Background: Competence is a critical attribute for paramedics in emergency medical services (EMSs) because of the complex and diverse demands of the prehospital environment. This study aimed to identify and rank the key competencies expected of advanced-level paramedics as perceived by EMS managers.

Methods: The modified Delphi study included three rounds conducted between October 2022 and June 2023. The panel consisted of 44 EMS managers, all working as superiors in EMS organizations across Finland.

Results: In Round 1, 44 experts (100% response rate) evaluated 43 claims, with a consensus (≥ 75%) reached on five claims. The open-ended responses generated seven additional claims. In Round 2, 45 claims were reviewed; however, no consensus was reached. In Round 3, the top 15 claims from previous rounds were reevaluated (95% response rate), with assessment of patient conditions via the ABCDE protocol ranking highest. The experts also emphasized patient-centered care, safe environments, and systematic approaches in EMS.

Conclusions: This study used the Delphi method to identify essential competencies for advanced-level paramedics, emphasizing patient assessment via the ABCDE protocol. This highlights the importance of core skills and nontechnical competencies such as supervision and well-being, stressing the need for continuous updates in paramedic training.

Keywords: Emergency medical services; Emergency nursing; Leadership; Paramedics; Professional competence; Support.

© 2025. The Author(s).

背景：能力是紧急医疗服务（EMS）中高级救护人员的关键属性，因为院前环境复杂且多变。本研究旨在识别并排名急救管理人员所认为的高级救护人员应具备的核心能力。

方法：该修改后的德尔菲研究包括在2022年10月至2023年6月期间进行的三轮调查，由44名EMS管理者组成，他们都在芬兰各地的EMS组织中担任领导职务。

结果：第一轮中，44位专家（100%响应率）评估了43项声明，并对5项声明达成了一致意见（≥ 75%）。开放式回答产生了七项额外的声明。在第二轮中，审查了45项声明；然而，未达成一致意见。第三轮重新评估了前几轮中的15项顶级声明（95%响应率），其中通过ABCDE协议进行患者状况评估排名最高。专家们还强调了以患者为中心的护理、安全环境和系统性方法在EMS中的重要性。

结论：本研究使用德尔菲法识别了高级救护人员所需的关键能力，特别强调了通过ABCDE协议进行患者评估的重要性。这突显了核心技能及监督和福祉等非技术性能力的重要性，并强调需要持续更新救护人员的培训。

关键词：紧急医疗服务；急诊护理；领导力；救护人员；专业能力；支持。

© 2025. The Author(s).