The Paramedic functions as an integral member of the interdiscipl inaryhealthcare team providing direct patient care. The Paramedic perfo rms avariety of activities across various practices settings and patient populations in accordance with the Paramedic scope of practice asdefined by the North Carolina Medical Board and with the approval of thepractic e setting Medical Director.

Responsi ble for providing direct patient care in accordance with theParamedic sc ope of practice as defined by the North Carolina MedicalBoard under the medical oversight of the Medical Director of thepractice setting where t he individual will function.Assistsclinical staff in the evaluation, tr eatment and care ofpatients. Obtains pertinent history and performs a ph ysical examination.Performs technical procedures as delegated.Monitors p atients and maintains records using patient monitoring systemand electro nic health records. Documents patients' status, delivery ofcare and eval uation of the patients' response to care according tospecific procedures and established protocols.Documents and maintains an informative and ac curate medical record toinitiate charges for each patient treated.Commun icates in a professional manner essential information to allappropriate members of the healthcare team to promote sharing ofinformation througho ut the continuum of care.Operates extensive medical and mechanical equipment in the hospital andtransport environment. Ensures all medical equi pment is functioning;restocks medical supplies as needed.Provides and ma intains a safe and therapeutic environment for thepatients, visitors, an d staff. Properly disposes of and handles asapplicable, sharps, soiled m aterials, and linens and disinfects area inaccordance with policy and po licy as applicable. Properly uses PPE whenin contact with patients, soil ed utility, hazardous materials inaccordance with policy.Act as precepto r and support the development of other staff and formallearners.Particip ate in the identification of clinical or operational performanceimprovem ent opportunities and in performance improvement activities.Supports an environment of evidence-based practice/research/qualityimprovement initi ativesMaintain certifications and clinical skills.Performs other related duties incidental to the work described herein.Level II - Life Flight A dvanced Life Support ParamedicComplete vehicle inspection and documentation each shift and complete aroad test of assigned ambulance(s). Respons ible for minor repairs to theunit to include but not limited to: changin g light bulbs, replenishingfluids, tightening nuts and bolts, inspecting tires, etc. Responsiblefor daily maintenance including fueling and clea ning of vehicle.Responsible for reporting minor and major repair needs t o 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 an dproviding family members information/directions to Duke.Responsible for providing direct patient care on ALS I, ALS II or BLStransports, not to exceed beyond the scope of The Paramedic as definedby the NCOEMS and ap proved by local medical direction, and documentingin the electronic medi cal record.Responsible for replenishing oxygen and medical supplies used duringtransport.Demonstrates safe driving skills and ability to use tec hnology tocomplete missions safely.Assist with continuing education outr each programs and public relationsevents as assigned.Provide staffing co verage to all bases as needed. Assist units withinDuke University Hospit al when necessary.Level III - Life Flight Critical Care ParamedicPerform all responsibilities specified for Life Flight Level II.Obtain pertinen t history and perform a physical examination based oncomprehensive knowl edge, advanced skills and sound professionaljudgement. Obtain historical data from an environmental survey,attending medical personnel, patient or significant other, and existingdocumentation.Complete a systematic, r apid primary assessment and a prioritizedsecondary survey. Analyze and a ssess available diagnostic data. Reviseplan of care as new information b ecomes available.Provide care in a critical care environment utilizing a ppropriate,timely interventions, per program protocols, in a priority se quencewithin scope of practice not to exceed standards set by the NorthC arolina office of EMS (NCOEMS) and local medical direction.Utilize Advan ced 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 i ntraosseous and central line).Demonstrates proficient use of advanced an d basic life support equipmentand maintains contact with Medical Control when necessary for protocoldeviation.Communicate essential information to all appropriate members of thehealthcare team. Evaluate patient progr ess, analyze data, and modify theplanning and implementation of care bas ed on patient response throughoutthe transfer process.Communicate betwee n referring and receiving healthcare professionals toensure continuity o f care. Act as a liaison between patients, families,referring healthcare professionals and DUHS staff.Plan, organize and maintain equipment and supplies for use before,during and after transport. Perform inventory of transport vehicle everyshift with restocking after each transport. Plan for special equipmentneeds for each transport. (I.e. external pacemaker , intravenous infusionpumps, intra-aortic balloon pump, isolette, baby p od). Maintainequipment repair as needed.Performs intubations (nasal, end otracheal), RSI, and needledecompression of tension pneumothoraces, perc utaneous cricothyroidotomy,central line placement (EJ), and intraosseous line placement.Provide and maintain a safe environment for fellow crewm embers, thepatients, assisting agencies, and ancillary personnel.Formula te research studies as needed.

Knowledge of and appropriate application Paramedic scope of practiceKnowledge of professional theory, practice and procedure Ability toassess needs of acute and chronically ill patients and their families Ability to independently seek out resources and work collaborativelyAbil ity to establish and maintain effective working relationshipsAbility to communicate clearly with patients, families, visitors,healthcare team, p hysicians, administrators, leadership and othersAbility to use sensory a nd cognitive functions to process and prioritizeinformation, treatment, and follow-up Ability to use fine motor skillsAbility to record activiti es, document assessments, plan of care,interventions, evaluation and re- evaluation of patient status Ability touse computer and learn new softwa re programs Able to document andcommunicate pertinent information using computer and/or paperdocumentation tools Ability to withstand prolonged standing and walkingAbility to remain focused and organized Working know ledge of proceduresand techniques involved in administering routine and special treatmentsto patients Working knowledge of infection control pro cedures and safetyprecautions Pre-employment Physical Capacity Testing R equired Must SpeakEnglish in good, understandable terms Participate in o wn professionaldevelopment by maintaining required competencies, identif ying learningneeds and seeking appropriate assistance or educational off erings.Critical thinking and ability to concentrate Must be able to resp ondquickly to changes in patient and/or unit conditionsLevel II and III: Operating knowledge of ambulance/fire truck or vehicle equivalent to the Duke Life Flight ambulances. Physical Requirements Work requireswalking, standing, sitting, lifting, reaching, stooping, bending,knelling, crouc hing/squatting, balancing, and pulling. Ability towithstand prolonged st anding and walking. Must be able to lift andsupport the weight up to 75 pounds in handling patients, medicalequipment, and supplies. Intact sens e of sight, hearing, smell, andtouch. Finger dexterity. Bimanual Dexteri ty: Requiring the use of bothhands.Life Flight:Level II:Vision must be 2 0/40 corrected. Successful completion of post offer jobtesting for physi cal fitness.Level IIIMeet Level II requirements Physically fit to allow for functionalmovement in an aircraft or ambulance and the ability to we ar the Dukeapproved helmet. Max weight 240 pounds fully outfitted for ai r crew. Maxheight 6'4" for air crew-See Weight Standards policy The transportenvironment may be indoors or outdoors in any type of weather. The airambulance (rotor wing or fixed wing) is noisy, may experience ex haustfumes. High and low frequency vibrations are present requiring hear ingprotection/helmet.

Minimum Qualifications

Education

Successful completion of an NCOEMS approved Paramedic Course or 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 CareParamedic 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 Obtain TPATC within 24 months of hire

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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

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