6.4 Prehospital Medicine Settings
Karen Piette, MHS, CMA
In addition to responding to emergency (911) calls, paramedics and EMTs (including AEMTs) may work in other settings. For example, community paramedics work as part of a mobile integrated healthcare network and provide non-emergency services within the community. These specialty-trained paramedics provide focused care to patients who may have difficulty accessing traditional healthcare. For example, community paramedics regularly visit the homeless to provide follow-up care, monitor medical conditions, and ensure adherence to prescribed medication regimens. They also play a key role in psychological interventions, with early interventions being crucial in these situations.
In some areas, community paramedics follow up with recently discharged patients, many of whom are elderly. Hospitals increasingly discharge patients as soon as possible after surgery or treatment, leaving some without the family resources needed to continue their recovery. For example, a patient discharged after surgery may have limited mobility and struggle with tasks such as refilling prescriptions or obtaining groceries. Community paramedics can assist in arranging home health services and help ensure these essential tasks are completed, even though they may not provide the services themselves. They also perform exams on patients, and if anything abnormal is found, they will contact the physician for further action, which may include adjustments to medications, scheduling early follow-up appointments, or changing rehabilitation schedules. The goal of these interventions is to speed up recovery and reduce the risk of being readmitted to the hospital.
EMTs, AEMTs, and paramedics also work in industrial settings, ranging from large construction sites in urban areas to offshore oil platforms located miles from shore. In these environments, EMS providers deliver much of the same care they would provide on an ambulance but also engage in primary care medicine, especially paramedics, who can administer medications. When transportation to the nearest emergency department could take up to 24 hours, being able to treat minor injuries and manage simple medical conditions is essential. For example, paramedics may suture simple lacerations or dispense certain medications for conditions such as nausea and diarrhea, usually after consulting with a physician via telemedicine.
In more traditional medical settings, EMTs and paramedics assist in emergency departments by aiding nurses and medical staff in patient care. In recent years, paramedics have taken on expanded roles, providing advanced care as an extension of the nursing and medical teams. During the COVID-19 pandemic, paramedics were also tasked to provide backup and relief in extended care facilities as emergency staff shortages arose.
Program that allows EMS providers to provide medical assessment and preventative healthcare education in the community within their current scope of practice.