Ambulance service is on the front line

The ambulance service is the front line of emergency medical and pre-hospital care. Ambulance personnel in the State are trained to the level of emergency medical technician (EMT).

This means they are qualified to stabilise and provide some basic treatment to patients suffering from cardiac problems, traumas, head and spinal injuries and other conditions requiring transfer to hospital. As well as pre-hospital care, they also carry out interhospital transfers which could involve transporting a patient with a delicate brain injury hundreds of miles from an outlying regional hospital to the National Neurological Centre in Beaumont Hospital in Dublin.

EMT training officer Vincent O'Connor says there are three main aspects to the job: ambulance driving, delivery of the highest level of quality care and patient communication.

"Patient communication is possibly the most important part of the job," he says. "It's vital that patients feel comfortable with you and are secure in the knowledge that you know how to do your job."

The types of calls EMTs respond to vary enormously says O'Connor. "No two types of emergency call are the same. Even if you've been given details of the emergency, you're heading out to you never really know what you're facing until you get there."

Each ambulance is staffed by two EMTs, one to drive while the other attends the patient. Both are trained to the same level so they usually swap jobs every second day. In general, the same two EMTs always work together so they build a strong working relationship. "The ambulance team need to have a good rapport so they can act as quickly as possible to each other," says O'Connor.

Training for EMTs from all health board areas in the State is conducted at the National Ambulance Training School in the Phoenix Park. Students follow a nine-month training programme, which is divided into four stages.

Stage I is a seven-week course conducted in the ambulance training school. This is an intensive education programme to develop foundation knowledge and skills in the area of pre-hospital emergency care. This is followed by examination and the awarding of the Stage I EMT certificate.

Stage II lasts 26 weeks and is workplace-based. For eight weeks of this, the student is based in hospital departments learning what happens to patients after admittance. The other 18 weeks are spent out in an emergency ambulance with an EMT team.

Stage III is a one-week pre-hospital trauma life support course. This allows the student to "sharpen up" what they've learnt during their work experience.

Stage IV is the final exam module. Successful students are awarded the EMT certificate by the school and, on registration with the UCD education programme, also receive a diploma in emergency medical technology. The health boards usually advertise for ambulance personnel every six months. Successful applicants are sent on the ambulance-school course. You can also apply directly to the school and on qualification seek work in the public or the private sector.

Once you start on the job you'll be working shifts and some on-call hours, which could mean working 24 hours in a row. Physical stamina is therefore important, but, says O'Connor, you also need to be very mentally strong. "It's one of the most stressful jobs you can do. You meet death on a regular basis and that can have a profound affect on you."

O'Connor says enthusiasm and friendliness are important assets to have if you want to be an EMT, but the most important quality is compassion. "Your going to see a lot of rough things and you need to be at your best, when patients are at their worst."

Although EMTs are trained to a very high level, they do not have full paramedic training. However the Ambulance Association of Ireland is submitting a proposal to the Department of Health for paramedic-standard training to be available in the State. Chairman of the association Pat Hanafin says this EMTA (emergency medical technician advanced) course should be launched this summer. "The bottom line is that it's the patient that counts. You're there to preserve life, so you should be trained to the highest possible level to do so," he says.