Abstract
Background
This narrative review presents a brief chronological history of the Anglo-American
paramedic system, combining decades of stories from across ambulance services in western,
English-speaking developed countries
Methods
Databases, including Embase, MEDLINE, Web of Science, CINAHL and Google Scholar were
searched from the inception of the databases. A grey literature search strategy was
conducted to identify non-indexed relevant literature along with forwards and backwards
searching of citations and references of included studies. Two reviewers undertook
title and abstract screening, followed by full-text screening. Included studies were
summarised using narrative synthesis structured around the exploration of the history
of the Anglo-American paramedic system.
Results
The research team structured the narrative in chronological order and used metaphorical
models based on philosophical underpinnings to describe in detail each era of paramedicine.
The narrative explores several key milestones including, industrial orientation, scope
of practice, innovation, education and training, regulation as well as significant
clinical and technological advancements in the delivery of traditional and non-traditional
paramedic care to patients.
Conclusions
Paramedicine, like other allied health professions, has successfully navigated the
pathway toward professionalisation in a considerably short period of time. From its
noble beginnings as stretcher bearers in times of war, the profession has looked outwards
to emulate the success of our healthcare colleagues in establishing its own unique
body of knowledge supported by strong clinical governance, national registration,
professional regulatory boards, self-regulation, and a move towards higher education
supported by the development of entry-to-practice degrees. Whilst the profession has
achieved many great milestones, their application across multiple jurisdictions within
the Anglo-American paramedic system remains inconsistent, and more research is needed
to explore why this is.
Keywords
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References
- Models of international emergency medical service (EMS) systems.Oman Med J. 2010; 25: 320-323
- Anglo-American vs. Franco-German emergency medical services system.Prehosp Disaster Med. 2003; 18: 29-37
- Emergency medical care in developing countries: is it worthwhile?.Bull World Health Organ. 2002; 80: 900-905
- Self-regulation and medical direction: conflicted approaches to monitoring and improving the quality of clinical care in paramedic services.Int J Health Gov. 2018; 23: 233-242
- Clinical leadership in paramedic services: a narrative synthesis.Int J Health Gov. 2017; 22: 251-268
- Writing narrative style literature reviews.Med Writ. 2015; 24: 230-235
- Writing narrative literature reviews for peer-reviewed journals: secrets of the trade.J Chiropr Med. 2006; 5: 101-117
- Optimal database combinations for literature searches in systematic reviews: a prospective exploratory study.Syst Rev. 2017; 6: 245
- Searching for qualitative research for inclusion in systematic reviews: a structured methodological review.Syst Rev. 2016; 5: 74
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.PLoS Med. 2009; 6e1000097
- The formation of the emergency medical services system.Am J Public Health. 2006; 96: 414-423
- The conceptual development of EMS systems in the United States, Part I.Emerg Med Serv. 1982; 11: 19-23
- Pollock A. Historical perspectives in the ambulance service. 2015
- Effect of military conflicts on the formation of emergency medical services systems worldwide.Acad Emerg Med. 2013; 20: 507-513
- The donkey who carried the wounded.Angus & Robertson, Sydney2009
- Sir Neville Howse (VC), Private John Simpson Kirkpatrick and Private Martin O’Meara (VC) and their contributions to Australian military medicine.J Emerg Prim Health Care. 2010; 8: 1-10
- Recommendations for organizational and structural changes to safeguard a preclinical medical treatment system.Chirurg. 1998; 69: Suppl 370-Suppl 372
- A brief military history of today's EMS.Emerg Med Serv. 2001; 30: 148
- Early management of battle casualties in Vietnam. An analysis of 1011 consecutive cases treated at a mobile army surgical hospital.Arch Surg. 1968; 97: 1-15
- Medical oversight of EMS systems.Emerg Med Serv. 2021; : 1-15
- From first aid to paramedical: ambulance officers in the health division of labour.Community Health Stud. 1986; 10: 57-67
- Exploring the structure and characteristics of the Anglo-American paramedic system in developed countries: a scoping review.Int J Emerg Serv. 2021; ([ahead-of-print(ahead-of-print)])
- Self-regulation and medical direction.Int J Health Gov. 2018; 23: 233-242
Wankhade P, Mackway-Jones K . Ambulance services: leadership and management perspectives; 2015.
- Defining two novel sub models of the Anglo-American paramedic system: a Delphi study.Austral Emerg Care. 2021;
- Aid, first and foremost: a brief outline history of the St John Ambulance Association and Brigade.Injury. 1979; 11: 104-109
- A history of first aid in Australia: the evolution of prehospital care.Med J Aust. 1998; 168: 38-41
- The ambulance service: the past, present and future.J Paramed Pract. 2012; 4: 365-368
Victoria A. Mobile intensive care ambulance celebrates 45 years of service; 2016. Available from: 〈https://www.ambulance.vic.gov.au/mobile-intensive-care-ambulance-celebrates-45-years-of-service/〉.
- The mobile coronary care unit.Hosp Pract. 1969; 4: 64-73
- Ambulance services in London and Great Britain from 1860 until today: a glimpse of history gleaned mainly from the pages of contemporary journals.Emerg Med J. 2013; 30: 218
- The beginnings of urban ambulance service in the United States and England.J Emerg Med. 1990; 8: 743-755
- Looking back 70 years at the evolution of the paramedic.J Paramed Pract. 2018; 10: 282-283
- Fifty years of modern EMS: looking back at the paper that started it all: accidental death and disability still greatly influences EMS today.EMS World. 2016; 45: 50-52
- Emergency medical services.United States Department of Transportation, Washington DC1969
- International EMS systems: the United States: past, present, and future.Resuscitation. 2004; 60: 239-244
- Freedom house: a rich history and a continuing legacy: an interview with George McCary.Australas J Paramed. 2015; 12: 3
- Birth of EMS. The history of the paramedic.Jems. 2013; 38 ([46–8, 50–1])
- The development of a degree qualification for paramedics at Charles Sturt University.Australas J Paramed. 2003; 1: 1
- A review of the literature: the transition of entry-level paramedic education in Australia from vocational to higher education (1961–2017).Australas J Paramed. 2018; 15: 2
- From stretcher-bearer to paramedic: the Australian paramedics’ move towards professionalisation.Australas J Paramed. 2009; : 7
Minney H, Bradley P, Health D. Taking healthcare to the patient transforming NHS ambulance services; 2005.
- The bargaining of professionalism in emergency care practice: NHS paramedics and higher education.Adv Health Sci Educ Theory Pract. 2018; 23: 353-369
- Professionalisation of paramedics – the role of regulation and registration.Can Paramed. 2018; : 42
Paramedics UCo. Post registration paramedic career framework policy bridgewater; 2018.
- The bargaining of professionalism in emergency care practice: NHS paramedics and higher education.Adv Health Sci Educ Theory Pract. 2018; 23: 353-369
- Paramedicine in Australia and New Zealand: a comparative overview.Aust J Rural Health. 2018; 26: 363-368
- Community paramedicine: higher education as an enabling factor.Australas J Paramed. 2014; 11: 2
- Expanding paramedic scope of practice in the community: a systematic review of the literature.Prehosp Emerg Care. 2013; 17: 361-372
- Paramedic-led prehospital thrombolysis is safe and effective: the East Anglian experience.Emerg Med J. 2009; 26: 452-455
- Paramedic prescribing: implementation in practice.J Paramed Pract. 2021; 13: 14-23
- Secondary triage in prehospital emergency ambulance services: a systematic review.Emerg Med J. 2015; 32: 486
Article info
Publication history
Published online: June 02, 2022
Accepted:
May 19,
2022
Received in revised form:
May 19,
2022
Received:
February 10,
2022
Identification
Copyright
© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
