Helping paramedics make right decisions

What’s the most terrifying job in the world? I think it’s “junior paramedic” or “emergency medical technician” to use the proper title. I can’t think of many jobs where the decisions you make are so fraught with meaning and consequence as they are when you are an EMT. 

At the beginning you’re likely to join as an apprentice and have on-the-job training for 12-18 months, after which you’ll be a qualified EMT. At this stage you are qualified to be a single responder to an incident.

Just think about that for a moment - after as little as 12 months training, you’re now involved with life or death decisions. And the NHS staffing crisis means that you are sometimes the only medic on the scene at the most serious, category 1 callouts. 

EMTs and paramedics get to learn on-the-job from senior clinicians and get to sleep at night, knowing their decisions were the right ones

The only sensible way to manage the risk might be to get all your patients to hospital as quickly as possible. But that, of course, adds pressure to overstretched accident and emergency departments. In which case, you need clinical support to give you the confidence to make decisions not to convey.

Our project at Ninewells Hospital in NHS Tayside has done just that. By allowing EMTs and paramedics to speak directly with ED clinicians, nearly a third of patients are avoiding hospital and being advised to make a GP appointment, see a pharmacist or take advantage of other appropriate local options.

This is far better for them – and for the NHS. But it’s also better for the EMTs and paramedics, who get to learn on-the-job from senior clinicians and who get to sleep at night, knowing their decisions were the right ones.