Paramedic Professionalism

From Journal of Emergency Primary Health Care:

Context for the Discussion
In the Canadian context, professionalism is defined as a set competencies or observable behaviours that are identified in a national competency profile. These competencies are embedded as a set of skills and knowledge to be mastered then applied in increasingly complex patient encounters before being assessed in a field practicum. The final assessment in the practicum involves a preceptor observing and documenting at least two instances of the student exhibiting the observable behaviours specified in the national competency profile.

Health care in Canada, including paramedic practice, is in the jurisdiction of the provinces. Each province has, over time, developed its own unique set of standards, scope of practice, and forms of regulation to meet local and regional needs. In 2001, the Paramedic Association of Canada released a National Occupational Competency Profile (NOCP) for Paramedics in Canada1. The NOCP established a common framework and terminology for standardization of paramedic programs across the country. The NOCP specified competencies for four levels of practitioner: Emergency Medical Responders (EMR), Primary Care Paramedics (PCP), Advanced Care Paramedics (ACP) and Critical Care Paramedics (CCP). While each province has retained its own standards and scope of practice, many adopted the NOCP as the basis of their licensure levels. In addition, the NOCP has helped to bring many non-patient care topics, such as professionalism, into the formal paramedic curriculum.

The first of the NOCP’s seven competency areas covers “Professionalism Responsibilities.” This section specifies seven general competencies, which, in turn, contain sub competencies and associated criteria which must be demonstrated by paramedic students (Table 1). Moreover, the NOCP identifies specific “performance domains” in which practitioners must demonstrate each competency. For example, EMRs must “acknowledge patient privacy” and “demonstrate empathy” in a simulation setting, while PCP, ACP, and CCP practitioners are required to demonstrate these competencies in the practicum environment. Thus, the NOCP provides a list of professionalism-related content “bits” and evaluation requirements that must be incorporated within a paramedic curriculum.

Therapeutic Hypothermia

From Cardiology:

Chill therapy in the patients with resuscitated cardiac arrest: A new weapon in the battle against anoxic brain injury

Improved cooling technologies (such as newer intravascular cooling devices) may result in earlier attainment of target temperature and even more robust clinical benefits in the management of the survivors of cardiac arrest. Earlier cooling may also be facilitated by the introduction of cooled saline infusions in the emergency room setting, prior to induction of cooling in the intensive care unit. However, there is a need for studies of adjunctive therapies to minimize the risk of medical complications associated with hypothermia, the most serious of which is infection. We strongly believe that larger confirmatory studies might encourage more widespread adoption of therapeutic hypothermia for survivors of cardiac arrest and further studies are also needed to evaluate the utility of this procedure for more expanded indications, including asystole, pulseless electrical activity, and in-hospital arrest in patients without significant comorbidity.