Community paramedicine is the newest specialization area in Emergency Medical
Services (EMS). It is also known as Mobile Integrated Health Paramedicine. In healthcare research, community paramedicine is a new concept of prehospital care which means that paramedics serve as a bridge between the community and primary access services. This paper examines the scope of practice of community paramedics, looks into the special skills required, explores the roles and responsibilities of community paramedics, lists the education requirements, and, finally, focuses on the certification/recertification requirements.
Scope of Practice
Just as the scope of practice community paramedics varies from one jurisdiction to another, their roles will vary depending on location. The key difference between the traditional role of paramedic and community paramedic is the focus of the latter on working with patients in their homes in order to prevent adverse conditions from escalating into threats that will require emergency medical care. The expanded role of a community paramedic includes chronic disease management, patient education, and wound care. In accordance with local programs and protocols, community paramedic home visits can include home safety assessment, medication inventory and compliance, managing and monitoring of chronic diseases, and wellness check. Community paramedics’ work is directed by a physician who acts as a medical director of a community paramedicine program. They bring primary care to patients’ homes, serve as navigators for patients, collaborating with other healthcare team members, and taking part in public education and prevention programs.
Special Skills Required
According to Dan Swayze from Center of Emergency Medicine of Western Pennsylvania, the special skills required include expanded patient assessment (e.g. injury risk assessment and oral health assessment, etc.), therapeutic communications (stabilizing patients’ illnesses or injuries), mental health understanding (mental health assessment), patient navigation and patient advocacy (i.e. navigating patients to relevant agencies and helping them enroll in respective programs), and localization (i.e. acting in accordance with the needs, cultural practices, and specifics of local communities) (Swayze, 2015).
Duties and Responsibilities
Community paramedics are responsible for carrying out minor medical procedures such as catheter replacement, fluid replacement, minor suturing, wound care, replacing a tracheostomy tube, and inserting a feeding tube; do some laboratory services such as blood draws or collecting lab specimen; provide chronic disease care for conditions such as asthma, hypertension, stroke, chronic obstructive pulmonary disease, or congestive heart failure, etc., provide some clinical care such as respiratory services or even an electrocardiography, and follow up on a care plan or hospital follow-up. Other duties may include immunization, medication compliance and medication administration.
Education Requirements, Certification & Recertification
Because of the novelty of the concept of community paramedicine only a few states in the U.S. have adopted education legislation requirements legislation for community paramedics while others are in the process. The candidates must pass Community Paramedic Exam and get CP certification. The expectation for the CP-C exam is competency in “mobile integrated healthcare and expanded EMS services in rural and urban settings” (IBSC, 2017). The latter includes a variety of healthcare as well as mental health needs in addition to patient housing needs and social service needs. The examination does not test knowledge at the entry level but rather validates the competencies of experienced paramedics in providing medical services beyond the conventional emergency care or transportation roles. To illustrate, according to American Academy of Orthopaedic Surgeons, in community paramedicine, “experienced paramedics receive advanced training to equip them to provide services within a community” (AAOS, 2016, p.20). As for the recertification, the 1st recertification cycle can only be completed through examination because of the dynamic changes in the materials of the exam based on the rapid growth in the designated specialty area (IBSC, 2017).
- AAOS (2016). Emergency care and transportation of the sick and injured. Jones & Bartlett Learning.
- AAOS (2017). Community health paramedicine. Jones & Bartlett Learning.
- International Board of Specialty Certification (2017). For community paramedics. Retrieved from https://www.ibscertifications.org/roles/community-paramedic.
- Swayze, D. (2015). Core competencies for community paramedics. Journal of Emergency Medical Services. Retrieved from http://www.jems.com/articles/supplements/special-topics/doing-it-right/core-competencies-for-community-paramedics.html.