What does it take to qualify as a Specialist Paramedic in Critical Care?

In May 2021, we welcomed our then newest Trainee Specialist Paramedic in Critical Care (SPCC) Callum. And in August 2022 Callum completed his training and became a fully qualified SPCC with Great Western Air Ambulance Charity (GWAAC).

Training to become an SPCC is not easy; it’s intense but it ensures our crew are ready to handle whatever they are called to.

How did Callum end up at GWAAC?

Originally from Australia, Callum completed his bachelor's degree and training in Victoria before moving to London to work as a paramedic. Initially working on ambulances in Central London he then joined the Tactical and Joint Response Unit. He was a solo paramedic that worked with police to provide early paramedic intervention to patients in hostile and high-threat areas such as public order incidents, marauding terror attacks, and firearms and stabbing scenes.

Callum completed a master’s in Specialist Paramedic Practice (critical care) just before joining GWAAC. He is very passionate about education and the paramedic profession and is now also a teaching associate at university teaching trainee paramedics and trainee critical care paramedics in his spare time.

The trainee SPCC recruitment process

In order to become a trainee SPCC with GWAAC, candidates must first successfully go through a recruitment process designed to assess which applicants have the skills and temperament to handle some of the most serious 999 calls in our region.

During recruitment days, potential new trainees undergo various exercises and assessments to test their medical knowledge and capabilities and their ability to work as part of a team in demanding environments. It’s important that our crew not only work well with each other but also with the wider emergency services community when at the scene of an incident.

Callum was one of over 100 applicants to become a trainee SPCC and attended the same recruitment day as two other GWAAC SPCCs, Dan and Fleur, alongside around 20 others.

Once selected as a trainee SPCC, what happens next?

GWAAC’s recruitment process is tough and so being selected as a trainee SPCC is a huge achievement; it shows the trainee is already highly skilled and capable with a number of years behind them in the profession.

As the newest member of the team, and with the support of the whole crew, the trainee gets stuck in helping all types of patients in all types of environments. When Callum joined, he could already bring a lot to the scene of an incident; However, learning to bring the extra decision making and skills an SPCC brings to scenes is a steep learning curve.

As they undergo their training, new SPCCs must collect evidence of their work and skills in a portfolio. There are four main portfolios that a trainee must complete. These portfolios are assigned by South Western Ambulance Service Foundation Trust (SWASfT) and focus on sedation and analgesia, advanced airway management, clinical skills and medical knowledge.

Each portfolio must contain proof that the trainee is competent in a subject or a procedure and requires sign-off by a GWAAC Specialist Paramedic, Advanced Clinical Practitioner in Critical Care or a Critical Care Doctor. The portfolios show that the trainee SPCC has performed a required number of procedures. For example, for Callum’s sedation portfolio, he had to provide evidence that he’d carried out the required number of sedations.

It's not just about the portfolios

As well as completing portfolios, trainee SPCCs are continually assessed by their GWAAC colleagues for their work on scene and in simulations. During simulations, trainees work on their skills as both a solo paramedic and as part of the GWAAC Critical Care Team.

Callum achieved sign-off as a fully qualified SPCC in August 2022, once all portfolios and assessments were completed. Receiving his epaulettes was a proud moment for him; he was now able to attend jobs as a solo SPCC treating and caring for the most seriously ill or injured patients in our region.

Callum recalls: “I was a little nervous on my first solo job as an SPCC because that support system of the other Critical Care Team member is not there however you know that the experience and knowledge you’ve built will help you through. I knew the more incidents I attended, the easier it would become. I was also able to fall back on my experiences as a solo paramedic in London, which helped.”

Did you know?

• Once signed off, as well as advanced decision making, our SPCCs are able to administer blood transfusions, perform surgical interventions such as finger thoracostomies and surgical airways as well as administer sedation and paralytic drugs to ventilate patients and perform synchronised cardioversion and pacing.
• All of GWAAC’s Advanced and Specialist Paramedics are hired through SWASfT. This means that our trainees must complete their training to both SWASfT’s and GWAAC’s specifications and be signed off by SWASfT before they become fully qualified.

The training doesn’t stop once you get your epaulettes

Once our crew are signed off and qualified, they continue to train and develop to ensure they are constantly providing the best care possible for their patients. Callum says, “There’s no end. Even after you qualify, you’re still learning every day. The mantra is, when you think you know it all, that’s when you’re in trouble.”

Simulations

Our crew work hard to ensure they are prepared for anything. This means the training never stops. Simulations are run between jobs so the crew can practice rare and complex procedures. And they re-enact scenarios that they have recently attended, talking through decisions made at the scene and learnings for next time.

“Doing regular training in as realistic an environment as possible, especially in surgical skills and in procedures we don’t use very often means when you are faced with that challenge, you feel confident to crack on and do it. There’s no ‘I think this should happen’, you know exactly what needs to be done because you have simulated and practiced it so many times.”

Callum, Specialist Paramedic in Critical Care

Educational shifts

As well as recreating scenarios and practicing through simulations, the crew have educational shifts built into their rotas. These shifts give them time to hone and develop their skills without the worry of being called out to a patient at any given moment.

The crew use their educational shifts to study for advanced qualifications, shadow clinicians in hospital, and take part in joint training sessions with other SWASfT units such as the Hazardous Area Response Team.

Multi-agency training

Training with other emergency response services means our crew can build relationships and be better prepared to work seamlessly together at a scene of an incident. Some of our clinical crew recently collaborated with Avon Fire and Rescue Service to run a training day with SWASfT and UWE Paramedic students at Avonmouth Docks. Practicing a variety of sims together is a great way to prepare for real-life emergencies.

Looking to the future

The future looks bright for Specialist Paramedics in Critical Care who want to further their career. In 2020, Vicki Brown became the first Advanced Clinical Practitioner in Critical Care (ACP-CC) in the South West. Then, in late 2021, she became the first person in the country to get on the Faculty of Pre Hospital Care (FPHC) Register of Consultant (Level 8) Practitioners by qualifying from a purely paramedic background.

Vicki’s achievements have been an inspiration to many of GWAAC’s SPCCs, including Callum. He says, ”progressing down the Advanced Practitioner route would be great, but to do that you need a lot of experience and exposure. Now is when the hard work starts for me; getting all the experience, exposure and learning is the key.”