What the PHECC: An Introduction to Pre-Hospital Emergency Care

Surprisingly, the way in which pre-hospital emergency care is delivered varies greatly internationally. Two contrasting models can be identified: one physician-led, the other with direct or indirect medical supervision. The development of pre-hospital care in Ireland has been convoluted and stunted. However, in less than a decade, the Irish emergency medical services have evolved significantly. Currently, three clinical levels of prehospital care practitioner exist in Ireland: emergency medical technician (EMT), paramedic and advanced paramedic. Advanced paramedics are the only level considered to be advanced life support providers. The levels were created following the establishment of a national emergency medical services regulator known as the Pre-Hospital Emergency Care Council (PHECC). PHECC aims to protect the public by developing education standards, maintaining the register of pre-hospital care practitioners and enforcing a code of professional conduct. PHECC have also introduced clinical practice guidelines, which direct how acutely ill or injured patients should be treated by pre-hospital care practitioners. In many jurisdictions, doctors play a pivotal role in the delivery of pre-hospital care, a specialty known as “immediate care” in some countries. There are few examples of doctors in Ireland providing formal pre-hospital care, despite evidence suggesting that the involvement of medical practitioners in the prehospital setting is beneficial even in the presence of other advanced life support providers. Introduction Pre-hospital care is defined as the provision of skilled health care at the site of a traumatic incident or medical emergency and encompasses those competencies delivered by appropriately trained clinicians1. The administration of emergency medical care outside of hospitals dates back to the late 18th century and has military origins2. Dominique Jean Larrey, Napoleon’s chief surgeon What the PHECC: An Introduction to Pre-Hospital Emergency Care