Swiss paramedics: a paradigm shift?

In Switzerland, two training levels are available for ambulance crews: ambulance technician (federal certificate level professional examination), and paramedic with a higher education diploma (3-year course at a higher-level professional school). The first corresponds to an emergency medical technician (EMT) basic training programme (1800 hours of training), while the second is equivalent to that of paramedics (5400 hours of training). Requirements are defined at the federal level by a framework study plan, and training mainly focuses on acute, urgent and severe care. Professional algorithms are used to guide practices and support training.

There is however a discrepancy, as these intervention patterns only represent 15% of the work situations of prehospital teams. The population's demand in this field has changed significantly, moving from acute interventions to demands of a more social, psychiatric or minor nature (85% of interventions concern NACA scores 0 to 3). At the same time, current sociodemographics are such that a groundswell orients health needs towards an ageing population, chronic pathologies, and polymorbidity.