ABSTRACT
Background: The outbreak of war in Israel on 7 October and the unique events of that day have presented unprecedented challenges to first responders (FRs), who are professionally trained to engage in providing assistance in such circumstances. Moreover, while research demonstrates the long-term psychological consequences of FRs, little is known regarding how FR's engagement in providing assistance relates to stress and resilience levels as events continue to unfold.Objective: The current study examined the relationship between traumatic stress symptoms (TSS) and resilience levels among FRs and controls during the first weeks of the Iron Swords war, while focusing on the moderating role of active engagement in providing assistance.Method: Data were collected during the first month of the Iron Swords war from 374 participants living in Southern Israel, of whom 77 (20.6%) were FRs. All participants filled out scales assessing TSS and resilience and provided relevant background information.Results: High TSS levels were associated with reduced resilience in FRs and non-FRs. Moreover, both the study group and active engagement were significant moderators for the TSS-resilience link, which was insignificant among FRs who provided assistance and for civilians who did not provide assistance. However, the TSS-resilience association remained significant for FRs who did not engage in providing assistance and for civilians who did.Conclusions: Our findings highlight the importance of examining the extent to which FRs act in line with their duties during times of adverse stress. Clinical interventions aimed towards FRs who did not engage in providing assistance are needed and should focus on the extent to which their moral values, beliefs and expectations are met, as these appear critical parameters in preserving resilience.
First responders report increased traumatic stress and reduced resilience.Active engagement moderated first responders' traumatic stressresilience link.Findings are discussed in the context of potentially morally injurious events.
Subject(s)
Emergency Responders , Resilience, Psychological , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/psychology , Disease Outbreaks , IronABSTRACT
BACKGROUND: The development of skin cancer is closely related to high exposure to UV radiation. Lifeguards are at an increased risk of excessive sun exposure. OBJECTIVES: The main objective of this study was to measure the exposure of Barcelona's beach lifeguards to UV radiation. METHODS: Measurements in the work chair were taken every 30min on a typical working day from 10:45 am to 19:15 pm. These measurements were carried out on four different days. These data were used to calculate the erythematous doses received during working hours, as well as those potentially received throughout the summer season. Vitamin D production was also estimated for the four days that the radiation received was measured, and the amount generated was calculated for the entire summer season. RESULTS: Exposure to UV radiation among Barcelona lifeguards far exceeds safety limits. In some locations, the exposure to UVB radiation is more than 16 times the minimum erythematous dose for phototype II skin. LIMITATIONS: This study assessed the radiation received during only four days. However, is a much higher number than most of the published papers. CONCLUSION: Although the health risks of excessive exposure to UV radiation are known, Barcelona's beach lifeguards are insufficiently protected.
Subject(s)
Occupational Exposure , Ultraviolet Rays , Ultraviolet Rays/adverse effects , Spain/epidemiology , Humans , Occupational Exposure/adverse effects , Bathing Beaches , Skin Neoplasms/etiology , Skin Neoplasms/prevention & control , Skin Neoplasms/epidemiology , Seasons , Vitamin D/biosynthesis , Occupational Diseases/etiology , Occupational Diseases/epidemiology , Occupational Diseases/prevention & controlABSTRACT
BACKGROUND: The development of skin cancer is closely related to high exposure to UV radiation. Lifeguards are at an increased risk of excessive sun exposure. OBJECTIVES: The main objective of this study was to measure the exposure of Barcelona's beach lifeguards to UV radiation. METHODS: Measurements in the work chair were taken every 30min on a typical working day from 10:45 am to 19:15 pm. These measurements were carried out on four different days. These data were used to calculate the erythematous doses received during working hours, as well as those potentially received throughout the summer season. Vitamin D production was also estimated for the four days that the radiation received was measured, and the amount generated was calculated for the entire summer season. RESULTS: Exposure to UV radiation among Barcelona lifeguards far exceeds safety limits. In some locations, the exposure to UVB radiation is more than 16 times the minimum erythematous dose for phototype II skin. LIMITATIONS: This study assessed the radiation received during only four days. However, is a much higher number than most of the published papers. CONCLUSION: Although the health risks of excessive exposure to UV radiation are known, Barcelona's beach lifeguards are insufficiently protected.
ABSTRACT
Purpose: The aim of this study was to analyze the different phases of a water rescue, their influence in the whole lifesavingand if lifeguards could be differentiated according to their abilities during a water rescue.Methods: A cross-sectional study was carried out to analyze the different phases and lifeguardsabilities of a simulated water rescue of 100 m. Thirty-fourprofessional lifeguards performed the test and the time was recorded for the first phase (swimming to the victim), the second phase (towing back the victim) and the third phase (extracting the victim). A discriminant analysis was conducted in order to classifylifeguards in two groups (high or medium level of abilities during the water rescue) and the times were compared on each phase.Results: The time during the second and the third phase classify correctly the lifeguards according to their level of abilities. Lifeguards with higher level of abilities performed the water rescue significantly faster, specifically during the second (p < 0.001, ES =1.38, large) and the third phase (p =0.002, ES = 1.09, medium), but no differences were found in the first part of the water rescue (p > 0.05). Conclusion: The time of a simulated water rescue seems to bea good method to classify lifeguards according to their abilities. These findings could allow rescue teams to know the skills of their lifeguards and design strategiesin order to decrease risks and enhance lifesaving (AU)
Objetivo: Analizar las diferentes fases del rescate para conocer su influencia sobre el resultado final y categorizar a los socorristas de acuerdo a su competencia acuática.Métodos: Se realizó un estudio cruzado simulando un rescate a 100 metros con 34 socorristas, analizando las tres fases del rescate: nado hacia la víctima, traslado a tierra y extracción. Se realizó un análisis discriminante para clasificar a los socorristas según el tiempo de rescate.Resultados: La segunda y la tercera fase clasificó correctamente a los socorristas de acuerdo al tiempo empleado. La mayor competencia fue determinada especialmente en la segunda fase del salvamento (p<0,001, TE=1,38, grande) y en menor medida de la tercera fase (p=0,002, TE=1,09, mediano).Conclusión: El tiempo empleado en la segunda fase parece ser un buen método para clasificar la competencia de los socorristas durante el rescate. Estos hallazgos proporcionan información relevante para el entrenamiento y organización de equipos de rescate (AU)
Subject(s)
Humans , Male , Female , Young Adult , Rescue Personnel , Aquatic Rescue , Search and Rescue , Physical Functional Performance , Cross-Sectional StudiesABSTRACT
Objetivo: compreender como os profissionais de saúde que atuam no pré-hospitalar vivenciam a comunicação de más notícias à família na emergência pediátrica, bem como propor um protocolo de comunicação baseado nessas experiências. Método: pesquisa qualitativa com sustentação teórico-metodológica baseada no Interacionismo Simbólico e na Análise Temática Indutiva, mediante entrevistas semiestruturadas, no 2º semestre de 2019. Resultados: os profissionais vivenciaram o difícil processo de comunicação sob a influência do ambiente hostil. Eles estabeleceram ações para tentar cuidar e acolher a família. O cuidado com a família gerou reflexões e desejo de oferecer um atendimento adequado. Após a análise dessas experiências, foi proposto o Protocolo Acolher. Considerações finais: os profissionais de saúde que atuam no pré-hospitalar sentem-se pouco preparados e extremamente desconfortáveis diante da comunicação de más notícias. O protocolo desenvolvido pode colaborar no direcionamento aos profissionais do Atendimento Pré-Hospitalar e ajudá-los no processo de comunicação de más notícias.
Objetivo: comprender cómo los profesionales sanitarios que trabajan en el prehospitalario experimentan la comunicación de malas noticias a la familia en la emergencia pediátrica, así como proponer un protocolo de comunicación basado en estas experiencias. Método: investigación cualitativa con soporte teórico-metodológico basado en el Interaccionismo Simbólico y el Análisis Temático Inductivo, a través de entrevistas semiestructuradas, en el 2º semestre de 2019. Resultados: los profesionales experimentaron el difícil proceso de comunicación bajo la influencia del ambiente hostil. Establecen acciones para tratar de cuidar y acoger a la familia. El cuidado familiar generó reflexiones y un deseo de brindar una atención adecuada. Tras el análisis de estas experiencias, se propuso el Protocolo de Bienvenida. Consideraciones finales: los profesionales de la salud que trabajan en el prehospitalario se sienten poco preparados y extremadamente incómodos ante la comunicación de malas noticias. El protocolo desarrollado puede colaborar en la dirección de los profesionales de la atención prehospitalaria y ayudarles en el proceso de comunicación de malas noticias.
Objective: to understand how health professionals working in the pre-hospital experience the communication of bad news to the family in the pediatric emergency, as well as to propose a communication protocol based on these experiences. Method: qualitative research with theoretical-methodological support based on Symbolic Interactionism and Inductive Thematic Analysis, through semi-structured interviews, in the 2nd semester of 2019. Results: the professionals experienced the difficult communication process under the influence of the hostile environment. They set out actions to try to care for and receive the family. Family care generated reflections and a desire to provide adequate care. After the analysis of these experiences, the Protocolo Acolher was proposed. Final considerations: health professionals working in the pre-hospital feel unprepared and extremely uncomfortable before communicating bad news. The protocol developed can collaborate in directing pre-hospital care professionals and help them in the process of communicating bad news.
Subject(s)
Humans , Pediatric Nursing , Family Nursing , Emergencies , Health Communication , Nursing TheoryABSTRACT
ABSTRACT Objective: Identify non-pharmacological therapies for the treatment of post-traumatic stress disorder in emergency responders. Method: Scope review according to the guidelines of the Joanna Briggs Institute and the PRISMA-ScR protocol. A search was conducted in nine databases, portals of theses and dissertations, and using an electronic search engine. Results: In total, 23 studies were selected and analyzed, and then categorized into six thematic fields - therapy with omega 3 food supplement, art therapy, physical exercise therapy, mindfulness-based therapy, therapy with elements of nature, and psychotherapy - which were considered non-pharmacological treatments for this psychopathology among emergency responders, as well as the use of psychotherapy via telehealth as an option for treatment. Conclusion: More evidence supporting diet therapy is required, while the other therapeutic options presented positive results, finding support in national and international recommendations of treatment and clinical practice.
RESUMEN Objetivo: Identificar las terapias no farmacológicas utilizadas para tratamiento del trastorno de estrés postraumático en profesionales emergencistas. Método: Revisión de alcance conforme indicaciones del Instituto Joanna Briggs y del protocolo PRISMA-ScR. Búsqueda realizada en nueve bases de datos, portales de tesis y disertaciones, y mediante buscador electrónico. Resultados: Fueron seleccionados y caracterizados 23 estudios, categorizados en seis ejes temáticos, a saber: terapia con suplemento alimentario de omega 3; arteterapia, terapia con ejercicios físicos, terapia con técnica de mindfulness, terapia con elementos de la naturaleza y psicoterapia, todos ellos destacados como tratamientos no farmacológicos para esta patología en profesionales emergencistas, así como el recurso de la psicoterapia vía telesalud como alternativa de tratamiento. Conclusión: Se necesita mayor cantidad de evidencias respaldando la terapia alimentaria, mientras que las demás alternativas terapéuticas encontradas demostraron resultados positivos, hallando respaldo en recomendaciones nacionales e internacionales de tratamiento y práctica clínica.
RESUMO Objetivo: Identificar as terapias não farmacológicas utilizadas no tratamento do transtorno de estresse pós-traumático em profissionais emergencistas. Método: Revisão de escopo conforme orientações do Instituto Joanna Briggs e do protocolo PRISMA-ScR. A busca foi realizada em nove bases de dados, portais de teses e dissertações e por meio de buscador eletrônico. Resultados: Foram selecionados e caracterizados 23 estudos, que foram categorizados em seis eixos temáticos, sendo eles: terapia com suplementação alimentar com ômega 3, arteterapia, terapia com exercícios físicos, terapia envolvendo a técnica mindfulness, terapia com elementos da natureza e psicoterapia, que foram apontados como tratamentos não farmacológicos para esta psicopatologia em profissionais emergencistas e, ainda, o recurso da psicoterapia via telessaúde como uma alternativa no tratamento. Conclusão: É necessário maior número de evidências que suportem a terapia dietética, enquanto as demais alternativas terapêuticas encontradas apresentaram resultados positivos, encontrando suporte nas recomendações nacionais e internacionais de tratamento e prática clínica.
Subject(s)
Stress Disorders, Post-Traumatic , Complementary Therapies , Review , Emergency Nursing , Emergency RespondersABSTRACT
Fundamento: la parada cardiaca primaria es un problema de salud mundial y una de sus soluciones es disponer, tanto la población como los profesionales de la salud, de conocimientos en reanimación cardiopulmocerebral. El proyecto para la formación e investigación en apoyo vital en emergencias y desastres puede ser un marco académico para lograrlo. Objetivo: actualizar, para el proyecto, las guías y estrategia docente para la enseñanza del socorrismo. Métodos: taller nacional realizado en julio del 2018 en Cienfuegos, con 13 expertos y cuatro informantes clave. Se utilizaron la técnica de tormenta de ideas y de grupo nominal, cuestionario semiestructurado y revisión documental previa. Resultados: se proponen para la enseñanza del socorrismo tanto en el pregrado como el posgrado: los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se definió la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusiones: las propuestas académicas para el curso "Apoyo vital socorrista" permiten el abordaje de la enseñanza de los primeros auxilios tanto a la población como a grupos especializados de socorristas.
Foundation: Primary cardiac failure is a worldwide Health problem and one of its solutions is to count on health professionals and the population in general with knowledge in cardio-pulmonary-cerebral resuscitation. The project for the training and research in life support in emergencies and disasters may be an academic framework to achieve it. Objective: to update, for the project, the teaching guides and strategy for first aids. Methods: national workshop developed in July 2018 in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming, and nominal group, semi-structured questionnaire and documentary review were used. Results: it is proposed for teaching first aids to undergraduate students and postgradutes as well: the objectives, specific aspects, teaching strategy, contents, scope, skills to develop, future research, and areas for inter-institutional collaboration. Conclusion: academic proposals for the course "Life Support" allows approaching treaching first aids to the population and specialized groups as well.
ABSTRACT
Fundamento: en situaciones de desastres, cuando el número de enfermos o lesionados es alto y los recursos limitados, la atención médica precisa de cambios de estructura y procesos si se quiere salvar un número elevado de personas. El personal de salud debe estar entrenado para enfrentar esta situación cada vez más frecuente. El "Proyecto para la formación e investigación en apoyo vital en emergencias y desastres" puede ser un marco académico para lograrlo. Objetivo: actualizar, para el proyecto, las guías y estrategia docente para la enseñanza del apoyo vital ante víctimas múltiples. Métodos: taller nacional realizado el 10-11 de julio del 2018 en Cienfuegos, con 13 expertos y cuatro informantes clave. Se utilizaron la técnica de tormenta de ideas y de grupo nominal, cuestionario semiestructurado y revisión documental previa. Resultados: se proponen para la enseñanza del apoyo vital en situaciones de desastres, tanto en el pregrado como el posgrado: los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se definió la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusiones: las propuestas académicas para el curso "Apoyo vital avanzado ante víctimas múltiples" permiten la preparación de los profesionales de la salud para brindar asistencia médica en situaciones de desastres, con escasos recursos y en ambientes complejos.
Foundation: in disaster situations, when the number of patients or injured is high and the resources are limited, medical care requires changes of structures and processes if it is aimed to save most of the persons involved. Health personnel should be trained to face this situation becoming more frequent each time. Objective: to update, for the project, the guidelines and strategies for teaching life support in the presence of mass casualty. Methods: national workshop developed in July 10th and 11th in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming and nominal group, semi-structured and previous documentary review. Results: objectives, specific aspects, teaching strategy, contents, scope of the abilities, skills to develop, future research, and areas for inter-institutional collaboration were proposed for teaching life support in situations of disaster. Conclusion: academic proposals for the course "Life support in the presence of mass casualty¨ allow preparing health professionals to offer medical assistance in situations of disasters with limited resources in complex environments.
ABSTRACT
Objetivo: identificar o conhecimento de profissionais do corpo de bombeiros militar sobre as manobras de ressuscitação cardiopulmonar. Método: estudo quantitativo, descritivo e exploratório. Foi aplicado questionário em 41 profissionais com questões referentes aos aspectos conceituais e práticos sobre a PCR de acordo com as diretrizes da American Heart Association/2015. Para a análise estatística, foram utilizados os programas Stata 12.0 e WinPepi, versão 11.43. Resultados: prevaleceu o sexo masculino, idade média de 35 anos, com formação superior e mais de cinco anos de experiência. Sobre os aspectos conceituais, apenas a definição de "Tempo de ouro" apresentou acertos inferiores a 50%. Para os aspectos práticos, as variáveis sobre a postura e profundidade das compressões torácicas ficaram abaixo de 50% de acertos. A associação da idade e a relação entre erros e acertos das questões sobre os aspectos práticos foi estatisticamente significativa. Conclusão: revelou-se a necessidade de qualificação em busca da excelência no atendimento à vítima de PCR dada a sua natureza emergencial.(AU)
