scholarly journals Associations between sleep, stress, and cardiovascular health in emergency medical services personnel

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Rebecca E. Cash ◽  
Sarah E. Anderson ◽  
Kathryn E. Lancaster ◽  
Bo Lu ◽  
Madison K. Rivard ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Cardiovascular Health ◽  
Medical Services ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel

scholarly journals Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

2021 ◽  
Author(s):  
Anna Vögele ◽  
Michiel Jan van Veelen ◽  
Tomas Dal Cappello ◽  
Marika Falla ◽  
Giada Nicoletto ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Chest Compression ◽  
Acute Exposure ◽  
Medical Services ◽  
Compression Depth ◽  
Helicopter Emergency Medical Services ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel ◽  
Cpr Quality

Background Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions. Methods and Results Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitude sequence, sex, qualification, weight, preacclimatization, and interactions were analyzed. Our trial showed a time‐dependent decrease in chest compression depth ( P =0.036) after 20 minutes at altitude; chest compression depth was below the recommended minimum of 50 mm after 60 to 90 seconds (49 [95% CI, 46–52] mm) of CCO‐CPR. Conclusions This trial showed a time‐dependent decrease in CCO‐CPR quality provided by helicopter emergency medical services personnel during acute exposure to altitude, which was not perceived by the providers. Our findings suggest a reevaluation of the CPR guidelines for providers practicing at altitudes of 3000 m and higher. Mechanical CPR devices could be of help in overcoming CCO‐CPR quality decrease in helicopter emergency medical services missions. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04138446.

Differences in Cardiovascular Health Metrics in Emergency Medical Technicians Compared to Paramedics: A Cross-Sectional Study of Emergency Medical Services Professionals

2019 ◽  
Vol 34 (03) ◽  
pp. 288-296 ◽  
Author(s):  
Rebecca E. Cash ◽  
Remle P. Crowe ◽  
Julie K. Bower ◽  
Randi E. Foraker ◽  
Ashish R. Panchal
Keyword(s):  
Emergency Medical Services ◽  
Cardiovascular Health ◽  
High Stress ◽  
Emergency Medical Technicians ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Lower Odds ◽  
Emergency Medical ◽  
Employment Characteristics

AbstractBackground:Emergency Medical Services (EMS) professionals face high physical demands in high-stress settings; however, the prevalence of cardiovascular health (CVH) risk factors in this health care workforce has not been explored. The primary objective of this study was to compare the distribution of CVH and its individual components between a sample of emergency medical technicians (EMTs) and paramedics. The secondary objective was to identify associations between demographic and employment characteristics with ideal CVH in EMS professionals.Methods:A cross-sectional survey based on the American Heart Association’s (AHA; Dallas, Texas USA) Life’s Simple 7 (LS7) was administered to nationally-certified EMTs and paramedics. The LS7 components were scored according to previously described cut points (ideal = 2; intermediate = 1; poor = 0). A composite CVH score (0-10) was calculated from the component scores, excluding cholesterol and blood glucose due to missing data. Multivariable logistic regression was used to estimate odds ratios (OR; 95% CI) for demographic and employment characteristics associated with optimal CVH (≥7 points).Results:There were 24,708 respondents that were currently practicing and included. More EMTs achieved optimal CVH (n = 4,889; 48.8%) compared to paramedics (n = 4,338; 40.6%). Factors associated with higher odds of optimal CVH included: higher education level (eg, college graduate or more: OR = 2.26; 95% CI, 1.97-2.59); higher personal income (OR = 1.26; 95% CI, 1.17-1.37); and working in an urban versus rural area (OR = 1.31; 95% CI, 1.23-1.40). Paramedic certification level (OR = 0.84; 95% CI, 0.78-0.91), older age (eg, 50 years or older: OR = 0.65; 95% CI, 0.58-0.73), male sex (OR = 0.54; 95% CI, 0.50-0.56), working for a non-fire-based agency (eg, private service: OR = 0.68; 95% CI, 0.62-0.74), and providing medical transport service (OR = 0.81; 95% CI, 0.69-0.94) were associated with lower odds of optimal CVH.Conclusions:Several EMS-related characteristics were associated with lower odds of optimal CVH. Future studies should focus on better understanding the CVH and metabolic risk profiles for EMS professionals and their association with incident cardiovascular disease (CVD), major cardiac events, and occupational mortality.Cash RE, Crowe RP, Bower JK, Foraker RE, Panchal AR. Differences in cardiovascular health metrics in emergency medical technicians compared to paramedics: a crosssectional study of Emergency Medical Services professionals.Prehosp Disaster Med.2019;34(3):288–296.

scholarly journals Effect of Task Load Interventions on Fatigue in Emergency Medical Services Personnel and Other Shift Workers: A Systematic Review

2018 ◽  
Vol 22 (sup1) ◽  
pp. 81-88 ◽  
Author(s):  
Jonathan R. Studnek ◽  
Allison E. Infinger ◽  
Megan L. Renn ◽  
Patricia M. Weiss ◽  
Joseph P. Condle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Shift Workers ◽  
Task Load ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel

P490Time boundaries of three-phase time-sensitive model for ventricular fibrillation cardiac arrest

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
Y Goto ◽  
A Funada ◽  
T Maeda ◽  
F Okada ◽  
Y Goto
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Phase Time ◽  
Emergency Medical ◽  
Three Phase ◽  
Emergency Medical Services Personnel ◽  
Neurologically Intact

Abstract Funding Acknowledgements Japan Society for the Promotion of Science (KAKENHI Grant No. 18K09999) Background Recent clinical evidence has suggested that the pathophysiology of ventricular fibrillation (VF) cardiac arrest may consist of three time-sensitive phases, namely electrical, circulatory, and metabolic. According to this model of cardiopulmonary resuscitation (CPR), the optimal treatment of cardiac arrest is phase-specific. The potential survival benefit of bystander cardiopulmonary resuscitation (BCPR) depends in part on ischemic time (i.e., the collapse-to-shock interval), with the greatest benefit occurring during the circulatory (second) phase. However, the time boundaries between phases are not precisely defined in the current literature. Purpose The purpose of the present study was to determine the time boundaries of the three-phase time-sensitive model for VF cardiac arrest. Methods We reviewed 20,741 adult patients with initial VF after witnessed out-of-hospital cardiac arrest from a presumed cardiac origin who were included in the All-Japan Utstein-style registry from 2013 to 2017. We excluded patients who underwent bystander defibrillation prior to arrival of emergency medical services personnel. The study end point was 1-month neurologically intact survival (Cerebral Performance Category scale 1 or 2). Collapse-to-shock interval was defined as the time from collapse to first shock delivery by emergency medical services personnel. Patients were divided into two groups, BCPR (n = 11,606, 56.0%) and non-BCPR (n = 9135, 44.0%), according to whether they had received BCPR or not. Results The rate of 1-month neurologically intact survival in the BCPR group was significantly higher than that in the non-BCPR group (27.9% [3237/11,606] vs 17.9% [1632/9135], P < 0.0001; adjusted odds ratio [OR], 1.90; 95% confidence interval [CI], 1.75–2.07; P < 0.0001). Overall, increased collapse-to-shock interval was associated with significantly decreased adjusted odds of 1-month neurologically intact survival (adjusted OR for each 1-minute increase, 0.94; 95% CI, 0.93–0.95; P < 0.0001). In the BCPR group, the ranges of collapse-to-shock interval that were associated with increased adjusted 1-month neurologically intact survival were from 7 minutes (adjusted OR, 1.95; 95% CI, 1.44–2.63; P < 0.0001) to 17 minutes (adjusted OR, 2.82; 95% CI, 1.62–4.91; P = 0.0002) as compared with those in the non-BCPR group. However, the increase in neurologically intact survival of the BCPR group became statistically insignificant as compared with that of the non-BCPR group when the collapse-to-shock interval was outside these ranges. Conclusions The above-mentioned findings suggest that the time boundaries of the three-phase time-sensitive model for VF cardiac arrest may be as follows: electrical phase, from collapse to <7 minutes; circulatory phase, from 7 to 17 minutes; and metabolic phase, >17 minutes onward from collapse.

Occupational Injuries among Emergency Medical Services Personnel

2005 ◽  
Vol 9 (4) ◽  
pp. 405-411 ◽  
Author(s):  
Brian J. Maguire ◽  
Katherine L. Hunting ◽  
Tee L. Guidotti ◽  
Gordon S. Smith
Keyword(s):  
Emergency Medical Services ◽  
Occupational Injuries ◽  
Medical Services ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel
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