Utilizing paramedics for in-patient critical care surge capacity

Michael J. Reilly, DrPH(c), MPH, NREMT-P, David Markenson, MD, EMT-P

Abstract


Introduction: While many hospitals have developed preliminary emergency department and in-patient surge plans, the ability to surge is often limited by critical resources.The resource which is often the most limited is usually the human resource and within this category the limiting factor is almost universally nursing. As a result, nursing shortages can result in an inability of a hospital or emergency department to create surge capacity to deal with large numbers of ill or injured patients. Utilizing paramedics in acute-care hospitals or at alternate care sites could serve as expansion staff to supplement existing nursing staff, allowing fewer nurses to care for a larger numbers of patients during a disaster, act of terrorism, or public health emergency.While the procedures performed for nursing do vary from hospital to hospital, there are national certifications for both emergency nursing (CEN®) and critical care nursing (CCRN®) that can be used to establish a standard for comparison.
Methods: A detailed review and curriculum mapping of the specific educational objectives and competencies of the US Department of Transportation National Standard Curriculum for the Emergency Medical Technician-Paramedic as well as the competencies and criteria for board certification as a Certified Emergency Nurse (CEN) and Critical Care Registered Nurse (CCRN) was performed.
Results: Approximately 90 percent of the CEN and CCRN knowledge skills and competencies are met or exceeded by the National Standard Paramedic Curriculum.
Conclusions: With appropriate training and orientation, paramedics may be used in an in-patient setting to augment emergency and critical care nursing staff during a disaster, act of terrorism, or public health emergency.


Keywords


surge capacity, paramedic, nursing, critical care, education, training, standard of care

Full Text:

PDF

References


Institute of Medicine (US). Committee on the Future of Emergency Care in the United States Health System: Hospital- Based Emergency Care: At the Breaking Point. Washington, DC: National Academies Press, 2007.

Institute of Medicine (US). Committee on the Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads. Washington, DC: National Academies Press, 2007.

Institute of Medicine (US). Committee on the Future of Emergency Care in the United States Health System: Emergency Care for Children: Growing Pains. Washington, DC: National Academies Press, 2007.

Qureshi K, Gershon RR, Sherman MF, et al.: Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005; 82(3): 378-388.

Markenson D, Reilly MJ, DiMaggio C: Public health department training of emergency medical technicians for bioterrorism and public health emergencies: Results of a national assessment. J Public Health Manag Pract. 2005; Suppl: S68-S74.

Reilly MJ, Markenson D, DiMaggio C: Comfort level of emergency medical service providers in responding to weapons of mass destruction events: Impact of training and equipment. Prehosp Disaster Med. 2007; 22(4): 297-303.

Walz BJ, Bissell RA, Maguire B, et al.: Vaccine administration by paramedics: A model for bioterrorism and disaster response preparation. Prehosp Disaster Med. 2003; 18(4): 321-326.

Emergency Nurses Association. Content List-CEN. Available at http://admin.ena.org/bcen/cen/CENContentListing-2007.asp. Accessed December 12, 2009.

Emergency Nurses Association: Emergency Nurses Association Scope of Emergency Nursing Practice. Des Plaines, IL: Emergency Nurses Association, 1999.

American Association of Critical-Care Nurses: Certification Exam Handbook. Aliso Viejo, CA: American Association of Critical- Care Nurses, 2009: 25-30.




DOI: https://doi.org/10.5055/ajdm.2010.0020

Refbacks

  • There are currently no refbacks.