06 Cardiovascular disease on the frontline: 999 staff at risk?

ObjectiveTo explore the Welsh public’s views of violence and aggression (V&A) directed at EMS (emergency medical services) staff, awareness of policy changes and the reach of media campaigns.Design/setting/participantsSurvey involving non-probabilistic purposive sampling of 1010 Wales adults (aged 18+) from a matched panel, representative of the population, derived from a UK YouGov panel of >360 000 adults registered.ResultsMost (62.5%) participants had heard of V&A directed towards EMS staff; 81.1% had heard about it through the media. 21.0% of participants had witnessed V&A towards EMS staff; younger participants were more likely to have witnessed an incident 18.7% via a social setting and 81.1% through the media. 90.4% disagreed with the statement that V&A towards EMS staff can be acceptable in some cases, and 53.3% were not aware of related media campaigns. Participants thought intoxication with alcohol (92.4%), drugs (90.5%) and altered mental status following illness and/or injury (84.3%) would likely contribute to V&A towards EMS staff. 22.0% of participants were aware of the Assaults on Emergency Workers Act. Although I thought the act was unlikely to deter perpetrators who were intoxicated with drugs (75.2%), alcohol (75.2%), with altered mental status following illness and/or injury (75.6%) or other member of the public (42.4%). Younger participants were more likely to think the act would deter those intoxicated with drugs, alcohol, with altered mental status following illness and/or injury and other members of the public. Those with social grades of C2/D/E thought the act was likely to deter those intoxicated with drugs.ConclusionThere is good public awareness of V&A directed towards EMS staff in Wales who find it unacceptable. Our survey found limited awareness and perceived effectiveness of related legislation and media campaigns in the last 2 years. Participants thought legislation would not deter those intoxicated with drugs, alcohol or altered mental status. Therefore, we recommend further research to understand and develop evidence-based interventions for these groups of people. We also recommend amplifying messages targeted towards young people and through social settings where V&A may be encountered.

Recognizing Pregnancy-Associated Cardiovascular Risk Factors

Chronic obstructive pulmonary disease (COPD) results from a complex interaction between genes and the environment, and occupational exposures are an underappreciated risk factor. Until now, little research attention has been paid to the potential impact of occupational risk factor exposure on the COPD in China. The aim of this retrospective study was to analyze the role of occupational risk factor exposure on the severity and progression of COPD for exploring new prevention strategies for this disease. This study adopted a random cluster-sampling method. Five grade-A tertiary hospitals that met the inclusion criteria were selected as the survey sites, and patients with COPD hospitalized in these hospitals from January 1, 2019, to December 31, 2019, were selected as the research subjects. Data of the patients diagnosed with COPD met the Global Initiative for Chronic Obstructive Lung Disease (2019) criteria and were collected from the computerized medical record databases. Among 4082 investigated COPD patients, 1063 (26%) were found to have occupational risk factor exposure history. The top 3 industries with a large COPD case number and a history of occupational risk factor exposure ranked in the order of agriculture (including farming, forestry, animal husbandry, and fishery), manufacturing, and mining. Further multivariate logistic regression analysis indicated that when setting a low exposure level as a reference, medium and high exposure levels were correlated with the severity of COPD (odds ratio values were 2.837 and 6.201, respectively, P < .05). Linear regression analysis showed that cumulative exposure to occupational risk factors was negatively correlated with the forced expiratory volume in 1-second percentage of COPD patients, with a correlation coefficient of 0.68. Our results indicated that occupational risk factor exposure levels were related to the severity of COPD significantly. The incubation period of COPD in the exposure group was significantly shorter than that in the non-exposure group. To prevent worked-related COPD, special attention and control efforts should be taken to reduce the level of occupational risk factors such as organic dust, irritating chemicals, etc in the work environments, especially in the industries of agriculture, forestry, animal husbandry and fishery, manufacturing, and mining.

Asymmetric dimethylarginine in end-stage renal disease patients: A biomarker modifiable by calcium blockade and angiotensin II antagonism?

Impact of psychological status on cardiovascular diseases: Is it time for upgrading risk score charts?

BackgroundThrombolysis can significantly reduce the burden of stroke but the time window for safe and effective treatment is short. In patients travelling to hospital via ambulance, the sending of a...

Background:Emergency medical service (EMS) staff in the UK routinely transport all emergency responses to the nearest emergency department (ED). Proposed reforms in the ambulance service mean that EMS staff will...

BackgroundPre-hospital spinal immobilisation by emergency medical services (EMS) staff is currently the standard of care in cases of suspected spinal column injuries. There is, however, a lack of data on the characteristics of patients who received spinal immobilisation during the pre-hospital phase and on the adverse effects of immobilisation. The objectives of this study were threefold. First, we determined the pre-hospital characteristics of blunt trauma patients with suspected spinal column injuries who were immobilised by EMS staff. Second, we assessed the choices made by EMS staff regarding spinal immobilisation techniques and reasons for immobilisation. Third, we researched the possible adverse effects of immobilisation.DesignA retrospective observational study in a cohort of blunt trauma patients.Study methodData of blunt trauma patients with suspected spinal column injuries were collected from one EMS organisation between January 2008 and January 2013. Coded data and free text notes were analysed.ResultsA total of 1082 patients were included in this study. Spinal immobilisation was applied in 96.3 % of the patients based on valid pre-hospital criteria. In 2.1 % of the patients immobilisation was not based on valid criteria. Data of 1.6 % patients were missing. Main reasons for spinal immobilisation were posterior midline spinal tenderness (37.2 % of patients) and painful distracting injuries (13.5 % of patients). Spinal cord injury (SCI) was suspected in 5.7 % of the patients with posterior midline spinal tenderness. A total of 15.8 % patients were immobilised using non-standard methods. The reason for departure from the standard method was explained for 3 % of these patients. Reported adverse effects included pain (n = 10, 0.9 %,); shortness of breath (n = 3, 0.3 %); combativeness or anxiety (n = 6, 0.6 %); and worsening of pain when supine (n = 1, 0.1 %).Conclusion/recommendationSpinal immobilisation was applied in 96.3 % of all included patients based on pre-hospital criteria. We found that consensus among EMS staff on how to interpret the criterion ‘distracting injury’ was lacking. Furthermore, the adverse effects of spinal immobilisation were incompletely documented in pre-hospital care reports. To provide validated information on potential symptoms of SCI, a uniform EMS scoring system for motoric assessment should be developed.

Prevalence of selected diseases among pre-hospital emergency services personnel in Germany – results of the EMS Health Study 2023 Objective: The health of pre-hospital emergency medical services (EMS) staff is crucial for the provision of high-quality medical care. However, currently only limited data on the health monitoring of German EMS staff is available. The aim of the study was therefore to analyse the 12-month prevalence of selected diseases and symptoms among German EMS staff. Methods: A nationwide survey study was conducted. Questions from the GEDA2019/2020 study were used to collect information on the health status of EMS staff. Subsequently, 12-month prevalences were calculated with the corresponding 95 % confidence intervals (95 % CI). Results: In the end, 1,171 active German EMS staff (67.9 % male/31.9 % female) with a median age of 32.0 years were included in the analysis. The results indicate that excess weight and obesity are common health problems among EMS staff, with men (68.4 % [95 % CI: 64.8 %; 71.4 %]) being more affected than women (45.0 % [95 % CI: 39.9 %; 50.2 %]). The highest 12-month prevalence was calculated for lower back pain (51.8 % [95 % CI: 48.9 %; 54.7 %]), followed by pain in the cervical spine (41.9 % [95 % CI: 39.1 %; 44.8 %]), allergies (34.1 % [95 % CI: 31.4 %; 36.9 %]), hypertension (19.1 % [95 % CI: 16.9 %; 21.5 %]) and depression (16.2 % [95 % CI: 14.2 %; 18.5 %]). Compared to the German general population, the 12-month prevalence of obesity, asthma, COPD, hypertension, elevated blood lipid levels, arthritis, depression and obesity was higher for certain gender and age groups of emergency workers. Conclusion: The result of this study indicate a poor health state among German pre-hospital EMS staff and the need for preventive measures. Keywords: 12-month prevalence – emergency medical services – health – obesity – epidemiology

Occupational stress and its relationship with spiritual coping among emergency department nurses and emergency medical services staff

Risk of Cardiovascular Events in Patients Receiving Celecoxib: A Meta-Analysis of Randomized Clinical Trials

Are We There Yet? Pediatric Screening for Inflammatory Biomarkers and Low Cardiorespiratory Fitness to Identify Youth at Increased Risk of Cardiovascular Disease

Perceived stress and coping strategies among emergency department nurses and emergency medical services staff during the fifth wave of COVID-19 in Iran: A cross-sectional correlational study

Long-term exposure to physical, chemical, ergonomic and psychosocial environmental factors may lead to occupational cardiovascular disease in metal industry employees. This study aimed to determine levels of knowledge levels regarding occupational and cardiovascular risk factors among metal industry employees. The study was conducted between 2nd and 6th June 2014 with the participation of 82 employees. All were working in a medium-sized workplace in the metal industry. Data were collected by means of a questionnaire, which included socio-demographic characteristics and occupational cardiovascular risk factors, and a scale developed by Arıkan et al. to measure awareness levels of risk factors for cardiovascular diseases (CARRF-KL). The mean age of employees was 39.97±8.44. Of the participants, 58.5% stated that they had knowledge on cardiac disease risk factors. The mean CARRF-KL score was found to be 18.65±4.04. The percentage of employees stating that they had no knowledge on the occupational risks for such diseases was 79.3%, while 19.5% stated that job stress caused cardiac diseases. One individual (1.2%) stated that one of the chemical solvents used in the working environment was a risk factor. Although awareness among metal industry employees of cardiovascular risk factors was above average, it was determined that they do not have adequate information on occupational risk factors. Prolonged and unprotected levels exposure to environmental factors constitute a risk for cardiovascular disease. This information is important for the development of preventive cardiology.

Nonalcoholic Fatty Liver Disease and Cardiovascular Disease Risk