Paramedics in Australia

A paramedic, is a highly trained health care professional who responds to and treats all types of medical and trauma emergencies outside of a hospital setting before and during transportation to an appropriate medical facility. Paramedics also work in the inter-facility transport environment where a paramedic will continue or upgrade medical care to a higher level while transporting a patient from one healthcare facility to another. Paramedics usually transport patients to a hospital based emergency department, but paramedics can treat patients out of the hospital setting and then not transport the patient to the hospital (e.g. a paramedic gives a diabetic patient 50% dextrose in water).

In Australia use of the term paramedic is not restricted or licensed. Prior to the 1990s most paramedics were known as ambulance officers.

Clinical Scope of Practice & Qualifications
Please note that these terms and qualifications vary slightly between states. These are the minimum qualifications, but some states require more advanced training to hold these positions. For example, in Victoria, "Ambulance Attendants" (who generally for non-emergency private companies) are now required to hold a Diploma, and the term "Ambulance Paramedic" in Victoria generally refers to an Advanced Care Paramedic (the minimum standard for emergency work) and are now required to hold a Bachelor degree.

First Responder
In some locations, volunteer first responders are used by ambulance services to begin basic treatment before an ambulance arrives. Their training is to a high standard of advanced first aid. In some states volunteer "Ambulance Officers" have little more training that First Responders. The term is nonspecific and is used by private first aid companies and workplaces to describe many levels of advanced first aid training.

Patient Transport Officer
Patient Transport Officers, or Ambulance Transport Officers, provide non-emergency patient transport. PTOs provide a pre-booked, non-urgent service that includes home to hospital and hospital to hospital transfers. In some states PTO's may occasionally be required to act as first responders to emergencies. This is usually limited to situations where it would take significantly longer for Paramedics to arrive at the scene than a nearby patient transport crew, or patients that are assessed to be low-risk and require a low level of care in transit.

Patient Transport Officers complete a course of training that will earn them a nationally recognised Certificate III in Non-Emergency Patient Transport.

Ambulance Officer/Ambulance Paramedic/Ambulance Attendant
This is the basic level of pre-hospital emergency care. These Paramedics hold a Certificate IV in Basic Emergency Care, or equivalent, and are trained in basic life support skills. Meanwhile, Ambulance Officers hold only Certificates I-IV in Basic Emergency Care. When entering the Ambulance service, workers can enter at Certificate I Level and can work towards a new Cert every year or, with the completion of a bachelor degree in paramedics, can enter as a level V Ambulance office AKA a Paramedic.

Advanced Care Paramedic
Advanced Care Paramedics are trained to a higher level than standard paramedics. In many states this is now the base-level paramedic qualification earned at the completion of Student Paramedic training.

Training includes advanced techniques and the administration of certain types of drugs and medications. Training is to the standard of Diploma of Paramedical Science (Ambulance) or equivalent, although some universities now offer Bachelor degrees in paramedicine.

Some of the skills possessed by Advanced Care Paramedics include basic-level CPR, first aid, airway management, oxygen administration, spinal immobilization, traction splinting, bleeding control and splinting, as well as the intermediate skills of IV therapy, advanced airway management and initial cardiac drug therapy. Paramedics are also educated in ECG interpretation, advanced respiratory support and airway skills including pharmacology, trauma resuscitation and paediatric life support.

Intensive Care Paramedic
Intensive Care Paramedics, or MICA (Mobile Intensive Care Ambulance) Paramedics in Victoria, have further training and skills including intubation, surgical airways and advanced cardiac life support.

Training involves the completion of an Advanced Diploma of Health Science, Graduate Diploma in Intensive Care Paramedical Practice, or equivalent qualifications.

Rescue Paramedic
Some ambulance services employ paramedics specially trained in rescue techniques. Officers are trained in areas such as road crash rescue, vertical rescue, confined space and trench rescue. They learn navigation skills, four wheel driving, urban search and rescue, and chemical biological and radiological procedures.

Flight Paramedic
Flight Paramedics work on fixed wing and helicopter aircraft in many states, performing both emergency and routine transport operations. They are generally considered to be extremely highly trained in emergency medical care, but also aviation medicine, rescue and aviation emergencies. In some states this role is performed by doctors (usually emergency or intensive care specialists).

Employment
Paramedics are employed by various public and private service providers. The state run ambulance services are activated by the 000 (similar to 911 in the USA or 112 in Europe). Paramedics may respond to medical incidents in a conventional ambulance, sedan, SUV, rescue vehicle, helicopter, fixed-wing aircraft, motorcycle or even bicycle or foot at large public gatherings.

There are also private transport ambulances which are crewed by Patient Transport Officers (or sometimes Ambulance Attendants and/or nurses). They generally transport non-emergency patients between hospitals and other health setting such as nursing homes.

In Australia paramedic salaries can range anywhere from unpaid volunteer positions to over $100,000 a year, depending on location, experience, supervisory responsibilities and overtime.

Professional Organisations
The Australian College of Ambulance Professionals is the professional organisation for ambulance paramedics. Note that industrial representation varies from state to state.