The Paramedic functions as an integral member of the interdiscip linaryhealthcare team providing direct patient care. The Paramedic perf orms avariety of activities acrossvarious practices settings and patien tpopulations in accordance with the Paramedic scope of practice asdefine d by the North Carolina Medical Board and with the approval of thepracti ce setting Medical Director.

Respons ible for providing direct patient care in accordance with theParamedic s cope of practice as defined by the North Carolina MedicalBoard under the medical oversight of the Medical Director of thepractice setting where the individual will function.Assists clinical staff in the evaluation, t reatment and care ofpatients. Obtains pertinent history and performs a p hysical examination.Performs technical procedures as delegated.Monitors patients and maintains records using patient monitoring systemand electronic health records. Documents patients' status, delivery ofcare and eva luation of the patients' response to care according tospecific procedure s and established protocols.Documents and maintains an informative and a ccurate medical record toinitiate charges for each patient treated.Commu nicates in a professional manner essential information to allappropriate members of the healthcare team to promote sharing ofinformation through out the continuum of care.Operates extensive medical and mechanical equipment in the hospital andtransport environment. Ensures all medical equ ipment is functioning;restocks medical supplies as needed.Provides and m aintains a safe and therapeutic environment for thepatients, visitors, a nd staff. Properly disposes of and handles asapplicable, sharps, soiled materials, and linens and disinfects area inaccordance with policy and p olicy as applicable. Properly uses PPE whenin contact with patients, soi led utility, hazardous materials inaccordance with policy.Act as preceptor and support the development of other staff and formallearners.Partici pate in the identification of clinical or operational performanceimprove ment opportunities and in performance improvement activities.Supports an environment of evidence-based practice/research/qualityimprovement init iativesMaintain certifications and clinical skills.Performs other relate d duties incidental to the work described herein.Level II - Life Flight Advanced Life Support ParamedicComplete vehicle inspection and documenta tion each shift and complete aroad test of assigned ambulance(s). Respon sible for minor repairs to theunit to include but not limited to: changi ng light bulbs, replenishingfluids, tightening nuts and bolts, inspectin g tires, etc. Responsiblefor daily maintenance including fueling and cle aning of vehicle.Responsible for reporting minor and major repair needs to the sitespecific Fleet Safety Coordinator, Clinical Team Lead, and/or ProgramManager.Responsible for assisting with patient care as requested to includeloading and unloading, operation of commonly used equipment a ndproviding family members information/directions to Duke.Responsible fo r providing direct patient care on ALS I, ALS II or BLStransports, not t o exceed beyond the scope of The Paramedic as definedby the NCOEMS and a pproved by local medical direction, and documentingin the electronic med ical record.Responsible for replenishing oxygen and medical supplies use d duringtransport.Demonstrates safe driving skills and ability to use te chnology tocomplete missions safely.Assist with continuing education out reach programs and public relationsevents as assigned.Provide staffing c overage to all bases as needed. Assist units withinDuke University Hospi tal when necessary.Level III - Life Flight Critical Care ParamedicPerfor m all responsibilities specified for Life Flight Level II.Obtain pertine nt history and perform a physical examination based oncomprehensive know ledge, advanced skills and sound professionaljudgement. Obtain historica l data from an environmental survey,attending medical personnel, patient or significant other, and existingdocumentation.Complete a systematic, rapid primary assessment and a prioritizedsecondary survey. Analyze and assess available diagnostic data. Reviseplan of care as new information becomes available.Provide care in a critical care environment utilizing appropriate,timely interventions, per program protocols, in a priority s equencewithin scope of practice not to exceed standards set by the North Carolina office of EMS (NCOEMS) and local medical direction.Utilize Adva nced Skills prioritizing the patient's needs based onpotential or actual needs. (I.e. intubation, Rapid Sequence Intubation,needle decompression of tension pneumothoraces, percutaneouscricothryoidotomy, placement of intraosseous and central line).Demonstrates proficient use of advanced a nd basic life support equipmentand maintains contact with Medical Contro l when necessary for protocoldeviation.Communicate essential information to allappropriate members of thehealthcare team. Evaluate patient prog ress, analyze data, and modify theplanning and implementation of care ba sed on patient response throughoutthe transfer process.Communicate betwe en referring and receiving healthcare professionals toensure continuity of care. Act as a liaison between patients, families,referring healthcar e professionals and DUHS staff.Plan, organize and maintain equipment and supplies for use before,during and after transport. Perform inventory o f transport vehicle everyshift with restocking after each transport. Pla n for special equipmentneeds for each transport. (I.e. external pacemake r, intravenous infusionpumps, intra-aortic balloon pump, isolette, baby pod). Maintainequipment repair as needed.Performs intubations (nasal, en dotracheal), RSI, and needledecompression of tension pneumothoraces, per cutaneous cricothyroidotomy,central line placement (EJ), and intraosseou s line placement.Provide and maintain a safe environment for fellow crew members,thepatients, assisting agencies, and ancillary personnel.Formul ate research studies as needed.

Knowledge of and appropriate application Paramedic scope of practiceKnowledge of professional theory, practice and procedure Abilit y toassess needs of acute and chronically ill patients and their familie sAbility to independently seek out resources and work collaborativelyAbi lity to establish and maintain effective working relationshipsAbility to communicate clearly with patients, families, visitors,healthcare team, physicians, administrators, leadership and othersAbility to use sensory and cognitive functions to process and prioritizeinformation, treatment, and follow-up Ability to use fine motor skillsAbility to record activit ies, document assessments, plan of care,interventions, evaluation and re -evaluation of patient status Ability touse computer and learn new softw are programsAble to document andcommunicate pertinent information using computer and/or paperdocumentation tools Ability to withstand prolonged standing and walkingAbility to remain focused and organized Working kno wledge of proceduresand techniques involved in administering routine and special treatmentsto patients Working knowledge ofinfection control pr ocedures and safetyprecautions Pre-employment Physical Capacity Testing Required Must SpeakEnglish in good, understandable terms Participate in own professionaldevelopment by maintaining required competencies, identi fying learningneeds and seeking appropriate assistance or educational of ferings.Critical thinking and ability to concentrate Must be able to res pondquickly to changes in patient and/or unit conditionsLevel II and III :Operating knowledge of ambulance/fire truck or vehicle equivalent to th eDuke Life Flight ambulances. Physical Requirements Work requireswalking , standing, sitting, lifting, reaching, stooping, bending,knelling, crou ching/squatting, balancing, and pulling. Ability towithstand prolonged s tanding and walking. Must be able to lift andsupport the weight up to 75 pounds in handling patients, medicalequipment, and supplies. Intact sen se of sight, hearing, smell, andtouch. Finger dexterity. Bimanual Dexter ity: Requiring the use of bothhands.Life Flight:Level II:Vision must be 20/40 corrected. Successful completion of post offer jobtesting for phys ical fitness.Level IIIMeet Level II requirements Physically fit to allow for functionalmovement in an aircraft or ambulance and the ability to w ear the Dukeapproved helmet. Max weight 240 pounds fully outfitted for a ir crew. Maxheight 6'4" for air crew-See Weight Standards policy Th e transportenvironment may be indoors or outdoors in any type of weather . The airambulance (rotor wing or fixed wing) is noisy, may experience e xhaustfumes. High and low frequency vibrations are present requiring hea ringprotection/helmet.

Minimum Qualifications

Education

Successful completion of an NCOEMS approved Paramedic Courseor a United States Department of Transportation (USDOT) centered course or similar approved Paramedic Course.

Experience

Level I - Paramedic One year experience in relevant clinical areas required, Paramedic experience preferred. Level II - Life Flight Advanced Life Support Paramedic One year ALS Paramedic experience required, preferred two to three years prehospital experience with a moderate call volume (>15,000 calls/year) 911 agency. Level III - Life Flight Critical Care Paramedic Minimum of three years and current ALS experience as a Paramedic in emergency setting with a moderate to high call volume 911 agency (20,000 to 35,000 calls/year) Obtain FP-C within 2 years of hire. Weight Standards policy

Degrees, Licensures, Certifications

Current certification as a North Carolina Paramedic required for all Level I Level II levels. BLS, ACLS, and PALS required. (Must obtain within 6 months if working in a hospital based department) Current trauma course preferred: PHTLS, BTLS or ITLS Applies to Life Flight Paramedic only BLS, ACLS, and PALS, required. ITLS (or PHTLS) preferred upon hire. If not, will need to acquire within the first year. NRP required within 6 months of hire. North Carolina Emergency Vehicle Driver certification or comparable. Current Class C driver's license Current three (3) year driving history absent of violations Level III Applies to Life Flight Paramedic only Satisfy all requirements of Level II Neonatal Resuscitation Provider (NRP) required CCP-C or FP-C certification required. PHTLS certification required within 1 year of hire. Specialty certification, i.e., FP-C, or CCEMTP required within 2 years of hire date if Paramedic is new to SCT transport ObtainTPATC within 24 months of hire