Paramedic Practice
The paramedic role
Paramedics deliver assessment, treatment and transport across the full age range and a wide range of presentations. Core competencies include systematic patient assessment (primary survey then secondary survey), airway and ventilation support including supraglottic airways and oxygen titration, IV access and fluid administration, administration of the medications within your scope, cardiac monitoring and defibrillation (AED and manual), and safe packaging and transport.
Concepts to master
Primary survey (catastrophic haemorrhage, airway, breathing, circulation, disability, exposure) with simultaneous resuscitation; history taking using SAMPLE and OPQRST; recognition of respiratory distress versus failure; asthma, COPD, anaphylaxis and cardiac emergencies; obstetric and paediatric adaptations; manual handling and patient positioning; and accurate documentation and handover using a structured format.
Traps in questions
Distinguish distress from failure: a silent chest, exhaustion, or rising CO2 with falling consciousness signals impending failure and demands assisted ventilation, not more nebulisers. Be careful with oxygen: titrate to target saturations rather than giving high-flow universally. Paediatric stems often hinge on weight-based dosing and age-appropriate vital signs. Handover questions reward structured, prioritised communication over narrative.
Rule of thumb
Treat the patient, not the number: a saturation reading with a poor trace or a patient deteriorating in front of you overrides the monitor. If the patient is peri-arrest, escalate to the highest available clinical level and request backup early.
Worked example
A 24-year-old with acute asthma is drowsy, has a quiet chest and a rising CO2 on capnography. The correct action is assisted ventilation with bag-valve-mask and urgent transport, not further nebulised bronchodilators alone, because this describes respiratory failure rather than simple distress.