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The Queensland Isolated Paramedic Initiative A review of national and international literature on ‘expanded scope paramedic practice’ and generic health provider initiatives was conducted through database searches (Pubmed, Medline, PsycINFO) of peer reviewed journals, and a review of several expanded scope evaluation studies. In addition, a survey of Queensland Paramedics working in rural and remote areas identified current health needs within their communities, whilst assessing the capacity and responsiveness of these Paramedics to undertake training for expanded practice roles. Several models that were developed and successfully trialled overseas were reviewed in detail, and key components for an expanded paramedic scope of practice were identified. The results of this study informed the design and development of a tertiary-based training curriculum for isolated practice paramedics. The teaching of a Graduate Certificate program commenced at James Cook University in Queensland in Semester 2 of 2006. There are plans to expand this program to a Graduate Diploma, and ultimately postgraduate programs in the future. Work to date provides a preliminary perspective on the range of options for expanded paramedic practice. It is anticipated that in the context of the clinical skill sets developed through current training programs, and the exposure of Queensland paramedics to a wide variety of health events, relatively moderate adjunct training will be required to facilitate safe, efficient and effective delivery of basic health monitoring in primary care settings. The intention of the Queensland Ambulance Service in developing a core curriculum to upgrade Paramedics for service provision in these environments is to improve health services responsiveness, particularly in rural and remote communities. However, international experience, particularly that of the UK, demonstrates that extended care providers of this type also have the capacity to significantly improve the responsiveness of health services to people in metropolitan and major regional communities. Off-shore deployments of Queensland paramedics to the Indian Ocean Health Response (specifically in Indonesia—Team Foxtrot, Banda Aceh) further demonstrate that Intensive Care Paramedics are already capable, with appropriate clinical support, of delivering high quality clinical outcomes for patients (eg: suturing, anaesthetic technician functions, wound management, health status monitoring etc).
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