Massage Therapy in Management of Occupational Stress in Emergency Medical Services Staffs: a Randomized Controlled Trial

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

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.

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

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...

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.

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...

Background: Lifestyle affects health, and health-promoting behaviour is pivotal to preventing chronic illnesses and to improving wellbeing. However, limited data exist on the health behaviours of German emergency medical services (EMS) staff. Aim. This research aimed to investigate and characterise the health behaviours of German EMS staff. Methods: Data from the EMS Health Study 2023 a nationwide survey of German EMS staff (n=1171) were analysed in the light of adherence to World Health Organization (WHO) recommendations on physical activity, tobacco and alcohol consumption and compliance with German Nutrition Society guidelines. Findings. German prehospital EMS staff ate inadequate amounts of fruits and vegetables, and consumed more high-energy foods and foods with unfavourable nutrient profiles – such as sugar-sweetened beverages, fast food, sweets and snacks – than recommended. Only 40.0% of men and 40.2% of women met the WHO recommendations for physical activity, 15.8% of men and 17.7% of women reported abstaining from alcohol and approximately one in three were current smokers. Conclusion: Health behaviour among German prehospital EMS staff is suboptimal, and there is an urgent need for targeted preventive interventions to promote healthier lifestyles.

Background: Workplace incivility can severely affect healthcare workers and patients. It creates an unhealthy and unsafe environment, reduces job satisfaction, and often leads to higher staff turnover rates. Therefore, it is crucial to establish a culture of respect and civility in healthcare workplaces to prevent these adverse outcomes. Aims: Research on the relationship between safety culture and workplace incivility in emergency medical service (EMS) settings in Iran needs to be improved, and more studies are required to examine patient safety culture globally. This study examines the relationship between workplace incivility and safety culture among the EMS staff. Research Design: Cross-sectional analytical survey. Methods: This study included 203 EMS staff members who were selected using census population sampling from emergency medical centers in Ardabil City. Researchers used the EMS-Safety Attitudes Questionnaire (EMS-SAQ), the workplace incivility scale, and a demographic characteristics' form to gather information. The study employed multivariable logistic regression and multiple linear regression analyses to analyze the impact of various factors on workplace incivility and safety culture amongst EMS staff. Results: According to the study, EMS workers' average patient safety culture was 51.32%. The study also revealed that more than half of EMS workers (52.7%) experience workplace incivility at least once a month. This behavior negatively affects the staff's adherence to patient safety guidelines during EMS missions, leading to high turnover rates. The study also found that workplace incivility is linked to patient safety culture, and these negative experiences can decrease patient safety culture. Conclusion: EMS workers in Iran exhibit a poor attitude toward patient safety culture, exacerbated by workplace incivility. This negative behavior impacts adherence to safety guidelines and contributes to high staff turnover intention rates. To improve outcomes, healthcare organizations need to implement policies and training programs to address inappropriate behaviors. Cultivating a culture of respect, professionalism, and effective communication can enhance staff safety and improve the quality of patient care.

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

A Comparison of the Quality of Blood Specimens Drawn in the Field by EMS Versus Specimens Obtained in the Emergency Department

Background and aimsPre-hospital emergency technicians face many problems in the workplace daily, so the ability to solve or overcome them in the workplace is essential. This article aimed to assess the predictors of problem-solving skills among emergency medical services staff in Iran.MethodsThis study was cross-sectional correlational research. Using convenience sampling methods, 140 emergency medical services (EMS) staff were enrolled in the study. Response time was assessed using ASAYAR software, problem-solving skills (PSS) were measured using the Hepner Petersen Problem Solving Questionnaire (PSI), and cognitive emotion regulation strategies were assessed using the Garnfsky Cognitive Emotion Regulation Questionnaire. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson's r correlation coefficient, and multiple linear regression analysis were applied using SPSS 14.0.ResultsThe results of our study showed that the total mean score for problem-solving skills was 136.84 (14.65) (range, 175–107 points). Multiple linear regression indicated that refocusing on planning, positive evaluation, stress management courses, delays and their causes, positive refocusing, catastrophizing, and acceptance were effective predictors of problem-solving skills in emergency personnel, accounting for 54% of the total variances.ConclusionThis study is one of the first studies in this field. Based on our findings, individuals who consider their emotions and feelings when solving problems are better able to use the process of thinking and problem-solving skills. Therefore, by training people in the field of emotional regulation skills, the skills to solve problems technicians can be increased.

Burn injuries are a worldwide health issue, significantly burdening healthcare facilities. Specialized burn centres are only sometimes available near the site of burn injury. First aid greatly impacted the outcomes of burns by evaluating the severity of the burn and associated injuries. Pre-hospital Emergency Medical Services (EMS) have more remarkable contributions to healthcare systems. We aimed to reveal the interventions provided by the EMS staff on the scene of burn injuries and the impact of these interventions on the outcomes of burn injuries. Furthermore, the study aimed to identify areas for improvement in pre-hospital burn care. A systematic literature review was carried out from inception to 1st July 2023 using twelve databases. All original articles that included patients with burn injuries who received the necessary pre-hospital care by EMS staff were included. Nine articles comprehending 6149 patients with burn injuries were retrieved. The analysis revealed that EMS interventions significantly improved the outcomes of burn management. This included better control for pain and vital parameters, and lower mortality risk. The EMS provided analgesic administration, cooling of the burn wound, and the necessary urgent therapies. However, the study identified a need for better EMS training in assessing burn severity and managing burn injuries effectively. Enhancing EMS providers' knowledge and skills in pre-hospital burn management could substantially improve patient outcomes and reduce the burden on healthcare systems. Improving the understanding of EMS providers towards burn care can minimize the risk of burn-related poor outcomes and reduce the burden on healthcare facilities.

مقدمه: از آنجا كه پرسنل اورژانس پیش بیمارستانی اولین ارایه دهندگان خدمات بهداشتي و درماني در مواقع بحران هستند، اين پژوهش با هدف تعيين ميزان آگاهي پرسنل اورژانس پیش بیمارستانی از مديريت بحران و عوامل مرتبط با آن در کلیه پایگاه های اورژانس سطح استان چهار محال و بختیاری انجام گرديد. روش کار: اين مطالعه به صورت توصيفي مقطعي انجام شد. نمونه گيري به صورت تمام شماري انجام گرديد. ابزار جمع آوري اطلاعات يك پرسشنامه محقق ساخته بود كه حاوي سؤالاتي در مورد ويژگي هاي دموگرافيك و ميزان آگاهي پرسنل اورژانس پیش بیمارستانی از مديريت بحران بود كه ميزان آگاهي را در چهار حيطه آموزشي، مديريتي، حرفه اي و امنيتي بررسي مي نمود. در هر حيطه چهار سؤال در نظر گرفته شد كه با مقياس ليكرت و توسط پنج گزينه اصلاً، كم، متوسط، زياد و خيلي زياد ميزان آگاهي پرسنل پیش بیمارستانی را مي سنجيد. اعتبار پرسشنامه به روش اعتبار محتوا و پايايي آن از طريق آلفاي كرونباخ برابر 88% ارزیابی شد. جهت تجزيه و تحليل داده ها از نرم افزار SPSS-13 و روش هاي آمار توصيفي استفاده شد. يافته ها: تحليل داده ها نشان داد 100 درصد شركت كنندگان در اين پژوهش مذکر و ميانگين سني آن ها، 47/6 ± 52/27 سال بود. سطح آگاهی 2/2 درصد پرسنل اورژانس پیش بیمارستانی نسبت به مدیریت بحران در حد خیلی زیاد؛ 2/10 درصد در حد زیاد؛ 4/48 درصد در حد متوسط؛ و 2/39 درصد در حد کم بود. در بررسي ارتباطات آماري مشخص گرديد كه بين سطح تحصيلات، شركت در مانورهاي وقوع بحران و عضويت در كميته بحران با آگاهي افراد از مديريت بحران رابطه مستقیم وجود داشت (05/0 > p). نتيجه گيری: نتایج مطالعه حاضر حاکی از آگاهی نسبتا پایین پرسنل پیش بیمارستانی از مدیریت بحران و عوامل مربوطه می باشد که نیاز به آموزش و انجام مانورهای جهت ارتقا سطح آگاهی به منظور آمادگی و رویارویی با خطرات را داشته باشند.

Background: Emergency Medical Services (EMS) personnel in Chobe, Botswana, operate in a remote region with limited infrastructure. They face challenges such as geographical isolation, wildlife risks, like encounters with elephants or lions during emergency calls and shortages of equipment and staff. These stressors can impact the effectiveness of emergency care provision and the well-being of EMS staff. Objectives: To explore lived experiences of EMS staff in Chobe, on the delivery of emergency medical services in Chobe District of Botswana. Methods: A qualitative case study design was employed to explore the lived experiences of EMS staff. This design enabled an in-depth understanding of participants' perspectives within their real-life context. Data were collected through in-depth, semi-structured interviews with eight EMS staff members selected using purposive sampling, ensuring the inclusion of participants with relevant knowledge and experience. Thematic analysis was used to analyze the data, following Braun and Clarke’s updated reflexive approach [1]. This involved six iterative steps: familiarization with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the final report. This method allowed for the systematic identification and interpretation of key themes that emerged from the data. Results: Four key themes emerged from the data, reflecting the lived experiences of Emergency Medical Services (EMS) staff in the Chobe region: (1) operational challenges, (2) Psychosocial stain and coping, (3) professional identity and team dynamics , and (4) environmental and safety risks. 1. Operational Challenges: Participants reported persistent shortages of essential resources, including ambulances, medical equipment, and staff. These constraints often resulted in delayed response times and hindered the delivery of effective emergency care. 2. Psychosocial strain and Coping: EMS personnel described experiencing significant physical exhaustion and emotional strain. Exposure to traumatic scenes, extended shifts, and lack of psychosocial support contributed to burnout. Coping strategies were mainly informal—such as peer debriefing and emotional withdrawal— and were perceived as inadequate. 3. Professional Identity and team dynamics: Respondents expressed frustration over limited training opportunities, unclear career progression, and a perceived lack of appreciation for their work. These factors negatively impacted morale and professional development. 4. Environmental and Safety Risks: The Chobe environment presented unique hazards, including encounters with wild animals, poor road infrastructure, and vast distances between emergency sites and healthcare facilities. These risks compromised both the safety of EMS staff and the quality of emergency response. Discussion: This study highlights that the delivery of Emergency Medical Services (EMS) in the Chobe region is significantly affected by a combination of operational limitations, professional challenges, staff well-being concerns, and environmental risks. These interconnected issues compromise the effectiveness and safety of EMS delivery. To address these challenges, it is essential to implement clear policies, allocate adequate resources, provide structured mental health support, and offer ongoing professional training. Such measures would improve both service delivery and the overall well-being of EMS personnel in remote and high-risk settings like Chobe. Keywords: Emergency Medical Services, pre-hospital care, psychological distress, staffing shortages, qualitative research.

Objectives: The aim of this study was to evaluate the procedures adopted by the staff of the Shiraz Emergency Medical Services (EMS) and the outcome of the patients discharged from the scene over a one-year period. Background: Unnecessary use of ambulances results in the overloading of EMS and the over-crowding of emergency departments. Medical assessment at the scene by EMS staff may reduce these issues. In an earlier study in Shiraz, 36% of the patients were left at home/discharged directly from the scene with or without treatment by EMS staff after consulting a physician at the dispatch center. However, there has been no evaluation of this system with regard to mortality and morbidity. Materials and Methods: Retrospective data on all missions performed by the Shiraz EMS (2012-2013) were reviewed. All the patients discharged from the scene by the EMS staff on the 5th, 15th, and 25th days of each month were included. A questionnaire with nine questions was designed, and available patients/relatives were interviewed prospectively (2014; follow-up period 4-12 months). Results: Out of 3019 cases contacted, 994 (almost 33%) replied. There were 26%-93% reductions in the complaints in all disease categories. A group of the patients left the scene at their own will. Of those who were discharged by the EMS staff at the scene, over 60% were without any complaints. Twelve out of 253 patients died after they were sent home by the EMS staff. Conclusions: Patients may be discharged at the scene by EMS staff and after consulting a physician. However, there is a need for a solid protocol to ensure total patient safety. This calls for a prospective study.