Ambulance - Crewing

Crewing

There are differing levels of qualification that the ambulance crew may hold, from holding no formal qualification to having a fully qualified doctor on board. Most ambulance services require at least two crew members to be on every ambulance (one to drive, and one to attend the patient), although response cars may have a sole crew member, possibly backed up by another double-crewed ambulance. It may be the case that only the attendant need be qualified, and the driver might have no medical training. In some locations, an advanced life support ambulance may be crewed by one paramedic and one EMT-Basic.

Common ambulance crew qualifications are:

First responder – A person who arrives first at the scene of an incident, and whose job is to provide early critical care such as cardiopulmonary resuscitation (CPR) or using an automated external defibrillator (AED). First responders may be dispatched by the ambulance service, may be passers-by, or may be dispatched to the scene from other agencies, such as the police or fire departments.
Ambulance Driver – Some services employ staff with no medical qualification (or just a first aid certificate) whose job is to simply drive the patients from place to place. In some emergency ambulance contexts this term is a pejorative toward qualified providers implying that they perform no function but driving, although it may be acceptable for patient transport or community operations. In some areas, these drivers would survey and study the local network of routes for better performance of service, as some road routes may be blocked, and the driver must know another route to the patient or to the hospital. The driver would gather the local weather and traffic status reports before and in-between emergencies. They may also have training in using the radio and knowing where medical supplies are stored in the ambulance.
Ambulance Care Assistant – Have varying levels of training across the world, but these staff are usually only required to perform patient transport duties (which can include stretcher or wheelchair cases), rather than acute care. Dependent on provider, they may be trained in first aid or extended skills such as use of an AED, oxygen therapy and other lifesaving or palliative skills. They may provide emergency cover when other units are not available, or when accompanied by a fully qualified technician or paramedic.
Emergency Care Assistant/Emergency Care Support Workers – Also known as ECA/ECSW are members of a frontline ambulance that drive the vehicles under both emergency and non-emergency conditions to incidents. There role is to assist the clinician that they are working with either a Technician or Paramedic in there duties whether that be drawing up drugs, setting up fluids (but not attaching), doing basic observations or performing 12 lead ECG assessments.
Emergency medical technician – Also known as Ambulance Technician. Technicians are usually able to perform a wide range of emergency care skills, such as defibrillation, spinal immobilization, bleeding control, splinting of suspected fractures, assisting the patient with certain medications, and oxygen therapy. Some countries split this term in to levels (such as in the US, where there is EMT-Basic and EMT-Intermediate).
Paramedic – This is a high level of medical training and usually involves key skills not permissible for technicians, such as cannulation (and with it the ability to administer a range of drugs such as morphine), tracheal intubation and other skills such as performing a cricothyrotomy. Dependent on jurisdiction, the title "paramedic" can be a protected title, and use of it without the relevant qualification may result in criminal prosecution.
Registered nurse (RN) – Nurses can be involved in ambulance work, and as with doctors, this is mostly as air-medical rescuers or critical care transport providers, often in conjunction with a technician or paramedic. They may bring extra skills to the care of the patient, especially those who may be critically ill or injured in locations that do not enjoy close proximity to a high level of definitive care such as trauma, cardiac, or stroke centers.
Emergency Care Practitioner – This position, sometimes called 'Super Paramedic' in the media, is designed to bridge the link between ambulance care and the care of a general practitioner. ECPs are already qualified paramedics who have undergone further training, and are trained to prescribe medicines (from a limited list) for longer term care, such as antibiotics, as well as being trained in a range of additional diagnostic techniques.
Doctor – Doctors are present on some ambulances – most notably air ambulances – will employ physicians to attend on the ambulances, bringing a full range of additional skills such as use of prescription medicines.