To what extent do paramedics apply safe handling principles when transferring patients from stair chairs to stretchers?

The efficiency of training programmes in handling designed to prevent injuries has rarely been demonstrated by studies in the workplace. This study aimed to identify factors that may favour or inhibit the application of safe handling principles by paramedics performing full-body transfers of patients from a stair chair to a stretcher. In an observational field study, handling methods used in 45 patient transfers from a stair chair to stretcher were characterised. Principles concerning the physical environment seem to be applied frequently, but those applicable during the transfer are neglected. Principles taught during training may not be applied due to the physical constraints of the workplace and the underestimation of risk exposure. The results suggest that training should be enhanced, not by focussing on handling techniques but by focussing on compromise and the capacity to adapt work techniques based on the working context and the team-mate.

Overall risk index for patient transfers in total assistance mode executed by emergency medical technician-paramedics in real work situations.

Few studies have quantified the risk of musculoskeletal disorders during patient transfers in total assistance mode in real-life prehospital emergency care situations. An index to assess the overall risk of patient transfers was created; it makes it possible to quantify risk based on the patient's position and the height of the patient's location. An analysis of 71 transfers executed by paramedics in actual work situations showed that moving a patient from the ground was characterized by acute sagittal flexions and axial rotations, respectively, 42% and 12% of the time. When the patient was lying on a raised surface, the lifting index and perceived exertion were the lowest (2.55; easy). According to the overall risk index, patient transfers from the ground are the riskiest. Paramedics execute many risky lifts even in favorable patient handling contexts.

Current state of knowledge of post-traumatic stress, sleeping problems, obesity and cardiovascular disease in paramedics.

PURPOSE: The impacts of emergency work on firefighters have been well documented and summarised, but this is not the case for paramedics. This paper explores the literature regarding the impact of work stress on paramedics. OBJECTIVE: To identify the literature available on the effect of paramedics' jobs on their health status. METHODS: Electronic database used: MEDLINE (Ovid, PubMed, National Library of Medicine) between 2000 and 2011. Key words used for the computer searches were: paramedics, emergency responders, emergency workers, shift workers, post-traumatic symptoms, obesity, stress, heart rate variability, physiological response, blood pressure, cardiovascular and cortisol. Exclusion criteria were: studies in which participants were not paramedics, participants without occupational exposure, physical fitness assessment in paramedics and epidemiological reports regarding death at work. RESULTS: The electronic databases cited 42 articles, of which we excluded 17; thus, 25 articles are included in this review. It seems clear that paramedics accumulate a set of risk factors, including acute and chronic stress, which may lead to development of cardiovascular diseases. Post-traumatic disorders, sleeping disorders and obesity are prevalent among emergency workers. Moreover, their employers use no inquiry or control methods to monitor their health status and cardiorespiratory fitness. CONCLUSIONS: More studies are needed to characterise paramedics' behaviour at work. These studies could allow the development of targeted strategies to prevent health problems reported in paramedics.

Paramedics on the job: dynamic trunk motion assessment at the workplace.

Many paramedics' work accidents are related to physical aspects of the job, and the most affected body part is the low back. This study documents the trunk motion exposure of paramedics on the job. Nine paramedics were observed over 12 shifts (120 h). Trunk postures were recorded with the computer-assisted CUELA measurement system worn on the back like a knapsack. Average duration of an emergency call was 23.5 min. Sagittal trunk flexion of >40° and twisting rotation of >24° were observed in 21% and 17% of time-sampled postures. Medical care on the scene (44% of total time) involved prolonged flexed and twisted postures (∼ 10s). The highest extreme sagittal trunk flexion (63°) and twisting rotation (40°) were observed during lifting activities, which lasted 2% of the total time. Paramedics adopted trunk motions that may significantly increase the risk of low back disorders during medical care and patient-handling activities.