Four Nova Scotia Health paramedics to support rural emergency care with expanded scope and skills

It was an opportunity too good to pass up for paramedic Dave Cotterill. 

An advanced care paramedic working out of the Colchester East Hants Health Centre in Truro since 2021, Cotterill recently graduated as a critical care paramedic, the highest scope of practice in paramedicine in Nova Scotia. 

He had long wanted to expand his scope and didn’t hesitate when offered the chance. 

“It is something that a lot of medics, both young and old, aspire to,” he said. “You’re a leader in your field, you’re a leader in your profession, and you want to help everybody else around you.” 

Cotterill was one of eight paramedics to graduate from the Critical Care Paramedic (CCP) program, a collaboration between multiple partners, including Nova Scotia Health, the Nova Scotia Department of Health and Wellness, Emergency Medical Care Inc., and EHS LifeFlight. 

Four of those eight paramedics, including Cotterill, are Nova Scotia Health employees with the remaining medics serving the ground and air ambulance system through Emergency Health Services (EHS). It is the third cohort of critical care paramedics to graduate from the program, which was launched in 2022.  

In the past, critical care paramedics within the hospital system worked out of the emergency department at the QEII Health Sciences Centre in Halifax, but all four of the most recent graduates will be using their upgraded skills at facilities in Yarmouth, Amherst and Truro, part of a concerted effort to expand the role of paramedics within medical facilities across the province.  

Paramedics in the emergency department, regardless of their scope, work in collaboration with the entire team, including doctors, nurses, respiratory therapists, assisting in any way they can. 

The new critical care paramedics will now be able to do more to assist the entire team. 

“We’ve got a broader scope of practice – we have more procedures we can do, more medications we can administer,” Cotterill said. “One of the big ones is procedural sedations - we can give anesthetics autonomously in the emergency department, so now we can do that and free up hands for the doctor to set a wrist or do a gastrointestinal sedation or these kinds of things.” 

Emily MacLeod, another recent graduate of the CCP program, came to Nova Scotia Health in 2022, working out of the emergency department at Cumberland Regional Health Care Centre in Amherst. 

While paramedics at the Cumberland Regional are nothing new, she is the first critical care paramedic there.  

“It’s exciting. I’m hoping that a bigger scope of practice will lead to being a member of their rapid response team which they’re in development of,” she said. “It’s always exciting to go through change and help with the development of something new and writing how you want your scope to be used.”  

After 25 years as a paramedic at EHS, Keith Ebbett made the move to Nova Scotia Health in 2022, working in the emergency department at Yarmouth Regional Hospital. 

Like his colleagues, he jumped at the chance to further his education and increase his scope to a critical care paramedic. 

“It was a challenge to be back in school after so long, but the program was great and the instructors were great,” he said. “I look forward to using my new knowledge and skills and continue to learn here in the department as we figure out how best to use me in this role at the Yarmouth Regional.”   

Over his 34 years as a paramedic, the last four at Nova Scotia Health out of Colchester East Hants, Dave Best has seen a dramatic evolution in paramedicine, mostly in the ground and air setting. 

To see the medical and critical thinking skills of paramedics valued and used more in hospital over the years is exciting and something that Best said he wanted a hand in shaping. 

Both he and Cotterill are the first, but likely not the last, critical care paramedics at the medical facility. 

“We’re going to be the ones that are going to help develop the position in the Colchester area,” Best said. “I’ve always enjoyed sharing my experience and helping train future paramedics throughout my entire career. 

“So, the opportunity is there to certainly help with the patients as well as other emergency department staff. A lot of staff are new to emergency medicine and we are sometimes the voice of experience in the room.”  

Photos of (clockwise) Dave Best, David Cotterill, Emily MacLeod and Keith Ebbett.