Paramedics and Emergency Medical Responders…What do we know about their profession?

Canadians paramedics work with municipal or provincial healthcare systems, hospitals, fire departments, government departments or agencies. Typically, they arrive at the home of a patient or the scene of an accident, a disaster, a crime scene, or where ever they must go to administer pre-hospital care to Canadians with injuries or illnesses. Often in the case of an emergency. Then they transport patients to hospitals or other medical facilities for further care. Throughout this pandemic, they have been the frontline of patient care.  

The Paramedic Association of Canada (PAC) is the national voice of paramedicine that supports paramedicine practitioners in providing high-quality health care to patients. Originally founded in 1984 as The Canadian Society of Ambulance Personnel (CSAP), it was transformed into PAC in 1997. PAC has a voluntary membership of over 20,000 paramedic members, each belonging to a provincial chapter and/or the Canadian Armed Forces.

There are many professional hazards for paramedics. Here’s just a few: Being a paramedic can be challenging physically as they are sometimes required to carry equipment up flights of stairs or to lift someone onto a stretcher. Paramedics suffer frequent work-related injuries because of the constant bending and kneeling and back injuries are common. They never know what they are about to encounter when responding to a call for help. Also, like many in the healthcare system today, paramedics have to concern themselves with municipal amalgamations, PPE, hiring freezes and other workplace considerations.

There are several types of paramedics or emergency medical responders in Canada and the scope and practice of paramedics and emergency medical responders is defined by the National Occupational Competency Profile (NOCP). This is a document that was developed by the Paramedic Association of Canada in conjunction with the Government of Canada and it outlines four different classifications of professional practitioners: Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Advanced Care Paramedic (ACP), and Critical Care Paramedic(CCP).

There are specific classification differences between provinces and each province maintains its authority to legislate the practices of paramedicine within its own jurisdiction. Practices, titles, job descriptions and remuneration vary across the Canada but the knowledge, skills, and abilities required across the spectrum are comparable and contribute to the high calibre of paramedic or emergency medical responder care available. 

In addition to the classifications of paramedics, there are also numerous specialized roles. Many colleges in Canadian provinces offer courses that provide the education and background required as prerequisites should a student be thinking about pursuing a career as a paramedic or emergency responder. Here are a few of the specializations:

  • Tactical paramedics are trained to attend high risk and dangerous events. For example, some handle weapons, scale buildings, or work alongside local police agencies.
  • Occupational paramedics work in a variety of work-place settings, including with companies that require the monitoring of high-risk occupational activities such as mining, drilling, and other industrial fields.
  • Community paramedics can work in various health care institutions but also in patient’s homes as well. They can provide assessments and treatments to patients by collaborating with other healthcare providers. They can work in rural areas. Some of the diagnostics they perform include: specimen collection (blood and urine), interpreting electrocardiograms, vital signs, etc. The treatments they can provide include: rehydration, blood transfusions, catheterization, wound care, oxygen therapy, medication administration, and more. 
  • Incident response paramedics are trained to respond to hazmat- and toxicology-related events. These paramedics may be required to administer a range of medications and treatments and may have to wear very specialized protective equipment to allow them to access patients at high-risk scenes. They might work closely with firefighters or other hazmat specialists. 

Canadians have the utmost respect for paramedics and emergency responders and believe that they play a critical role in the delivery of healthcare within our communities from coast to coast to coast. Based upon research results, paramedics are considered to be well-regarded, trusted, and vital to community care. 

In a 2016 study, entitled “What is the Role of Paramedics in Canada’s Healthcare System?” it was revealed that:

  • 66% of Canadians believe that paramedics play a central role in our healthcare system. 
  • 61% Canadians said they had high trust in paramedics.
  • Older Canadians were more likely to trust paramedics to make on-the-spot medical decisions than younger Canadians. There was no variation across region or gender.
  • 80% of Canadians support the idea of community paramedicine. Community paramedicine is about employing paramedics in non-traditional roles to assist in delivering health care in non-life-threatening situations. By expanding the role of paramedics, and working collaboratively with other health care professionals and community agencies, paramedics can manage patients who do not require immediate treatment or transportation to an emergency department.
  • 90% of Canadians believe that paramedics should be involved in any negotiations concerning a new national health accord. Respondents were asked who should be invited to participate in negotiations around a new health accord between the federal and provincial governments. Overall, a large majority of Canadians believe that doctors (92%), nurses (91%), and paramedics (90%) should be around the table.

Despite the fact that paramedics are considered to be amongst the most at risk during the current pandemic, because of their frontline duty, working in confined spaces in ambulances or in aircrafts, responding in red zones and other high-risk environments, it was surprising to learn that some provinces’ vaccine rollout plans, such as those of Alberta and Saskatchewan did not initially include paramedics in the first round of Canadians eligible for vaccines.

  • Alberta paramedics will have to wait until the second phase of vaccinations, currently slated for April of 2021. 
  • In Saskatchewan, only the immunization pilot scheme in Regina is set to include EMS—the rest of the province does not include paramedics in their first phase.
  • After initially telling paramedics that they would have to wait until spring 2021, Ontario changed its policy including them in the first round of vaccinations, which has been extended into March.
  • Most other provinces have announced that paramedics will receive vaccinations in the first three months of 2021.
  • The Northwest Territories, Yukon and Nunavut announced that they hope to vaccinate 75 per cent of the adult population within the first three months of 2021, starting with elders and health-care workers.

The pandemic has hit paramedics and emergency responders hard over the last year. For example, consider British Columbia’s Ambulance Service—the largest provider of emergency health care in Canada and one of the largest in North America. It serves over 4.3 million British Columbians and responds to calls for service across six health authorities covering 929,730 square kilometres. 

So it’s a large organization with good resources, yet, when B.C.’s paramedics reached out for mental-health support in April of 2020 at twice the rate of the previous year, services were stretched. B.C. Emergency Health Services said it had tracked an 80-per-cent increase in calls from paramedics, dispatchers and other staff to its critical-incident stress program this year.

The organization said most cases are linked to the pandemic. Paramedics and their dispatchers, in B.C. and elsewhere, face unprecedented challenges, including concerns about bringing the virus home, adapting to new treatments for patients, such as airway procedures and increased stress, with no end in sight. Indeed, the long-term impact of prolonged stress is unclear.