Composition of emergency medical services teams and the problem of specialisation of emergency medical services physicians in the opinions of occupationally active paramedics

Introduction: Emergency medicine includes prevention, prehospital care, specialised treatment, rehabilitation, and education.

Aim of the research: The objective of the analysis was to determine the opinions of paramedics concerning the problem of the composition of emergency medical services (EMS) teams and specialisation of EMS system physicians according to their education level and sense of coherence.

Material and methods: The study was conducted among 336 occupationally active paramedics working in EMS teams delivering prehospital care in selected units in Poland. The study was conducted at Ambulance Stations and in Hospital Emergency Departments, which within their structure had an out-of-hospital EMS team. The study was conducted by the method of a diagnostic survey, and the research instrument was the Orientation to Life Questionnaire SOC-29 and a questionnaire designed by the author.

Results: The respondents who had licentiate education relatively more frequently indicated paramedics with licentiate education level as persons most suitable to undertake medical actions (26.32%) rather than physicians (21.05%). Paramedics with 2-year post-secondary school education relatively more often mentioned physicians (33.07%) than those with licentiate education (17.32%). As many as 89.58% of the paramedics reported the need for a physician in the composition of the EMS team delivering prehospital care, while only 10.42% of them expressed an opinion that there should be teams composed of paramedics only. According to 30.65% of respondents, EMS team delivering prehospital care should include a physician with the specialty in emergency medicine, whereas 8.04% of respondents reported the need for a physician, irrespective of specialisation. However, 42.56% of the paramedics expressed an opinion that a physician is needed only in a specialist team with a specialisation in emergency medicine. The opinions of the paramedics concerning the need for a physician in an EMS team delivering prehospital care, which also considers the problem of specialisation, significantly differ statistically according to the sense of manageability, meaningfulness, and global sense of coherence.

Conclusions: The assessment of the composition of a paramedical team depends on the level of education of paramedics. The need for a doctor in a team, as well as for specialization in emergency medicine, has been proven by the levels of obtained SOC and its components, together with the relations observed in groups assessing the studied problems.