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Jonsson, Anders, and Kerstin Segesten. "Daily Stress and Concept of Self in Swedish Ambulance Personnel." Prehospital and Disaster Medicine 19, no. 3 (September 2004): 226–34. http://dx.doi.org/10.1017/s1049023x00001825.
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AbstractIntroduction:This study investigated the prevalence of post-traumatic stress symptoms among professional ambulance personnel in Sweden and investigated the question: “Does self-knowledge have influence on how well one copes with the effects of daily work exposure from such events?” Little is known about the variables that might be associated with post-traumatic stress symptoms in highrisk occupational groups such as ambulance service groups.Methods:Data were gathered from ambulance personnel by means of an anonymous questionnaire. Survey responses of 362 ambulance personnel from the county of Västra Götaland were analyzed. A correlation was established between post-traumatic symptoms using the impact of event scale (IES-15) and the Professional Self-Description Form (PSDF).Results:Of those who reported a traumatic situation, 21.5% scored ≥ 26 on the IES-15 subscale. Scores >26 indicate “PTSD caseness”. There were significant differences on PSDF subscales between those presenting with or without posttraumatic symptoms.Conclusions:The mental health and emotional well-being of ambulance personnel appear to be compromised by accident and emergency work. The high prevalence of PTSD symptoms in ambulance personnel indicates an inability to cope with post-traumatic stress caused by daily work experiences.
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James, Alma. "Perceptions of stress in British ambulance personnel." Work & Stress 2, no. 4 (October 1988): 319–26. http://dx.doi.org/10.1080/02678378808257493.
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Jonsson, A. "Post-traumatic stress among Swedish ambulance personnel." Emergency Medicine Journal 20, no. 1 (January 1, 2003): 79–84. http://dx.doi.org/10.1136/emj.20.1.79.
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Lebimoyo, AzizatAbiodun, and MumtazOladipupo Sanni. "Posttraumatic stress disorder in ambulance service personnel." Malaysian Journal of Psychiatry 32, no. 2 (2023): 47. http://dx.doi.org/10.4103/mjp.mjp_9_23.
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Betlehem, J., É. Nagy, A. Oláh, I. Boncz, A. Sebestyén, J. Marton-Simora, G. Nagy, K. Deutsch, I. Kriszbacher, and Z. Göndöcs. "PMH64 THE POSTTRAUMATIC STRESS AMONG AMBULANCE PERSONNEL IN HUNGARY." Value in Health 12, no. 7 (October 2009): A363. http://dx.doi.org/10.1016/s1098-3015(10)74783-5.
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Ntatamala, Itumeleng, and Shahieda Adams. "The Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress." International Journal of Environmental Research and Public Health 19, no. 4 (February 11, 2022): 2046. http://dx.doi.org/10.3390/ijerph19042046.
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We investigated factors associated with increased risk for post-traumatic stress disorder (PTSD) in ambulance personnel and the barriers faced in accessing support for work-related stress (WRS). A cross-sectional study of 388 ambulance personnel used self-administered questionnaires to assess for PTSD and level of occupational stressors: Impact of Event Scale-Revised, Emergency Medical Services (EMS) Critical Incident Inventory, EMS Chronic Stress Questionnaire, SF-36 Quality of Life and the Connor–Davidson Resilience Scale. The prevalence of PTSD in the study population was 30%. The participants were predominantly female (55%), with a median age of 38 (IQR; 31–44) years. PTSD was associated with smoking (OR = 1.76, 95% CI: 1.05–2.95), illicit drug use (OR = 16.4, 95% CI: 1.87–143.86) and problem drinking (OR = 3.86, 95% CI: 1.80–8.23). A self-reported mental health condition (OR = 3.76, 95% CI: 1.96–7.21), being treated for a medical condition (OR = 1.95, 95% CI: 1.22–3.11), exposure to critical incident stress (OR = 4.27, 95% CI: 2.24–8.15) and chronic WRS (OR = 4.46, 95% CI: 1.93–10.31) were associated with PTSD risk. Barriers to seeking help included concerns that services were not confidential and the negative impact on the participant’s career. The increased levels of WRS, strong associations with substance use and barriers to accessing care offer starting points for workplace interventions to reduce the impact of PTSD in ambulance personnel.
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Pihl-Thingvad, Jesper, Maria Louison Vang, Sara Rosenbeck Møller, and Nina Beck Hansen. "Critical Incidents Scale for Ambulance Work ‐ Denmark (CISAW-D): the development of a screening tool for work exposure to critical events in operative ambulance personnel." British Paramedic Journal 7, no. 3 (December 1, 2022): 26–33. http://dx.doi.org/10.29045/14784726.2022.12.7.3.26.
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Introduction: Critical incidents in ambulance work are not easily compared to other risk occupations. Understanding types of incidents that can be considered critical in operational ambulance work is important to prevent work-related post-traumatic stress (PTS).Aim: This study aimed to develop a scale of critical incidents in ambulance work and assess its predictive validity in relation to the severity of PTS symptoms.Methods: A total of 1092 open-ended descriptions from Danish ambulance personnel were content analysed to develop a categorical scale that identifies types of events perceived as critical to operative ambulance personnel. Multiple regression was used to assess whether the scale predicted PTS symptoms and to assess the cumulative effect of exposure to these events.Results: The study found that the 1092 descriptions of critical events could be condensed into 28 categories of critical events. These ranged from life-threatening situations and deaths, to more daily events such as handling strong emotional reactions from patients’ relatives and working with terminally ill children. The frequency of events significantly predicted the severity of PTS symptoms with low to moderate effect (std beta = 0.2, t(375) = 3.7, p < .001), even when adjusting for known risk factors for post-traumatic stress disorder.Conclusion: This study showed that critical events in ambulance work included events that are not normally considered traumatic, and indicated that understanding the cumulative effect of these events is important when trying to prevent traumatic sequalae in ambulance personnel. The study highlighted the importance of increased focus on non-traumatic incidents that have an ongoing impact on paramedics’ mental health and well-being. The Critical Incidents Scale for Ambulance Work ‐ Denmark (CISAW-D) is a promising tool for systematic screening for exposure to critical events in ambulance work.
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Karlsson, Kåre. "Stress Response in Swedish Ambulance Personnel Evaluated by Trier Social Stress Test." Journal of Health and Environmental Research 5, no. 1 (2019): 14. http://dx.doi.org/10.11648/j.jher.20190501.13.
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Harrison, Juliet. "Organisational factors: impacting on health for ambulance personnel." International Journal of Emergency Services 8, no. 2 (August 5, 2019): 134–46. http://dx.doi.org/10.1108/ijes-02-2018-0013.
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Purpose The purpose of this paper is to establish if organisational factors are leading to a negative effect on ambulance personnel’s health. In recent years, frontline ambulance personnel have displayed a consistent high rate of sickness amongst healthcare workers within the National Health Service in the UK. Post-traumatic stress disorder (PTSD) has previously been cited, but organisational factors may be stressors to health. Design/methodology/approach A search of electronic databases MEDLINE EBSCO, MEDLINE OVID, MEDLINE PUBMED, AMED, CINAHL, Web of Science, Zetoc within the time period of 2000–2017 resulted in six mixed methods studies. Hand searching elicited one further study. The literature provided data on organisational and occupational stressors (excluding PTSD) relating to the health of 2,840 frontline ambulance workers in the UK, Australia, Norway, the Netherlands and Canada. The robust quantitative data were obtained from validated questionnaires using statistical analysis, whilst the mixed quality qualitative data elicited similar themes. Narrative synthesis was used to draw theories from the data. Findings Organisational factors such as low job autonomy, a lack of supervisor support and poor leadership are impacting on the health and well-being of frontline ambulance workers. This is intertwined with the occupational factors of daily operational demands, fatigue and enforced overtime, so organisational changes may have a wider impact on daily occupational issues. Originality/value The findings have possible implications for re-structuring organisational policies within the ambulance service to reduce staff sickness.
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Aasa, Ulrika, Nebojsa Kalezic, Eugene Lyskov, Karl-Axel Ängquist, and Margareta Barnekow-Bergkvist. "Stress monitoring of ambulance personnel during work and leisure time." International Archives of Occupational and Environmental Health 80, no. 1 (May 6, 2006): 51–59. http://dx.doi.org/10.1007/s00420-006-0103-x.
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Jacoub, Shirooq M., Jawad K. Al-Diwan, and Nabeel M. Al-Dakhily. "Posttraumatic stress disorder among emergency ambulance personnel in Baghdad, Iraq." Journal of the Faculty of Medicine Baghdad 51, no. 4 (January 3, 2010): 382–84. http://dx.doi.org/10.32007/jfacmedbagdad.5141088.
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Hutchinson, Lucy Catherine, Mark J. Forshaw, and Helen Poole. "The role of individual factors in the mental health of NHS ambulance personnel." Journal of Paramedic Practice 14, no. 8 (August 2, 2022): 314–20. http://dx.doi.org/10.12968/jpar.2022.14.8.314.
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Background: An estimated 27% of ambulance personnel experience general psychological distress. The relationship between work and mental health is complex. Aims: This study aimed to explore whether and to what extent individual factors affect the mental health of ambulance personnel. Methods: Four UK NHS ambulance trusts facilitated recruitment of ambulance personnel (n=160). Well-validated measures were used to collect data on the predictor variables: the Perceived Stress Scale; the Satisfaction with Life Scale; and the Brief Resilience Scale. Mental health, assessed according to response to trauma measured by the Impact of Events Scale Revised (IES-r), and anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS), were the outcome measures. Findings: Regression models demonstrated that all predictor variables accounted for nearly half of the variance in each outcome (P<0.01). Conclusions: A significant proportion of variance was accounted for by individual factors. This assists in understanding the impact and role of individual factors in the mental health of this occupational group. Future research could inform intervention development.
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Brooks, Damian, and Rachel Brooks. "A systematic review: what factors predict Post-Traumatic Stress Symptoms in ambulance personnel?" British Paramedic Journal 5, no. 4 (March 1, 2021): 18–24. http://dx.doi.org/10.29045/14784726.2021.3.5.4.18.
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<sec id="s1"> Background: Ambulance personnel are frequently exposed to traumatic accidents, which makes them a high risk for poor mental health. High rates of Post-Traumatic Stress Symptoms (PTSS) have been found within ambulance personnel samples but no review has been completed to examine the factors that may be implicated in the development of these symptoms. This literature review provides an overview of the factors that predict PTSS in ambulance personnel. </sec> <sec id="s2"> Methods: A systematic search strategy was conducted in April 2020 across the following four databases: PsycINFO, PsycARTICLES, MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL). </sec> <sec id="s3"> Results: Eighteen papers were included in this review, and the predictive factors examined were grouped into four categories: coping style, personal factors, environmental factors and organisational factors. </sec> <sec id="s4"> Conclusions: An array of factors across the four categories were implicated in the development of PTSS, but these tended to be indicated in only one or two papers. Evidence was found to suggest that dysfunctional coping styles, reduced levels of some personality traits, proximity and nature of the critical incident and high levels of organisation stress can all lead to PTSS. Further research is needed to support the reliability of findings. </sec>
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Innes, J. Michael, and Jennifer K. Slack. "Some Considerations on Personal Reactions to Emergency Stress in Employed and Volunteer Disaster Organization Personnel." International Journal of Mass Emergencies & Disasters 8, no. 3 (November 1990): 379–400. http://dx.doi.org/10.1177/028072709000800309.
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This paper reviews research on occupational stress as it is relevant to the demands made upon members of the emergency services, in particular fire service and ambulance personnel. Personal characteristics which may enhance or alleviate reactions to job stress are considered in concert with the effects, both positive and negative, of the support provided by other people, whether co-workers or family members. Particular attention is paid to the impact of stress upon volunteer personnel, as the characteristics which motivate people to take voluntary positions may in some cases heighten their reaction to job stressors.
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Simpson, Karen. "Post-traumatic stress disorder among ambulance personnel: a review of the literature." Journal of Paramedic Practice 5, no. 11 (November 2013): 638–44. http://dx.doi.org/10.12968/jpar.2013.5.11.638.
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Karlsson, Kåre, Patrik Niemelä, and Anders Jonsson. "Heart Rate as a Marker of Stress in Ambulance Personnel: A Pilot Study of the Body's Response to the Ambulance Alarm." Prehospital and Disaster Medicine 26, no. 1 (February 2011): 21–26. http://dx.doi.org/10.1017/s1049023x10000129.
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AbstractIntroduction: Studies have demonstrated the presence of stress and post-traumatic stress among ambulance personnel, but no previous research has focused on the body's reaction in the form of the change in heart rate of ambulance staff in association with specific occupational stress.Hypothesis: The purpose of this study is to investigate whether work as an ambulance professional generates prolonged physiological arousal that can be measured by heart rate in different situations.Methods: Twenty participants carried a pulse-meter in the form of a wristwatch, which continuously measured and stored their heart rate 24 hours per day for a period of seven days. All ambulance alarms that occurred during the test period were recorded in journals, and the participants completed diaries and a questionnaire describing their experiences. The alarms were divided into different phases. Correlations between heart rate in the different phases were computed.Results: Analysis of study data indicated a significant rise of heart rate unrelated to physical effort during an emergency alarm and response. This increased heart rate was noticed throughout the mission and it was not related to the length of experience the staff had in the ambulance profession. In addition, a non-significant trend suggested that alarms involving acutely ill children lead to an even higher increase in heart rate. In addition, this research showed that constant tension existed during sleep, while available for an emergency, indicated by a noticeable increase in heart rate during sleep at work compared to sleeping at home.Conclusions: A rise in heart rate was experienced during all acute emergency missions, regardless of a subject's experience, education, and gender. Missions by themselves generated a rate increase that did not seem to correlate with physical effort required during an emergency response. This study shows that working on an ambulance that responds to medical emergencies is associated with a prolonged physiological arousal.
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Abdo, Molly, and Annette Schlösser. "A systematic review of post-traumatic growth in ambulance personnel: facilitators and prevalence rates." British Paramedic Journal 9, no. 1 (June 1, 2024): 34–46. http://dx.doi.org/10.29045/14784726.2024.6.9.1.34.
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Introduction: Ambulance personnel are exposed to traumatic and stressful situations, which can increase the risk of mental health conditions, such as post-traumatic stress disorder (PTSD). High rates of PTSD have been found in ambulance personnel (Petrie et al., 2018), but no review is available to examine post-traumatic growth (PTG - positive psychological change following a trauma) in this population. This literature review provides an overview of the prevalence rates and facilitators that may contribute to PTG in ambulance personnel.Methods: A systematic search was conducted on EBSCOhost in January 2024 across the following six databases: Academic Search Ultimate, PsycINFO, PsycARTICLES, MEDLINE, ERIC and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate.Results: Eleven papers were identified for this review. Pooled prevalence of PTG was moderate (52%), and facilitators for PTG were grouped into five categories: coping style/strategies, resilience, personality traits, gender and incident characteristics.Conclusions: Numerous facilitators contributed to the development of PTG, although these did not arise in all papers. The quality of research ranged from satisfactory to excellent. Evidence suggested that adaptive coping style, high levels of resilience, the absence of a personality trait (neuroticism) and being female may facilitate PTG. Further research is needed to support the reliability of findings.
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Băldean, Doru-Laurean, and Viorel Chindea. "Analyzing the Development and Implementation Posibility of the Robotic Ambulance for COVID Pacients." Journal for Social Media Inquiry 3, no. 1 (July 27, 2021): 8–18. http://dx.doi.org/10.18662/jsmi/3.1/13.
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During Covid pandemic, the automation, robotization and digitization were accelerated, but the results do not meet all expectations. Telecommunications have undeniable successes, but in other sectors the benefits of technological advancement are still missing. The "online school" and the "online procedures" of some institutions have been partially upgraded, but things have been as well in other activities which were less suitable for automation, robotization and digitization. The healthcare sector was highly stressed in the context of COVID-19 crisis, but it has not fully benefited from the advantages of the robotic vehicles. Life and death during COVID-19 crisis has affected most people, either as victims or actors in a reality that took them unprepared. Ambulances have been challenged by events which were not always managed successfully. They must respond promptly to save the lives of those who call for help. Staff in this sector are often overworked and highly stressed. The simultaneous existence of robotic ambulances that can take over some of the victims who need medical services could be both a good idea and a life-saving measure. The paper proposes implementation of existing technology for optimizing ambulance services with robotic tools and suitable for digitization. In this way, complementary solutions can be generated for increasing the quality of life, respectively for mitigating the emotional and physical stress when it comes to near death experiences. When on-site complex resuscitation and first aid maneuvers are not necessary, being required only the lifting and transportation procedures by a medical robot, the use of a robotic vehicle mitigates the ambulance’s personnel from stresses. These solutions are complementary, leading to an improvement in life’s quality.
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Almaazmi, Amna M., Shamma H. Alhammadi, Amna A. Al Ali, Najat I. Alzaabi, and Joelle Makoukji Kiklikian. "Riding to the Rescue: A Comprehensive Review of Health and Safety Measures in Ambulance Cars." International Journal of Occupational Safety and Health 14, no. 2 (March 25, 2024): 282–93. http://dx.doi.org/10.3126/ijosh.v14i2.55311.
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Paramedics are registered health professionals in numerous countries. Whilst ambulance services must prioritize their patients, they also require personnel to be healthy to perform at their utmost to provide optimal patient care. Ambulance transport is associated with predictable and likely preventable occupant hazards. Ambulance services provide care 24 hours a day, 7 days a week, and shift work is known to be a risk factor for poor health. Working unsociable hours has detrimental consequences on the health and well-being of healthcare workers and can ultimately result in compromised patient care. Ambulance service utilization rates are high, with paramedics working in unpredictable environments, and undertaking complex clinical and manual handling tasks whilst caring for critically unwell patients; thus, there are several reasons postulated for poor health in this professional group. These include injuries, serious infections, high rates of musculoskeletal diseases, stress, and mental health problems. This review article aims to identify the occupational risks in an ambulance service, assess their impact on the health of employees, and explore control measures that can be implemented to reduce the risks and improve the safety of healthcare workers and patients.
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Bracken-Scally, Mairéad, Sinéad McGilloway, and Jeffrey T. Mitchell. "Retirement Policies and Support for Emergency Service Personnel: The Transition to Retirement." Canadian Journal on Aging / La Revue canadienne du vieillissement 35, no. 2 (April 26, 2016): 161–74. http://dx.doi.org/10.1017/s0714980816000210.
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RÉSUMÉL’objectif principal de cette étude a été d’examiner les politiques et les procédures pour soutenir les employés prenant leur retraite de leur travail aux services d’urgence. On a mené des entrevues avec les participants qui connaissaient bien les politiques et les procédures actuelles d’un grand ambulance (n = 8) et le service d’incendie (n = 6) en Irlande. Quatre thèmes principaux ont été révelés: (1) «Je ne pense pas que ce soit un bon travail d’etre ambulancier d’urgence quand on a 65 ans»; (2) “ils se sentent véritablement un tout petit peu isolé”; (3) l’amélioration du «choc culturel»; et (4) «Je continue a m’avancer en espérant que tout aille pour le mieux. » Les conclusions indiquent que la retraite est un changement majeur de la vie, et mettent en évidence la nécessité pour une préparation de pré-retraite plus structurée et efficace. Les éléments uniques au personnel des services d’urgence comprennent: le stress physique et émotionnel intense impliqué dans les services d’urgence; une forte identification avec ce service; et un manque de clarté sur les règles et les droits, exigeant meilleure renseignements et préparation pour prendre sa retraite.
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Oliveira, Ana Cristina, Félix Neto, Filipa Teixeira, and Ângela Maia. "Working in prehospital emergency contexts." International Journal of Workplace Health Management 12, no. 6 (November 21, 2019): 469–82. http://dx.doi.org/10.1108/ijwhm-01-2019-0004.
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Purpose Ambulance personnel face a diversity of stressful events that could be potentially traumatic, putting their health and well-being at risk. The purpose of this paper is to explore, from this group perspective, sources of stress, coping strategies and support measures. Design/methodology/approach The authors interviewed 14 ambulance workers of Portuguese Red Cross local structures from the north of Portugal. Data were analyzed according to thematic analysis procedures. Findings The authors identified three themes: operational and organizational factors, control and predictability; anticipating scenarios, focusing on procedures and dealing with reactions; and from undervalued support to support as routine. Dealing with human lives, the unpredictability of calls and working under pressure are the main sources of stress, causing, in some of them, insomnia, fatigue, anxiety and intrusive thoughts. Road accidents, situations involving children and cardiac arrest are the most distressing events. During events, they cope focusing on technical procedures, but after them they prefer to talk with colleagues and seek support from family and friends. All participants emphasize the inexistence of structured support measures. Practical implications It is important to develop support measures tailored to ambulance personnel’s needs, leading to enhancements of theirs work performance, health and well-being. Originality/value Contrarily to most of the studies that explore mostly PTSD and/or burnout, the authors explored, from the perspective of professionals, other dimensions such as sources of stress, coping strategies and support measures, adopting a qualitative approach, which has been rarely used.
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Wang, Kuei-Ying, Fang-Wen Hu, Shu-Chen Yu, Yohana Yobelina Lin, and Chien-Ying Han. "Experiences of nurses involved in air ambulance service: A qualitative study." Jurnal Ners 19, no. 1 (February 29, 2024): 69–77. http://dx.doi.org/10.20473/jn.v19i1.50175.
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Introduction: Nurses undertaking air ambulance service encounter environmental, equipment, and personnel limitations during their work. Moreover, they must cope with various types of injuries and illnesses, as well as changes in patient conditions. These factors pose a significant pressure on nurses. Currently, there is a lack of qualitative research on the experiences of nurses performing air ambulance tasks. The purpose of this study is to explore the experiences of nurses undertaking air ambulance service, with a focus on capturing their personal perceptions regarding this field of work. Methods: Twelve nurses were selected using purposive sampling, and semi-structured interviews were conducted to collect data. Content analysis was used to analyze the data. Results: The analysis identified three major themes: "Ambiguous and risky emergency missions," "Challenges during air transfer," and "Nurses’ personal limitations.” Eight categories were formulated within these themes, including "Mission uncertainty," “Urgency of medical conditions," “Hazards at high altitude," "Cabin environment limitations," "Inadequate equipment," "Incomprehensive operating mechanisms," "Physical discomfort," and "Recognition of professional shortcomings." Conclusions: Improving the performance and well-being of nurses engaged in air ambulance services necessitates the implementation of a psychological adaptation program. This includes the utilization of psychological stress assessment tools or engaging in role-playing activities. Successful patient rescues demand the establishment of comprehensive standard operating procedures, involving an interprofessional team. Supporting nurses in adeptly managing challenges during air ambulance services requires an expanded scope of education and training, facilitated through initiatives like situational simulation and similar approaches.
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Reynolds, Christine A., and Shannon L. Wagner. "Stress and First Responders: The Need for a Multidimensional Approach to Stress Management." International Journal of Disability Management 2, no. 2 (May 1, 2007): 27–36. http://dx.doi.org/10.1375/jdmr.2.2.27.
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AbstractFirst responders are exposed to traumatic, nontraumatic and organisational stressors that conspire to create stress, potentially leading to emotional issues and/or physical or psychological illness. In addition to individual consequences, stress also takes a toll on the function of emergency departments and their communities. Fortunately, police, fire and ambulance agencies have initiated various preventive measures in an effort to mitigate the ill-effects of continued exposure to stressors by their personnel. However, combating stress effectively requires more than offering individual coping skills and access to counseling for first responders. To best preserve the wellbeing of their workers, emergency service administrators must recognise the impact of stress from a variety of sources, including organisational factors, and approach stress prevention in a multi-staged and comprehensive manner, paying special attention to primary stage interventions. When agencies embrace and act on a broad, holistic view of stress management that includes instituting cultural and organisational changes to support stress prevention, significant improvements in the stress level and health of first responders will be possible.
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Jonsson, Anders, and Kerstin Segesten. "Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel." Accident and Emergency Nursing 12, no. 4 (October 2004): 215–23. http://dx.doi.org/10.1016/j.aaen.2004.05.001.
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Backé, Eva M., Gerlinde Kaul, André Klußmann, Falk Liebers, Carmen Thim, Peter Maßbeck, and Ulf Steinberg. "Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance." International Archives of Occupational and Environmental Health 82, no. 9 (June 17, 2009): 1057–64. http://dx.doi.org/10.1007/s00420-009-0428-3.
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Alaqeel, Meshal K., Nawfal A. Aljerian, Muhannad A. AlNahdi, and Raiyan Y. Almaini. "Post-Traumatic Stress Disorder among Emergency Medical Services Personnel: A Cross-sectional Study." Asian Journal of Medical Sciences 10, no. 4 (June 20, 2019): 28–31. http://dx.doi.org/10.3126/ajms.v10i4.23990.
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Background: Post-Traumatic Stress Disorder is characterized by directly experiencing traumatic events or witnessing, learning, or repetitively experiencing the details of these events. High risk occupations (i.e., EMS personnel) frequently encounter traumatic eventscoping with events exceeding the range of human experiences. Regional lack of studies necessitated the need to report the prevalence of PTSD among healthcare providers in Saudi Arabia (SA).
Aims and Objective: To explore the prevalence of PTSD among EMS personnel.
Materials and Methods: This a descriptive cross-sectional study at King Abdul Aziz Medical City (KAMC), Riyadh, SA among 110 paramedics, emergency medical technicians (EMT), and ambulance drivers who were conveniently selected for this screening. Post-Traumatic Stress Disorder Checklist, the Civilian version, (PCL-C) was used to screen the participants, and cut-off point was 30-35. PTSD symptoms (present & absent) was considered as outcome measure.
Results: Total of 110 participants were contacted, 74 (67%) agreed to participate. Around half of the participants were EMT (52%). Total number of screened individuals is 52, 14 (26.9%) had positive screening, of those, EMT had higher proportion than paramedics (32% vs 20.8%).
Conclusion: This report is the first PTSD prevalence among healthcare providers in SA. The results showed that 26% of EMS personnel had positive screening for PTSD. Attention should be directed toward this issue by regular psychological evaluation and implementing psychological rehabilitation programs for EMS personnel. The study reflects only one center in the city, thus generalization would not be inappropriate.
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Smith, A. "Interventions for post-traumatic stress disorder and psychological distress in emergency ambulance personnel: a review of the literature." Emergency Medicine Journal 20, no. 1 (January 1, 2003): 75–78. http://dx.doi.org/10.1136/emj.20.1.75.
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Sterud, Tom, Erlend Hem, Øivind Ekeberg, and Bjørn Lau. "Occupational Stress and Alcohol Use: A Study of Two Nationwide Samples of Operational Police and Ambulance, Personnel in Norway." Journal of Studies on Alcohol and Drugs 68, no. 6 (November 2007): 896–904. http://dx.doi.org/10.15288/jsad.2007.68.896.
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Sterud, T., E. Hem, A. Ekeberg, and B. Lau. "Occupational stress and alcohol use: A study of two nationwide samples of operational ambulance personnel and police in norway." European Psychiatry 22 (March 2007): S201. http://dx.doi.org/10.1016/j.eurpsy.2007.01.665.
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Smolyakov, Yu N., V. V. Ramensky, N. A. Nolfin, L. I. Anokhova, E. V. Fedorenko, and M. M. Mikhahanov. "Comparative analysis of bioelectric activity of the brain of ambulance station personnel before and after daily duty." Meditsinskiy sovet = Medical Council, no. 12 (September 19, 2021): 392–96. http://dx.doi.org/10.21518/2079-701x-2021-12-392-396.
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Introduction. The adaptive overload of the central nervous system, caused by occupational stress, leads to the disruption of complex operational activities in the ambulance station workers and an increasing number of errors in medical decision-making towards the end of the work shift.Aim. To assess the level and prevalence of changes in the work of the central nervous system (CNS) under the influence of occupational stress.Materials and methods. The study involved 35 workers (medical and nursing staff) of ambulance station (19 men and 16 women aged 20 to 55 years). Electroencephalogram (EEG) was recorded at rest for 3 minutes, according to international scheme 10-20 in six leads: F3, F4, T3, T4, P3, P4. The following rhythmic activity indicators were used: THETA rhythm (4–8 Hz), ALPHA rhythm (8–12 Hz), BETA rhythm (BETA, 12–25 Hz) and their ratios.Results and discussion. When analyzing the overall activity, there is a decrease in all the studied parameters. At the same time, THETA, BETA and the total power of all ranges showed significant dynamics. In spatial analysis, the most noticeable decrease in activity in the frontal lobes (F3, F4) is responsible for motor behavior (premotor area of the cortex), executive functions (behavior control, inductive reasoning, planning), short-term and spatial memory, attention (spatial and motor). The decrease in activity in the temporal (T3, T4) and parietal (P3, P4) departments is observed only in some indicators.Conclusions. Professional workload during the 24 hour shift has a predominant effect on the activity of the frontal lobes, reducing the ability to control and plan complex (precise) motor functions, visual-spatial attention and planning abilities. These mechanisms are key to the professional work of the personnel of the emergency medical service and determine the number of errors.
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Neely, Keith W., and William J. Spitzer. "A Model for a Statewide Critical Incident Stress (CIS) Debriefing Program for Emergency Services Personnel." Prehospital and Disaster Medicine 12, no. 2 (June 1997): 43–48. http://dx.doi.org/10.1017/s1049023x00037390.
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AbstractPurpose:Emergency services personnel are highly vulnerable to acute and cumulative critical incident stress (CIS) that can manifest as anger, guilt, depression, and impaired decision-making, and, in certain instances, job loss. Interventions designed to identify such distress and restore psychological functioning becomes imperative.Methods:A statewide debriefing team was formed in 1988 through a collaborative effort between an academic department of emergency medicine and a social work department of a teaching hospital, and a metropolitan area fire department and ambulance service. Using an existing CIS debriefing model, 84 pre-screened, mental health professionals and emergency services personnel were provided with 16 hours of training and were grouped into regional teams.Debriefing requests are received through a central number answered by a communicator in a 24-hour communications center located within the emergency department. Debriefings are conducted 48–72 hours after the event for specific types of incidents. Follow-up telephone calls are made by the debriefing team leader two to three weeks following a debriefing. The teams rely on donations to pay for travel and meals.Results:One hundred sixty-eight debriefings were conducted during the first four years. Rural agencies accounted for 116 (69%) requests. During this period, 1,514 individuals were debriefed: 744 (49%) firefighters, 460 (30%) EMTs, and 310 (21%) police officers, dispatchers, and other responders. Deaths of children, extraordinary events, and incidents involving victims known to the responders (35%, 14%, and 14% respectively) were the most common reasons for requesting debriefings. Feedback was received from 48 (28%) of the agencies that requested the debriefing. All of those who responded felt that the debriefing had a beneficial effect on its personnel. Specific individuals identified by agency representatives as having the greatest difficulty were observed to be returned to their pre-incident state.Conclusion:CIS debriefings are judged as beneficial. A statewide response team is an effective way to provide these services at no cost to agencies.
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Gyllencreutz, Lina, Sofia Karlsson, Andreas Sjölander, Johanna Björnstig, and Pia Hedberg. "Chemical Incident Preparedness Among Emergency Medical Service Personnel." International Journal of Paramedicine, no. 5 (January 5, 2024): 103–17. http://dx.doi.org/10.56068/zwic1429.
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Background: Hazardous chemicals are essential for modern society but the use and transportation of them bears the risk of major incidents. Past incidents have revealed the importance of preparation and training of emergency medical service (EMS) personnel when responding to these incidents. However, studies have shown the level of preparedness to be insufficient. There is a lack of knowledge as to how EMS personnel perceive their preparedness and response when facing chemical incidents.
Aim: The aim of this study was to qualitative investigate working procedures regarding chemical incidents among a cohort of EMS personnel.
Method: Seventeen ambulance nurses from rural and urban areas were individually interviewed using four different realistic scenarios (vignettes). The transcribed text from the interviews was analyzed using qualitative content analysis.
Result: The results were derived into two categories with underlying sub-categories: a struggle to organize the onsite work situation (insufficient managerial support, limited resources, trust in rescue services, difficult decision making, stressful responsibilities); and decontamination—a demanding and risky situation (risk management, work in protective gear, aggravating circumstances). Participants often lack real life experience in facing a chemical incident and training that improves preparedness and the ability to respond adequately.
Conclusion: Chemical incidents pose many challenges for EMS personnel, but with proper training efforts many of these challenges could be solved. This study has shown the need for more accessible chemical incident training targeting EMS personnel: especially focusing on risk assessment; managerial support; resource management; equipment; and decontamination, including stress management and decision-making. Research in the area of chemical incidents is sparse and there remains much to understand concerning work procedures during chemical incidents.
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van der Velden, Peter G., Rolf J. Kleber, and Karestan C. Koenen. "Smoking predicts posttraumatic stress symptoms among rescue workers: A prospective study of ambulance personnel involved in the Enschede Fireworks Disaster." Drug and Alcohol Dependence 94, no. 1-3 (April 2008): 267–71. http://dx.doi.org/10.1016/j.drugalcdep.2007.11.001.
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Smeets, Math MJ, Piet Vandenbossche, Wilma LJM Duijst, Walther NKA van Mook, and Mathie P. G. Leers. "Validation of a new method for saliva cortisol testing to assess stress in first responders." Emergency Medicine Journal 38, no. 4 (February 11, 2021): 297–302. http://dx.doi.org/10.1136/emermed-2019-209205.
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BackgroundAcute or chronic stress can lead to physical and mental disorders. Measuring cortisol can objectify the degree of stress. Cortisol is traditionally measured in serum, but recently the relevant fraction of free cortisol can be reliably measured in saliva, using the very sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method. The use of saliva is non-invasive and allows easy serial testing around stressful events. The main objective of this study is to investigate whether serial saliva cortisol determinations using the LC-MS/MS method can be used to assess the stress response that first responders may experience during moments of acute professional deployment in their daily work.MethodsHealthy first responders (police officers, firefighters, rapid response team, ambulance personnel, first aid and emergency medical personnel) were recruited to participate in a Euregional high-reliability simulation training (‘Be Aware’-scenario training, 19 April 2018). At three time points, simultaneous venous blood samples and saliva samples were obtained. These time points were 1 hour before, immediately after and 10 hours after the simulation training. The correlation between changes in saliva cortisol measured by LC-MS/MS and serum cortisol at all three time points was determined. Results were compared with spectators not directly participating in the simulation.Results70 subjects participated in the simulation. There was a strong correlation between the changes in saliva and blood cortisol at the three time points. A significant increase in blood and saliva cortisol was shown 1 hour after the experienced stress moments. The levels had almost completely returned to baseline in all healthy volunteers 10 hours later. Cortisol in spectators was unaffected.ConclusionSerial saliva cortisol measurements using LC-MS/MS is a reliable and fast non-invasive functional stress assay, which can be easily collected in daily practice and used for investigation and monitoring of stress response in front line responders.
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Maiorano, Tiziana, Monia Vagni, Valeria Giostra, and Daniela Pajardi. "COVID-19: Risk Factors and Protective Role of Resilience and Coping Strategies for Emergency Stress and Secondary Trauma in Medical Staff and Emergency Workers—An Online-Based Inquiry." Sustainability 12, no. 21 (October 29, 2020): 9004. http://dx.doi.org/10.3390/su12219004.
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The COVID-19 crisis has placed a heavy burden on medical staff and emergency workers, who may be at risk of developing psychological distress and secondary trauma. Coping and resilience to stress during a pandemic are protective factors that can mitigate the potential adverse psychological effects. Here, we investigated the direct and mediated effects of coping strategies and hardiness on secondary trauma among Italian medical staff (physicians and nurses, n = 140) and emergency workers (firefighters, civil protection, and ambulance personnel, n = 100) involved in the first phase of the pandemic. For this purpose, we collected data from participants through online questionnaires to measure emergency stress, coping strategies, hardiness, and secondary trauma. Other variables analyzed were age, sex, direct contact with COVID-19 patients, and use of personal protective equipment (PPE). We performed a correlational analysis, regressions, and a mediation analysis. The results show that nurses and physicians experienced higher levels of emergency stress than emergency workers. Direct contact with COVID-19 patients, female sex, unexpected events, and lack of PPE were risk factors for emergency stress, while resilience and coping strategies played a protective role. Mediation analysis shows that coping strategies and hardiness are protective factors and reduce the effect of stress on secondary trauma.
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Korehova, Maria V., Irina A. Novikova, and Andrey G. Soloviev. "Professional stress in the activities of paramedics of emergency medical care." Russian Journal of Occupational Health and Industrial Ecology 1, no. 7 (August 17, 2019): 417–23. http://dx.doi.org/10.31089/1026-9428-2019-59-7-417-423.
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Emergency medical workers can be at ributed to specialists of extreme prof le of activity, as their work is associated with a variety of stress factors. 44 paramedics of the Arkhangelsk region (mean age 38.1±10.8 years, M±σ) were examined in order to identify the features of occupational stress in the activities of emergency medical personnel (NSR). T e following methods we used: scale of organizational stress, Mak-Lin, the questionnaire «At itude to work and professional burn-out» Vinokur V.A., test Ch. Spielberger, coping test of R. Lazarus and S. Volkman, a method of studying the risk appetite Shmelev A.G., projective test «Nonexistent animal», a method of assessing the psychological atmosphere in the team. It is established that during the performance of professional duties more than 2/3 of paramedics emergency medical care are of en faced with stressful situations; every third employee is threatened with life or danger of injury, injury in the process. More than half of the respondents have a high level of professional stress and burnout, 40.5% — use non-adaptive coping strategies in the f ght against intractable situations, and 1/5 — there is a high rate of situational anxiety and aggressiveness. T e directions of prevention of occupational stress in paramedics ambulance.
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Sahin, Taner, Humeyra Aslaner, Özlem Olguner Eker, Mebrure Beyza Gökçek, and Murat Doğan. "A Questionnaire Study Effect of COVID-19 Pandemic on Anxiety and Burnout Levels in Emergency Healthcare Workers." International Journal of Medical Science and Clinical invention 7, no. 09 (September 16, 2020): 4991–5001. http://dx.doi.org/10.18535/ijmsci/v7i09.010.
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Objectives
During the COVID19 pandemic, an increase in anxiety and burnout levels may occur unwittingly due to the increased workload and intense stress experienced by emergency healthcare workers (HCWs) dealing with potential or suspected COVID-19 and other emergency patients. In our study, it is aimed to investigate whether there is an increase of anxiety and burnout levels of the HCWs working in ES and pandemic fields fighting against the outbreak of COVID-19 in Turkey.
Methods
The study was carried out between April 1 to May 15, 2020, with the online questionnaire method with the participation of 920 HCWs that are working actively in pandemic areas across the country. In the questionnaire, the sociodemographic characteristics of the participants were questioned, and Beck anxiety scale (BAI) and Maslach Burnout Inventory (MBI) were applied.
Results
The pandemic area and the intensive care workers' BAI score are similar to those in the emergency service and ambulance (p = 0.05). The MBI-desensitization score of those working in the field of ED, ICUs and pandemics was higher than other places (p <0.05). The MBI-emotional score of the emergency and ambulance workers was higher (p = 0.001), and the MBI-personal accomplishment score was lower than radiology, laboratory and office personnel (p=0.049).
Conclusions
The COVID-19 outbreak may create stress in HCWs, leading to various psychiatric disorders such as anxiety, depression, and burnout syndrome. Early recognition, prevention and coping methods of burnout and anxiety in HCWs play a key role in during the pandemic period.
Keywords: COVID-19, Emergency Service, Healthcare Worker, Beck Anxiety Inventory, Maslach Burnout Inventory
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Alrutz, Anna Stowe, Stephen Buetow, Linda D. Cameron, and Peter Kenneth Huggard. "What Happens at Work Comes Home." Healthcare 8, no. 3 (September 21, 2020): 350. http://dx.doi.org/10.3390/healthcare8030350.
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Emergency responders (police, fire, ambulance and defence force personnel) risk exposure to dangerous and traumatic events, and the possible subsequent development of post-traumatic stress disorder. Consequently, partners of these emergency responders risk developing secondary traumatic stress (STS) from vicarious exposure to the trauma through communication and engagement with their responders. A mixed-methods study of the partners of emergency responders in New Zealand examined the extent of such partner-associated STS. This article focuses on two research questions: to what extent were risk factors for STS identified within that population, and what did the participants believe may help them to mitigate the impact of STS. An online anonymous survey was developed and eligible participants completed a 17-item STS scale, a social support measure, and answered several open-ended questions. Of the 646 participants, twenty percent appear to be experiencing intrusion, arousal, and avoidance symptoms related to the trauma experienced by their responder. Almost half stated they have little or no emotional/informational support related to their responder’s work. Thematic analysis of free-text responses identified the need for additional support and more direct communication/engagement from the organisations for partners to navigate their experiences of STS and the level of social support received and required. The authors conclude with recommendations to emergency responder organisations.
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Wojtysiak, Katarzyna, Adriana Wielgus, and Halina Zielińska-Więczkowska. "THE IMPACT OF WORKING CONDITIONS ON STRESS AND ITS EFFECTS IN THE GROUP OF PARAMEDICS: A SYSTEMATIC REVIEW." Humanities & Social Sciences Reviews 9, no. 4 (August 18, 2021): 188–93. http://dx.doi.org/10.18510/hssr.2021.9426.
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Purpose: This is a review to assess the working conditions that affect the stress level of paramedics and their ability to cope with stress. The profession of a paramedic is characterized by constant contact with other people and exposure to many factors, including biological (HIV, flu virus), chemical (causing allergic reactions, burns) physical (noise, low or excessive temperature), psychosocial (aggression, violence, traumatic experiences).
Methodology: This is a Systematic review paper. The PubMed, Cochrane Library, and Google scholar search were used to analyze the problem. The following keywords were used to search for information sources: paramedic, working conditions, medical rescue, ambulance, stress, coping with stress. Articles were selected according to the impact of working conditions on stress and its consequences among the group of paramedics.
Main Findings: The work of a rescuer is a constant action under the influence of a high level of stress and emotions, caused by an unforeseen sequence of events and time pressure. The long-term presence of negative factors is the cause of the appearance of burnout syndrome, rumination, PTSD, and somatic symptoms related to stress in the workplace. It can result in a deterioration of the quality of patient care.
Implications of this study: The above results should be taken into account by units of the emergency medical care system. The paper indicates the occurrence of negative psychological effects of work-related stress and as a consequence the need to train the personnel in the field of stress-coping techniques and to provide emergency medical service workers with mental health monitoring and psychological care in the workplace.
Novelty in this study: There is a lack of systematic reviews of the impact of working conditions on the mental health of workers in emergency medical care services. The paper is an attempt to assess the impact of working conditions on stress and its effects on the group of paramedics and other emergencies medical care system employees.
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Taranu, Sabinne Marie, Adina Carmen Ilie, Ana-Maria Turcu, Ramona Stefaniu, Ioana Alexandra Sandu, Anca Iuliana Pislaru, Ioana Dana Alexa, Calina Anda Sandu, Tudor-Stefan Rotaru, and Teodora Alexa-Stratulat. "Factors Associated with Burnout in Healthcare Professionals." International Journal of Environmental Research and Public Health 19, no. 22 (November 9, 2022): 14701. http://dx.doi.org/10.3390/ijerph192214701.
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Burnout in healthcare professionals remains an ongoing concern. There are a number of variables associated with reactivity to stress in healthcare staff. This study wants to identify risk factors which predispose healthcare professionals to burnout. Material and Methods: The cross-sectional study included a group of 200 subjects, medical staff and auxiliary staff from the national health units, who gave their free consent to answer the questions regarding the level of perceived stress at work. The screening tool used was disseminated through the Google Forms platform, maintaining the anonymity of the participants. Results: Resident doctors (42%) responded predominantly, reporting the highest level of burnout, with nurses (26.5%) being the least affected (χ2 = 36.73, p < 0.01). Less work experience is correlated with increased burnout (rho = 0.29, p < 0.01). Reactivity to stress was highly associated with workplace, with ambulance staff being the most vulnerable (χ2 = 6.58, p < 0.05). Participants’ relationship status significantly influenced the burnout rate, the unmarried, with or without a partner, being more affected (χ2 = 16.14, p < 0.01). There are no significant differences between male and female gender, regarding the average level of burnout (U = 1.47; p > 0.05), nor between living in a house or apartment (U = 4.66; p > 0.05). Positive associations were identified between the level of burnout and variables such as: management pressure, administrative work, routine, regretting decisions regarding patients, harassment at work and sacrifice of personal time. Conclusions: The results of this study identify age, profession, workplace seniority and relationship status as factors associated with burnout in medical personnel.
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Sanatkar, Samineh, Jenn Bartlett, Samuel Harvey, Isabelle Counson, and David Lawrence. "The Influence of Stigma Perceptions on Employees’ Claims Experiences for Psychological Injuries: Re-Examination of a Cross-Sectional Survey among Australian Police and Emergency Service Personnel." International Journal of Environmental Research and Public Health 19, no. 19 (September 29, 2022): 12438. http://dx.doi.org/10.3390/ijerph191912438.
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While a large body of research assessed the contribution of mental health stigma on disclosure, treatment seeking, and recovery, limited research exists seeking to identify the relative contribution of stigma beliefs on workers’ compensation claims for psychological injury. Survey data of ambulance, fire and rescue, police, and state emergency service personnel (N = 1855, aged 45–54 years, 66.4% male) was re-examined to assesses the unique and combined associations of self-, personal, and workplace stigma with workers’ compensation claims experiences and recovery. Participants responded to self-report stigma items (predictor variables), perceived stress, fairness, and support perceptions of going through the claims process and its impact on recovery (outcome variables). Multiple regression analyses revealed that the combined stigma dimensions predicted about one fifth of the variance of claims and recovery perceptions. Organisational commitment beliefs and the self-stigma dimension of experiences with others were the two most important, albeit weak, unique predictors across outcomes. Given the small but consistent influences of organisational commitment beliefs and the self-stigma dimension of experiences with others, it seems warranted to apply workplace interventions that are looking to establish positive workplace contact and a supportive organisational culture to alleviate negative effects attributable to mental health stigma.
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Rosamond, Wayne D., Dexter L. Morris, Kelly R. Evenson, Jane H. Brice, and Emily B. Schroeder. "Seeking Help When Strokes Happen: A Study of 911 Tapes." Stroke 32, suppl_1 (January 2001): 324. http://dx.doi.org/10.1161/str.32.suppl_1.324.
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43 Recommendations from the American Stroke Association stress the importance of treating stroke symptoms as medical emergencies and encourages the public to call 911 if they witness or experience a stroke. However, many patients experience delays from onset of symptoms to hospital arrival of 4 to 6 hours. Use of emergency medical service (EMS) is an important link in the chain of recovery. To investigate EMS use, tapes of calls to 911 were evaluated for 93 confirmed stroke cases arriving at the hospital by ambulance in 2 North Carolina counties during 1999. Tapes were transcribed and linked to EMS trip sheets. Seventy-two percent of patients were women, 30% were black, and their mean age was 76 years. Forty-three percent of the calls were placed by medical personnel and 37% by a family member. Only 5 of the 93 calls were made by the patient. In 42 (45%) of calls, the term “stroke” or “cerebrovascular accident” was recorded. In most instances (35 of 42) the term was first used by the caller. A decreased ability to walk or altered mental status were the two most frequently reported symptoms (30% each), followed by breathing difficulty (27%), impaired speech (25%), and muscle weakness (16%). In 78% of the calls, dispatchers sent EMS personnel to the scene at highest priority, with lights and sirens. The median time from dispatch to arrival of EMS personnel on the scene was 7 minutes. The median elapsed time from receiving the 911 call to the patient’s arrival at the hospital was 42 minutes. This study suggests that most 911 calls in these two counties were dispatched with highest priority. While EMS arrived in 7 minutes, it took more than one-half hour from arrival at the scene to reach the hospital. Few calls to 911 were made by the patients themselves. The information from this study will be useful in designing public health strategies to reduce prehospital delay for stroke patients.
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Wild, Jennifer, Shama El-Salahi, Michelle Degli Esposti, and Graham R. Thew. "Evaluating the effectiveness of a group-based resilience intervention versus psychoeducation for emergency responders in England: A randomised controlled trial." PLOS ONE 15, no. 11 (November 12, 2020): e0241704. http://dx.doi.org/10.1371/journal.pone.0241704.
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Background Emergency responders are routinely exposed to traumatic critical incidents and other occupational stressors that place them at higher risk of mental ill health compared to the general population. There is some evidence to suggest that resilience training may improve emergency responders’ wellbeing and related health outcomes. The aim of this study was to evaluate the effectiveness of a tertiary service resilience intervention compared to psychoeducation for improving psychological outcomes among emergency workers. Methods We conducted a multicentre, parallel-group, randomised controlled trial. Minim software was used to randomly allocate police, ambulance, fire, and search and rescue services personnel, who were not suffering from depression or post-traumatic stress disorder, to Mind’s group intervention or to online psychoeducation on a 3:1 basis. The resilience intervention was group-based and included stress management and mindfulness tools for reducing stress. It was delivered by trained staff at nine centres across England in six sessions, one per week for six weeks. The comparison intervention was psychoeducation about stress and mental health delivered online, one module per week for six weeks. Primary outcomes were assessed by self-report and included wellbeing, resilience, self-efficacy, problem-solving, social capital, confidence in managing mental health, and number of days off work due to illness. Follow-up was conducted at three months. Blinding of participants, researchers and outcome assessment was not possible due to the type of interventions. Results A total of 430 participants (resilience intervention N = 317; psychoeducation N = 113) were randomised and included in intent-to-treat analyses. Linear Mixed-Effects Models did not show a significant difference between the interventions, at either the post-intervention or follow-up time points, on any outcome measure. Conclusions The limited success of this intervention is consistent with the wider literature. Future refinements to the intervention may benefit from targeting predictors of resilience and mental ill health. Trial registration ISRCTN registry, ISRCTN79407277.
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Shkatula, Yu V., Y. O. Badion, M. V. Novikov, and Ya V. Khyzhnia. "EMERGENCY MEDICINE: PROBLEMS OF VIOLENCE AND SAFETY AT WORK." Eastern Ukrainian Medical Journal 7, no. 4 (2019): 351–57. http://dx.doi.org/10.21272/eumj.2019;7(4):351-357.
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The work of medical workers is associated with constant psycho-emotional stress, which is caused by close contact with human suffering, the need to make immediate decisions, uncomfortable conditions of the pre-hospital stage and cases of aggressive and violent actions by patients or third parties. Statistics show that 54 to 84.8 % of medical workers have become victims of verbal or physical aggression annually. In 2013-2017, 543 crimes against life and health of medical workers on duty were registered in Ukraine. The purpose of the research was to study the causes, nature and risk factors of violent actions against emergency medical personnel with finding the ways to normalize the situation. Material and methods. An anonymous non-personified survey was conducted among 127 workers of the Sumy Regional Centre for Emergency Medical Care and Disaster Medicine. A modified questionnaire “Violence and aggression in the Health Service” (B. Mullan, F. Badger, 2007) was used in the study. It has been established that 74.8 % of emergency medical care and disaster medicine personnel were victims of violence caused by patients, their relatives or friends. Most often, the reasons for aggressive behaviour of the patient or third parties were the time of waiting for a medical worker and the suspicion of incompetence. According to the results of the survey, 35.43 % of employees believe that it is possible to improve the situation by completing and forming ambulance teams of a mixed type. Almost a third of the surveyed medical workers (24.41 %) indicated the need to provide personal protective equipment, another 14.96 % of respondents wanted better legal support and assistance. The authors come to the conclusion that it is necessary to solve the problem of the safety of a medical worker during an emergency call at the state legislative level. Particular attention should be paid to the further improvement of legal assistance, as well as to the development of measures to prevent violence.
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Dell, Colleen, Linzi Williamson, Holly McKenzie, Ben Carey, Maria Cruz, Maryellen Gibson, and Alexandria Pavelich. "A Commentary about Lessons Learned: Transitioning a Therapy Dog Program Online during the COVID-19 Pandemic." Animals 11, no. 3 (March 23, 2021): 914. http://dx.doi.org/10.3390/ani11030914.
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In 2015, the University of Saskatchewan PAWS Your Stress Therapy Dog program partnered with St. John Ambulance for therapy dog teams to visit our campus and offer attendees love, comfort and support. We recognized at the start of the COVID-19 pandemic that students, staff and faculty may require mental health support, particularly with the challenges of isolation and loneliness. In response, our team transitioned from an in-person to a novel online format at the start of the COVID-19 pandemic. We designed online content for participants to (1) connect with therapy dogs and experience feelings of love, comfort and support as occurred in in-person programming, and (2) learn about pandemic-specific, evidence-informed mental health knowledge. Our unique approach highlighted what dogs can teach humans about health through their own care and daily activities. From April to June 2020, we developed a website, created 28 Facebook livestreams and 60 pre-recorded videos which featured therapy dogs and handlers, and cross-promoted on various social media platforms. Over three months, first a combined process-outcome evaluation helped us determine whether our activities contributed to the program’s goals. A subsequent needs assessment allowed us to elicit participant preferences for the program moving forward. This commentary reflects on these findings and our teams’ collective experiences to share our key lessons learned related to program personnel needs, therapy dog handler training and support requirements, and online programming prerequisites. This combined understanding is informing our current activities with the virtual program and should be of interest to other therapy dog programs transitioning online.
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Laima, Sigitas, Dmitrij Fomin, Algimantas Jasulaitis, Gerda Andriuškevičiūtė, Sigitas Chmieliauskas, Vaidas Sabaliauskas, and Vladimiras Sergejevas. "The effect of conducted electrical weapons on the human body." Acta medica Lituanica 21, no. 2 (August 12, 2014): 73–80. http://dx.doi.org/10.6001/actamedica.v21i2.2944.
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Background and objective. Fatal accidents occur due to the effect of electric current on the human body. The most common reasons are invalid electrical installations or misuse of electrical devices, but rarely murder and suicide cases are possible. Recently, conducted electrical weapon handling cases which resulted in sudden death have been observed. In this article we have provided our findings about the effects of conducted electrical weapons on the heart muscle, with emphasis on the use of conducted electrical weapons by officials. Materials and methods. Lithuanian and foreign authors’ findings about the effect of conducted electrical weapons on the heart muscle are analysed. Recommendations for the use of these weapons are made to the officials. The results are evaluated using descriptive statistical methods. Results. The working principle of this weapon is the effect on striated muscles. The muscles contract reacting to electric impulses, hence the affected person cannot struggle with the policeman. Although this weapon was created as a safe tool to suppress aggressive persons, new researches revealed its dangerous effect on the heart muscle that caused fatal arrhythmias. Conclusions. Stress on the body, systemic disease and the presence of chemicals in the body modify the body’s response to electrical impulses that directly increase the risk of cardiac arrhythmia due to the developing of ventricular fibrillation and probability of sudden cardiac death. It is recommended to officials who use conducted electrical weapons that in the location of the event there should be qualified medical personnel (ambulance) able to provide the first aid in case of complications after the use of the weapon.
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Anderson, Paul B. "A Comparative Analysis of the Emergency Medical Services and Rescue Responses to Eight Airliner Crashes in the United States, 1987–1991." Prehospital and Disaster Medicine 10, no. 3 (September 1995): 142–53. http://dx.doi.org/10.1017/s1049023x00041923.
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AbstractIntroduction:Crashes involving commercial airliners stress emergency medical services (EMS) and rescue operations to performance far in excess of everyday activities, and special adaptations of everyday responses need to be implemented. Fortunately, these events are infrequent and usually do not occur more than once in any location. The responses that occur must be highly coordinated and efficient. Little is known about the responses to such events. This study examines the EMS and rescue responses associated with eight recent crashes involving commercial airliners in the United States.Objective:To identify common factors for which alterations in responses may enhance the survival and decrease the morbidity to victims involved in commercial aviation crashes.Study population:Eight commercial airliner crashes in the United States from 1987 through 1991.Methods:Case review using: 1) press and media accounts; 2) U.S. National Transportation and Safety Board testimony and reports; and 3) structured interviews with airport, fire, EMS, and hospital personnel. Data were collated and common factors identified for the cases. Findings are classified into: 1) conditions at the crash sites; 2) initial responses; 3) scene management; 4) scene status; 5) patient transport; 6) hospital responses; and 7) preplanning exercises.Results:Common factors that impaired responses for which some remediation is possible include: 1) new methods for training including computerized simulations; 2) improvements in rescue-extrication equipment and supplies; 3) stored caches of EMS equipment and supplies at airports; 4) ambulance transport capabilities; and 5) augmentation of patient transport capabilities.Conclusions:Many lessons can be learned through structured studies of commercial aircraft crashes. These findings suggest that simple and relatively inexpensive modifications may enhance all levels of emergency response to such events.
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Miller, Bradley S., Sandra P. Spencer, Mitchell E. Geffner, Evgenia Gourgari, Amit Lahoti, Manmohan K. Kamboj, Takara L. Stanley, Naveen K. Uli, Brandy A. Wicklow, and Kyriakie Sarafoglou. "Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings." Journal of Investigative Medicine 68, no. 1 (February 28, 2019): 16–25. http://dx.doi.org/10.1136/jim-2019-000999.
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Adrenal insufficiency (AI) remains a significant cause of morbidity and mortality in children with 1 in 200 episodes of adrenal crisis resulting in death. The goal of this working group of the Pediatric Endocrine Society Drug and Therapeutics Committee was to raise awareness on the importance of early recognition of AI, to advocate for the availability of hydrocortisone sodium succinate (HSS) on emergency medical service (EMS) ambulances or allow EMS personnel to administer patient’s HSS home supply to avoid delay in administration of life-saving stress dosing, and to provide guidance on the emergency management of children in adrenal crisis. Currently, hydrocortisone, or an equivalent synthetic glucocorticoid, is not available on most ambulances for emergency stress dose administration by EMS personnel to a child in adrenal crisis. At the same time, many States have regulations preventing the use of patient’s home HSS supply to be used to treat acute adrenal crisis. In children with known AI, parents and care providers must be made familiar with the administration of maintenance and stress dose glucocorticoid therapy to prevent adrenal crises. Patients with known AI and their families should be provided an Adrenal Insufficiency Action Plan, including stress hydrocortisone dose (both oral and intramuscular/intravenous) to be provided immediately to EMS providers and triage personnel in urgent care and emergency departments. Advocacy efforts to increase the availability of stress dose HSS during EMS transport care and add HSS to weight-based dosing tapes are highly encouraged.
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Betlehem, József, Attila Horváth, Zsigmond Göndöcs, Sára Jeges, Imre Boncz, and András Oláh. "Major contributing factors of self perceived health in Hungarian ambulance personnel." Orvosi Hetilap 151, no. 51 (December 1, 2010): 2089–98. http://dx.doi.org/10.1556/oh.2010.28976.
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A mentődolgozók egészségi állapota önmagában is befolyásolja a betegellátás minőségét. Magyarország egyes régióiban végzett felmérések ugyan rendelkezésre állnak a mentődolgozók egészségi állapotával összefüggő szokásaikról, azonban ezek nem az egészségi állapot dimenzióinak komplexitásával készültek. A jelenlegi tanulmány célja, hogy bemutassa a mentődolgozók észlelt egészségi állapotával összefüggő jelentősebb munkahelyi és egyéni faktorokat. Módszerek: Keresztmetszeti vizsgálat készült az Országos Mentőszolgálat dolgozói körében 2008-ban. A vizsgálatban a mentőszervezet valamennyi régiója részt vett, ezért a minta jó reprezentatív értékkel bír. A dolgozók közül 364 fő válaszai voltak értékelhetők. Adatfelvétel, -rögzítés és -kódolás után leíró adatbemutatás és Spearman-, χ2-teszt és logisztikus regressziós elemzés történt az SPSS 15.0 szoftverrel. A vizsgálat önkitöltős kérdőívvel készült, amely az észlelt egészségi állapot alábbi fő dimenzióit mérte: egészségi állapot önértékelése, fizikai fittségi állapot önértékelése, napi munkavégzésben akadályozó egészségi problémák. Eredmények: Az eredmények rámutatnak arra, hogy a mentődolgozók észlelt egészségi állapota szignifikánsan nem különbözik az ellátóegység-típusok szerint a legtöbb vizsgált paraméterben, jóllehet az általuk ellátott esetek különböző összetettségűek. Az egészségi állapotuk önértékelésében 1,9-szer (95% CI: 1,2–2,8), a fizikai fittségi állapotuk önértékelését illetően 2-szer (95% CI: 1,3–3) és a mindennapokban jelentkező munkájukat befolyásoló egészségi problémájukat illetően 1,9-szer (95% CI: 1,2–3,1) kedvezőbben élik meg azok a dolgozók, akik valamilyen sportot űznek. Általánosságban elmondható, hogy komoly stressz éri őket, alig van szabadidejük, és kevés rekreációs fizikai aktivitást végeznek. A kedvezőtlen életmódjukból következően a kóros elhízás minden ötödik dolgozónál megjelenik. Következtetések: A fizikai aktivitás képes az egészségi állapotot még akkor is pozitívan befolyásolni, ha már bizonyos panaszok jelen vannak. Rendszeres testmozgást, mely növeli a fizikai fittséget, minden mentődolgozónak végezni kellene, s ez jelentős mértékben javítaná az észlelt egészségi állapotot. Orv. Hetil., 2010, 151, 2089–2098.
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Dieckmann, Ronald A., and Ralph Vardis. "High-Dose Epinephrine in Pediatric Out-of-Hospital Cardiopulmonary Arrest." Pediatrics 95, no. 6 (June 1, 1995): 901–13. http://dx.doi.org/10.1542/peds.95.6.901.
Full textAbstract:
Objective. To compare the efficacy of high-dose epinephrine (HDE) and standard-dose epinephrine (SDE) for out-of-hospital treatment of pediatric cardiopulmonary arrest (CPA). Design. Forty-eight-month retrospective cohort study. Setting. Prehospital emergency medical services (EMS) system of a large metropolitan region. Patients. All children younger than 18 years of age, who suffered nontraumatic CPA, did not meet local EMS criteria for death in the field, and were treated by paramedics according to EMS pediatric CPA protocols. Interventions. Paramedics administered HDE (>0.1 mg/kg), SDE (<0.1 mg/kg), or no epinephrine (NE), based on base hospital physician order and availability of access for drug delivery. Protocols permitted either HDE or SDE. The drug was given through an endotracheal tube, intraosseous line, or intravenous line. Main outcome measures. Return of spontaneous circulation (ROSC) and return of an organized electrical rhythm (ROER) in the ambulance and emergency department, hospital admission, hospital discharge, and short-and long-term neurologic outcome by pediatric cerebral performance category (PCPC) score. Results. During the study period, 65 children met inclusion criteria and underwent attempted out-of-hospital resuscitation. Forty patients (62%) received HDE (mean dose ± SD, 0.19 ± 0.06 mg/kg); 13 patients (20%) received SDE (mean dose ± SD, 0.02 ± 0.02 mg/kg); and 12 patients (18%) received NE. The HDE and SDE groups were statistically different only in epinephrine dose but not in age, gender, proportion of asystolic presenting rhythms, success of endotracheal tube intubation or intraosseous line insertion, rate of ROSC, rate of ROER, survival, or proportion of sudden infant death syndrome final diagnoses. Fifty-four children (83%) presented in asystole, 5 (8%) had pulseless electrical activity (PEA), and 6 (9%) had ventricular fibrillation (VF). None presented with either supraventricular tachycardia or ventricular tachycardia. Thirty-nine patients receiving HDE had asystole or VF as presenting rhythms, 4 (10%) had ROER, and 1 had ROSC. The single child receiving HDE presenting with PEA did not have ROSC. Ten patients receiving SDE had asystole or VF, 2 (20%) had ROER, and none had ROSC. There were 3 children receiving SDE who had PEA, and 1 had ROSC. Eleven patients receiving NE had asystole or VF, and none had ROER. One child receiving NE had PEA and ROSC. Altogether, 1 patient receiving HDE, 1 receiving SDE, and 1 receiving NE had ROSC in the field, which continued in the emergency department; all 3 were admitted to the hospital. Two children (3%), 1 receiving HDE and 1 receiving SDE, survived to hospital discharge. The survivor receiving HDE had spastic quadriplegia and profound neurologic handicaps at discharge, with a PCPC score of 4 (severe disability with daily living milestones below the 10th percentile and excessive dependence on others for provision of activities of daily living); at a 1-year follow-up, she had a PCPC score of 4. The survivor receiving SDE was neurologically healthy at discharge; at discharge and at follow-up at age 1 year, she had a PCPC score of 1 (age-appropriate level of functioning and developmentally appropriate). Conclusions. HDE does not seem to improve the rates of ROER and ROSC, hospital admission, survival, or neurologic outcome when compared with SDE for treatment of out-of-hospital pediatric CPA. A large, blinded prospective clinical trial testing different epinephrine doses is necessary to determine drug efficacy and safety. Future pediatric CPA studies must standardize reporting of core data elements, using the adult Utstein criteria modified for pediatrics, to allow valid treatment comparisons. Overall, survival in out-of-hospital pediatric CPA is dismal. When strict inclusion criteria for cardiac standstill are observed, outcome from out-of-hospital pediatric CPA may be significantly worse than previously reported. Like adults, children failing out-of-hospital advanced life support are extremely unlikely to have meaningful survival. Out-of-hospital pediatric treatment and transport policies should assure delivery of appropriate advanced life support; in some well-controlled situations, termination of resuscitation without hospital transport may be possible. Immediate grief counseling for the parents and critical incident stress debriefing for ambulance personnel are essential.