Ambulance services in the 90's

5500

Hi Guys
Im looking for some info on training levels in both Dfb and Hse in the 90's before phecc came along. Did each service have there own form of qualification ie Emt or was there a national qualification used by both?

Also something I remember from years ago and always wondered about was "cardiac" ambulances with the ehb at the time. I remember a Dfb ambulance in attendance for a neighbour with chestpains but they wouldnt transport untill a then Ehb ambulance came which had a defib.

Was it a case at the time of all Hse ambulances carried defibs and not Dfb or again was it down to different training levels between the two services?

Hooch

eireal wrote: »

Hi Guys
Im looking for some info on training levels in both Dfb and Hse in the 90's before phecc came along. Did each service have there own form of qualification ie Emt or was there a national qualification used by both?

Also something I remember from years ago and always wondered about was "cardiac" ambulances with the ehb at the time. I remember a Dfb ambulance in attendance for a neighbour with chestpains but they wouldnt transport untill a then Ehb ambulance came which had a defib.

Was it a case at the time of all Hse ambulances carried defibs and not Dfb or again was it down to different training levels between the two services?

Not the proper person to answer thing, im sure the usual Para heads will fill you in better but heres a start.

HSE (Health boards as they where then) were using EMTs (two or one with a nurse). The EMTs were certified such by northeastern University in the states, all training was done here in Ireland......although some individuals in both DFB and the HBs went to the states themselves to train.

coolmoose

Wasn't in the service in the 90's but have a fair idea. No idea of the DFB/OBi setup so I'll leave that to one of the DFB lads to answer!

In general it was basic ambulance training provided by the then NATS, HB's advertised locally, ran their own selection processes and then employed people.

Untrained, you could be put to work straight away. Once the opportunity arose, you were then sent to NATS to do your training. 1996 saw the introduction of the Diploma in Emergency Medical Technology between NATS and UCD. Each class usually contained a number of trainees from each HB, Army Medical Corps, and private students.

The Northeastern University in Boston was associated with the OBI EMT training, and some individuals from both the HBs and DFB went to the States to complete Paramedic training in the 90's.

Standardised training and qualification existed, but the implementation varied. Most HBs had 2 EMTs or 1 EMT and a nurse. This nurse wasn't necessarily trained in pre hospital care, and was normally sent down from a ward to meet the "driver" in the ambulance and go to a call.

Only a small number of nurses remain in the ambulance service today, and will be replaced with PHECC Practitioners once they retire.

With regards to cardiac ambulances, this was generally an ambulance that carried a defib/monitor, as they were rare at the time in the service. There were also other variations of the "cardiac ambulance" which included a Cardiology Reg or ED Reg on call for a certain shift (say 10am-8pm for example), and thrombolytics carried on board.

bobboberson

Hey coolmoose do you know what area the nurse that still work are in or do you know what kinda of interventions they can do

Bob

coolmoose

Hey bob, it's the MW area, not 100% sure of their scope of practice as I've never worked with any of them, but I know it doesn't extend to a number of P or AP interventions. The nurses who are still "on-the-road" are not ward based anymore and have a large amount of pre-hospital care experience behind them.

As I said these nurses will eventually be replaced with PHECC Registered Practitioners through natural wastage.

bobboberson

I take it that MW is mid-west
and thanks very much

coolmoose

Yep Mid-West, sorry! No probs!

5500

Thanks Coolmoose.

Prior to 96 how did the training compare to nowadays? Was it basic as in OFA or more comparible to current Emt?

Were the guy's that went to the states allowed practice their skills when they came back or was it back to basics?

coolmoose

Prior to 1996 was basic ambulance aid training, not really comparable to any current standard, only widely administered medication was oxygen really, Entonox really came in with introduction of the (old) EMT training. Defibs etc were carried and seperate "Cardiac" certification was undertaken by some EMTs.

With the introduction of the Dip EMT in 1996 the real career progression began, with a number of medications and skills introduced. These continued to be authorised under SOPs (standard operating procedures), and the introduction of PHECC in 2000 saw these SOPs standardised in 2001

The 2nd Edition CPGs were published in 2004, and were designed with EMTs (now Paramedics) employed by the former HB's (now HSE) and DFB.

CPG-As were introduced for the first time in 2005, and this allowed for the first cohort of APs (or EMT-As as they were then known) to practice under guideline. Prior to this the individuals who went over to the states to complete US Paramedic level training were not allowed to practice their newly acquired skills and interventions.

In 2007 the PHECC Education & Training standards were published, which led to the publication of additional CPG-Ps for Paramedics and CPG-Es for EMTs. These authorised additional skills and medications such as Epi 1:1000 IM and Salbutamol nebuliser etc.

The 1st New Entrant Paramedic course entered the now NASC (National Ambulance Service College) in March 2008, and since then 3rd Edition CPGs were published in 2009 and all new entrant classes from the 1st onwards have been trained to the 3rd Edition CPGs. All current operational staff are undergoing online and in-service upskilling to these CPGs currently.