What is a Paramedic?
At Middlesex – London EMS, we have a combined service of both Primary Care Paramedics (PCP) and Advanced Care Paramedics (ACP).
All paramedics provide out of hospital care to ill and injured people. Paramedics are graduates of a Community College full-time graduate program dedicated to the Paramedic Profession. The two-year Paramedic Program emphasizes areas of anatomy, physiology, pharmacology, and mechanisms involved in acute injury and illness. Upon graduation from a Paramedic Program, the paramedic student must complete the Ontario Ministry of Health and Long-Term Care provincial certification. This certification, known as the Paramedic exam or Advanced Emergency Medical Care Assistant (A-EMCA) exam, must be successfully completed to practice as a Primary Care Paramedic in Ontario. In addition, a paramedic must be authorized by a medical director of a Regional Base Hospital (RBH) to perform controlled medical acts. In Middlesex – London EMS, all paramedics are certified under the South West Ontario Regional Base Hospital Program by Dr. Matt Davis.
Primary Care Paramedics (PCP)
Primary Care Paramedics can be recognized by the one stripe on their shoulder epaulettes.
The PCP functions to provide:
- patient assessment
- cardiopulmonary resuscitation (CPR)
- patient immobilization
- basic trauma life support
- oxygen therapy via various methods
- blood glucose testing
- trauma care, including basic wound care
The PCP skill set and medications include:
- medication administration including
- oral glucose
- Acetylsalicylic acid (ASA)
- Nitroglycerine spray
- Salbutamol (Ventolin)
- Dimenhydrinate (Gravol)
- Diphenhydramine (Benadryl)
- 12-Lead ECG Application
- Pulse oxymetry monitoring
- Continuous Positive Airway Pressure therapy (CPAP)
- Supraglottic Airway insertion (King LT)
- Medical and Traumatic Termination of Resuscitation (TOR)
- Some PCP’s are also certified in peripheral IV starts and IV Dextrose Administration
Advanced Care Paramedics (ACP)
Advanced Care Paramedics (ACP) must have a minimum of 2 years experience in the paramedic field as a Primary Care Paramedic before being able to qualify for training at the ACP level. The ACP Program is an additional 1 year in length and is considered a post-diploma program. Advanced Care Paramedics (ACP) build upon the knowledge and experience gained while working as a Primary Care Paramedic enabling them to deliver an expanded set of controlled medical acts to patients suffering from serious medical and traumatic emergencies. Utilizing advanced assessment, critical thinking, and decision-making skills, the ACP is able to perform invasive therapeutic interventions to manage life-threatening situations in the pre-hospital environment. ACP’s must successfully complete many mandatory and elective continuing medical education courses on an annual basis to maintain their qualifications and certification to perform these controlled medical acts under the direction of the Base Hospital Physician. ACP’s can be recognized by the two stripes on their shoulder epaulettes.
In addition to the PCP skill set, ACP providers are qualified to perform and/or use:
- advanced airway management equipment
- orotracheal and nasotracheal intubation equipment
- ETCO2 monitoring
- laryngoscopy and removal of foreign body obstruction using Magill forceps
- intravenous therapy
- 12-Lead ECG interpretation
- needle thoracostomy
- intraosseous , external jugular IV starts and central venous access device
- manual defibrillation, synchronized cardioversion and external transcutaneous cardiac pacing
- treatment of cardiac emergencies according to the Heart & Stroke Foundation Advanced Cardiac Life Support (ACLS) guidelines
- administration of the following emergency medications: Adenosine, Amiodarone, ASA, Atropine, Dextrose, Dimenhydrinate, Diphenhydramine, Dopamine, Epinephrine, Fentanyl, Furosemide, Glucagon, Lidocaine, Lidocaine Spray, Midazolam, Morphine, Naloxone, Nitroglycerine, Salbutamol, Sodium Bicarbonate, and Xylometazoline Spray.
A level of paramedic is specified in Ontario Regulation257/00 made under the Ambulance Act, RSO 1990, c A‐19. Schedules 1, 2 and 3 to this regulation specify the mandatory controlled acts for each level of paramedic. Ambulance Act of Ontario