A taxonomy of Australian and New Zealand paramedic clinical roles

Introduction
This article aims to summarise and categorise the current types of frontline paramedics in Australia and New Zealand, their relative scopes of practice, their qualifications and training, and the titles used in each jurisdictional ambulance service.

Methods
Each of the 10 jurisdictional ambulance services were contacted and their current clinical roles discussed with a manager or senior paramedic between June and October 2020. Information was summarised in tables and text.

Results
Minimum qualifications for paramedics range from a diploma to an undergraduate degree, with graduate programs ranging from six to 18 months’ duration. Additional minimum qualifications for Extended Care Paramedics range from no minimum qualifications to a nursing degree. Additional minimum qualifications for Intensive Care Paramedics range from no minimum qualifications to a postgraduate diploma. Additional minimum qualifications for Retrievalists range from no minimum qualifications to a master degree. Helicopter emergency medical services (HEMS) teams range from primarily physician-led in four services to autonomous paramedics in five services.

Armed offender paramedics exist in four services; urban search and rescue paramedics exist in five services; wilderness paramedics exist in five services; CBRNE paramedics exist in three services; mental health paramedics exist in three services. Special Operations variously refers to HEMS, USAR, CBRNE or armed offender. Critical Care variously refers to Intensive Care, HEMS in a physician-led team and autonomous HEMS. Advanced life support refers to paramedics and intensive care. Rescue Paramedic refers to road crash extrication or wilderness paramedics. Flight Paramedic refers to Paramedics or Intensive Care Paramedics, either HEMS or fixed wing.

Conclusion
The jurisdictional ambulance services are heterogenous in the structure, qualifications, training and terminology for their frontline paramedic roles. Due to this lack of consistency, roles for paramedics in Australasia are currently largely incomparable between services, rendering shared titles inoperable from intranational and international perspectives.