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Malone DF, Sims A, Irwin C, Wishart D, MacQuarrie A, Bell A, Stainer MJ. Lights, Sirens, and Load: Anticipatory emergency medical treatment planning causes cognitive load during emergency response driving among paramedicine students. ACCIDENT; ANALYSIS AND PREVENTION 2024; 204:107646. [PMID: 38830295 DOI: 10.1016/j.aap.2024.107646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 05/12/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024]
Abstract
Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator. We recruited 28 non-paramedic participants to complete a simulated baseline drive with no task and a cognitive load manipulation using the 1-back task. We also recruited 18 paramedicine students who completed a drive while considering two cases they were travelling to: cardiac arrest and infant seizure, representing varying difficulty in required treatment. The results indicated that both cases imposed considerable cognitive load, as indicated by NASA Task Load Index responses, comparable to the 1-back task and significantly higher than driving with no load. These findings suggest that contemplating cases and treatment plans may impact the safety of novice paramedics driving ambulances for emergency response. Further research should explore the influence of experience and the presence of a second individual in the vehicle to generalise to broader emergency response driving contexts.
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Affiliation(s)
- Daniel F Malone
- School of Applied Psychology, Griffith University, Australia
| | - Alan Sims
- School of Applied Psychology, Griffith University, Australia
| | - Christopher Irwin
- School of Health Sciences and Social Work, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia
| | - Darren Wishart
- School of Applied Psychology, Griffith University, Australia
| | | | - Andrew Bell
- The Royal Flying Doctor Service Western Australia, Australia
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2
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Wagner SL, White N, White M, Fyfe T, Matthews LR, Randall C, Regehr C, Alden LE, Buys N, Carey MG, Corneil W, Krutop E, Fraess-Phillips A. Work outcomes in public safety personnel after potentially traumatic events: A systematic review. Am J Ind Med 2024; 67:387-441. [PMID: 38458612 DOI: 10.1002/ajim.23577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/29/2024] [Accepted: 02/18/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety. METHODS The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis. RESULTS Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization. CONCLUSIONS Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.
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Affiliation(s)
- Shannon L Wagner
- Office of the Vice President Research, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Nicole White
- Department of Health Sciences, School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Lynda R Matthews
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Christine Randall
- School of Health Sciences & Social Work, Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Cheryl Regehr
- Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- School of Health Sciences & Social Work, Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences & Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Elyssa Krutop
- Aligned Counselling, Kamloops, British Columbia, Canada
| | - Alex Fraess-Phillips
- Department of Health Sciences, School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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Pryce R, Weldon E, McDonald N, Sneath R. The effect of power stretchers on occupational injury rates in an urban emergency medical services system. Am J Ind Med 2024; 67:341-349. [PMID: 38356274 DOI: 10.1002/ajim.23571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND To examine occupational injury rates in a dual-response emergency medical services (EMS) system before and after implementation of a power-lift stretcher system. METHODS The seasonally-adjusted occupational injury rate was estimated relative to medical call volume (per 1000 calls) and workers (per 100 FTEs) from 2009 to 2019, and stratified by severity (lost-time, healthcare only), role (EMS, FIRE) and type (patient-handling). Power-lift stretchers were adopted between 2013 and 2015. Preinjury versus postinjury rates were compared using binomial tests. Interrupted time series (ITS) analysis was used to estimate the trend and change in injuries related to patient-handling, with occupational illnesses serving as control. RESULTS Binomial tests revealed varied results, with reductions in the injury rate per 1000 calls (-14.0%) and increases in the rate per 100 FTEs (+14.1%); rates also differed by EMS role and injury severity. ITS analysis demonstrated substantial reductions in patient-handling injuries following implementation of power-lift stretchers, both in the injury rate per 1000 calls (-50.4%) and per 100 FTEs (-46.6%), specifically among individuals deployed on the ambulance. Injury rates were slightly elevated during the winter months (+0.8 per 100 FTEs) and lower during spring (-0.5 per 100 FTEs). CONCLUSIONS These results support the implementation of power-lift stretchers for injury prevention in EMS systems and demonstrate advantages of ITS analysis when data span long preintervention and postintervention periods.
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Affiliation(s)
- Rob Pryce
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Erin Weldon
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Emergency Medical Services, Winnipeg Fire Paramedic Service, Winnipeg, Manitoba, Canada
| | - Neil McDonald
- Emergency Medical Services, Winnipeg Fire Paramedic Service, Winnipeg, Manitoba, Canada
| | - Ryan Sneath
- Emergency Medical Services, Winnipeg Fire Paramedic Service, Winnipeg, Manitoba, Canada
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Malone AL, Armstrong DP, MacPhee RS, Fischer SL. Factors influencing the likelihood of females passing the Ottawa paramedic physical ability test. APPLIED ERGONOMICS 2024; 116:104187. [PMID: 38056128 DOI: 10.1016/j.apergo.2023.104187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/26/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
The Ottawa Paramedic Physical Ability Test (OPPAT) was launched in Ontario as a physical employment standard for front-line paramedics. When considering pass rates based on sex, males had a higher likelihood of passing than females. To help understand how to improve pass rates among females we aimed to understand if factors such as participant demographics, college type, employment status and/or peak heart rate (a surrogate of fitness level) were related to OPPAT pass rates. Females who were employed, who were educated in a public paramedic college, and who had higher body mass were more likely to successfully complete the OPPAT. Those educated in a public paramedic college were more than twice as likely to pass relative to those educated in a private college program. This may underscore a need to further explore different modes of paramedic education to understand why public college program trained students are more likely to pass.
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Affiliation(s)
- Alexander L Malone
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Daniel P Armstrong
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Renée S MacPhee
- Kinesiology & Physical Education and Health Sciences, Wilfrid Laurier University, Waterloo, Canada
| | - Steven L Fischer
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada.
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Marvin G, Schram B, Orr R, Canetti EFD. Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7055. [PMID: 37998287 PMCID: PMC10671419 DOI: 10.3390/ijerph20227055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.
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Affiliation(s)
- Graham Marvin
- Tactical Research Unit, Faculty of Health Sciences & Medicine, Bond University, Robina, QLD 4226, Australia
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Maguire BJ, Al Amiry A, O’Neill BJ. Occupational Injuries and Illnesses among Paramedicine Clinicians: Analyses of US Department of Labor Data (2010 - 2020). Prehosp Disaster Med 2023; 38:581-588. [PMID: 37559197 PMCID: PMC10548021 DOI: 10.1017/s1049023x23006118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/06/2023] [Accepted: 05/14/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Paramedicine clinicians (PCs) in the United States (US) respond to 40 million calls for assistance every year. Their fatality rates are high and their rates of nonfatal injuries are higher than other emergency services personnel, and much higher than the average rate for all US workers. The objectives of this paper are to: describe current occupational injuries among PCs; determine changes in risks over time; and calculate differences in risks compared to other occupational groups. METHODS This retrospective open cohort study of nonfatal injuries among PCs used 2010 through 2020 data from the US Department of Labor (DOL), Bureau of Labor Statistics; some data were unavailable for some years. The rates and relative risks (RRs) of injuries were calculated and compared against those of registered nurses (RNs), fire fighters (FFs), and all US workers. RESULTS The annual average number of injuries was: 4,234 over-exertion and bodily reaction (eg, motion-related injuries); 3,935 sprains, strains, and tears; 2,000 back injuries; 580 transportation-related injuries; and over 400 violence-related injuries. In this cohort, women had an injury rate that was 50% higher than for men. In 2020, the overall rate of injuries among PCs was more than four-times higher, and the rate of back injuries more than seven-times higher than the national average for all US workers. The rate of violence-related injury was approximately six-times higher for PCs compared to all US workers, seven-times higher than the rate for FFs, and 60% higher than for RNs. The clinicians had a rate of transportation injuries that was 3.6-times higher than the national average for all workers and 2.3-times higher than for FFs. Their overall rate of cases varied between 290 per 10,000 workers in 2018 and 546 per 10,000 workers in 2022. CONCLUSIONS Paramedicine clinicians are a critical component of the health, disaster, emergency services, and public health infrastructures, but they have risks that are different than other professionals.This analysis provides greater insight into the injuries and risks for these clinicians. The findings reveal the critical need for support for Emergency Medical Services (EMS)-specific research to develop evidence-based risk-reduction interventions. These risk-reduction efforts will require an enhanced data system that accurately and reliably tracks and identifies injuries and illnesses among PCs.
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Affiliation(s)
- Brian J. Maguire
- Leidos Inc., Reston, VirginiaUSA
- Central Queensland University - School of Medical and Applied Sciences, Queensland, Australia
| | - Ala’a Al Amiry
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Haruna J, Uemura S, Taguchi Y, Muranaka S, Niiyama S, Inamura H, Sawamoto K, Mizuno H, Narimatsu E. Influence of work and family environment on burnout among emergency medical technicians. Clin Exp Emerg Med 2023; 10:287-295. [PMID: 36796782 PMCID: PMC10579723 DOI: 10.15441/ceem.22.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Burnout among emergency medical technicians is a serious problem affecting delivery of quality emergency medical services. Although the repetitive nature of the job and lower education level requirements for technicians have been reported as risk factors, little is known about the influence of burden of responsibility, degree of supervisor support, and home environment on burnout among emergency medical technicians. This study aimed to test the hypothesis that burden of responsibility, degree of supervisor support, and home environment increase burnout probability. METHODS A web-based survey was conducted among emergency medical technicians in Hokkaido, Japan from July 26, 2021 to September 13, 2021. A total of 21 facilities were randomly selected from 42 fire stations. Prevalence of burnout was measured using the Maslach Burnout-Human Services Survey Inventory (MBI-HSS). Burden of responsibility was measured using a visual analog scale. Occupational background was also measured. Supervisor support was measured using the Brief Job Stress Questionnaire (BJSQ). Family-work negative spillover was measured using the Japanese version of Survey Work-Home Interaction-NijmeGen (SWING). The cutoff value for burnout syndrome was defined as emotional exhaustion≥27 and/or depersonalization≥10. RESULTS A total of 700 survey respondents were included, and 27 surveys with missing data were excluded. The suspected burnout frequency was 25.6%. Covariates were adjusted using multilevel logistic regression model analysis. Low supervisor support (odds ratio, 1.421; 95% confidence interval, 1.136-1.406; P<0.001) and high family-work negative spillover (odds ratio, 1.264; 95% confidence interval, 1.285-1.571; P<0.001) were independent factors associated with higher probability of burnout. CONCLUSION This study indicated that focusing on improvement of supervisor support for emergency medical technicians and creating supportive home environments may assist in reducing burnout frequency.
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Affiliation(s)
- Junpei Haruna
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shuji Uemura
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yukiko Taguchi
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan
| | - Saori Muranaka
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Sachi Niiyama
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Hirotoshi Inamura
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Keigo Sawamoto
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirotoshi Mizuno
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Eichi Narimatsu
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
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Jakonen A, Mänty M, Nordquist H. Applying Crew Resource Management tools in Emergency Response Driving and patient transport-Finding consensus through a modified Delphi study. Int Emerg Nurs 2023; 70:101318. [PMID: 37517359 DOI: 10.1016/j.ienj.2023.101318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/15/2023] [Accepted: 05/31/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Emergency Response Driving (ERD) comprises a significant risk to safety in Emergency Medical Services (EMS). Crew Resource Management (CRM) tools play a major role in securing actions in high-risk procedures. The aim of this study was to find consensus on the important factors to consider when applying CRM tools in ERD and patient transport. METHODS ERD experts (n = 50) were recruited for a modified three-round Delphi study. Round 1 was based on previous research. The experts evaluated the items as important, neutral, or not important. The predetermined level of consensus was set at ≥ 80%. Answers given to the open-ended questions were analyzed using inductive content analysis. RESULTS Predetermined consensus was reached on 64 of 86 presented items (74.4 %). The mean values of items reaching consensus varied between 3.81 and 4.86 on a five-point Likert scale. The items where consensus was reached were rated as "important" on a trichotomized scale. CONCLUSION Multiple important factors to consider when applying CRM tools to ERD and patient transport were highlighted. This study provides valuable information to consider regarding EMS safety improvements. Further scientific research is needed to develop comprehensive recommendations.
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Affiliation(s)
- Antti Jakonen
- RDI Sustainable Wellbeing, South-Eastern Finland University of Applied Sciences, 48220 Kotka, Finland; Department of Public Health, Faculty of Medicine, University of Helsinki, 00140 Helsinki, Finland.
| | - Minna Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00140 Helsinki, Finland; Unit of Strategy and Research, City of Vantaa, 01300 Vantaa, Finland
| | - Hilla Nordquist
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00140 Helsinki, Finland; Department of Healthcare and Emergency Care, South-Eastern Finland University of Applied Sciences, 48220 Kotka, Finland; Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland
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Stallman HM, Dodd N, Warren-James M, Chiera B. Workplace sense of belonging and paramedic wellbeing using network analysis: A cross-sectional study. Australas Emerg Care 2023; 26:254-263. [PMID: 36868938 DOI: 10.1016/j.auec.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/26/2023] [Accepted: 02/06/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Workplace sense of belonging is an important contributor to health and wellbeing. It may be even more important for paramedics to buffer against distress inherent in the workplace. To date, however, there has been no research on paramedic workplace sense of belonging and wellbeing. METHODS Using network analysis, this study aimed to identify the dynamic relationships of workplace sense of belonging in paramedics with variables associated with wellbeing and ill-being-identity, coping self-efficacy and unhealthy coping. Participants were a convenience sample of 72 employed paramedics. RESULTS The results showed workplace sense of belonging linked to other variables through distress, distinguishable by the relationship with unhealthy coping for wellbeing and ill-being. The relationships between identity (perfectionism and sense of self) as well as the relationship between perfectionism and unhealthy coping were stronger for those with ill-being than observed for those with wellbeing. CONCLUSIONS These results identified the mechanisms by which the paramedicine workplace can contribute to distress and unhealthy coping strategies, which can lead to mental illnesses. They also highlight contributions of individual components of sense of belonging highlighting potential targets for interventions to reduce the risk of psychological distress and unhealthy coping amongst paramedics in the workplace.
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Affiliation(s)
- Helen M Stallman
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Natalie Dodd
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia.
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Maguire BJ, O'Neill BJ, Al Amiry A. A Cohort Study of Occupational Fatalities among Paramedicine Clinicians: 2003 through 2020. Prehosp Disaster Med 2023; 38:153-159. [PMID: 36880160 DOI: 10.1017/s1049023x23000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
INTRODUCTION/STUDY OBJECTIVES Emergency medical technicians (EMTs) and paramedics respond to 40 million calls for assistance every year in the United States; these paramedicine clinicians are a critical component of the nation's health care, disaster response, public safety, and public health systems. The study objective is to identify the risks of occupational fatalities among paramedicine clinicians working in the United States. METHODS To determine fatality rates and relative risks, this cohort study focused on 2003 through 2020 data of individuals classified as EMTs and paramedics by the United States Department of Labor (DOL). Data provided by the DOL and accessed through its website were used for the analyses. The DOL classifies EMTs and paramedics who have the job title of fire fighter as fire fighters and so they were not included in this analysis. It is unknown how many paramedicine clinicians employed by hospitals, police departments, or other agencies are classified as health workers, police officers, or other and were not included in this analysis. RESULTS An average of 206,000 paramedicine clinicians per year were employed in the United States during the study period; approximately one-third were women. Thirty percent (30%) were employed by local governments. Of the 204 total fatalities, 153 (75%) were transportation-related incidents. Over one-half of the 204 cases were classified as "multiple traumatic injuries and disorders." The fatality rate for men was three-times higher than for women (95% confidence interval [CI], 1.4 to 6.3). The fatality rate for paramedicine clinicians was eight-times higher than the rate for other health care practitioners (95% CI, 5.8 to 10.1) and 60% higher than the rate for all United States workers (95% CI, 1.24 to 2.04). CONCLUSIONS Approximately 11 paramedicine clinicians are documented as dying every year. The highest risk is from transportation-related events. However, the methods used by the DOL for tracking occupational fatalities means that many cases among paramedicine clinicians are not included. A better data system, and paramedicine clinician-specific research, are needed to inform the development and implementation of evidence-based interventions to prevent occupational fatalities. Research, and the resulting evidence-based interventions, are needed to meet what should be the ultimate goal of zero occupational fatalities for paramedicine clinicians in the United States and internationally.
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Affiliation(s)
- Brian J Maguire
- Leidos, Reston, VirginiaUSA
- School of Health, Medical, and Applied Sciences, Central Queensland University, New London, ConnecticutUSA
| | - Barbara J O'Neill
- School of Nursing, University of Connecticut, Storrs, Connecticut USA; School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
| | - Ala'a Al Amiry
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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11
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Phung VH, Sanderson K, Pritchard G, Bell F, Hird K, Wankhade P, Asghar Z, Siriwardena N. The experiences and perceptions of wellbeing provision among English ambulance services staff: a multi-method qualitative study. BMC Health Serv Res 2022; 22:1352. [PMCID: PMC9664049 DOI: 10.1186/s12913-022-08729-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
NHS ambulance service staff are at risk of poor physical and mental wellbeing because of the likelihood of encountering stressful and traumatic incidents. While reducing sickness absence and improving wellbeing support to ambulance staff is a key NHS priority, few studies have empirically documented a national picture to inform policy and service re-design. The study aimed to understand how ambulance service trusts in England deal with staff health and wellbeing, as well as how the staff perceive and use wellbeing services.
Methods
To achieve our aim, we undertook semi-structured telephone interviews with health and wellbeing leads and patient-facing ambulance staff, as well as undertaking documentary analysis of ambulance trust policies on wellbeing. The study was conducted both before and during the UK first COVID-19 pandemic wave. The University of Lincoln ethics committee and the Health Research Authority (HRA) granted ethical approval. Overall, we analysed 57 staff wellbeing policy documents across all Trusts. Additionally, we interviewed a Health and Wellbeing Lead in eight Trusts as well as 25 ambulance and control room staff across three Trusts.
Results
The study highlighted clear variations between organisational and individual actions to support wellbeing across Trust policies. Wellbeing leads acknowledged real ‘tensions’ between individual and organisational responsibility for wellbeing. Behaviour changes around diet and exercise were perceived to have a positive effect on the overall mental health of their workforce. Wellbeing leads generally agreed that mental health was given primacy over other wellbeing initiatives. Variable experiences of health and wellbeing support were partly contingent on the levels of management support, impacted by organisational culture and service delivery challenges for staff.
Conclusion
Ambulance service work can impact upon physical and mental health, which necessitates effective support for staff mental health and wellbeing. Increasing the knowledge of line managers around the availability of services could improve engagement.
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Tremblay M, Albert WJ, Fischer SL, Beairsto E, Johnson MJ. Relationship between occupational stress injury score and simulated patient-care scenario performance among experienced paramedics. Work 2022; 73:1347-1358. [DOI: 10.3233/wor-211033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: It is well known that psychosocial health status of paramedics may be altered by their job demands. However, it is unknown whether psychosocial health status can affect occupational performance. OBJECTIVE: The goal of this study was to explore whether a paramedic’s symptom severity of Occupational Stress Injury (OSI) was related to simulated patient-care performance. METHODS: Nineteen paramedics with 15.0±8.7 years of paramedic experience participated in this study. Participants completed both an OSI symptom severity questionnaires, and a patient-care simulation. Vagal activity was also collected during the patient-care simulation. The simulation was used to assess experienced paramedics in a realistic stressful setting. Based on the provincial standard in New Brunswick, an experienced paramedic instructor graded the patient-care simulation using the provincial standard charts, observing performance videos and assessing data from the manikin. RESULTS: The current study suggests that paramedics who self-reported elevated symptoms of OSI were less likely to successfully complete the simulated patient-care scenario. CONCLUSION: This research suggests that the presence of self-reported elevated symptoms of OSI negatively impacts paramedics’ performance during a stressful work task simulation. Therefore, to help paramedics maintain optimal performance, it may be important to ensure that paramedics have access to appropriate resources to monitor and improve their psychosocial health.
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Affiliation(s)
- Mathieu Tremblay
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, QC, Canada
| | - Wayne J. Albert
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Steven L. Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Eric Beairsto
- New Brunswick EMS, Medavie Health Services, Moncton, NB, Canada
| | - Michel J. Johnson
- School of Kinesiology and Leisure, Université de Moncton, Moncton, NB, Canada
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MacQuarrie AS, Hunter JR, Sheridan S, Hlushak A, Sutton C, Wickham J. Paramedic Student Clinical Performance During High-Fidelity Simulation After a Physically Demanding Occupational Task: A Pilot Randomized Crossover Trial. Simul Healthc 2022; 17:234-241. [PMID: 34738962 DOI: 10.1097/sih.0000000000000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Paramedic duties include assessing, treating, and maneuvering patients in physically challenging environments. Whether clinical skills and patient care are affected by these occupational demands is unknown. High-fidelity simulation affords the opportunity to study this in a controlled setting. METHODS Using a randomized crossover design, 11 regional paramedicine students and graduates (mean ± SD age = 23 ± 2 years) completed two, 20-minute high-fidelity simulations that included cardiopulmonary resuscitation (CPR) immediately after either an acute bout of occupational physical activity (OPA) or a rest period (REST). Heart rate, respiratory rate, and mean arterial pressure were measured throughout. Clinical performance was scored using the Global Rating Score and a patient care record. Measures of CPR efficacy were recorded in the manikin. RESULTS There were no significant differences in Global Rating Score ( P = 0.07, ES = 0.03) or CPR efficacy between conditions. Patient care record accuracy was higher after the OPA versus REST simulations (mean ± SD = 61.8 ± 12.6% vs. 55.5 ± 12.0%, P = 0.03, ES = 0.5). Mean heart rate was higher during OPA simulations versus REST simulations (121 ± 14 vs. 84 ± 9 beats per minute, P < 0.01, ES = 3.1), as was mean respiratory rate (19 ± 3 vs. 16 ± 3 breaths per minute, P < 0.01, ES = 1.0). Mean arterial pressure was higher for OPA versus REST at simulation start (105 ± 11.3 vs. 95.8 ± 11.8 mm Hg, P = 0.01, Effect Size = 0.8), although not different after simulation. CONCLUSIONS Paramedicine students including recent graduates performed as well, or better, in a simulated clinical scenario immediately after occupation-specific acute physical exertion compared with a REST, despite higher physiological exertion. Whether this is the case for more experienced but potentially less physically fit paramedics in the workforce warrants investigation.
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Affiliation(s)
- Alex Sandy MacQuarrie
- From the Paramedicine Program (A.M.), Griffith University School of Medicine, Gold Coast, Queensland; Holsworth Research Initiative (J.R.H.), La Trobe University, Bendigo, Victoria; Paramedicine Program (S.S.), Charles Sturt University, Port Macquarie, New South Wales; Paramedicine Program (A.H.), Australian Catholic University, Brisbane, Queensland; Charles Sturt University (C.S.), School of Biomedical Sciences, Bathurst; and Charles Sturt University (J.W.), School of Biomedical Sciences, Orange, New South Wales, Australia
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14
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Dodd N, Warren-James M, Stallman HM. How do paramedics and student paramedics cope? A cross-sectional study. Australas Emerg Care 2022; 25:321-326. [PMID: 35525725 DOI: 10.1016/j.auec.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/06/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
Despite threats to wellbeing inherent in paramedicine, little is known about how paramedics cope. This study explored the breadth of healthy and unhealthy coping strategies used by paramedics and student paramedics. A convenience sample of 198 paramedics and student paramedics completed an online survey. Wellbeing was measured using WHO-5 and coping using the Coping Index. Primary outcomes were summarised using descriptive statistics. Most of the sample had wellbeing (68%); student paramedics had significantly better wellbeing than paramedics. There was no significant difference between paramedics and student paramedics on healthy or unhealthy coping. Participants with ill-being had significantly fewer healthy and more unhealthy coping strategies than those with wellbeing, and relatively few used professional support (28%). Internationally, few studies have reported coping strategies in paramedics. This study expands our understanding of healthy and unhealthy coping strategies used by paramedics and student paramedics. The results support research that shows paramedic work affects wellbeing, however not that paramedics are at greater risk of unhealthy coping than students or the general population. The results have implications for both the prevention of overwhelming distress in the workplace and the need to increase the use of professional support to prevent unhealthy coping, including suicidality.
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Affiliation(s)
- Natalie Dodd
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia.
| | - Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Helen M Stallman
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Birtinya, Qld, Australia
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15
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Sawyer S, Cowlishaw S, Kendrick K, Boyle M, Dicker B, Lord B. A systematic review of incidence, prevalence, and trends in health outcomes for Australian and New Zealand paramedics. PREHOSP EMERG CARE 2022; 27:398-412. [PMID: 35394892 DOI: 10.1080/10903127.2022.2064019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction: The paramedic role carries inherent risk to practitioner health, due to a combination of work characteristics and the employment practices of different organisations. Emerging evidence suggests that paramedics worldwide may face a range of negative health outcomes. The purpose of this paper was to systematically review the literature of paramedic health outcomes in the Australian and New Zealand context.Methods: A systematic search of key databases and grey literature was conducted to identify all available studies reporting on quantitative health outcomes for paramedics working in Australia or New Zealand. The review was conducted using the JBI methodology for prevalence studies, and uses a narrative synthesis approach to reporting.Results: There were k = 20 studies that met inclusion criteria, and most used Australian samples. Results indicated between 57.3-66.5% of paramedics studied were classified as overweight or obese, while up to 80% reported poor sleep, and 55.6% reported fatigue. Incidence rates per 100,000 FTE included 26.62 for completed suicide, 5.46 for drug-caused death, and 9.3 for workplace fatalities. The most recent incidence per 1,000 FTE for injury compensation claims was 141.4.Conclusions: Australian and New Zealand paramedics demonstrate poor health according to several metrics. Our sample demonstrated considerably worse health than the general population or similar occupations. There is little trend data available, so it was difficult to ascertain if rates are changing. The range of health outcomes studied was limited, and correlations between different health outcomes were rarely considered by authors. Data relating to specific rates for gender and sexuality, location of work, and First Nations status or ethnicity was often not available.Systematic review registration number (PROSPERO): CRD42021232196.
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16
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Warren-James M, Dodd N, Perera C, Clegg L, Stallman HM. How do paramedics cope? A scoping review. Australas Emerg Care 2022; 25:191-196. [PMID: 35000895 DOI: 10.1016/j.auec.2021.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/29/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022]
Abstract
Exposure to repeated trauma is an inherent component of paramedicine. Additionally, paramedics are exposed to threats that can undermine healthy workplaces, social connectedness, and health behaviour, predisposing them to overwhelming distress and unhealthy coping, including suicidality and psychiatric disorders. This scoping review aimed to identify how paramedics cope. PubMed, PsycINFO and CINAHL were searched between January 1, 2010, to April 21, 2021. Studies were included if they used any research design to identify specific coping strategies used by paramedics. Three studies met the inclusion criteria-two qualitative and one cross-sectional survey design. There was a high risk of bias across all studies. Studies were conducted in Israel, Poland, and the UK, primarily with males. Two studies only identified healthy coping strategies-self-soothing and social and professional support. Unhealthy strategies identified in the third study were limited to negative self-talk and alcohol use, with no mention of other harmful behaviours, social withdrawal, or suicidality. There is limited research describing how paramedics cope, and in particular, how female paramedics cope. Further research exploring the breadth of coping strategies used by paramedics is needed to understand the impact of the work paramedics undertake on coping and inform prevention and support activities.
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Affiliation(s)
- Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Natalie Dodd
- School of Medicine and Dentistry, Griffith University, Birtinya, Qld, Australia; School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Qld, Australia; Sunshine Coast Health Institute, Birtinya, Qld, Australia
| | - Chantal Perera
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Lisa Clegg
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Helen M Stallman
- Thompson Institute, University of the Sunshine Coast, Birtinya, Qld, Australia.
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17
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Jenkins N, Smith G, Stewart S, Kamphuis C. Pre-Employment physical capacity testing as a predictor of musculoskeletal injury in Victorian paramedics. Work 2021; 70:263-270. [PMID: 34511529 DOI: 10.3233/wor-213570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Paramedic work has periods of intermittent high physical demand, a risk of workplace injury, may be confounded by inherent fitness of the paramedic. OBJECTIVE This study aimed to identify the nature of workplace musculoskeletal injury, and determine if there was a relationship between pre-employment physical capacity testing (PEPCT) scores and risk of workplace musculoskeletal injury within the paramedic industry. METHODS A retrospective case review using PEPCT scores and workplace injury (WI) manual handling data collected from 2008 to 2015 by an Australian pre-hospital emergency care provider (Ambulance Victoria), enabled comparison and analysis of two distinct data sets. RESULTS A total of 538 paramedics were included for analysis with 34 paramedics reporting a workplace musculoskeletal injury from manual handling. The mean time to injury from commencement of employment was 395.4 days (SD 516.2). Female paramedics represented 53.0%and male paramedics represented 47%of the sample. Mean total PEPCT score for the entire sample was 19.1 (SD 2.9) with a range from 16.2-22, while for those reporting injuries it was 18.3 (SD 2.6) with a range from 15.7-20.9. CONCLUSIONS Musculoskeletal injury amongst Victorian paramedics is more prevalent where the paramedic is female, and/or within three years of commencement of employment. The PEPCT score did not differentiate those at risk of subsequent injury.
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Affiliation(s)
- Natasha Jenkins
- College of Health and Biomedicine, Allied Health Program, Paramedicine, Victoria University, Melbourne, VIC, Australia
| | - Gavin Smith
- College of Health and Biomedicine, Allied Health Program, Paramedicine, Victoria University, Melbourne, VIC, Australia
| | - Scott Stewart
- Australian Catholic University, School of Nursing, Midwifery and Paramedicine, Brisbane, QLD, Australia
| | - Catherine Kamphuis
- College of Health and Biomedicine, Allied Health Program, Paramedicine, Victoria University, Melbourne, VIC, Australia
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18
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Al Amiry A, Maguire BJ. Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review). Open Access Emerg Med 2021; 13:407-414. [PMID: 34522146 PMCID: PMC8434918 DOI: 10.2147/oaem.s324568] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/05/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Over the course of the COVID-19 progress, reports from many locations around the world indicated major increases in EMS call volume, which imposed great pressure on EMS dispatch centers (EMSDC) globally. No studies yet have been done to examine this phenomenon. OBJECTIVE This paper examines the interrelated effects of the unprecedented global increase of EMS call, the effect of the COVID-19 crisis on responding to non-COVID-19 emergencies, and the concurrent effects of having overwhelmed dispatch centers. It tries to explain the current evidence of the bottleneck of EMS calls during the early phase of the worldwide pandemic. ELIGIBILITY CRITERIA We examine the numbers of EMS calls internationally between March and June 2020, derived from published literature and news media. Only articles in English were selected, with certain keywords related to EMS calls, ambulance delay, stroke and cardiac arrest. SOURCE OF EVIDENCE Google Scholar was the main searching source. RESULTS After applying the selection criteria, a total of 29 citations were chosen, and a pattern of knowledge resulted in the emergence of five themes: EMS calls during COVID-19, Reduced EMS operator response time, Ambulance response delays, Collateral mortality and morbidity among non-COVID-19 cases, and Total ambulance call time. CONCLUSION Over the course of COVID-19 progress, there was a global phenomenon of exponential increases in EMS calls, which is expected to impose a great pressure on EMS dispatch centers. Several factors contributing to the bottleneck of EMS calls are identified and explained.
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Affiliation(s)
- Alaa Al Amiry
- Department of Clinical Studies, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Brian J Maguire
- Leidos (Research Laboratory), Groton, CT, USA
- Central Queensland University in Australia, Rockhampton, Queensland, Australia
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19
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Jakonen A, Mänty M, Nordquist H. Safety Checklists for Emergency Response Driving and Patient Transport: Experiences from Emergency Medical Services. Jt Comm J Qual Patient Saf 2021; 47:572-580. [PMID: 34183282 DOI: 10.1016/j.jcjq.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Emergency response driving (ERD) is considered one of the most significant occupational risk factors affecting both patient and traffic safety in emergency medical services (EMS). The majority of the risk factors in ERD are crew related and could be affected positively with crew resource management (CRM). The aim of this study was to examine how the safety checklists developed for ERD and patient transport are experienced in practical work in EMS by paramedics. METHODS Safety checklists for ERD and patient transport were developed and then piloted in practical work among 30 paramedics in five different EMS areas around Finland for a two-month period in fall 2019. Afterward, semistructured thematic interviews were performed with the pilot participants, and the material was analyzed using inductive content analysis. RESULTS Paramedics experienced that use of ERD and patient transport safety checklists improved safety, and deployment of the checklists required systematic planning. Use of the safety checklists was seen as changing the mindset of the ERD drivers to a more safety critical stance and increasing a systematic approach to ERD. Paramedics also stated that when deploying the checklists in EMS, their use should be standardized as a nationwide operating model and that service-dependent fine-tuning is required. CONCLUSION This study's findings support the use of ERD and patient transport safety checklists in practical work in EMS for promoting safety. In addition to safety checklists, other sections of CRM and its applications to EMS should also be studied.
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20
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Warren-James M, Hanson J, Flanagan B, Katsikitis M, Lord B. Paramedic students' experiences of stress whilst undertaking ambulance placements - An integrative review. Australas Emerg Care 2021; 24:296-301. [PMID: 33814343 DOI: 10.1016/j.auec.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Abstract
Work integrated learning (WIL) in the ambulance setting is an essential part of the paramedic curriculum. However, qualified ambulance personnel are reported to experience higher suicide rates and mental stress disorders due to high pressure work environments, and there is growing concern for the wellbeing of students entering this setting. The aim of this integrative review was to explore how studies have reported paramedic students' experience of stress whilst undertaking WIL. Five studies met the inclusion criteria and were evaluated for quality according to validated tools from the Critical Appraisal Skills Program, then ranked on the level of evidence used. Data was summarised in a comprehensive research paper matrix, and findings were categorised into levels and sources of stress. Levels of stress were measured by the percentage of paramedic students who developed post-traumatic stress disorder. The primary sources of stress were experiencing death and fear of making clinical mistakes. Students also identified emotional expression as a negative attribute. Future research should prioritise identifying the levels and sources of stress students face in each year of their academic program when undertaking WIL to provide a direction for preparatory activities that may mitigate the negative effects of stress.
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Affiliation(s)
- Matthew Warren-James
- The University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD, 4556, Australia.
| | - Julie Hanson
- The University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD, 4556, Australia.
| | - Belinda Flanagan
- The University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD, 4556, Australia.
| | - Mary Katsikitis
- Flinders University, Sturt Rd, Bedford Park, SA, 5042, Australia.
| | - Bill Lord
- Monash University, McMahons Road, Frankston, VIC, 3199, Australia.
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Catania VE, Malaguarnera G, Fiorenza G, Chisari EM, Lipari AR, Gallina V, Pennisi M, Lanza G, Malaguarnera M. Hepatitis C Virus Infection Increases Fatigue in Health Care Workers. Diseases 2020; 8:diseases8040037. [PMID: 33076215 PMCID: PMC7709099 DOI: 10.3390/diseases8040037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/04/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
Fatigue is a common state associated with a weakening or depletion of one's physical and mental resources, that leads to the inability to continue the individual functioning at a normal level of activity. Frequently, fatigue represents a response to infections, inflammation and autoimmune diseases. The scope of this study was to evaluate the fatigue in healthcare workers with and without hepatitis C virus (HCV) infection. Mental, physical and severity fatigue were evaluated through Krupp, Wessely and Powell fatigue scale. Anti-HCV antibodies, HCV RNA and HCV genotypes were also measured. Physical, mental and severity fatigue were higher in healthcare workers with HCV infection than the healthcare workers without infection (p < 0.01). Our data showed a direct link between fatigue and HCV infection in healthcare workers. Further studies are needed to evaluate HCV antiviral treatments on fatigue severity and on quality of life in healthcare workers.
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Affiliation(s)
- Vito Emanuele Catania
- Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95124 Catania, Italy;
| | - Giulia Malaguarnera
- “The Great Senescence” Research Centre, University of Catania, 95100 Catania, Italy; (G.M.); (G.F.)
| | - Giorgia Fiorenza
- “The Great Senescence” Research Centre, University of Catania, 95100 Catania, Italy; (G.M.); (G.F.)
| | | | | | - Valentino Gallina
- SPRESAL ASP ENNA, 94100 Enna, Italy; (A.R.L.); (V.G.)
- Faculty of Engineering and Architecture-Risk analysis and work safety organization-Kore University of Enna, 94100 Enna, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy;
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Michele Malaguarnera
- “The Great Senescence” Research Centre, University of Catania, 95100 Catania, Italy; (G.M.); (G.F.)
- Correspondence:
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Du B, Boileau M, Wierts K, Karch SB, Yung M, Fischer S, Yazdani A. Exploring the need for and application of human factors and ergonomics in ambulance design: Overcoming the barriers with technical standards. APPLIED ERGONOMICS 2020; 88:103144. [PMID: 32678770 DOI: 10.1016/j.apergo.2020.103144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 03/31/2020] [Accepted: 05/02/2020] [Indexed: 06/11/2023]
Abstract
Ergonomic risk factors, such as excessive physical effort, awkward postures or repetitive movements, were the leading causes of injuries amongst EMS workers in the United States, of which 90% were attributed to lifting, carrying, or transferring a patient and/or equipment. Although the essential tasks of patient handling, transport, and care cannot be eliminated, the design of ambulances and associated equipment is modifiable. Our aims were to identify the extent of Human Factors and Ergonomic (HFE) considerations in existing ambulance design standards/regulations, and describe how HFE and the standards/regulations were applied in the EMS system. Through an extensive environmental scan of jurisdictionally relevant standards/regulations and key informant interviews, our findings demonstrated that existing standards/regulations had limited considerations for HFE. As a result, HFE principles continue to be considered reactively through retrofit rather than proactively in upstream design. We recommend that performance-based HFE requirements be integrated directly into ambulance design standards.
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Affiliation(s)
- Bronson Du
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Michelle Boileau
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada; Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Kayla Wierts
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada; School of Public Health and Health Systems, University of Waterloo, ON, Canada
| | - Stephanie Beatrix Karch
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada; School of Public Health and Health Systems, University of Waterloo, ON, Canada
| | - Marcus Yung
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Steven Fischer
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada; Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Amin Yazdani
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada; Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada; School of Public Health and Health Systems, University of Waterloo, ON, Canada; School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada.
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Shi Y, Xue H, Ma Y, Wang L, Gao T, Shi L, Wang Y, Cui M, Wang C, Yang X, Liu M, Fan L, Yan G. Prevalence of occupational exposure and its influence on job satisfaction among Chinese healthcare workers: a large-sample, cross-sectional study. BMJ Open 2020; 10:e031953. [PMID: 32303512 PMCID: PMC7200032 DOI: 10.1136/bmjopen-2019-031953] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study had three objectives: (1) describe the prevalence of occupational exposure among Chinese medical personnel in detail, (2) verify the partial mediating role of work environment satisfaction in the relationship between occupational exposure and job satisfaction, and (3) examine if stress symptoms moderate the relationship between occupational exposure and job satisfaction. DESIGN A large cross-sectional online survey was conducted in July 2018 in China. SETTING A survey was conducted in 54 cities across 14 provinces of China. PARTICIPANTS A total of 12 784 questionnaires were distributed, and 9924 healthcare workers (HCWs) completed valid questionnaires. The response rate was 77.63%. OUTCOME MEASURES A confidential questionnaire was distributed to HCWs. The relationships among and the mechanisms of the variables were explored using descriptive statistical analyses, Pearson's correlation coefficient and multiple linear regression analysis. RESULTS The most common occupational exposures among HCWs in the past 12 months were psychosocial and organisational hazards (85.93%). Overall, physicians (93.7%) and nurses (89.2%) were the main victims of occupational exposure. Occupational exposure correlated negatively with work environment satisfaction and job satisfaction, and positively with stress symptoms. Moreover, work environment satisfaction fully mediated the relationship between occupational exposure and job satisfaction, and stress symptoms moderated the relationship between occupational exposure and job satisfaction. CONCLUSION The incidence of occupational exposure among HCWs is generally high. The high frequency of psychosocial and organisational hazards among physicians and nurses should be taken seriously and dealt with in a timely manner by hospital managers. The negative impact of occupational exposure on job satisfaction must be buffered by measures to reduce stress symptoms and enhance working environment satisfaction, ultimately improving the overall quality of life of HCWs and promoting comprehensive development of the medical team.
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Affiliation(s)
- Yu Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haifeng Xue
- Department of Nutrition and Food Hygiene, School of Public Health, Qiqihar Medical College, Qiqihar, China
| | - Yuanshuo Ma
- School of Health Management, Harbin Medical University, Harbin, China
| | - Licheng Wang
- Office of the Outpatient Department of the Fourth Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Tian Gao
- Performance Office, Jinan Central Hospital, Jinan, China
| | - Lei Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yang Wang
- Office of Coordination of Doctor-Patient Relations, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Mei Cui
- Doctor-Patient Office, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Chao Wang
- Medical Insurance Office, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xi Yang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ming Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Lihua Fan
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guanyun Yan
- Department of Marketing, College of Humanities and Social Sciences, Harbin Medical University, Harbin, China
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Reardon M, Abrahams R, Thyer L, Simpson P. Review article: Prevalence of burnout in paramedics: A systematic review of prevalence studies. Emerg Med Australas 2020; 32:182-189. [PMID: 32067408 DOI: 10.1111/1742-6723.13478] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/16/2020] [Indexed: 01/20/2023]
Abstract
Paramedic wellness is an increasing priority within the profession. Burnout has been described as having areas of 'emotional exhaustion, depersonalisation and reduced personal accomplishment'. Prevalence of burnout is unclear, hampering evaluation of protective initiatives. The aim of this systematic review was to identify prevalence and predictors of burnout in paramedic populations. A systematic review was registered via PROSPERO and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO and PsycARTICLES were searched from 2000 to present. Abstract screening and selection of articles was undertaken with good agreement. Quality assessment of included articles used Hoy's validated quality assessment tool, with excellent inter-rater agreement (K = 0.9). Qualitative synthesis of included studies was performed. Each step of the process was performed independently by two authors, with a third arbitrating disputes as required. Five studies met inclusion criteria; two were from the USA, and one each from Australia, South Africa and Israel. Burnout measurement varied; three used Copenhagen Burnout Inventory (CBI), one Maslach's Burnout Inventory (MBI), and one General Burnout Measure (GBM). Prevalence of burnout ranged between 16% and 56%. Higher prevalence was reported in CBI studies (30%, 38% and 56%), while lower prevalence was seen with other tools (MBI 18%, GBM 16%). Included studies were of low to moderate quality. The prevalence of burnout in paramedics varies from 16% to 56%. Existing evidence describing burnout in paramedics is weak; research of good methodological rigour is needed to quantify prevalence of burnout, providing a reliable baseline against which protective interventions could be measured.
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Affiliation(s)
- Matthew Reardon
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Raquel Abrahams
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Liz Thyer
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Paul Simpson
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
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Murray RM, Davis AL, Shepler LJ, Moore-Merrell L, Troup WJ, Allen JA, Taylor JA. A Systematic Review of Workplace Violence Against Emergency Medical Services Responders. New Solut 2020; 29:487-503. [PMID: 31841060 PMCID: PMC8594050 DOI: 10.1177/1048291119893388] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Emergency Medical Service (EMS) responders deliver patient care in high-risk, high-stress, and highly variable scenarios. This unpredictable work environment exposes EMS responders to many risks, one of which is violence. The primary goals of this systematic literature review were to (1) define the issue of violence experienced by EMS responders and (2) identify the risk factors of violence associated with the EMS profession. An innovative inclusion of industrial literature with traditional peer-reviewed literature was performed. Of 387 articles retrieved, 104 articles were assessed and reviewed. Career exposure for EMS responders to at least one instance of verbal and/or physical violence was between 57 and 93 percent. There is a great need for rigorously designed, nationally representative examinations of occupational exposures in order to better understand the temporal associations of violence, cumulative occupational stressors, and the outcomes of physical and psychosocial injuries that are occurring as a result of exposures to violence.
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Affiliation(s)
- Regan M. Murray
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Andrea L. Davis
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lauren J. Shepler
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | | | | | - Jennifer A. Taylor
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Alobaid A, Gosling C, Mckenna L, Williams B. Gendered organizational theory and glass ceiling: Application to female Saudi paramedics in the workplace. SAUDI JOURNAL FOR HEALTH SCIENCES 2020. [DOI: 10.4103/sjhs.sjhs_56_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ishimaru T, Kubo T, Honno K, Toyokuni Y, Fujino Y. Near misses and presenteeism among paramedics. Occup Med (Lond) 2019; 69:593-597. [PMID: 31206581 DOI: 10.1093/occmed/kqz076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Paramedics need to be in good physical health to be able to respond to emergencies. We hypothesized that near misses by paramedics and unanticipated incidents that cause no harm may be associated with presenteeism during emergency rescues. AIMS To examine the association between presenteeism and near misses among paramedics. METHODS A cross-sectional study was conducted among 254 paramedics using a self-administered questionnaire. Presenteeism was measured using the work functioning impairment scale (WFun). RESULTS Twelve per cent of respondents experienced high work function impairment indicating presenteeism. The rate of near-miss experiences steadily increased with increasing work function impairment among paramedics (WFun score category: middle, odds ratio (OR) 3.62, 95% confidence interval (CI) 1.62-8.11; high, OR 4.36, 95% CI 1.37-13.84; very high, OR 8.62, 95% CI 2.09-35.48). CONCLUSIONS This study demonstrated a positive relationship between impaired work function indicating presenteeism and near misses among paramedics. This suggests that presenteeism may be associated with errors that have the potential to cause serious accidents. Improved access to treatment for frequent health problems may reduce the number of incidents among paramedics.
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Affiliation(s)
- T Ishimaru
- Department of Health Management, Nishinihon Occupational Health Service Center, Kitakyushu, Japan.,Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - T Kubo
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - K Honno
- Department of Public Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Y Toyokuni
- Department of Public Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Y Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Hunter JR, Macquarrie AJ, Sheridan SC. Physical capacity of New South Wales ambulance paramedics. Occup Med (Lond) 2019; 69:534-540. [PMID: 31605617 DOI: 10.1093/occmed/kqz131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Paramedics are among the most frequently injured health professionals in Australia. A lack of physical capacity may contribute to injury risk in this occupational population. AIMS This study sought to describe and compare the physical fitness of male and female paramedics across age groups to ascertain differences in physical capacity. METHODS A group of regional Australian paramedics (n = 140; 78 males; mean ± SD 37.4 ± 9.9 years; body mass index 28.1 ± 4.9 kg/m2) underwent a fitness assessment. Measures included upper, lower and core-body muscular strength and flexibility. Outcomes were compared between genders and across age groups using two-way between-groups analysis of variance. RESULTS Male paramedics had greater upper body strength (P < 0.05; push-ups) mean (95% CI): 22.6 (19.4-25.9) versus 18.7 (15.2-22.3); similar lower body strength (single-leg wall squat): 39.0 (32.6-45.3) s versus 36.7 (27.1-46.3) s; greater core strength (P < 0.05; prone plank hold): 87.9 (77.6-98.3) s versus 73.8 (63.7-83.8) s; similar upper body flexibility (back scratch): -4.0 (-6.7 to -1.3) cm versus -0.3 (-2.2 to 1.7) cm; and similar lower body flexibility (sit and reach): 20.4 (18.2-22.6) cm versus 26.1 (23.5-28.7) cm to female paramedics. Core, upper and lower body strength all decreased with age (P < 0.05). CONCLUSIONS Core, upper and lower body strength and upper body flexibility were poorer for older compared to younger regional paramedics in New South Wales, Australia. Future research should investigate whether these outcomes are associated with occupational injury risk. This information would assist in the design of injury prevention interventions for paramedics such as tailored workplace exercise programs.
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Affiliation(s)
- J R Hunter
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - A J Macquarrie
- School of Biomedical Sciences, Charles Sturt University, Bathurst, New South Wales, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - S C Sheridan
- School of Biomedical Sciences, Charles Sturt University, Bathurst, New South Wales, Australia
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Coomber K, Curtis A, Vandenberg B, Miller PG, Heilbronn C, Matthews S, Smith K, Wilson J, Moayeri F, Mayshak R, Lubman DI, Scott D. Aggression and violence at ambulance attendances where alcohol, illicit and/or pharmaceutical drugs were recorded: A 5-year study of ambulance records in Victoria, Australia. Drug Alcohol Depend 2019; 205:107685. [PMID: 31704380 DOI: 10.1016/j.drugalcdep.2019.107685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study describes the frequency and characteristics of aggression and/or violence in ambulance attendances involving alcohol, illicit and/or pharmaceutical drug use in Victoria, Australia between January 2012 and January 2017. METHODS Patient characteristics, context, and substance use involvement in ambulance attendances were examined to determine associations with attendances where aggression and/or violence was recorded. RESULTS There were 205,178 ambulance attendances where use of alcohol, pharmaceutical drugs or illicit substances contributed to the reason for the attendance. Paramedics recorded acts of aggression and/or violence in 11,813 (5.76 %) of these attendances. Aggression/violence was more likely to be recorded in certain contexts. Compared with attendances where aggression/violence was not recorded, attendances where aggression/violence was recorded were significantly more likely to involve younger and male patients, and occur on Friday and Saturday nights. Alcohol intoxication was involved in more than half of attendances where aggression/violence was recorded, and was almost twice as prevalent as those involving illicit drug use where aggression/violence was recorded. This pattern was consistent across all hours, high-alcohol hours only, by metropolitan/regional location, and by police co-attendance. CONCLUSIONS Aggression and violence are frequently recorded in ambulance attendances involving alcohol, pharmaceutical drugs or illicit substances, and, most often involve alcohol. This violence poses a recurring threat to the health and safety of paramedics, bystanders, and patients. Greater priority should be given to reducing alcohol-related violence through evidence-based policy measures targeting high-risk groups (e.g. young adult males) and contexts (e.g. weekends, late at night) where harm is most likely to occur.
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Affiliation(s)
- Kerri Coomber
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Ashlee Curtis
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Brian Vandenberg
- School of Social Sciences, Monash University, Victoria, Australia.
| | - Peter G Miller
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Cherie Heilbronn
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Sharon Matthews
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Karen Smith
- Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventative Medicine and Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia.
| | - James Wilson
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Foruhar Moayeri
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Richelle Mayshak
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Debbie Scott
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
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Armstrong DP, Makhoul PJ, Sinden KE, Fischer SL. Ranking Stretcher and Backboard Related Paramedic Lifting Tasks Based on Their Biomechanical Demand on the Low Back. IISE Trans Occup Ergon Hum Factors 2019. [DOI: 10.1080/24725838.2019.1688894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Paul J. Makhoul
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON, Canada
| | | | - Steven L. Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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Hanna H. Slaying the dragons: rehabilitating emergency services personnel. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2019; 17:1956-1957. [PMID: 31633635 DOI: 10.11124/jbisrir-d-19-00281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Hilding Hanna
- MClinSc Candidate, Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia
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McCann L, Granter E. Beyond ‘blue-collar professionalism’: Continuity and change in the professionalization of uniformed emergency services work. JOURNAL OF PROFESSIONS AND ORGANIZATION 2019. [DOI: 10.1093/jpo/joz006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AbstractThe sociology of professions has so far had limited connections to emergency services occupations. Research on emergency occupations tends to focus on workplace culture and identity, often emphasizing continuity rather than change. Police officers, firefighters, and paramedics have their historical roots in manual, technical, or ‘semi-professional’ occupations and their working lives still bear many of the hallmarks of blue-collar, uniformed ‘street-level’ work. But uniformed emergency services—like many other occupations—are increasingly undergoing processes of ‘professionalization’. The organizations in which they are employed and the fields in which they work have undergone significant change and disruption, calling into question the core features, cultures, and duties of these occupations. This article argues that sociology of work on emergency services could be helpfully brought into closer contact with the sociology of professions in order to better understand these changes. It suggests four broad empirical and conceptual domains where meaningful connections can be made between these literatures, namely, leadership and authority; organizational goals and objectives; professional identities; and ‘extreme’ work. Emergency services are evolving in complex directions while retaining certain long-standing and entrenched features. Studying emergency occupations as professions also sheds new light on the changing nature of ‘professionalism’ itself.
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Affiliation(s)
- Leo McCann
- The York Management School, University of York, York, UK
| | - Edward Granter
- Birmingham Business School, University of Birmingham, Birmingham, UK
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Armstrong DP, Sinden KE, Sendsen J, MacPhee RS, Fischer SL. Evaluating the effect of a strength and conditioning program to improve paramedic candidates' physical readiness for duty. Work 2019; 63:623-633. [PMID: 31282455 DOI: 10.3233/wor-192953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Ottawa Paramedic Physical Ability Test (OPPAT™) is a physical employment standard for the paramedic sector. If a candidate is unsuccessful in meeting the OPPAT™ performance standard they should be provided with an appropriate accommodation, such as a strength and conditioning program, to improve performance. OBJECTIVE Develop, implement and evaluate the effectiveness of a 4-week strength and conditioning program on improving OPPAT™ performance and associated fitness measures in paramedic candidates. METHODS A 4-week strength and conditioning program was developed to focus on strength and power improvements. Based on initial OPPAT™ performance, participants were divided into high and low performing groups; only the low performing group received the training intervention. OPPAT™ completion times and relevant fitness measures were compared pre- to post- intervention and between groups. RESULTS Over the 4-weeks, peak lower body power and grip strength did not significantly improve in the intervention group, however OPPAT™ performance improved by 10%. The control group had significantly lower OPPAT™ completion times both pre- and post-intervention (19% and 11% lower respectively), as well as greater grip strength and peak lower body power. CONCLUSIONS Implementation of a targeted strength and conditioning program successfully improved OPPAT™ performance in low performing candidates.
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Affiliation(s)
- Daniel P Armstrong
- Department of Kinesiology, University of Waterloo, Waterloo, ONT, Canada
| | - Kathryn E Sinden
- School of Kinesiology, Lakehead University, Thunder Bay, ONT, Canada
| | - Jonathan Sendsen
- Department of Kinesiology, University of Waterloo, Waterloo, ONT, Canada
| | - Renée S MacPhee
- Kinesiology & Physical Education and Health Sciences, Wilfrid Laurier University, Waterloo, ONT, Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ONT, Canada
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Perception of Musculoskeletal Symptoms and Psychosocial Risk Factors Among a Sample of Portuguese Emergency Medical Technicians. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-3-030-24067-7_6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Koski A, Sumanen H. The risk factors Finnish paramedics recognize when performing emergency response driving. ACCIDENT; ANALYSIS AND PREVENTION 2019; 125:40-48. [PMID: 30708262 DOI: 10.1016/j.aap.2019.01.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/14/2019] [Accepted: 01/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Paramedics face several safety risks in their occupation, and crashes during emergency response driving (ERD) are quite common. However, there is a need for more research to develop educational and implementation suggestions to determine how these risks can be reduced and managed. In this study, we examined what risk factors Finnish paramedics recognize when performing ERD. METHODS The study material consisted of 161 pages of material that had been written by experienced paramedics (n = 44) who were master's degree students of South-Eastern Finland University of Applied Sciences in fall 2017. They wrote essays based solely on their own thoughts and experiences regarding the risk factors associated with ERD. The material was analyzed via inductive content analysis. RESULTS Two main categories were found: Crew-related risk factors and environmental risk factors. These categories could be further divided into eight sub-categories. The crew-related risk factors consisted of lack of education and training for ERD, insufficient concentration on driving, irresponsibility and indifference, crew member's inability to take collective responsibility for safety as a team, and excessive load experienced by the driver. Environmental risk factors consisted of demanding handling of ambulance, poor visibility, and other road users. CONCLUSIONS Finnish paramedics recognized several risk factors in ERD. Some of the factors have been noted in previous literature regarding ambulance crashes and should be addressed as a matter of urgency to improve safety. Overall, better knowledge regarding these risks needs to be developed worldwide. The results led to several further study suggestions.
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Affiliation(s)
- Anssi Koski
- Project Researcher at South-Eastern Finland University of Applied Sciences, Advanced Level Paramedic at Kymsote - Kymenlaakso Social and Health Services, Doctoral Candidate at University of Helsinki, Faculty of Medicine, Finland.
| | - Hilla Sumanen
- Principal Lecturer at South-Eastern Finland University of Applied Sciences, Adjunct Professor in Health Policy at University of Helsinki, Finland
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Du B, Boileau M, Wierts K, Hignett S, Fischer S, Yazdani A. Existing Science on Human Factors and Ergonomics in the Design of Ambulances and EMS Equipment. PREHOSP EMERG CARE 2019; 23:631-646. [DOI: 10.1080/10903127.2019.1568651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
IntroductionEach year, Emergency Medical Services (EMS) personnel respond to over 30 million calls for assistance in the United States alone. These EMS personnel have a rate of occupational fatality comparable to firefighters and police, and a rate of non-fatal injuries that is higher than the rates for police and firefighters and much higher than the national average for all workers. In Australia, no occupational group has a higher injury or fatality rate than EMS personnel. Emergency Medical Services personnel in the US have a rate of occupational violence injuries that is about 22-times higher than the average for all workers. On average, more than one EMS provider in the US is killed every year in an act of violence.Hypothesis/ObjectiveThe objective of this epidemiological study was to identify the risks and factors associated with work-related physical violence against EMS personnel internationally. METHODS An online survey, based on a tool developed by the World Health Organization (WHO; Geneva, Switzerland), collected responses from April through November 2016. RESULTS There were 1,778 EMS personnel respondents from 13 countries; 69% were male and 54% were married. Around 55% described their primary EMS work location as "urban." Approximately 68% described their employer as a "public provider." The majority of respondents were from the US.When asked "Have you ever been physically attacked while on-duty?" 761 (65%) of the 1,172 who answered the question answered "Yes." In almost 10% (67) of those incidents, the perpetrator used a weapon. Approximately 90% of the perpetrators were patients and around five percent were patient family members. The influence of alcohol and drugs was prevalent. Overall, men experienced more assaults than women, and younger workers experienced more assaults than older workers. CONCLUSIONS In order to develop and implement measures to increase safety, EMS personnel must be involved with the research and implementation process. Furthermore, EMS agencies must work with university researchers to quantify agency-level risks and to develop, test, and implement interventions in such a way that they can be reliably evaluated and the results published in peer-reviewed journals. MaguireBJ, BrowneM, O'NeillBJ, DealyMT, ClareD, O'MearaP. International survey of violence against EMS personnel: physical violence report. Prehosp Disaster Med. 2018;33(5):526-531.
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Reichard AA, Al-Tarawneh IS, Konda S, Wei C, Wurzelbacher SJ, Meyers AR, Bertke SJ, Bushnell PT, Tseng CY, Lampl MP, Robins DC. Workers' compensation injury claims among workers in the private ambulance services industry-Ohio, 2001-2011. Am J Ind Med 2018; 61:986-996. [PMID: 30417397 DOI: 10.1002/ajim.22917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Ambulance service workers frequently transfer and transport patients. These tasks involve occupational injury risks such as heavy lifting, awkward postures, and frequent motor vehicle travel. METHODS We examined Ohio workers' compensation injury claims among state-insured ambulance service workers working for private employers from 2001 to 2011. Injury claim counts and rates are presented by claim types, diagnoses, and injury events; only counts are available by worker characteristics. RESULTS We analyzed a total of 5882 claims. The majority were medical-only (<8 days away from work). The overall injury claim rate for medical-only and lost-time cases was 12.1 per 100 full-time equivalents. Sprains and strains accounted for 60% of all injury claims. Overexertion from patient handling was the leading injury event, followed by motor vehicle roadway incidents. CONCLUSIONS Study results can guide the development or improvement of injury prevention strategies. Focused efforts related to patient handling and vehicle incidents are needed.
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Affiliation(s)
- Audrey A. Reichard
- Division of Safety Research; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | | | - Srinivas Konda
- Division of Safety Research; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Chia Wei
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Steven J. Wurzelbacher
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Alysha R. Meyers
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Stephen J. Bertke
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - P. Timothy Bushnell
- Economic Research Support Office, Office of the Director; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Chih-Yu Tseng
- Division of Surveillance, Hazard Evaluations, and Field Studies; National Institute for Occupational Safety and Health; Cincinnati Ohio
| | - Michael P. Lampl
- Division of Safety and Hygiene; Ohio Bureau of Workers’ Compensation; Columbus Ohio
| | - David C. Robins
- Division of Safety and Hygiene; Ohio Bureau of Workers’ Compensation; Columbus Ohio
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Lad U, Oomen NMCW, Callaghan JP, Fischer SL. Comparing the biomechanical and psychophysical demands imposed on paramedics when using manual and powered stretchers. APPLIED ERGONOMICS 2018; 70:167-174. [PMID: 29866307 DOI: 10.1016/j.apergo.2018.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 06/08/2023]
Abstract
The aim of this investigation was to compare the effect of three different stretchers (two powered and one manual) on the biomechanical and psychophysical demands experienced by paramedics when performing routine stretcher handling activities. Eight experienced paramedics performed stretcher raising, lowering, unloading and loading tasks. Video data of task performance and static force requirements were recorded and input into a posture matching program with a quasi-static linked segment model (3DMatch) to compute peak and cumulative L4/L5 compression and shear forces and shoulder moments during each activity. Ratings of perceived exertion (RPE) were recorded from paramedics upon the completion of each task. Use of powered stretchers with load assist functionality reduced the demands on paramedics. Peak L4/L5 forces were reduced by 13-62% and 58-93% for compression and shear respectively when using powered stretchers to perform routine stretcher handling activities. Shoulder flexor moments and RPE scores were reduced by 16-95% and 29-60% respectively when using the powered stretchers compared to the manual stretcher. However, cumulative forces showed mixed results. Although powered stretcher use decreased peak forces, loading and unloading a powered stretcher took 1.5 to 3.4 times longer then when using the manual stretcher, which may explain the mixed results regarding cumulative forces. Based on the RPE scores, paramedics preferred power stretchers relative to the manual stretcher. This study demonstrates that powered stretchers can reduce peak biomechanical and psychophysical exposures associated with the development of musculoskeletal disorder (MSD) during routine stretcher handling activities with minimal increases in cumulative exposures.
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Affiliation(s)
- Uma Lad
- University of Waterloo, Department of Kinesiology, 300 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Nathalie M C W Oomen
- University of Waterloo, Department of Kinesiology, 300 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Jack P Callaghan
- University of Waterloo, Department of Kinesiology, 300 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Steven L Fischer
- University of Waterloo, Department of Kinesiology, 300 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
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Preventing EMS workplace violence: A mixed-methods analysis of insights from assaulted medics. Injury 2018; 49:1258-1265. [PMID: 29861309 DOI: 10.1016/j.injury.2018.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/14/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe measures that assaulted EMS personnel believe will help prevent violence against EMS personnel. METHODS This mixed- methods study includes a thematic analysis and directed content analysis of one survey question that asked the victims of workplace violence how the incident might have been prevented. RESULTS Of 1778 survey respondents, 633 reported being assaulted in the previous 12 months; 203 of them believed the incident could have been prevented and 193 of them (95%) answered this question. Six themes were identified using Haddon's Matrix as a framework. The themes included: Human factors, including specialized training related to specific populations and de-escalation techniques as well as improved situational awareness; Equipment factors, such as restraint equipment and resources; and, Operational and environment factors, including advanced warning systems. Persons who could have prevented the violence were identified as police, self, other professionals, partners and dispatchers. Restraints and training were suggested as violence-prevention tools and methods CONCLUSIONS: This is the first international study from the perspective of victimized EMS personnel, to report on ways that violence could be prevented. Ambulance agencies should consider these suggestions and work with researchers to evaluate risks at the agency level and to develop, implement and test interventions to reduce the risks of violence against EMS personnel. These teams should work together to both form an evidence-base for prevention and to publish findings so that EMS medical directors, administrators and professionals around the world can learn from each experience.
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The Emergency Medical Service Microbiome. Appl Environ Microbiol 2018; 84:AEM.02098-17. [PMID: 29222105 DOI: 10.1128/aem.02098-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/01/2017] [Indexed: 11/20/2022] Open
Abstract
Emergency medical services (EMS) personnel are an integral component of the health care framework and function to transport patients from various locations to and between care facilities. In addition to physical injury, EMS personnel are expected to be at high risk to acquire and transmit health care-associated infections (HAIs) in the workplace. However, currently, little is known about EMS biosafety risk factors and the epidemiological contribution of EMS to pathogen transmission within and outside the health care sector. Health care facility microbiomes contain diverse bacterial, fungal, and viral pathogens that cause over 1.7 million HAIs each year in the United States alone. While hospital microbiomes have been relatively well studied, there is scant information about EMS infrastructure and equipment microbiomes or the role(s) they play in HAI transmission between health care facilities. We review recent literature investigating the microbiome of ambulances and other EMS service facilities which consistently identify antibiotic-resistant pathogens causing HAIs, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, and Klebsiella pneumoniae Our review provides evidence that EMS microbiomes are dynamic and important pathogen reservoirs, and it underscores the need for more widespread and in-depth microbiome studies to elucidate patterns of pathogen transmission. We discuss emerging DNA sequencing technologies and other methods that can be applied to characterize and mitigate EMS biosafety risks in the future. Understanding the complex interplay between EMS and hospital microbiomes will provide key insights into pathogen transmission mechanisms and identify strategies to minimize HAIs and community infection.
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Maguire BJ, O'Meara P, O'Neill BJ, Brightwell R. Violence against emergency medical services personnel: A systematic review of the literature. Am J Ind Med 2018; 61:167-180. [PMID: 29178541 DOI: 10.1002/ajim.22797] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Violence against emergency medical services (EMS) personnel is a growing concern. The aim of this systematic review is to synthesize the current literature on violence against EMS personnel. METHODS We examined literature from 2000 to 2016. Eligibility criteria included English-language, peer-reviewed studies of EMS personnel that described violence or assaults. Sixteen searches identified 2655 studies; 25 studies from nine countries met the inclusion criteria. RESULTS The evidence from this review demonstrates that violence is a common risk for EMS personnel. We identified three critical topic areas: changes in risk over time, economic impact of violence and, outcomes of risk-reduction interventions. There is a lack of peer reviewed research of interventions, with the result that current intervention programs have no reliable evidence base. CONCLUSIONS EMS leaders and personnel should work together with researchers to design, implement, evaluate and publish intervention studies designed to mitigate risks of violence to EMS personnel.
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Affiliation(s)
- Brian J. Maguire
- School of Health, Medical and Applied Sciences; CQUniversity; North Rockhampton, Queensland Australia
| | - Peter O'Meara
- La Trobe Rural Health School, College of Science, Health & Engineering; La Trobe University; Bendigo Australia
| | - Barbara J. O'Neill
- School of Nursing, Midwifery and Social Sciences; CQUniversity; Rockhampton, Queensland Australia
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Varker T, Metcalf O, Forbes D, Chisolm K, Harvey S, Van Hooff M, McFarlane A, Bryant R, Phelps AJ. Research into Australian emergency services personnel mental health and wellbeing: An evidence map. Aust N Z J Psychiatry 2018; 52:129-148. [PMID: 29108439 DOI: 10.1177/0004867417738054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. AIMS 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. METHODS A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. RESULTS In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. CONCLUSION This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.
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Affiliation(s)
- Tracey Varker
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Olivia Metcalf
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - David Forbes
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Katherine Chisolm
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Sam Harvey
- 2 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,3 Black Dog Institute, Randwick, NSW, Australia
| | - Miranda Van Hooff
- 4 Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia
| | - Alexander McFarlane
- 4 Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia
| | - Richard Bryant
- 5 School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Andrea J Phelps
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
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Fischer SL, Sinden KE, MacPhee RS. Identifying the critical physical demanding tasks of paramedic work: Towards the development of a physical employment standard. APPLIED ERGONOMICS 2017; 65:233-239. [PMID: 28802444 DOI: 10.1016/j.apergo.2017.06.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/22/2017] [Accepted: 06/29/2017] [Indexed: 06/07/2023]
Abstract
Public safety related occupations including police, fire and military commonly apply physical employment standard (PES) to facilitate job matching, an approach to evaluate if candidates demonstrate acceptable physical capabilities as required to perform the job safely and effectively. In Canada, paramedics remain as one of the few public safety occupations without an evidence-based, validated PES. The purpose of this study was to document and describe the physical demands of paramedic work and to identify the most physically demanding tasks. These outcomes are essential to inform the design and development of an evidence-based PES for the paramedic sector. Physical demands of paramedic work were documented and described using a direct observation-based task analysis technique. Five paramedic's were trained to document the physical demands of their work, then applied their training to observe more than 90 calls over the course of 20 full 12-h work shifts. Physical demands data were then listed in a survey, administered service-wide, where 155 frontline paramedics identified critically demanding tasks and rank-ordered physical demands from not physically demanding to very strongly demanding. Critically important and physically demanding tasks were identified such as: transferring a patient; loading or unloading a stretcher in to or out of the ambulance; performing CPR; and, raising and lowering a stretcher. It is important that a paramedic-based PES evaluate a candidate's physical capabilities to perform the critical and physically demanding tasks identified in this study.
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Affiliation(s)
- Steven L Fischer
- University of Waterloo, Department of Kinesiology, 300 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Kathryn E Sinden
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Renee S MacPhee
- Health Sciences and Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
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Maguire BJ, O'Neill BJ. Emergency Medical Service Personnel's Risk From Violence While Serving the Community. Am J Public Health 2017; 107:1770-1775. [PMID: 28933934 PMCID: PMC5637660 DOI: 10.2105/ajph.2017.303989] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To determine the risks of violence-related injury among emergency medical services (EMS) personnel in the United States. METHODS We analyzed 1630 violence-related occupational injury cases reported to the US Bureau of Labor Statistics for the years 2012 to 2015 and conducted secondary searches within the Bureau of Labor Statistics Web site. RESULTS The number of cases per year varied between 250 and 560. Perpetrators included patients (77%) and coworkers (8%). Female EMS personnel had a disproportionately greater risk of violence-related injuries. The most common (35%) injury type was "sprains-strains-tears"; about 4% of the assault cases resulted in fractures, 13% resulted in surface wounds, and 190 were head injuries. About a third of the cases were classified as intentional. CONCLUSIONS The findings indicate a clear need for reliable interventions. The differences in risk for women indicate that some interventions may need to be demographic-specific. Because of the limitations of national data, future researchers will need access to agency-level data that include hours worked and call volume by demographic factors such as gender.
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Affiliation(s)
- Brian J Maguire
- Brian J. Maguire is with the School of Health, Medical, and Applied Sciences, Central Queensland University, North Rockhampton, Queensland, Australia. Barbara J. O'Neill is with the School of Nursing, Midwifery, and Social Sciences, Central Queensland University
| | - Barbara J O'Neill
- Brian J. Maguire is with the School of Health, Medical, and Applied Sciences, Central Queensland University, North Rockhampton, Queensland, Australia. Barbara J. O'Neill is with the School of Nursing, Midwifery, and Social Sciences, Central Queensland University
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Gray SE, Collie A. The nature and burden of occupational injury among first responder occupations: A retrospective cohort study in Australian workers. Injury 2017; 48:2470-2477. [PMID: 28964511 DOI: 10.1016/j.injury.2017.09.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 09/19/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Workers in first responder (FR) occupations are at heightened risk for workplace injury given their exposure to physical/psychological hazards. This study sought to (1) characterise the occupational risk of injury; (2) determine factors associated with injury; and (3) characterise the burden of injury-related disability in police, ambulance officers, fire/emergency workers, compared with other occupations. METHODS A retrospective cohort of 2,439,624 claims occurring between July 2003 and June 2012 was extracted from the Australian National Dataset for Compensation-Based Statistics. Cases aged 16-75 years working 1-100 pre-injury hours per week were included. Regression models estimated risk of making a workers' compensation (WC) claim by age, gender, occupation and injury type. Injury burden was calculated using count and time loss, and statistically compared between groups. RESULTS The risk of making a WC claim among FR occupations was more than 3 times higher than other occupations. Risk of claiming was highest among female FRs and those aged 35-44 years. Ambulance officers had the greatest risk of upper-body MSK injuries and fire and emergency workers the greatest risk of lower-body MSK injuries. The risk of mental health conditions was elevated for all FR occupations but highest among police officers. The total burden of injury (expressed as working weeks lost per 1000 workers) differed significantly between groups and was highest amongst police. DISCUSSION AND CONCLUSIONS First responders record significantly higher rates of occupational injury claims than other occupations. Using a national population based dataset, this study demonstrates that not only are first responders exposed to significantly higher rates of occupational injury than all other occupations combined, but they experience differential injury patterns depending on their occupation. This suggests that among FR occupations injury prevention efforts should reflect these differences and be targeted to occupation-specific patterns of injury.
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Affiliation(s)
- Shannon E Gray
- Insurance Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia.
| | - Alex Collie
- Insurance Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia
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Work-Related Accidents and Sharp Injuries in Paramedics-Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080901. [PMID: 28796193 PMCID: PMC5580604 DOI: 10.3390/ijerph14080901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 07/25/2017] [Accepted: 07/31/2017] [Indexed: 11/16/2022]
Abstract
(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005-2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics.
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Armstrong DP, Ferron R, Taylor C, McLeod B, Fletcher S, MacPhee RS, Fischer SL. Implementing powered stretcher and load systems was a cost effective intervention to reduce the incidence rates of stretcher related injuries in a paramedic service. APPLIED ERGONOMICS 2017; 62:34-42. [PMID: 28411738 DOI: 10.1016/j.apergo.2017.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/13/2017] [Accepted: 02/13/2017] [Indexed: 06/07/2023]
Abstract
Paramedic services are considering moving towards the use of powered stretcher and load systems to reduce stretcher related injuries, but cost is perceived as a barrier. This study compared injury incidence rates, days lost, and compensation costs between Niagara Emergency Medical Service (NEMS) and Hamilton Paramedic Service (HPS) pre- (four years) and post- (one year) implementation of powered stretcher and load systems in NEMS. Prior to the intervention stretcher related musculoskeletal disorder (MSD) incidence rates averaged 20.0 (±6.8) and 17.9 (±6.4) per 100 full time equivalent (FTE), in NEMS and HPS respectively. One-year post intervention rates decreased to 4.3 per 100 FTE in NEMS, a 78% reduction. Rates modestly increased to 24.6 per 100 FTE in HPS in same period. Cost-benefit analysis estimated that the added cost to purchase powered stretcher and load systems would be recovered within their expected 7-year service life due to the reduction in compensation costs.
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Affiliation(s)
| | | | | | | | | | - Renée S MacPhee
- Kinesiology & Physical Education and Health Sciences, Wilfrid Laurier University, Canada
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Everyday Dangers - The Impact Infectious Disease has on the Health of Paramedics: A Scoping Review. Prehosp Disaster Med 2017; 32:217-223. [PMID: 28134071 DOI: 10.1017/s1049023x16001497] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Paramedics respond to emergency scenes in often uncontrolled settings without being aware of potential risks. This makes paramedicine one of the most dangerous occupations. One of these dangers is the risk of contracting infectious diseases. Research in this area is predominantly focused on compliance in the use of protective equipment, attitudes and perceptions of paramedics, infectious disease policy, and exposure rates to blood and body fluids. The purpose of this scoping review was to determine what is known about the impact of infectious disease on the health of paramedics. METHODS Using the Arskey and O'Malley methodological framework, a scoping review was undertaken, which allows for a broad search of the available evidence. RESULTS The literature search identified eight articles for review that reported on paramedic exposure trends; the lack of reported blood-borne infections contracted, such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV); instances of severe acute respiratory syndrome (SARS) infections; and the higher prevalence of methicillin-resistant staphylococcus aureus (MRSA) nasal infections amongst paramedics. CONCLUSIONS Exposure to infectious diseases is decreasing, yet it remains significant. The decrease is attributed to prevention strategies; however, paramedic knowledge and attitudes as well as the uncontrolled environment paramedics work in can be a barrier. Contraction of infectious diseases is generally low; exceptions to this are MRSA colonization, influenza, and SARS. Paramedics are at greater risk of acquiring these infectious diseases compared to the general public. The effect on the health of paramedics is not well reported. Thomas B , O'Meara P , Spelten E . Everyday dangers - the impact infectious disease has on the health of paramedics: a scoping review. Prehosp Disaster Med. 2017;32(2):217-223.
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Reichard AA, Marsh SM, Tonozzi TR, Konda S, Gormley MA. Occupational Injuries and Exposures among Emergency Medical Services Workers. PREHOSP EMERG CARE 2017; 21:420-431. [DOI: 10.1080/10903127.2016.1274350] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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