Relationship between occupational stress injury score and simulated patient-care scenario performance among experienced paramedics.

BACKGROUND: It is well-known that psychosocial health status of paramedics may be altered by their job demands. However, it is unknown whether psychosocial health status can affect occupational performance. OBJECTIVE: The goal of this study was to explore whether a paramedic's symptom severity of Occupational Stress Injury (OSI) was related to simulated patient-care performance. METHODS: Nineteen paramedics with 15.0±8.7 years of paramedic experience participated in this study. Participants completed both an OSI symptom severity questionnaires, and a patient-care simulation. Vagal activity was also collected during the patient-care simulation. The simulation was used to assess experienced paramedics in a realistic stressful setting. Based on the provincial standard in New Brunswick, an experienced paramedic instructor graded the patient-care simulation using the provincial standard charts, observing performance videos and assessing data from the manikin. RESULTS: The current study suggests that paramedics who self-reported elevated symptoms of OSI were less likely to successfully complete the simulated patient-care scenario. CONCLUSION: This research suggests that the presence of self-reported elevated symptoms of OSI negatively impacts paramedics' performance during a stressful work task simulation. Therefore, to help paramedics maintain optimal performance, it may be important to ensure that paramedics have access to appropriate resources to monitor and improve their psychosocial health.

Physiological responses during paramedics' simulated driving tasks.

BACKGROUND: Most ambulance collisions happen in emergency driving conditions and are caused by human factors. OBJECTIVE: This study investigated the influence of human factors associated with time pressure, patient-care intervention, and health status on the physiological responses of simulated emergency driving tasks. METHODS: A cohort of seventeen experienced paramedics performed a battery of three simulated diving tasks. The driving tasks were a non-urgent and two urgent driving simulations (one to the scene and one to the hospital). The second urgent driving task was preceded by a patient-care simulation (unstable cardiac patient with cardiopulmonary resuscitation). RESULTS: The physiological responses between the three driving tasks were not significantly different due to time pressure and patient-care intervention. It is postulated that the physiological response of experienced paramedics was influenced by the fact that they are accustomed to handling stressful situations daily. Furthermore, it was observed that paramedics with health conditions were more physiologically aroused during the urgent driving scenarios (pre and post-intervention), suggesting they might have an elevated risk of collision when they drive with urgency. Paramedics with health conditions also had higher physiological responses for the post-intervention baseline, leading to a longer recovery time period, which might represent an elevated risk of developing chronic health problems or amplifying existing ones. CONCLUSIONS: The findings of this research suggest that experienced paramedics manage the influence of time pressure and the impact of challenging patient-care well. Paramedics with health conditions represent an elevated risk of collision.

Exploration of the health status of experienced New Brunswick paramedics.

BACKGROUND: Literature reports that paramedics represent an at-risk occupation for the development of health problems. At least half of the paramedic population presents at least one risk factor associated with a negative health condition. These reports may suffer a "mono-method bias" where most reported outcomes are based on a single screening tool approach (may attenuate or inflate the prevalence). OBJECTIVE: The current study characterizes the health status of a cohort of twenty-five experienced New Brunswick (Canadian province) paramedics. METHODS: To understand possible limitations of past research, health status was characterized using four different methods: two methods using only one health measure and two were combined methods, integrating outcomes from at least two health measures to determine the prevalence of a given health status. RESULTS: Mono-bias was observed when using the single health measure methods. The difference among the four methods highlighted that a third of the cohort seemed unaware of their health condition. This result shed additional light on paramedics' health, where a high proportion of paramedics worked without knowledge of their health conditions. Based on a two health measures combined method, it was observed that only two-fifths of the current sample had no health conditions or could otherwise be considered as a "healthy". CONCLUSIONS: Because the literature has focused on single screening methods, our results were difficult to compare. However, there was a consensus that paramedics represent an at-risk occupation comprised of health problems. This study was exploratory and should be the basis for further research.