Primary Care Paramedics (PCPs) – entry-level of paramedic practice in Nova Scotia. Scope of practice includes performing semi-automated external defibrillation, oxygen administration, vascular access, cardiac monitoring such as Lead 2 and 12 Lead interpretation and administration of Symptom Relief Medications for a variety of emergency medical conditions.

Some services have started implementing non-opiate medications so that Primary Care Paramedics can treat patients that require pain management, including ketorolac, acetaminophen, and ibuprofen. As of 2015, PCP’s can now administer Naloxone for suspected opiate overdose, perform trauma immobilization, including cervical immobilization, and other basic medical care.

Intermediate Care Paramedic – introduced to Nova Scotia in the 90’s to provide Advanced Life Support training to the primary level of paramedic. Scope of practice includes all of the medications and skills of a Primary Care Paramedic along with Endotracheal Intubation, Medication Administration – ET, PR, Nasal, and the administration of Atropine, Diazepam (Valium), EPI 1:10,000, Morphine, Oxytocin and Sodium Bicarbonate.

Advanced Care Paramedic (ACP) –  perform advanced airway management including intubation, surgical airways; intravenous therapy, place external jugular IV lines, perform needle thoracotomy; perform and interpret 12-lead ECGs, perform synchronized and chemical cardioversion, transcutaneous pacing; perform obstetrical assessments and provide pharmacological pain relief for various conditions.

In Nova Scotia, ACP’s have adopted pre-hospital fibrinolytic. Current programs include providing ACPs with direct 24-hour access to PCI labs, bypassing the emergency department, and representing a fundamental change in both the way that patients with S-T segment elevation myocardial infarctions (STEMI) are treated, profoundly affecting survival rates and bypassing closer hospitals to get an identified stroke patient to a stroke center.

Stay tuned! There’s more to Come: CCP, Life Flight RN’s, ECP