Proposed Core Scope of Practice

The scope of practice of the Paramedic Practitioner encompasses a broad range of clinical skills that cover critical care and primary health area. The Paramedic Practitioner upon completion of their training would be able to do, use or complete:

Detailed history taking including mental health, social and family aspects

Comprehensive physical examination of all body systems that includes:

• General survey and vital signs
• Head, Eyes Ears, Nose and Throat (HEENT) examination with otoscope
• Cardiac and carotid sound examination
• Complete integumentary assessment
• Spirometry
• Advanced musculoskeletal assessment including joints such as the shoulder or temporomandibular joint
• Advanced neurological assessment including cranial nerve evaluation and reflexes

Advanced psychosocial assessments including:

• Fall risks
• Palliative care
• Dialysis follow-up
• Dietary evaluation
• Age care assessments including test such as a MMSE
• Home medication review
• Diabetic follow-up and other chronic medical assessments/counseling

Point-of-care testing devices and screening tools for diagnosis and treatment evaluation including:

• Urinalysis
• Glucose and diabetic monitoring
• Blood tests such as CBCs, chemistries, INR or cardiac markers (such as troponin)
• Sonography (including FAST)
• Stool guaiac or faecal occult blood test
• Corneal abrasion evaluation using fluorescein staining (screening only)
• Other diagnostic tests to be obtained and sent for evaluation such as cultures

Medical and critical care skills including:

• Fracture reduction and short-term casting/immobilisation
• Joint relocation
• Intubation and RSI
• Cricothyrotomy
• Mechanical ventilator use
• Advanced cardiac dysrhythmia management with synchronised cardioversion and transcutaneous pacing
• Thoracostomy and chest tube maintenance
• Intraosseous access
• Central line maintenance and management
• Gastric tube placement, evaluation or maintenance
• Urinary catheter replacement or maintenance
• Acute and chronic wound evaluation, debridement, drain and other care

Other areas of medical management including:

• Back pain, infection (ranging from respiratory to sexual transmitted infections), migraine, GI illness and other low acuity illnesses

Simple surgical procedures including:

• Suturing , stapling or gluing of acute injuries
• Incision and drainage (non-dental skin abscesses)
• Punch skin biopsies

Expanded pharmacology for administration and management including:

• Advance critical care pharmacology including antiarrhythmics, analgesics, diuretics, antipsychotics, sedatives and others
• Local or regional anaesthetics
• Antibiotic therapy
• Over the counter therapies including Gastrolyte or paracetamol
• Short-course therapies including steroids, analgesics, anti-inflammatories, antiemetics, muscle relaxants, gastro relievers, etc.
• Vaccine administrations
• Short term dispensing of ‘out of medicines’ coverage for non-scheduled medication. This covers classes of medication such as antihypertensives or antidiabetics where the provider would carry one type from each class of medications such as a beta-blocker, calcium channel blocker, ACE inhibitor or metformin.

Palliative care and management

• Subcutaneous cannulation for pain management
• Counselling and reassurance
• Secretion management
• Breakthrough pain management

Referrals for specialties including:

• Radiographs of injuries or chest x-rays
• Other diagnostic lab tests not able to be tested by point-of-care screening (such as haemoglobin A1C)
• Cardiology (including stress tests or echocardiograms)
• Orthopaedics, physiotherapists or physical therapy
• Dental evaluations or procedures
• Prevention evaluations such as a colonoscopy or colposcopy

General practitioner for follow-ups as needed

• All case information from patients to be referred back to the GP as well

Additionally, includes the standard scope of practice of a paramedic including:

• Manual handling, extrication, triage, driving and other essential duties of the paramedic
• Basic life support, intermediate life support and resuscitation skills (in line with the Australian Resuscitation Council)
• Intermediate airway management including supraglottic airways
• Emergency management of medical and trauma conditions for adults, paediatrics or other special populations
• Use of emergency pharmacology including pain management
• Pulse oximetry, ECG or other vital monitoring and interpretation tools

Graduate Diploma of Paramedic Science (Critical Care) or equivalent degree

Year 1 - Term 2
Students must complete 2 from the following units:
PMSC20004	Advanced Clinical Care of Special Populations
PMSC20006	Advanced Clinical Care of Trauma and Environmental Emergencies
PMSC20007	Aeromedical, Retrieval and Tactical Medicine

Year 1 - Term 1
Students must complete the following compulsory units:
PMSC20001	Advanced Clinical Assessment and Decision Making
PMSC20002	Advanced Critical Skills Application
PMSC20003	Pharmacological Application in the Critical Care Setting
MEDS21003	Medical Science Research Project 1

Year 1 - Term 2
Students must complete the following compulsory units:
PMSC20005	Advanced Assessment, Diagnostic Interpretation and Management
MEDS21006	Medical Science Research Project 2

Year 2 - Term 1
Students must complete the following compulsory units:
PMSC20008	Primary Healthcare Management
PMSC20009	Primary Healthcare Assessment, Pharmacology and Skills
PMSC20010	Health Communication and Community Involvement
PMSC20011	Independent Practice and Leadership