Setting the scene for the paramedic in primary care: a review of the literature.

Recognition of the paramedic "profession" began in 2003, with the introduction of statutory registration and the promotion of graduate entry. This paper explores the published evidence which surrounds paramedic practice in an attempt to identify the skills, training, and professional capacity which paramedics of the future will require. A systematic analysis was carried out of key reviews and commentaries published between January 1995 and April 2004, and informal discussions with experts and researchers in the field were undertaken. There remains little high quality published evidence with which to validate many aspects of current paramedic practice. To keep pace with service developments, paramedic training must embrace the complexities of autonomous practice. Undoubtedly in the short term, paramedics must be taught to appropriately identify and manage a far wider range of commonly occurring conditions, minor illnesses, and trauma. However, in the longer term, and more importantly, paramedics must learn to work together to take ownership of the basic philosophies of their practice, which must have their foundation in valid and reliable research.