What is a Paramedic

A paramedic is a specialized healthcare professional who is primarily trained to respond to emergency calls for medical help outside of a hospital. Paramedics in Manitoba primarily work in ambulances as part of the Emergency Response Service (ERS).  Paramedics may also provide medical care outside of an emergency response environment. For example, they may provide:

• • care to a patient transferring from one health facility to another (both ground and aeromedical)
  • care within an emergency department and/or Nursing Station
  • care in community settings (Community Paramedicine, Palliative Care) and
  • care through private companies on industrial sites or at special events

Paramedics can also function as educators, administrators, and managers. Education program standards and approval are the responsibility of the College of Paramedics of Manitoba.  For more information about approved paramedical education programs in Manitoba, and the eligibility requirements for program entry, please see the College website at: https://collegeparamb.ca/professional-practice/education-providers/ and https://collegeparamb.ca/public/becoming-registered/

In Manitoba, there are 5 different practice levels: Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Intermediate Care Paramedic (PCP-IC), Advanced Care Paramedic (ACP), and Critical Care Paramedic (CCP). The scope of practice of each practice level is defined under the College of Paramedics of Manitoba General Regulations and the Reserved Acts. Each practitioner is responsible for ensuring they understand their scope or practice, they are competent in the skills/procedures within that scope, and they comply with the scope of work as determined by their employer. Each practice level must be registered with the College of Paramedics of Manitoba and receive a certificate of Practice (formerly known as a license) to practice in Manitoba. A list of paramedic education programs approved by the College of Paramedics of Manitoba can be found here.

Emergency Medical Responder

This is the basic level for registrants providing patient care in Manitoba. EMR’s perform patient assessments, vital signs, trauma injury management, and basic care for medical issues. In Manitoba, EMR’s also have the responsibility of assisting patients with some symptom relief medications they may have been prescribed, as well as administering medications the patient assessment indicates would benefit the patient in an acute/urgent situation (example Ventolin for difficulty breathing). Education Programs for EMR are 312 hours in length with a small portion being in a clinic applying skills in a precepted environment) but no practicum (applying skills in a precepted environment on an ambulance) requirements. Practitioners may work with a Medical First Response service, in an Industrial setting, providing emergency services dispatch, low acuity patient transport service, or a ground emergency response service.

EMR – Student enrollment/qualifications include:

• • • • Must be 18 years of age before entering an Emergency Medical Responder program.
      • BLS level CPR/First Aid current within 12 months
      • Updated Immunizations: • Hepatitis B • Measles, mumps, rubella • Pertussis (adult) • Polio • Tetanus and diphtheria • Varicella (chickenpox) • Influenza As well, students should obtain documentation of any previous tuberculin skin tests (TSTs or Mantoux), chest x-ray reports obtained after a positive TST, and documentation of a previous diagnosis of, or therapy for, latent tuberculosis infection (LTBI) or active tuberculosis disease.
      • COVID-19 immunization: requirements for Covid -19 immunization should align with current Provincial Ministerial and Public Health orders.
      • Students should be aware of provincial requirements and College of Paramedics of Manitoba practice directions. CRVS/CA/AA checks current within 12 months. Checks received that are not clear are subject to review and consultation with the College of Paramedics of Manitoba regarding suitability for registration.
      • A Physical Fitness test which reflects the physical requirements for working in an emergency services environment is required. This test may be a prerequisite, or a progression requirement (within 90 days of starting a Program) Those unable to successfully complete a physical fitness test are subject to review and consultation with the Education Provider regarding suitability for employment.
      • Driver’s License – Minimum Class 5 upon enrollment. Students must be made aware by the Education Provider of the requirement of a minimum Class 4 for operation of an emergency vehicle.

Primary Care Paramedic

This is the primary level for registrants providing patient care in Manitoba. In addition to the basic assessment and patient management skills of an EMR, PCP’s also provide symptom relief with a variety of medications and procedures, initiate Intravenous cannulation, and manage airways at the intermediate level.

Education Programs for PCP range from 11 months to two years months in length with significant clinical and practicum requirements. Practitioners may work with a ground emergency response service, providing emergency services dispatch, Community and Outreach settings, assisting medical or nursing practitioners in a clinical setting, Industrial settings, aeromedical transport services and self-employed practice.

PCP – Student enrollment/qualifications include:

• • • • High school Diploma with one senior credit in Chemistry or Physics and English
      • Six (6) Credits of Post-Secondary Human Anatomy and Physiology (including lab component) completed within five (5) years of beginning a Paramedic program.
      • BLS level CPR/First Aid current within 12 months
      • Updated Immunizations: • Hepatitis B • Measles, mumps, rubella • Pertussis (adult) • Polio • Tetanus and diphtheria • Varicella (chickenpox) • Influenza As well, students should obtain documentation of any previous tuberculin skin tests (TSTs or Mantoux), chest x-ray reports obtained after a positive TST, and documentation of a previous diagnosis of, or therapy for, latent tuberculosis infection (LTBI) or active tuberculosis disease.
      • COVID-19 immunization: requirements for Covid -19 immunization should align with current Provincial Ministerial and Public Health orders. Students should be aware of provincial requirements and College of Paramedics of Manitoba practice directions.
      • CRVS/CA/AA checks current within 12 months. Checks received that are not clear are subject to review and consultation with the College of Paramedics of Manitoba regarding suitability for registration.
      • A Physical Fitness test which reflects the physical requirements for working in an emergency services environment is required. This test may be a prerequisite, or a progression requirement (within 90 days of starting a Program) Those unable to successfully complete a physical fitness test are subject to review and consultation with the Education Provider regarding suitability for employment.
      • Driver’s License – Minimum Class 5 upon enrollment. Students must be made aware by the Education Provider of the requirement of a minimum Class 4 for operation of an emergency vehicle.

Intermediate Care Paramedic

In addition to PCP skills, PCP-IC’s have enhanced medication administration responsibilities, and with additional training can perform more advanced procedures (cardiac arrest resuscitation, advanced cardiac procedures) in the emergency response environment. PCP-IC’s have received training in addition to successfully completing a PCP Program. Practitioners may work with a ground emergency response service, providing emergency services dispatch, Community and Outreach settings, assisting medical or nursing practitioners in a clinical setting, Industrial settings, and aeromedical transport services. The PCP-IC practice level was created at a time when Advanced Care Paramedic education access was limited in Manitoba, and more advanced patient care was required. Currently only practitioners who have completed the first year of the accredited Winnipeg Fire Paramedic Service Advanced Care Paramedic program can be granted the Intermediate Care designation. This is a temporary notation as the requirement is that the paramedic complete the Winnipeg Fire Paramedic Service Advanced Care Paramedic program.

Advanced Care Paramedic

In addition to PCP skills, ACP’s have extensive additional education and have advanced medication and procedural responsibilities. ACP programs are 2-3 years in length blending didactic and extensive practical application of knowledge, and practitioners must have a minimum of two years’ experience as a PCP to enroll. Practitioners may work with an Emergency Response Service (Ambulance), dispatch, Community and Outreach settings, assisting medical or nursing practitioners in a clinical setting, Industrial settings, and aeromedical transport services and self-employed practice.

ACP – Student enrollment/qualifications include:

• • • • Students must have a minimum two (2) years’ experience as a Primary Care Paramedic,
      • be registered with the College of Paramedics of Manitoba, be in good standing, and hold a valid Certificate of Practice
      • If not already completed for entry into a Primary Care Paramedic program, six (6) Credits of Post-Secondary Human Anatomy and Physiology (including lab component) completed within five (5) years of beginning an ACP Paramedic program.
      • BLS level CPR current within 12 months
      • Updated Immunizations: • Hepatitis B • Measles, mumps, rubella • Pertussis (adult) • Polio • Tetanus and diphtheria • Varicella (chickenpox) • Influenza As well, students should obtain documentation of any previous tuberculin skin tests (TSTs or Mantoux), chest Xray reports obtained after a positive TST, and documentation of a previous diagnosis of, or therapy for, latent tuberculosis infection (LTBI) or active tuberculosis disease.
      • COVID-19 immunization: requirements for Covid -19 immunization should align with current Provincial Ministerial and Public Health orders. Students should be aware of provincial requirements and College of Paramedics of Manitoba practice directions.
      • CRVS/CA/AA checks current within 12 months. Checks received that are not clear are subject to review and consultation regarding employability. Education Providers should follow their policies regarding non-clear record checks.

Critical Care Paramedic

In addition to ACP skills, CCP’s have extensive additional education which allows them to perform very advanced skills. This is the highest level of responsibility for patient care currently working in Manitoba. At this time in Manitoba, CCP practitioners work in aeromedical transport services, but wider clinical and field applications are possible.