This article aims to summarise and categorise the current types of frontline paramedics in Australia and New Zealand, their relative scopes of practice, their qualifications and training, and the titles used in each jurisdictional ambulance service.
Each of the 10 jurisdictional ambulance services were contacted and their current clinical roles discussed with a manager or senior paramedic between June and October 2020. Information was summarised in tables and text.
Minimum qualifications for paramedics range from a diploma to an undergraduate degree, with graduate programs ranging from six to 18 months’ duration. Additional minimum qualifications for Extended Care Paramedics range from no minimum qualifications to a nursing degree. Additional minimum qualifications for Intensive Care Paramedics range from no minimum qualifications to a postgraduate diploma. Additional minimum qualifications for Retrievalists range from no minimum qualifications to a master degree. Helicopter emergency medical services (HEMS) teams range from primarily physician-led in four services to autonomous paramedics in five services.
Armed offender paramedics exist in four services; urban search and rescue paramedics exist in five services; wilderness paramedics exist in five services; CBRNE paramedics exist in three services; mental health paramedics exist in three services. Special Operations variously refers to HEMS, USAR, CBRNE or armed offender. Critical Care variously refers to Intensive Care, HEMS in a physician-led team and autonomous HEMS. Advanced life support refers to paramedics and intensive care. Rescue Paramedic refers to road crash extrication or wilderness paramedics. Flight Paramedic refers to Paramedics or Intensive Care Paramedics, either HEMS or fixed wing.
The jurisdictional ambulance services are heterogenous in the structure, qualifications, training and terminology for their frontline paramedic roles. Due to this lack of consistency, roles for paramedics in Australasia are currently largely incomparable between services, rendering shared titles inoperable from intranational and international perspectives.
Paramedics Australasia. Paramedicine Role Descriptions. Melbourne, Australia; 2009. Available at: http://apcollege.edu.au/pdf/media-other/paramedic-information-paramedics.org-australian-paramedical-college.apcollege.edu.au.pdf
Australian Health Practitioners Regulatory Agency. Paramedicine Board. 2020. Available at: www.paramedicineboard.gov.au/
Parliament of Australia. Health Practitioner Regulation National Law Act 2009.
Parliament of Queensland. Health Practitioner Regulation National Law (Queensland).
Parliament of New South Wales. Health Practitioner Regulation National Law (NSW) No 86a.
Parliament of Victoria. Health Practitioner Regulation National Law (Victoria) Act 2009.
Parliament of the Australian Capital Territory. Health Practitioner Regulation National Law (ACT) Act 2010. Available at: www.legislation.act.gov.au/a/db_39269/current/pdf/db_39269.pdf
Parliament of the Northern Territory. Health Practitioner Regulation (National Uniform Legislation) Act 2010. Available at: www.legislation.qld.gov.au/view/html/inforce/current/act-2009-045
Parliament of Tasmania. Health Practitioner Regulation National Law (Tasmania) Act 2010. Available at: www.legislation.tas.gov.au/view/html/inforce/current/act-2010-002
Parliament of South Australia. Health Practitioner Regulation National Law (South Australia) Act 2010. Available at: www.legislation.sa.gov.au/LZ/C/A/Health%20Practitioner%20Regulation%20National%20Law%20(South%20Australia)%20Act%202010.aspx
Parliament of Western Australia. Health Practitioner Regulation National Law (WA) Act 2010. Available at: www.legislation.wa.gov.au/legislation/statutes.nsf/RedirectURL?OpenAgent&query=mrdoc_40825.pdf
Parliament of New Zealand. Health Practitioners Competence Assurance (Designation of Paramedic Services as Health Profession) Order 2019. Available at: www.legislation.govt.nz/regulation/public/2019/0249/latest/whole.html
The New Zealand Ministry of Health. Paramedics to be formally regulated. 2019. Available at: www.health.govt.nz/news-media/news-items/paramedics-be-formally-regulated#
Paramedicine Council. Consultation on proposed scopes of practice and prescribed qualifications for registration as a paramedic [Internet]. 2019. Available at: https://paramediccouncil.org.nz/common/Uploaded files/Consult PDFs/Consult proposed scopes.pdf
Carden KA, Chervin RD. Consistency and clarity in sleep medicine terminology. J Clin Sleep Med 2016;12:157-8. Available at: http://jcsm.aasm.org/doi/10.5664/jcsm.5472
Nargund G, Fauser BCJM, Macklon NS, et al. The ISMAAR proposal on terminology for ovarian stimulation for IVF. Hum Reprod 2007;22:2801-4. Available at: https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dem285
Yourkavitch J, Chetwynd EM. Toward consistency: updating lactation and breastfeeding terminology for population health research. J Hum Lact 2019;35:418-23. Available at: http://journals.sagepub.com/doi/10.1177/0890334419851488
Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity terminology. J Sci Med Sport 2010;13:496-502. Available at: https://linkinghub.elsevier.com/retrieve/pii/S1440244009002242
Chabra S. Subsets of preterm and term infants: call for consistency in terminology. Dev Med Child Neurol 2013;55:673. Available at: http://doi.wiley.com/10.1111/dmcn.12126
Page SJ, Schmid A, Harris JE. Optimizing terminology for stroke motor rehabilitation: recommendations from the American Congress of Rehabilitation Medicine Stroke Movement Interventions Subcommittee. Arch Phys Med Rehabil 2012;93:1395-9. Available at: https://linkinghub.elsevier.com/retrieve/pii/S0003999312001773
Oh SH, Lee J. A systematic review of audiology terminology. J Audiol Otol 2016;20:109-13. Available at: http://ejao.org/journal/view.php?doi=10.7874/jao.2016.20.2.109
Falconer N, Barras M, Martin J, Cottrell N. Defining and classifying terminology for medication harm: a call for consensus. Eur J Clin Pharmacol 2019;75:137-45. Available at: http://link.springer.com/10.1007/s00228-018-2567-5
Kimberly LL, Beuttler MM, Shen M, Caplan AL, Bateman-House A. Pre-approval access terminology: a cause for confusion and a danger to patients. Ther Innov Regul Sci 2017;51:494-500. Available at: http://link.springer.com/10.1177/2168479017696267
Australian Capital Territory Ambulance Service. Clinical management guidelines, 2019. Available at: https://esa.act.gov.au/about-esa-emergency-services/ambulance/clinical-management-guidelines
Ambulance Tasmania. Clinical practice guidelines for ambulance paramedics. 2012. [Internet]. Available at: www.dhhs.tas.gov.au/ambulance/clinical_services/medical_protocols/paramedic_protocols
Ambulance Victoria. Clinical practice guidelines. 2020. Available at: www.ambulance.vic.gov.au/paramedics/clinical-practice-guidelines/
New South Wales Ambulance. New South Wales Ambulance Protocols 2.0.1. 2016. Available at: https://apps.apple.com/au/app/nsw-ambulance-protocols/id1103576564
Queensland Ambulance Service. Clinical practice manual. 2020. Available at: www.ambulance.qld.gov.au/clinical.html
South Australia Ambulance Service. Clinical practice guideline. 2019.
St John New Zealand. Clinical procedures and gGuidelines. 2019. Available at: www.stjohn.org.nz/globalassets/documents/health-practitioners/clinical-procedures-and-guidelines---comprehensive-edition.pdf
St John Northern Territory. Clinical practice procedures. 2013. Available at: www.stjohnnt.org.au/img/documents/clinical-manuals/cpphv23june2013.pdf
St John Western Australia. Clinical resource. 2020. Available at: https://clinical.stjohnwa.com.au/
Wellington Free Ambulance. Clinical procedures and guidelines. 2019. Available at: www.wfa.org.nz/what-we-do/clinical-care/