Paramedicine: Beyond the Hospital Walls

What is paramedicine?

What’s the primary profession that comes to your head when someone says they work in medicine? A doctor, right? Then comes a nurse and maybe after that a pharmacist. An integral aspect called “paramedicine” gets ignored more often than not. If you ask google to define paramedicine, it’ll tell you “the branch of medicine dealing with emergency medical care given to people who are injured or ill, typically in a setting outside a hospital.” So the ambulance driver that rushes the vehicle through traffic to reach you if you get in an accident, or the EMT (Emergency Medical Technician) that provides you the primary care of first aid would be a part of the paramedical staff. Highly pivotal to get ignored we’d say.?

Who is a paramedic??

A little over a week ago eighteen people lost their lives and more than 30 were injured when a double-decker sleeper bus rammed into a milk container on the Lucknow-Agra Expressway in Unnao district, Uttar Pradesh. (source: Business Standard). We’ll spare the details of the crash but we will focus on how medical assistance must’ve been provided in such an incident. Shortly after the crash police and ambulances, from the nearest public health centre, would have arrived on site. In this particular case, an ambulance provided by the road and highways ministry for emergencies along the national highways (through Dial-112) must’ve been sent to the location of the crash. “Paramedics” equipped with basic life support techniques, as in first aid and enough treatment of the injured people so that they reach the hospital in time.

So a paramedic often tackles emergency situations outside of a hospital setting and primarily works in ambulances or other mobile settings to treat patients on their way to a hospital to receive further treatment and care from a licensed physician or doctor. A paramedic's job involves several tasks, such as talking to hospital staff, checking patients, and giving treatment. They also keep track of patient conditions and care, provide CPR, first aid, or life support, clean medical equipment, and transport patients to hospitals.

Types of Paramedics?

There are various types of paramedics, each with specific roles: Advanced care paramedics manage trauma and cardiac arrest cases; Community paramedics provide home healthcare in remote areas; Critical care paramedics transport critically ill patients and administer advanced treatments; Emergency care assistants support paramedics with basic care and equipment management; Emergency medical technicians (EMTs) handle on-site emergency care; Emergency room technicians assist in hospitals with patient monitoring and procedures; Firefighter paramedics handle fire emergencies and provide burn care; Flight paramedics offer critical care during air transport; General care paramedics treat patients in non-hospital settings, often working with the elderly; On-location paramedics provide care at events; Primary care paramedics offer basic life support and transport patients; SWAT paramedics support SWAT teams and manage tactical injuries; and Shipboard paramedics work on ships, often with a medical team, to treat sea-related illnesses.

Challenges faced by Paramedics

All of those mentioned above, in simple words, are really tough and sometimes life threatening jobs. Working day in and day out on road accidents, house fires, natural calamities, and more such situations requires not only technical knowledge and precision of medical assistance but also a whole lot of compassion and generosity towards the people in distress. For instance, working with elderly people or differently abled people is also a profession based on the principle of kindness and care. It could be exhausting, draining and even agitating at times, but that’s what the job is. You’d wonder what the annual income of such an intricate job would be, right? The average pay of a paramedic in India varies from Rs 2 lakh to Rs 5 lakh per annum. Oh, let’s actually rephrase it, the average pay of a paramedic in India varies from a mere Rs 2 lakh to Rs 5 lakh per annum. Government appointed EMTs get some additional benefits under the National Health Mission, like paid leaves, CLs and CCLs, but the private hospitals are more often than not paying well pretty low. Other challenges commonly faced by the paramedics in India would include exploitation by employers, unpaid overtime work, shortage of qualified persons, disrespect faced from patients that could even boil down to violence and assault.?

With shortage of doctors in public health centres of rural areas of the nation, the workload on nurses and paramedics is ever increasing. Deployment in dispensaries or having to deliver the entire treatment rather than just what their job description involves are common occurrences in the life of an EMT or nurse placed in a Primary or Community Health centre. Such cases even lead to discrepancies in healthcare delivery due to miscommunication and lack of a certain skill or equipment. Also as there is no real way of optimising the process to reach a patient, instances of delays, referrals and misunderstandings amongst the staff and the patients are recurring. Neglecting such instances is obviously not an option as what’s at stake here are the lives of people.?

Conclusion

Working in healthcare, at any level, has always been and shall always be a blessing and a burden. Working as a paramedic, does definitely come with a blessing of the beautiful skill of saving lives, and the curse of inadequate salaries and depressing working conditions. While only the government and the industry stakeholders can influence the paychecks and vacancies for the benefit of these integral medical professionals, day to day inaccuracies in the workflow can be minimised with the digitisation of emergency care as much as possible. The HPR (Health Professional Registry) and hiring in positions of CHO (Community Health Officers) under the Ayushman Bharat Mission, the government does seem to create better job profiles and simplified healthcare delivery. On the other hand, healthcare IT startups like Medoc health are developing technologies that could bring unimaginable changes in the lifestyle and working environment of the ambulance and hospital co-ordination. Hospital management systems completed with real-time ambulance tracking services and a paramedic alerting system that notifies the workforce of any emergencies requiring their assistance in surrounding areas, could completely revolutionise not only the existing staff under paramedicine category but also encourage students to take up the profession.

Credits Sneha Kumar