[From volunteer work to critical care paramedic : The history of an ongoing process of professionalisation].

backgroundFor 4 years, the profession of critical care paramedic has been established in Germany. As a result, nonmedical rescue service personnel receive a 3-year apprenticeship for the first time. This also led to a revaluation of functions and responsibilities within this occupational field.

objectivesWhich medical and social processes contributed to the establishment of the occupational profile of a critical care paramedic? How did training methods change over the last 50 years and which debates helped to shape the development of the occupational field? MATERIALS AND

methodsThe article at hand is based on an interpretation of archival primary sources of the parties observed. Moreover, it is also predicated on a qualitative content analyses of the secondary literature focusing on the subject area of nonmedical rescue service personnel.

resultsIn the 1960s, a professionalisation process for paramedics was initiated after realising that rapid medical treatment on location can have a positive impact on the healing process. The debate on the training for paramedics has been influenced by longstanding negotiations between different parties about the question of which tasks could be ascribed to nonmedical rescue service personnel.

conclusionsIn the larger context, the discussions about the tasks of critical care paramedics are centered around the question of delegation and, respectively, the substitution of medical tasks usually assigned to physicians. The academization of the profession that is currently emerging will continue to lead to conflicts with the medical profession.