The Paramedic is an allied health professional whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical system.
The Paramedic possesses the complex knowledge and skills necessary to provide patient care and transportation.
Paramedics function as part of a comprehensive EMS response, under medical oversight. Paramedics perform interventions with the basic and advanced equipment typically found on an ambulance. The Paramedic is a link from the scene into the health care system.
I. REQUIREMENTS FOR BECOMING A PARAMEDIC 1. Be 18 years of age or older. 2. Hold a current NREMT certification or state license at the EMT level or higher. 3. Have successfully completed, within the past 2 years, a Paramedic program that has been accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), or a program that has a CAAHEP “Letter of Review.” The Program Director nf the course you take must verify your successful completion of the course through the NREMT website. 4. Have a current CPR-BLS for “Healthcare Provider” or equivalent credential. 5. Successfully complete the NREMT cognitive (knowledge) and psychomotor (skills) exams.
II. THE EXAM The National Paramedic Certification exam is a computer-adaptive test (CAT). This means that you take the test using a computer, and that an algorithm adjusts the exam to your maximum ability level in real time as you are taking the test. The exam delivers questions one at a time and the questions are not randomly chosen. Instead, the test tailors itself to your individual abilities. While you are taking the test, the software that drives the test is estimating your ability level. The ability estimate gets more and more precise as the exam progresses. The exam ends when there is a 95% certainty that your demonstrated competency is above or below the passing standard. It is unlikely any two candidates will take the same exact test; however, all candidates will take a test that meets the same test plan. The exam complies with the Americans with Disabilities Act (ADA) with regard to requests for examination accommodations consistent with its mission and public protection.
III. TOPICS COVERED ON THE EXAM Your exam will most likely have at least 80 and no more than 150 questions. You will have 2 hours and 30 minutes to complete the test. Less than 1% of candidates are unable to finish the exam in the time allowed. Take the time to read every question carefully. All of the questions will be multiple-choice and each question will have 4 answer choices. You need to choose the “best” answer for the question posed. The exam will broadly cover the content of the current National EMS Education Standards (NEMSES) and the current American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Correct answers are based on national standards, not local or state protocols. The exam emphasizes questions about what a Paramedic should do in the field, so you should expect a lot of scenario-based questions. Topics will include airway, respiration and ventilation, cardiology and resuscitation, trauma, medical emergencies, obstetrics, gynecology, and EMS nperations. The table below shows the percentages for the topics found on the exam.
NREMT Test Plan for Paramedic Candidates Content Area - Percent of Exam
Airway, Respiration & Ventilation 18%–22% Cardiology & Resuscitation 22%–26% Trauma 13%–17% Medical; Obstetrics & Gynecology 25%–29% EMS Operations 10%–14% Source: https://www.nremt.org/rwd/public/document/cognitive-exam xi
The EMT-Paramedic Practical Examination The practical exam consists of six stations, arranged as scenarios, that approximate the situations that the EMT-Paramedic will encounter in the prehospital setting. The stations match the National Standard EMT-Paramedic Training Curriculum, as well as current American Hospital Association standards.
To pass the practical exam, you must demonstrate competence in the following areas and sub-areas: 1. Patient Assessment/Management a. Primary survey/resuscitation b. Secondary survey 2. Ventilatory Management 3. Cardiac Arrest Skills a. Dynamic cardiology (managing a code) b. Static cardiology (interpreting ECG tracings) 4. IV and Medication Skills a. Intravenous therapy b. Intravenous bolus medications c. Intravenous piggyback medications 5. Spinal Immobilization (seated patient) 6. Random Basic Skills (includes two of the following): a. Bleeding-wounds-shock b. Long bone splinting c. Traction splinting d. Spinal immobilization (lying patient)
FOUR RESPONSIBILITIES OF AN EMT
1. Respect (R-E-S-P-E-C-T) Paramedics must respond with respect, to both the physical and the emotional needs of patients. This means putting aside personal beliefs and prejudices. They must also be respectful of patient confidentiality, just as any other health professional must be. “Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law,” states the EMT Oath, written by Dr. Charles B. Gillespie, and adopted by the National Association of Emergency Medical Technicians. Respect has great importance in everyday life. As children, we are taught (one hopes) to respect our parents, teachers, and elders. As a fundamental professional value, respect should permeate a paramedic’s relationship with his or her patients. Outwardly, respect is manifested by behaviors that reinforce a patient’s dignity: simply introducing ourselves and explaining our roles carefully; addressing patients as Mr. or Ms., rather than using first names; asking permission before examining patients; sitting and making eye contact; paying close attention when patients speak to us. These are all well-understood ways to convey respect. Unintrusiveness is less often emphasized as an aspect of respectfulness. Patients give paramedics unrivaled access to their privacy. This vulnerability of patients must be counterbalanced by respect. Thus, we should expose as little as possible when examining private parts of patients and be extremely respectful of confidentiality. We should avoid discussing patients with anyone not involved in their care and certainly never mention patients in public places. 2. Skills Mastery Like other medical professionals, paramedics take an oath to do no harm. Paramedics may face legal liability for failing to perform their jobs appropriately. However, they also have an ethical responsibility to make sure they have a mastery of the skills needed to do the job effectively. This means participating in continuing education and refresher trainings. Innovations are constantly changing the medical field. As a result, paramedics must make sure that they have a good working knowledge of new concepts and modalities in emergency patient care. Additionally, they should review their own performance on a constant basis as a way to ensure that they are always improving the level of service they provide. 3. Cooperation Paramedics must report with honesty anything they believe can help a patient’s health. They must also work harmoniously with other emergency medical personnel, including doctors and nurses, to ensure a patient’s health is the top priority. In instances where they are responding to situations alongside other emergency responders, such as firefighters and police, paramedics have an ethical responsibility to be cooperative and respectful of other emergency efforts occurring simultaneously with their own. 4. Patient Advocacy Paramedics should work with citizens and other healthcare professionals to promote a high standard of medical care for all, according to the EMT Code of Ethics. They should also “demonstrate concern for the competence of other members of the Emergency Medical Services healthcare team.”
Also see: EMT Exam Emergency Medical Technician
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