Paramedic training for Bermuda's emergency medical technicians (EMTs) is on the way this year, Health Minister Nelson Bascome revealed yesterday.

Government is looking to buy a high-tech simulator from the US which will allow ambulance crews and other emergency response workers to be trained to a higher level on the Island.

King Edward VII Memorial Hospital has just one paramedic — the top level for an EMT — in its emergency response team.

It also has nine basic and 14 intermediate EMTs.

Bermuda Fire Service, which also responds to medical emergencies, has more than 70 EMTs, none of whom are paramedic-trained. About 30 are intermediate EMTs and the rest are basic.

Mr. Bascome told The Royal Gazette: "We are looking at a programme right now that's coming out of one of the US institutions that would help to train the fire and ambulance and the Police and so it's at its early phase.

"It's going to take communication between the three emergency response entities to look at their budgets."

The Minister said the idea was not prompted by the recent inquest into the death of Norman Palmer, which heard criticism about the ambulance crew which dealt with him when he got into breathing difficulty last April.

Bermuda Hospitals Board (BHB) has strenuously denied allegations that the two EMTs — one basic and one intermediate — who attended Mr. Palmer's home were not adequately trained.

Mr. Bascome said paramedic training to "sharpen and enhance" the skills of Bermuda's EMTs had been mooted since about 2002 but the cost of the simulator was prohibitive until recently, when the price dropped.

He added that paramedics were not needed on a daily basis here and that the difficulty in such a small jurisdiction was keeping their skills up-to-date when they might not have to use them regularly.

"I would say it is a rare occasion, although I don't have the statistics to verify the exact amount of times that a paramedic is used," he said. "I do know that it's less frequently than more frequently."

Despite that, the Minister said he expected all of the Island's EMTs to want to take advantage of the training, meaning the number of paramedics available to deal with emergencies in Bermuda could increase dramatically.

"I think that the exciting part about the training is that anyone who is an EMT, anyone who is practising right now, would want to be a part of it," said Mr. Bascome, adding that it would happen in the next fiscal year.

"The simulators have just, in the last couple of years, been modified so that you are almost working in a real human situation. The response of the simulator is almost like working with a real human."

Mr. Bascome also spoke yesterday about the efficiency of the emergency dispatch system, another issue raised at the Norman Palmer inquest. The hearing heard from KEMH emergency services director Edward Schultz that the hospital had "raised concerns on numerous occasions" about the dispatch.

Mr. Bascome said he believed the response times for medical emergencies had dropped over the years but there was always room for improvement and discussions were ongoing between BHB, Bermuda Fire Service and the Police.

"I think when you have instances such as the recent inquest it brings into question if you are working at optimal best. I don't think you can call it a problem but it's an issue that they have been talking about for a little while."

Chief Fire Officer Vincent Hollinsid said he was not prepared to comment on the concerns mentioned by Dr. Schultz until they met to discuss them, which was planned "very shortly".

"I do have some concerns as well that I would like to discuss with Dr. Schultz that are in the hospital," he said, declining to comment further on those.

Mr. Hollinsid explained that all 911 calls are answered by the Police and are transferred to the fire service dispatch if they involve a medical emergency.

"I'm confident that the staff here do their jobs to the best of their ability, particularly those people who are working out in the field and in the dispatch facility.

"They handle in excess of 7,000 calls over the course of a year and they do a fantastic job."

EMT facts

• All King Edward VII Memorial Hospital ambulance crew members are trained as emergency medical technicians (EMT), either at a basic or intermediate level. One EMT has completed paramedic training.

• Basic EMTs must have 78 hours of classroom training and 71 clinical hours, 21 of them in the Emergency Department. Basic EMTs are trained in immobilisation techniques, transport, the administration of some medicine and the use of heart defibrillators.

• Intermediate EMTs complete an extra 36 classroom hours and 32 clinical hours. They can insert intravenous lines and some advanced airway devices, analyse heart ECGs and give medicine.

• Paramedics can receive anything between 1,000 to 2,000 hours of training, with some institutions offering two-year degrees. They are allowed to give more medications and perform a wider variety of emergency procedures than basics and intermediates.

• The training of KEMH EMTs is based on the US Department of Transportation's national programme. Skills assessment is required annually and re-certification is required every two years.