Medical Technicians Research Articles

Health care professionals' self-efficacy in identifying and treating human trafficking victims

BackgroundHuman trafficking is characterized as a violation of human rights that exploits males and females of any age for personal or financial gain. Recently, health care professionals have been identified as feasible change agents in this global issue. However, many health care professionals are not trained in identifying and treating human trafficking victims. Through human trafficking education, health care professionals have the potential to be better equipped to recognize and assist trafficking victims and guide them to the specialized care they need. ObjectiveThe purpose of this study was to measure the effect of a trauma-informed human trafficking education intervention and the impact of this training on the self-efficacy of health care professionals in identifying and recognizing human trafficking victims in healthcare settings. DesignThe study was a quasi-experimental research design with snowball and convenience recruitment Setting100 % virtual, online. ParticipantsHealth care professionals (N = 30) including Nurse Practitioners, Physician Assistants, Registered Nurses, Licensed Practical Nurses, Certified Medical Assistants, Certified Nursing Assistants, Emergency Medical Technicians, and Paramedics from a variety of healthcare settings. Methods30 min total program to include Qualtrics pre-intervention Violence Against Women Health Care Provider survey, 20 min educational intervention on YouTube©, and an identical Qualtrics post-intervention survey. ResultsTotal of 30 sets of paired data. The results showed statistically significant improvement in self-efficacy in all survey questions pre- and post-human trafficking educational intervention (p < .001). ConclusionsAn increase in health care professionals' self-efficacy in identifying and treating human trafficking victims yields better patient and health care system outcomes. Trauma-informed human trafficking education for all health care professionals is recommended.

Austere Diagnosis and Reduction of Anterior Shoulder Dislocations: 10-Year Review of a Ski Patrol-Based Program with Emergency Medical Technicians

Glenohumeral dislocations present a challenging management dilemma in austere settings where patient transport time may be prolonged. Expeditious reduction is preferable, but treatment is commonly expected to take place within a hospital or comparable facility. Through a novel shoulder injury program, professional ski patrollers trained as emergency medical technicians (EMTs) have diagnosed and reduced anterior shoulder dislocations using biomechanical techniques without sedation or analgesia for over 20 y. Summary records have been maintained to track the performance and safety of this program. Five hundred forty-six records of winter sports-related shoulder injuries from 2009-10 to 2019-20 were retrospectively analyzed to determine the assessment performance and dislocation reduction efficacy of EMTs, with the intent of ascertaining whether EMT-trained practitioners can reliably and safely diagnose and reduce anterior shoulder dislocations without premedication in a remote and resource-limited setting. EMTs identified anterior shoulder dislocations with 98% sensitivity and 96% diagnostic accuracy. The overall success rate of reduction attempts was 86%, or 88% when limited to confirmed anterior dislocations. Two fracture-dislocations and 4 misdiagnoses were manipulated. No instances of iatrogenic harm were identified, and no patients who underwent successful reductions required ambulance transportation. With appropriate education and within a structured program, EMT-trained practitioners can reliably and safely diagnose and reduce anterior shoulder dislocations using biomechanical techniques without premedication in remote and resource-limited environments. Implementation of similar programs in austere settings has the potential to improve patient care. Further, using biomechanical reduction techniques may reduce reliance on procedural sedation irrespective of care setting.

Fear of Covid-19 and Burnout Among Healthcare Providers in Malaysia: Is Resilience a Missing Link?

Introduction: During the COVID-19 pandemic, healthcare providers have been in great fear due to the high risk of contracting COVID-19 infection at any time. This study aimed to determine the mediating role of resilience on the relationship between fear of COVID-19 and burnout in primary care healthcare providers in Malaysia. Methods: This was an online cross-sectional study involving 1280 healthcare providers aged 18 years and older from 30 government primary care clinics in Malaysia. We used the COVID-19 Fear Scale, the Copenhagen Burnout Inventory Scale, and the Short Brief Resilience Scale to collect data from the respondents. Smart-PLS was used to perform mediation analysis. Results: The mean age of the respondents was 36 years old and mean duration of working experience was 11 years. The majority of the respondents were female (82.4%) and Malays (82.3%). The study population consisted of nurses (47.4%), doctors (26%), medical assistants (11.9), healthcare assistant (7.1%), medical laboratory technicians (6.4%) and drivers(1.3).The results show that fear of COVID-19 positively predicts burnout. According to the results, resilience mediates the relationship between fear of COVID-19 and all the three burnout domains, namely personal burnout (β=0.175,p&lt;0.001), work-related burnout (β=0.175,p&lt;0.001) and client-related burnout (β=0.172,p&lt;0.001). Additionally, resilience reduces the impact of COVID-19 fear on the three domains of burnout. Conclusion: Our study has reported a mediating effect of resilience on the relationship between fear of COVID-19 and burnout.

Eyes for Ears: Usage and Efficacy of a Podcast for Ophthalmic Education.

To characterize listenership and perceived educational impact of the ophthalmic podcast "Eyes for Ears". A cross-sectional, internet-distributed, 9-question Qualtrics survey was made available to podcast listeners. Listenership metrics were analyzed from the podcast host platform. From January 10, 2019 to September 2, 2021, the podcast was downloaded over 422,000 times, averaging about 4442 downloads per episode. 209 Qualtrics survey responses were analyzed from podcast listeners with backgrounds in eye care including medical students, residents, fellows, clinicians and technicians. The majority were residents (60.3%), representative of the target audience of the podcast. Listeners reported using the podcast while commuting (81.3%), felt it increased the time they could spend on self-care (63.2%), and thought it improved their fund of knowledge (99.0%). Respondents recalled feeling better prepared for the OKAP or written boards after using this podcast (before median = 50/100 on Likert Scale, IQR 30-65 vs median = 70/100, IQR 56-81, p <0.001). Respondents identified question banks as the most helpful for OKAP studying, followed by podcasts. Podcasts were preferred over articles and lectures in terms of helpfulness (p < 0.001). The Eyes for Ears podcast has achieved a robust international audience. The surveyed audience felt the podcast was useful for their education and well-being.

Clinical Practice Patterns of Interprofessional Collaboration: Considerations for Athletic Training Education

Context As required elements of accreditation, interprofessional education (IPE), and interprofessional collaborative practice (IPCP) are key considerations for athletic training educators, students, and practicing professionals. Objective Despite the emphasis on IPE and IPCP, little information exists regarding which health care professionals athletic trainers should collaborate with outside of physicians. In addition, no study has established which professionals athletic training students should be educated alongside in preparation for future interprofessional collaboration. Design Cross-sectional survey. Setting Clinical practice settings. Patients or Other Participants Stratified sample of 105 athletic trainers across various employment settings. Data Collection and Analysis Participants selected the top 5 health care professionals with whom they currently interact, desire to collaborate, and believe students should be learning to interact with during clinical practice. Participants indicated how much time they spent in collaborative practice and the frequency and method of their interactions. We analyzed data using descriptive statistics including means, standard deviations, and frequency counts. Results In addition to physicians, participants identified physical therapists, physician assistants, nurses, and nurse practitioners as the primary professionals with whom they interacted in the past 12 months. Participants identified a desire to collaborate with sport and exercise psychologists, physical therapists, nutritionists, physician assistants, and certified or licensed professional counselors. In addition, participants indicated that athletic training students should learn with physical therapists, paramedics or emergency medical technicians (EMTs), physician assistants, nutritionists, and sport and exercise psychologists in preparation for future clinical practice. Regarding time, the majority (64.7%) of participants interact with other health care professionals multiple times a day or week. Conclusions These results are indicative of the need to prepare athletic training students to engage in collaboration with professionals beyond the naturally occurring partnerships with physicians. Educators could use these findings in the development or modification of IPE experiences, and the results may be considered in the development of continuing education opportunities to enhance practicing athletic trainers’ collaborations.

‘On the inside I’m grossed out and wanting to puke’: Exploring professional facework and emotional labour as impression management tools in rural emergency medical services

Abstract In the foothills of rural Appalachia, situations arise where emergency medical services (EMS) providers—such as paramedics and emergency medical technicians—must reflect professionalism in their ‘face’. However, as EMS providers practice facework in their organizational roles, it is important to consider how they manage professionalism when emotional labour and dirty work are required, such as when supporting patients from underserved rural communities. Guided by 181 hours of participant observation with 23 interviews with EMS providers from two county-wide EMS organizations, this organizational ethnography reveals the value of impression management strategies in the form of emotional labour. Notably, such practices aid in EMS providers’ maintenance of professional face as they encounter face threats on the job. In such moments, EMS providers utilize emotional labour in their corrective and preventive facework. Importantly, this research makes a meaningful theoretical and practical contribution to organizational communication by illustrating the value of impression management, emotional labour, and facework that aid in the management of professionalism.

Video characteristics for remote recognition of agonal respiration: A pilot study

AimThe mobile network quality in ambulances can be variable and limited. This pilot study aimed to identify a suitable network setting for recognizing agonal respiration under limited network conditions. MethodsWe recruited five emergency medical technicians, and each participant viewed 30 real-life videos with different resolutions, frame rates, and network scenarios. Thereafter, they reported the respiration pattern of the patient and identified agonal respiration cases. The time at which agonal respiration was identified was also recorded. The answers provided by the five participants were compared with those of two emergency physicians to compare the accuracy and time delay in breathing pattern recognition. ResultsThe overall accuracy for initial respiratory pattern recognition was 80.7% (121/150). The accuracy for normal breathing was 93.3% (28/30), for not breathing was 96% (48/50), and for agonal breathing was 64.3% (45/70). There was no significant difference in successful recognition between video resolutions. However, the rate of time delay in recognizing agonal respiration less than 10 seconds between 15-fps group and 30-fps group had statistical significance (21% vs 52%, p = 0.041). ConclusionThe frame rate emerges as one of critical factors in agonal respiration recognition through telemedicine, outweighing the significance of video resolution.

Science of Life Saving Through Paramedical Care: A Comprehensive Review

The science of life-saving through paramedical care is a vital component of modern healthcare. This review encompasses various aspects, including the role of paramedics, emergency medical technicians, and other healthcare professionals, in delivering immediate and pre-hospital care. By addressing various dimensions of paramedical care, this review sheds light on the crucial role this discipline plays in safeguarding lives and ensuring the best possible outcomes for patients. Paramedical care significantly benefits society. Paramedics play a crucial role in providing rapid medical assistance during emergencies. This study explores the vital societal impact of paramedical care and its indispensable role in emergency healthcare. The field of paramedical care presents difficulties due to its intricate and ever-changing nature, requiring continual adaptation to technological advancements, regulatory modifications, and a wide range of patient requirements. Addressing these challenges calls for a dynamic and comprehensive approach to ensure the provision of effective and high-quality healthcare. Paramedical care which extends beyond traditional practices to encompass a variety of medical services demanding innovative solutions to ensure favorable patient outcomes. Given that paramedical services represent one of the most intimately interconnected industries, touching upon our emotional, physical, mental, and financial well-being, it is imperative to promptly address the influence of the new economy and healthcare technology to meet the challenges posed by paramedics. Paramedical care not only saves lives in emergencies but also acts as an essential for preventive healthcare, public health education, and community resilience. This study highlights the far-reaching positive effects of paramedical care on society, shedding light on the science behind its lifesaving impact and its potential to improve overall community health and resilience.

Effect of Short versus Long Duration Naps on Blood Pressure during Simulated Night Shift Work: A Randomized Crossover Trial

Objective Blunting of the sleep-related dip in blood pressure (BP) has been linked to numerous cardiovascular outcomes including myocardial infarction. Blunting of BP dipping occurs during night shift work and previous research suggest that a 60-min or longer on-shift nap is needed to restore normal/healthy BP dipping. We sought to determine the effect of different durations of napping on BP during and following simulated night shifts. We hypothesized that the greatest benefit in terms of restoration of normal BP dipping during night shift work would be observed during a longer duration nap versus a shorter nap opportunity. Methods We used a randomized crossover laboratory-based study design. Participants consented to complete three separate 72-hr conditions that included a 12-hr simulated night shift. Nap conditions included a 30-min and 2-hr nap compared to a no-nap condition. Ambulatory BP monitoring was assessed hourly and every 10-30 mins during in-lab naps. Blunted BP dipping during in-lab naps was the primary outcome. Goal enrollment of 25 (35 with attrition) provided 80% power to detect a mean difference of 5 mmHg in BP between nap conditions. Results Of the 58 screened, 28 were consented, and 26 completed all three 72-hr conditions. More than half (53.6%) were female. Mean age was 24.4 years (SD7.2). Most (85.7%) were certified as emergency medical technicians or paramedics. The mean percentage dip in systolic BP (SBP) and diastolic BP (DBP) did not differ between the 30-min and 2-hr nap conditions (p > 0.05), yet a greater proportion of participants experienced a 10-20% dip in SBP or DBP during the 2-hr nap versus the 30-min nap (p < 0.05). For every additional minute of total sleep during the 30-min nap, the percentage of SBP dip improved by 0.60%, and the percentage of DBP dip improved by 0.68% (p < 0.05). These improvements approximate to a 6% per minute relative advancement toward normal/healthy BP dipping. Conclusions Restoration of a normal/healthy dip in BP is achievable during short and long duration nap opportunities during simulated night shift work. Our findings support the hypothesis that BP dipping is more common during longer 2-hr versus shorter 30-min naps. Trial registration ClinicalTrials.gov, NCT04469803. Registered on 9 July 2020.

The impact of COVID-19 pandemic on hand hygiene compliance of healthcare workers in a tertiary hospital in East China.

Hand hygiene is a cost-effective measure to reduce healthcare-associated infections (HAIs) in healthcare facilities. The impact of the coronavirus disease 2019 (COVID-19) pandemic on hand hygiene performance (HHP) provided evidence for targeted hand hygiene intervention measures. This study evaluated the HHP rate in a tertiary hospital before and after the COVID-19 outbreak. HHP was checked by infection control doctors or nurses every day, and they inputted the HHP rate to the full-time infection control staff every week. A random examination of HHP was conducted by a confidential worker every month. The HHP of healthcare workers (HCWs) was monitored in the outpatient department, inpatient ward, and operating room from January 2017 to October 2022. The influence of COVID-19 prevention and control strategies on HHP was elucidated by analyzing the results of HHP during the study period. The average HHP rate of HCWs was 86.11% from January 2017 to October 2022. The HHP rate of HCWs after the COVID-19 pandemic was statistically significantly higher than that before the pandemic (P < 0.001). The HHP rate was the highest (93.01%) in September 2022 when the local epidemic occurred. Among the different occupation categories, medical technicians showed the highest HHP rate (89.10%). The HHP rate was the highest after contact with body fluids or blood of patients (94.47%). The HHP rate of HCWs in our hospital showed an increasing trend in the recent 6 years, especially during the COVID-19 pandemic, and the increase was most obvious during the local epidemic.

Are Short Duration Naps Better than Long Duration Naps for Mitigating Sleep Inertia? Brief Report of a Randomized Crossover Trial of Simulated Night Shift Work

Objective We sought to test the effects of different duration naps on post-nap cognitive performance during simulated night shifts. Methods We used a randomized laboratory-based crossover trial design with simulated 12-hr night shifts and each participant completing three conditions of 72 hrs each (Clinicaltrials.gov; registration # NCT04469803). The three conditions tested included no-nap, a 30-min nap opportunity, and a 2-hr nap opportunity. Naps occurred at 02:00 hrs. Cognitive performance was assessed with the Brief 3-min Psychomotor Vigilance Test (PVT-B). Four PVT-B measures include: reaction time (RT in milliseconds (ms)), lapses (RT > 355 ms), false starts (reactions before stimulus or RT <100 ms), and speed (1,000/RT). The PVT-B was performed at the start of the simulated night shift (19:00), end of shift (07:00), pre-nap (02:00), and at 0 mins, 10 mins, 20 mins, and 30 mins following the 30-min and 2-hr nap conditions. Simultaneously, participants reported subjective ratings of fatigue and other constructs. Results Twenty-eight (15 female), mostly certified emergency medical technicians or paramedics, consented to participate. For all three conditions, looking within condition, PVT-B lapse performance at the end of the 12-hr simulated night shift (at 07:00) was poorer compared to shift start (p < 0.05). Performance on PVT-B speed, RT, and false starts were poorer at shift end than shift start for the no-nap and 30-min nap conditions (p < 0.05), but not for the 2-hr nap condition (p > 0.05). Compared to pre-nap measures, performance on the PVT-B assessed at 0 mins post-nap showed significant performance declines for lapses and speed for both the 30-min and 2-hr nap conditions (p < 0.05), but not at 10, 20, or 30 mins post-nap. After waking from the 2-hr on-shift nap opportunity (at 0 mins), participants rated sleepiness, difficulty with concentration, and alertness poorer than pre-nap (p < 0.05). Participants in the 30-min nap condition rated alertness poorer immediately after the nap (at 0 mins) compared to pre-nap (p < 0.05) Conclusions While sleep inertia was detectable immediately following short 30-min and long 2-hr nap opportunities during simulated night shift work, deficits in cognitive performance and subjective ratings quickly dissipated and were not detectable at 10–30 mins post-nap.

Usefulness of Key Word Methods to Execute Early Requests for a Physician-Staffed Helicopter Emergency Medical Service Dispatch to Facilitate Early Medical Intervention by Physicians

ObjectiveA physician-staffed helicopter emergency medical service is called a doctor helicopter (DH) in Japan. We retrospectively investigated this service using a data bank provided by the Japan DH registry system. MethodsThe following details of the dispatch activity were collected: patient age and sex, vital signs (Japan Coma Scale [JCS], systolic blood pressure, heart rate, and respiratory rate) at the scene measured by emergency medical technicians (EMTs), dispatch of the DH before the EMTs made contact with patients (key words group) or after (control group), and the survival outcome at 1 month. ResultsDuring the investigation period, 28,357 patient records were analyzed (key words group, n = 13,861; control group, n = 14,496). The age, JCS, and respiratory rate were significantly smaller in the key words group than in the control group. The rates of male sex and survival in the key words group were significantly greater than those in the control group. In the multivariate analysis, dispatch of the DH after EMTs made contact with the patients (odds ratio [OR] = 0.72; 95% confidence interval [CI], 0.55-0.92), female sex (OR = 0.86; 95% CI, 0.75-0.98), older age (OR = 0.97; 95% CI, 0.96-0.97), elevated respiratory rate (OR = 0.97; 95% CI, 0.97-0.98), and high JCS (OR = 0.99; 95% CI, 0.99-0.99) were associated with a decreased 1-month survival (P > .0001). ConclusionThis is the first report to describe the key words method as a potential factor influencing optimal outcomes/potential survival rates in patients evacuated by the DH using the JDRS. Our study results suggest that the firefighting central command room should consider adopting the key words method when the helicopter emergency medical service is used.

EEG Neuro-markers to Enhance BCI-based Stroke Patients Rehabilitation

Stroke is the second largest cause of death worldwide and one of the most common causes of disability. However, several approaches have been proposed to deal with stroke patient rehabilitation like robotic devices and virtual reality systems, researchers have found that the brain-computer interfaces (BCI) approaches can provide better results. In this study, the electroencephalography (EEG) dataset from post-stroke patients were investigated to identify the effects of the motor imagery (MI)-based BCI therapy by investigating sensorimotor areas using frequency and time-domain features and to select particular methods that help in enhancing the MI-based BCI systems for stroke patients using EEG signal processing. Therefore, to detect the imagined movements that are typically required within conventional rehabilitation therapy with good identification accuracies, the conventional filters and wavelet transform (WT) denoising technique was used in the first stage. Next, attributes from frequency and entropy domains were computed. Finally, support vector machine (SVM) classification techniques were utilized to test the motor imagery (MI)-based BCI rehabilitation. The results demonstrate the capability of the WT denoising technique together with the used features and SVM classifier to discriminate the tested classes of the left hand, right hand and foot MI-based BCI rehabilitation. This study will help medical doctors, clinicians, physicians and technicians to introduce a good rehabilitation program for post-stroke patients.

Prehospital Pediatric Emergency Training Using Augmented Reality Simulation: A Prospective, Mixed Methods Study

Objective Pediatric emergencies are high-stakes yet low-volume clinical encounters for emergency medical services (EMS) clinicians, necessitating innovative approaches to training. We sought to explore the acceptability, usability, and ergonomics of a novel augmented reality (AR) software for EMS crisis management training. Methods This was a prospective, mixed-methods study employing qualitative and quantitative analyses. We enrolled emergency medical technicians (EMTs) and paramedics at a municipal fire service in Northern California. We ran the Chariot Augmented Reality Medical simulation software (#details_redacted_for_peer_review) on the ML1 headset (Magic Leap, Inc., Plantation, FL), which enabled participants to view an AR image of a patient overlaid with real-world training objects. Participants completed a simulation of a pediatric hypoglycemia-induced seizure and cardiac arrest. Participants subsequently engaged in structured focus group interviews assessing acceptability, which we coded and thematically analyzed. We evaluated the usability of the AR system and ergonomics of the ML1 headset using previously validated scales, and we analyzed findings with descriptive statistics. Results Twenty-two EMS clinicians participated. We categorized focus group interview statements into seven domains after an iterative thematic analysis: general appraisal, realism, learning efficacy, mixed reality feasibility, technology acceptance, software optimization, and alternate use cases. Participants valued the realism and the mixed reality functionality of the training simulation. They reported that AR could be effective for practicing pediatric clinical algorithms and task prioritization, building verbal communication skills, and promoting stress indoctrination. However, participants also noted challenges with integrating AR images with real-world objects, the learning curve required to adapt to the technology, and areas for software improvement. Participants favorably evaluated the ease of use of the technology and comfortability of wearing the hardware; however, most participants reported that they would need technical support. Conclusion Participants positively evaluated the acceptability, usability, and ergonomics of an AR simulator for pediatric emergency management training, and participants identified current technological limitations and areas for improvement. AR simulation may serve as an effective training adjunct for prehospital clinicians.

The Right to Refuse: Understanding Healthcare Providers' Perspectives on Patient Autonomy in Emergency Care.

Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into the attitudes of these providers toward treatment refusal, unearthing the strategies they employ in navigating such challenging situations while actively working in prehospital emergency health services. Our findings showed that, as the participants' age and experience increased, so did their inclination to respect patient autonomy and avoid persuading them to change their decision about treatment. It was noted that doctors, paramedics, and emergency medical technicians demonstrated a deeper understanding of patients' rights than other medical specialists. However, even with this understanding, the prioritization of patients' rights tended to diminish in life-threatening situations, giving rise to ethical dilemmas. This underlines the complexity of balancing the healthcare professionals' responsibilities and the patients' autonomy, which can generate ethically challenging scenarios for those working in emergency healthcare. By investigating these attitudes and experiences, this study seeks to foster a more profound understanding of the ethical quandaries faced by emergency healthcare providers. Our ultimate aim is to contribute to the development of effective strategies that support both patients and professionals in managing these tough circumstances.

Multidisciplinary Collaboration to Address Maternal Mortality and Morbidity

Pregnancy-related emergencies do not occur only in the hospital setting. They occur in the community setting as well. First responders, emergency medical technicians (EMTs), paramedics, and firefighters need to be trained in current evidence-based guidelines that highlight symptoms and stabilization modalities to facilitate readiness, recognition, and response to common pregnancy-related emergencies. Our organization identified knowledge gaps in guidelines for first responders (EMTs, paramedics, and firefighters), emergency departments, and trauma departments.

Identifying high cognitive load activities during simulated pediatric cardiac arrest using functional near-infrared spectroscopy

AimTo identify specific activities associated with high cognitive load during simulated pediatric out-of-hospital cardiac arrest (POHCA) resuscitation using physiological monitoring with functional near-infrared spectroscopy (fNIRS). MethodsWe recruited teams of emergency medical services (EMS) responders from fire departments located throughout the Portland, OR metropolitan area to participate in POHCA simulations. Teams consisted of both paramedics and emergency medical technicians (EMTs), with one paramedic serving as the person in charge (PIC). The PIC was outfitted with the OctaMon to collect fNIRS signals from the prefrontal cortex. Signals reported changes in oxygenated and deoxygenated hemoglobin concentrations, which were used to determine moments of increased cognitive activity. Increased cognitive activity was determined by significant increases in oxygenated hemoglobin and decreases in deoxygenated hemoglobin. Significant changes in fNIRS signals were associated with specific concurrent clinical tasks recorded by two independent researchers using video review. ResultsWe recorded cognitive activity of EMS providers in 18 POHCA simulations. We found that a proportion of PIC’s experienced relatively high cognitive load during medication administration, defibrillation, and rhythm checks compared to other events. ConclusionEMS providers commonly experienced increased cognitive activity during key resuscitation tasks that were related to safely coordinating team members around calculating and administering medications, defibrillation, and rhythm and pulse checks. Understanding more about activities that require high cognitive demand can inform future interventions that reduce cognitive load.

Relationship between job stress and work-related quality of life among emergency medical technicians: a cross-sectional study

ObjectiveThis study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran.DesignThis was a cross-sectional...

Evaluation of the psychological distress and mental well-being of pre-hospital care providers in Saudi Arabia during COVID-19.

Pre-hospital care providers are the first line of contact when emergencies occur. They are at high risk of mental health disorders associated with trauma and stress. The magnitude of their stress could increase during difficult times such as the COVID-19 pandemic. This study reports on the state of mental well-being and the degree of psychological distress among pre-hospital care workers (paramedics, emergency medical technicians, doctors, paramedic interns and other healthcare practitioners) during the COVID-19 pandemic in Saudi Arabia. The study was a cross-sectional survey study in Saudi Arabia. A questionnaire was distributed among pre-hospital care workers in Saudi Arabia during the first wave of the COVID-19 pandemic. The questionnaire was based on the Kessler Psychological Distress Scale (K10) and the World Health Organization Well-Being Index (WHO-5). In total, 427 pre-hospital care providers completed the questionnaire; 60% of the respondents had scores of more than 30 in the K10 and were likely to have a severe disorder. The WHO-5 showed a similar percentage of respondents with a score of more than 50 and coded as having poor well-being. The findings of this study provide evidence around mental health and well-being for pre-hospital care workers. They also highlight the need to better understand the quality of mental health and well-being for this population and to provide appropriate interventions to improve their quality of life.

Evaluating changes in the emergency medical services workforce: A preliminary multistate study.

There is growing concern with the strength and stability of the emergency medical services (EMS) workforce with reports of workforce challenges in many communities in the United States. Our objective was to estimate changes in the EMS workforce by evaluating the number of clinicians who enter, stay, and leave. A 4-year retrospective cohort evaluation of all certified EMS clinicians at the emergency medical technician (EMT) level or higher was conducted for 9 states that require national EMS certification to obtain and maintain EMS licensure. The study spanned 2 recertification cycles (2017-2021) for 2 workforce populations: the certified workforce (all EMS clinicians certified to practice) and the patient care workforce (the subset who reported providing patient care). Descriptive statistics were calculated and classified into 1 of 3 categories: EMS clinicians who entered, stayed in, or left each respective workforce population. There were 62,061 certified EMS clinicians in the 9 included states during the study period, and 52,269 reported providing patient care. For the certified workforce, 80%-82% stayed in and 18%-20% entered the workforce. For the patient care workforce, 74%-77% stayed and 29%-30% entered. State-level rates of leaving each workforce ranged from 16% to 19% (certified) and 19% to 33% (patient care). From 2017 to 2020, there was a net growth of both the certified (8.8%) and patient care workforces (7.6%). This was a comprehensive evaluation of both the certified and patient care EMS workforce dynamics in 9 states. This population-level evaluation serves as the first step for more detailed analyses to better understand workforce dynamics in EMS.