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From stretcher bearer to practitioner: A brief narrative review of the history of the Anglo-American paramedic system

  • Timothy Makrides
    Correspondence
    Corresponding author at: Department of Paramedicine, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, Australia.
    Affiliations
    Department of Paramedicine, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, Australia

    British Columbia Emergency Health Services, Vancouver, Canada
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  • Linda Ross
    Affiliations
    Department of Paramedicine, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, Australia
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  • Cameron Gosling
    Affiliations
    Department of Paramedicine, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, Australia
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  • Joseph Acker
    Affiliations
    Ambulance Tasmania, Hobart, Australia
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  • Peter O’Meara
    Affiliations
    Department of Paramedicine, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, Australia
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      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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