Répercussions psychologiques de la prise en charge des appels d’urgence sur les assistants de régulation médicale (ARM) d’un SAMU–Centre 15

Abstract

IntroductionIn France, the emergency call center is called SAMU (service d’aide médicale d’urgence). The Medical Dispatcher Assistant (MDA) is the first responder and is exposed to first calls of distress and has a high risk of stress disorder. AimPsychological impact of emergency calls on MDA. MethodNational multicenter prospective study from January to August 2018 by electronic surveys, including all MDA of 13 SAMU, subdivided in 5 sections: population characteristics, PCL-5 scale (DSM-5) assessing post-traumatic stress disorder (PTSD), ProQOL assessing professional quality of life, call categories and an MDA's emotional perception, and work impacts on an MDA's quality of life. Univariate descriptive statistical analysis of the group with PCL-5≥34 (=complete PTSD group) and with PCL-5<34 (=group without complete PTSD). ResultsOf 400 MDA asked to be interviewed, 283 (71 %) replied of whom 72 % (205) were women and 28 % (79) men. Age groups: 9 % (25) for 18–25 yrs, 39 % (110) for 26–35 yrs, 31 % (89) 36–45 yrs, 15 % (43) 46–55 yrs and 6 % (16) for more than 56 yrs. All MDA reported having been exposed to death experience. For 46 % (129) the most recent traumatic event occurred within the last 7 months. 78 % (219) have reported intense fear, feeling helpless, or even sensed horror when answering the calls. 97 % (273) could talk about it with colleagues but only 64 % (180) with family. 72 % (203) felt lack of recognition at work. 78 % (220) had no knowledge about psycho-traumatic disorder. While 11 % (30) suffered symptoms suggestive of a complete PTSD, 15 % (42) an incomplete PTSD, 3 % (8) suffer burnout and 4 % (11) compassion fatigue, none reported secondary traumatic stress. The only significant difference (P<0.05) between the two groups characteristics was on the education level. 74 % (22) of the MDA with a complete PTSD had a High School diploma or less. MDA with symptoms suggestive of complete PTSD developed significantly (P<0.001) more stress reduction strategies (alcohol, drugs, medication) (13 % vs 2 %), had more food disorders (80.5 % vs 38 %), more sleeping problems (75.5 % vs 21 %), more anxiety (67 % vs 17 %), and more sick leaves (13 % vs 4 %) than the group without complete PTSD. ConclusionPart of the surveyed MDAs showed symptoms suggestive of PTSD. The study highlights that MDAs is a vulnerable population, and PTSD prevention techniques should be systematically implemented for them. The study also highlights that a higher education level prevents the psycho traumatic process with its accompanying disorders.