COVID-19: What paramedics need to know!

Assessing COVID-19 knowledge, attitudes, and practices among hospital employees: identifying sociodemographic determinants for improved public health strategies

Background

The working environment of healthcare institution during pandemic puts all hospital employees at high-risk of being exposed to contagious infections. An individual's behavior and response are largely determined by their level of knowledge, attitudes and practices (KAP) toward a disease. Therefore, the present study aimed to evaluate and assess the KAP toward COVID-19 among hospital employees working in various positions and to identify the sociodemographic determinants associated with the level of KAP.

Methods

A cross-sectional survey was conducted from July 1 to July 15, 2020 in Almoosa Specialist Hospital, Alhasa, Eastern Province, Saudi Arabia in which 221 hospital employees with varied job titles participated. The data for demographics and history of COVID-19 exposure, KAP related to COVID-19 spread and prevention were collected online using a web-based platform (Survey Monkey). Student's t-test/One-way ANOVA were used to compare total mean and standard deviation of KAP scores with demographic profiles and history of exposure.

Results

89.1% employees knew that COVID-19 virus is mostly transmitted from human-to-human, and 76.0% employees acknowledged droplet transmission. 64.7% employees preferred to take a sick person with unconfirmed COVID-19 to a health facility. Physicians had higher knowledge scores for COVID-19 infection and non-medical employees had the lowest scores (7.47 ± 1.23 and 6.47 ± 1.44, respectively). Nurses had the highest practice scores and non-medical employees lowest practice score (6.16 ± 0.74 and 5.37 ± 1.14, respectively). Attitude scores were similar among all the employees. All employees reported an increase in hand-washing frequency and physical contact avoidance.

Conclusion

The study results revealed socio-demographic factors; level of education, nationality, and field of service are associated with COVID-19 KAP. The study highlights that there is a gap in the level of knowledge about COVID-19, especially among nonmedical employees. Targeted interventional programs need to be planned and implemented to improve COVID-19 awareness among non-medical employees.

Burnout and Health Issues among Prehospital Personnel in Taiwan Fire Departments during a Sudden Spike in Community COVID-19 Cases: A Cross-Sectional Study

A spike in COVID-19 cases in Taiwan’s communities caused a significant increase in workload and infection concerns among prehospital personnel working in Taiwan fire departments. The present study was aimed at investigating their health status during this period. The target population was prehospital personnel who are from Taiwan fire departments, and who responded to COVID-19 patients during the community outbreak period. A questionnaire was employed to assess their physical and mental health status. The results showed that prehospital personnel suffered from moderate to severe degrees of burnout. Workload, body burden, and perceived pressure increased significantly during this period. Participants received more support from friends, family, and colleagues than they did from authorities. The paramedics reported higher scores for personal burnout than the emergency medical technicians (EMTs). Compared to non-COVID-19 response units, special COVID-19 response units reported higher scores for workload, body burden, and supportive environment. The results suggested that personal and work-related burnout were associated with higher perceived pressure. This study is the first investigation of physical and mental health burdens among prehospital personnel in Taiwan fire departments during the COVID-19 pandemic. The physical and mental health status of these personnel should be continuously monitored, and intervention provided as necessary.

Application of bow tie analysis and inherently safer design to the novel coronavirus hazard

This work involves the application of process safety concepts to other fields, specifically bow tie analysis and inherently safer design (ISD) to COVID-19. An analysis framework was designed for stakeholders to develop COVID-19 risk management plans for specific scenarios and receptor groups. This tool is based on the incorporation of the hierarchy of controls (HOC) within bow tie analysis to identify priority barriers. The analysis framework incorporates inherently safer design (ISD) principles allowing stakeholders to assess the adequacy of controls along with the consideration of degradation factors and controls. A checklist has also been developed to help stakeholders identify opportunities to apply the ISD principles of minimization, substitution, moderation, and simplification. This work also considers barrier effectiveness with respect to human and organization factors (HOF) in degradation factors and controls. This paper includes a collection of bow tie elements to develop bow tie diagrams for specific receptor groups and scenarios in Nova Scotia, Canada. The pandemic stage (At-Peak or Post-Peak) and its influence on different scenarios or settings is also considered in this work. Bow tie diagrams were developed for numerous receptor groups; bow tie diagrams modelling a generally healthy individual, a paramedic and a hair salon patron contracting COVID-19 are presented in this work.

Management of Acute Coronary Syndromes During the Coronavirus Disease 2019 Pandemic: Deviations from Guidelines and Pragmatic Considerations for Patients and Healthcare Workers

Coronavirus disease 2019 (COVID-19) is forcing cardiology departments to rapidly adapt existing clinical guidelines to a new reality and this is especially the case for acute coronary syndrome pathways. In this focused review, the authors discuss how COVID-19 is affecting acute cardiology care and propose pragmatic guideline modifications for the diagnosis and management of acute coronary syndrome patients, particularly around the appropriateness of invasive strategies as well as length of hospital stay. The authors also discuss the use of personal protective equipment for healthcare workers in cardiology. Based on shared global experiences and growing peer-reviewed literature, it is possible to put in place modified acute coronary syndrome treatment pathways to offer safe pragmatic decisions to patients and staff.