Introduction of an Extended Care Paramedic role

This would entail the placement of a QAS clinician in a GP clinic or ‘super-clinics’ (where deemed appropriate in consultation with the clinic) where the paramedic would include the same scope of practice as our current LARU officers, with the addition of:
•    The ability to refer patients for simple imaging and testing (such as X-Rays for un-complicated fractures and musculo-skeletal injuries and blood cultures)
•    The ability to actively refer patients to a doctor or other health provider (such as a physiotherapist)
•    Establishing a regular GP for further follow up on acute health issue 
The primary role of the extended care paramedic in the clinic would be to treat QAS patients (brought to the clinic by on road paramedics), and therefore create a new alternative referral pathway, supported by knowledge of QAS policies and procedures.
 

Why the contribution is important

The extended care paramedic would be able to provide onsite treatment, such as intravenous cannulation and normal saline therapy, provide monitoring (consistent with current ambulance monitoring and facilitated using the same equipment), and provide further bookings for appointments with the respective GP.
The option would also exist for the paramedic to assist the GP where required, for instance first aid for walk in patients, and emergency medicine care for patients who present but will require transport to the hospital.
Keeping patients with their same doctor (as referred to by the paramedic practitioner) would result in a better continuity of care for the patient, and ensures the patient is managed by the fewest number of practitioners necessary, fostering better doctor-patient relationships.
The paramedic would be able to facilitate bi-directional education, where GPs are made more aware of the potential to manage patients out of hospital, and the paramedic can provide QAS with an improved method of referring GP patients to hospital.
Patient care would improve, for instance chest pain patients that GPs diagnose with ischaemic chest pain. These patients often receive a single dose of nitrate and are left to await QAS while the GP must see further patients. The presence of a paramedic practitioner allows this patient to receive the medically necessary treatment while awaiting an acute ambulance arrival.
This role would be a suitable referral pathway for both acute ambulance crews and the LARU officers, providing a vital new option for patient care rather than just proceeding to the emergency department due to lack of a better option.
 

by rblackman on August 23, 2019 at 03:49PM

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