The Evolving Role of Paramedics Across the Disaster Cycle

Mass casualty incidents (MCIs) impose a burden on the health care ecosystem and are rising in prominence. Paramedics are crucial first responders during these incidents. The PubMed and Google Scholar databases were assessed for contemporary articles pertaining to the role of paramedics in MCIs. Over many decades of accumulated experience with the incorporation of modern technology, the role of the paramedic has evolved from transportation service to full-scale triage and treatment providers in the prehospital setting. The organizational skill and experience of paramedics in setting up the incident command system (ICS) at the scene is a key component for proper patient throughput and timely, effective communication from the scene to definite care center, and can result in favorable outcomes. Paramedics also conduct and direct patient transport from the scene to treatment centers, demonstrating competency and efficiency in routing logistics. Challenges remain for paramedics to perform their role in MCIs though, such as keeping up with continuous medical education and training, gaps in data collection and bookkeeping, and funding. These issues could be ameliorated by leveraging modern technology and approaches for training, as well as fostering greater awareness for paramedics' role in MCIs among the public and government officials.