ring blocks Intensive Care Paramedic Provides advanced management where knowledge, rationale, judgement, skill and leadership are well developed and utilises the most comprehensive regime of pharmacology, airway support and ECG interpretation. Current scope of practice: All of the above plus laryngoscopy, endotracheal intubation, capnography, cricothyrotomy, chest decompression, IO access, IO lignocaine, adrenaline, atropine, amiodarone, adenosine, calcium chloride, sodium bicarbonate, midazolam, ketamine, pacing, rocuronium, rapid sequence induction (select personnel only) Additionally, there is a "First Responder" level used for non Ambulance work (such as Events and non emergency transfers (PTS)) as well as community first response in rural areas, as an initial starting point for those on the clinical education pathway (i.e. completing the Diploma or above) or where the standard education pathway has been found unsuitable for a volunteer. It must be noted that this level does not have an "authority to practice" and does not independently utilise the Clinical Practice Guidelines or many pieces of clinical equipment. The Trustees of Ambulance New Zealand submitted an application to the Minister of Health in June 2011 that requested Paramedic and Intensive Care Paramedic be included as registered health professions and this is expected to be approved later in 2013. Registration would mean that a responsible authority (RA) under the Health Practitioners Competency Assurance Act would become responsible for governing Paramedic practice in New Zealand that practitioners would ultimately be responsible to this professional body which would be a significant change from the current "employer led" regulation. Communications The EMS system in New Zealand is served by three dispatch centres, located in Auckland, Wellington, and Christchurch. The dispatch centre in Christchurch provides coverage to the entire South Island, and is operated by St. John Ambulance. The dispatch centre in Auckland provides coverage for the north half of North Island, and is also operated by St. John Ambulance. The dispatch centre in Wellington provides coverage for the southern half of the North Island, is jointly operated by Wellington Free Ambulance and St John Ambulance but is staffed by Wellington Free Ambulance personnel. All three dispatch centres collaborate, and are capable of handling overflow of call volume for one another. The communication centre technology is fully integrated and seamless, providing a single, 'virtual' national dispatch centre. To illustrate, if an emergency has occurred in Christchurch but those 111 lines are all busy, the call will be forwarded to the dispatch centres in either Auckland