Abstract
Introduction
Community paramedicine is a model of healthcare that utilizes paramedic services to deliver nonurgent healthcare services to patients.1 The intended goal is to improve patient care by identifying community dwelling patients who may benefit from additional services, such as home care services or mobile health teams, to prevent progression to more serious illness.1 The use of community paramedicine programs has expanded in multiple jurisdictions in the last decade and offers numerous advantages. 2.,3 Paramedics are medical professionals who can efficiently be trained to gain expanded roles and skills to provide care beyond acute care management and transportation. Focused role-specific training can include recognizing geriatric syndromes, performing procedures, providing point-of-care testing and interventions, assessing and managing chronic diseases, coordinating care with primary care teams, making referrals, providing health education, and following up with patients post-discharge. 2, 3
Case
A 75-year-old woman is transported to the hospital by ambulance after sustaining a fall at home. The paramedics report that they have attended to this patient multiple times in the past few months for similar falls. Usually, the patient requires assistance to get up and then declines transport to the hospital. On this instance, the patient was unable to ambulate even with assistance and there is an obvious deformity of the right hip noted. The paramedic tells you, “Everytime I see this patient’s address pop-up on my shift, I worry that this time will be a more serious fall.” The patient’s pain is managed, she is diagnosed with a hip fracture, and consulted to orthopedics.
Case Conlusion
After learning about community paramedicine programs, you wonder if there is an opportunity to implement a paramedics led falls-prevention initiative in your jurisdiction. You reach out to your local EMS medical director to share your thoughts on how expanded paramedic roles and how such a program could help address ED visits and EMS costs. Together you explore whether a community paramedics program exists locally and if there is interest in one. You brainstorm ideas on how paramedics could be trained to conduct fall assessments, how protocols could be developed to facilitate community care and fall prevention program referrals by paramedics, and if similar programs in other jurisdictions could be adapted locally. You begin the conversation about expanded roles for paramedics in the health system to provide care for older adults in your community.