Other than rescue personnel such as fire fighters, paramedics are one of the first professionals to arrive at the scene of any emergency. But paramedics sometimes have a skills challenge when they are the first to arrive at the emergency scene only to find the victim still trapped in a burning structure or under a collapsed building. It is this that has now led to an increasingly changing focus from pure paramedics to rescue trained paramedics. A rescue trained paramedic, as the term suggests, is an emergency response person whose role combines two functions: rescue and paramedic.
In an effort to deal with the realities of every day emergencies, rescue trained paramedics go beyond the emergency medical care; they are skilled in search and rescue techniques. Therefore, they can work as a rescue-trained person within a paramedic team or as a paramedic within a rescue team. In 2006, the FDNY trained and commissioned its first set of rescue trained paramedics.
The rescue trained paramedic can work with or as part of a law enforcement unit. Consider high-risk shooting incidents, such as those that were witnessed at Columbine High School and at Virginia Tech University. Traditionally, the police and the SWAT team would move in and neutralize the shooter after which the paramedics would move in to treat the injured. The problem is that between the time the shooting starts and when the shooter is neutralized, many people could be fatally injured. By the time the paramedics come in, a number of people might be past the point of resuscitation. A rescue trained paramedic works with law enforcement teams to move into the scene of an active shooting to provide treatment to the injured even before the shooter is neutralized.
To become a rescue trained paramedic, you have to undergo paramedic training that includes 6 to 8 months of class room training where you will cover subjects such as physiology, anatomy, trauma emergency and cardiology. Overall you will need to go through a number of advanced life support (ALS) courses including cardiac monitoring, transcutaneous pacing, surgical cricothyrotomy, needle decompression of tense pneumothorax etcetera.
Expect to learn maneuvers evacuating persons from a burning or collapsed building, how to handle a shooting in case you arrive at the scene while it is still taking place and the best methods to evacuate persons when facing a bomb threat. The advanced medical knowledge that you learn as a rescue trained paramedic means that you are capable of diffusing a dangerous situation while simultaneously making sure not to compromise the health of the victim. For instance, imagine you are evacuating someone from a building; you would be able to quickly assess the injury of the trapped person and use that to formulate an extraction technique that will not aggravate the injury.
Class room training will then be transposed to a real environment where you train and work supervised in a hospital on real patients before starting to accompany a team in the field. You begin as an assistant and then as experience grows, a full paramedic. Once you have completed all the training necessary, you will then be required to sit for and pass a recognized paramedic exam such as the NREMT (National Registry of Emergency Medical Technicians) exam and then apply for the EMT paramedic certification.