in the time of emergency situations.

The training of paramedics in the past was just linked with the health sector, where the doctors provide first aid training and other related patient care safety training to the paramedics. But with the passage of time, on-the-job training of the paramedics is shifted into vocational qualifications, which provide proper training and certifications to the paramedics. Now a range of different qualifications is available for paramedic services. Vocational qualifications include Certificate II in Emergency Medical Service First Response, Certificate III in Basic Health Care, Certificate III in Non-Emergency Client Transport, Certificate IV in Health Care (Ambulance), Diploma of Paramedical Science (Ambulance) and Advanced Diploma of Paramedical Science (Ambulance). These are certainly important certifications that are now providing opportunities for paramedics to get training in the proper way of their choice. Also, many universities are providing assistance in the certifications of the paramedics as it is an important role in any country now.

How and why did we go from simple first aiders to paramedics who can perform a range of invasive procedures?

First aid providers are the ones who can easily get training in first aid and start their work. Now it is not difficult to get first aid training as online courses and video tutorials are making the way easier for people who want to be trained in the proper way of first aid services. But there is a much difference between a first aid provider and a paramedic.

First aid is simply the help provided by any person until the injured, sick, or ill person gets complete medical attention. The services of first aid providers include CPR providence, plaster to injury, help to stop bleeding, or help to provide oxygen to patients in urgent situations. First aid is simple and can be easily learned by anyone in some days or in even some hours. However, the paramedic is the one who is professionally trained appropriately to provide certain care to the patients in their need. A simple technician of the ambulance is called an Emergency medical technician who is also available in the ambulance system. But a paramedic is more professional than an EMT. The major difference between an EMT and a paramedic is the scope of their practice and certain actions they are allowed to do with the patients. EMT needs the training of 120 to 150 hours before being fully trained for their job. But paramedics need more than 1500 hours of their training and they are more professional and trained in a more specified way to conduct their duties. Moreover, paramedics are now receiving more than 1-year degree, mostly two years, and they are trained to become a paramedic. The paramedics are allowed to break the skin of the patients and also to provide breathing treatment to save the lives of the patients. They are trained in a proper way or airway management system in which they help the patients to support their breathing power. Simply the paramedics are allowed to perform a range of invasive procedures.

What and when were some of the major milestones of paramedic practice in Australia? For example, when and why were Mobile Intensive Care Ambulance(MICA) Paramedics introduced to Victoria or Extended Care Paramedics (ECP) in NSW?

In Australia, the ambulance system is advanced and uses the latest technological advancements in their healthcare systems. The evolution of the ambulance system in Australia developed in its education and culture. The culture needs to change when the educational understanding is developing. Similarly, paramedics are now working as professionals from first aid providers in the past due to cultural changes and improvements in educational understanding. The profession of paramedics is now based on the skills and abilities of trained professionals. The paramedics are now working in the professional environment in Australia and have become valued healthcare professionals in their respective fields. Now, the degree is required for the paramedics and it is now considered as a milestone.

In Australia, paramedics are earning more than in many developed nations such as the United States of America. However, the salary issue of paramedics is still an arguable point in Australia. Similarly, the EMS education system is still an issue in the country, but the country is consistently trying to cope with all the related issues of the Ambulance system. A major contribution to the healthcare system in Australia is the invention and development of Australian Mobile Intensive Care Ambulances. The system provides the services of highly professional staff and highly trained paramedics who are available in every situation and deal with workload efficiently. MICA services in Australia provide extremely high professional services, and the paramedics are qualified degree holders and allowed to practice their abilities. They have an advanced diploma in health sciences and another related bachelor’s degree that allows them to practice their abilities and their degree. The paramedics are also trained in the emergency healthcare system, and the healthcare system requires their services after having two years of experience as a student.

Ambulance services of the New South Whales area are exceptional and working professionally in their healthcare system. It operates from different perspectives, and its vehicles are registered and also designed in a proper way to deliver exceptional services. They are having their rescue trucks and rapid response vehicles that show their advanced use of medical equipment for the prosperity of their country. The system also includes the over-snow vehicles and the mega lift trucks that are effectively working in their respective areas of concern. Moreover, the command and communication vehicles also provide quick assistance in the major events and the different management systems of different events.

What does the future look like? Where is the profession going? What is driving the evolution of paramedic practice?

According to the new systems and usage of new advanced technology in the paramedic care and ambulance facilities, it is predictable that in the coming years, more appropriate systems will be designed, and more technological advancements could occur. The change will happen, and it will be a positive change that will bring more prosperity and easiness in the societies. In the future, paramedic care will more accurate and more professional and will aim to provide more certain care to the patients and the societies. The modern and coming paramedic system will be an enhancement of the healthcare professional system and it will improve the future medical care system. The educational understanding, globalization and more advanced technology will evolve the evolution of paramedic practice in the future. The paramedics are now working in the professional environment in Australia and have become valued healthcare professionals in their respective fields. Now, the degree is required for the paramedics and it is now considered as a milestone, and in the future, degree requirements will be applied in all countries.

In the future, paramedic care will be advanced more accurately and quickly in many other areas of the world due to its evolution and desired need in many countries.

References

Ambulance facts, information, pictures | Encyclopedia.com articles about Ambulance. (2018). Encyclopedia.com. Retrieved 12 March 2018, from https://www.encyclopedia.com/medicine/divisions-diagnostics-and-procedures/medicine/ambulance

Ambulance Service Australia | Paramedic and ambulance services for special events. (2018). Ambulanceaustralia.com. Retrieved 12 March 2018, from http://www.ambulanceaustralia.com/

Ambulance Service. (2012). politics.co.uk. Retrieved 12 March 2018, from http://www.politics.co.uk/reference/ambulance-service

Batt, Alan & Morton, Jessica & Kloepping, Klint & Buick, Jason & Todd, Jamie. (2015). The evolution of the paramedic. Canadian Paramedicine. 38. 22-25.

Brouhard, R. (2017). How to Differentiate Between Paramedics and EMTs. Verywell Health. Retrieved 12 March 2018, from https://www.verywell.com/the-difference-between-an-emt-and-a-paramedic-1298493

Eburn, M., & Bendall, J. (2010). The provision of Ambulance Services in Australia: a legal argument for the national registration of paramedics. Australasian Journal of Paramedicine, 8(4). Retrieved from http://ro.ecu.edu.au/jephc/vol8/iss4/4

Escott, M. (2016). American EMS can Learn from Australian Systems. Jems.com. Retrieved 12 March 2018, from http://www.jems.com/articles/print/volume-41/issue-3/departments-columns/field-physicians/american-ems-can-learn-from-australian-systems.html?c=1

M Batt, A. (2018). The evolution of the paramedic. Research Gate. Retrieved 12 March 2018, from https://www.researchgate.net/publication/281720003_The_evolution_of_the_paramedic

Thind, A., Hsia, R., Mabweijano, J., Hicks, E., Zakariah, A., & Mock, C. Prehospital and Emergency Care. Retrieved 12 March 2018, from https://www.ncbi.nlm.nih.gov/books/NBK333513/

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