Survey results obtained from nearly 1,600 paramedics, EMTs, first responders, prehospital nurses and EMS physicians working full- or part-time or volunteering in an EMS agency offer an inside look at the safety-related culture of these organizations. These findings serve as “a wake-up call,” Daniel Patterson, Ph.D., MPH, EMT-B, at the University of Pittsburgh School of Medicine in Pennsylvania, told Research Monitor. He and colleagues report a wide variation in EMS providers’ views of safety and organizational aspects which, when viewed as a whole, reveal an agency’s overall “safety culture.” The results, from 61 rural, urban, air and ground ALS-level EMS agencies (one in Canada, the rest in the U.S.), reveal the following:
- More than half of the respondents had positive perceptions regarding their organization’s commitment to safety (58.6 percent), within-agency teamwork (52.8 percent) and personal job satisfaction (63.4 percent). Approximate mean scores (zero = low, 100 = high) in each area varied from 50–90 for safety, 45–90 for teamwork and 48–94 for job satisfaction.
- Less than half reported positive perceptions of overall managerial decisions (43.8 percent); working conditions, such as staffing and equipment (46.3 percent); and how stress affects their personal performance (28.6 percent). Approximate mean scores in these areas ranged from 32–92 for management, 37–91 for working conditions and 31–71 for stress.
While these findings should not be interpreted as nationally representative, they do provide benchmarking and comparative data that highlight how safety culture differs among organizations. EMS agencies interested in participating in annual safety culture data collection can visit U of Pittsburgh’s EMS Agency Research Network (emsarn.org), which administers this and other EMS-related initiatives.
— Prehospital Emergency Care 14(4):448–460, October–December 2010.
EMS Training Shortfalls, Take 1
EMS personnel receive little or no training in family-witnessed resuscitation and death notification, yet will increasingly deal with these situations as growing evidence supports prehospital TOR. With this in mind, Comilla Sasson, M.D., M.S., and colleagues at the University of Colorado in Denver assessed the feasibility and utility of a family-witnessed resuscitation educational module.
Forty-five paramedics, first responders, nurses and EMS administrators sat through a one-hour lecture on family-witnessed resuscitation and how to communicate bad news and respond to family needs. In before-and-after evaluations completed by 31 of the attendees, 61 percent correctly retained the information presented. Afterward, 20 participants joined life-like resuscitation scenarios; of the 10 with complete and linked pre- and post-training data, nine felt better able to communicate with and comfort family members. Eight felt better prepared to follow resuscitation protocols and communicate with colleagues while family members were present. Based on these findings, Sasson’s team hopes to develop an easily offered and economic standardized EMS training module.
— Prehospital Emergency Care 14(4):537–542, October–December 2010.
EMS Training Shortfalls, Take 2
Beyond treating physical injuries, EMS providers receive little or no formal training in supporting domestic violence victims, report Robin Mason, Ph.D., and colleagues at Women’s College Research Institute at Women’s College Hospital in Toronto, Canada. Mason and her team developed an Internet-based survey to assess prehospital responses to, and EMS provider knowledge of, domestic violence.
Over three months in 2005 and 2006, 480 EMT-Ds, EMT-Is and EMT-Ps from urban and rural locations in Canada answered some or all of the survey questions. Of the 385 who noted their responses to domestic violence calls during the previous 12 months, 90 percent went to at least one call, 24 percent went to 10, and only 10 percent dealt with none. Of the 381 respondents noting some prior domestic violence education, more than 58 percent self-educated—fewer than 36 percent via an EMS conference or CEU initiative. Less than 18 percent had formal academic domestic violence education, while close to 85 percent wanted more formal training. Mason’s team notes that while one standard prehospital training text offers some domestic violence training, these findings highlight a need and desire for more prehospital domestic violence education opportunities.
— Emergency Medicine Journal 27(7):561–564, July 2010.
Emergency Respirator Could Save Firefighters
An air filtering respirator could save firefighters’ lives in the event their SCBA regulator runs out before they can escape a burning environment. David C. Cone, M.D., and colleagues at Yale University School of Medicine in New Haven, Conn., assessed a 3x5-inch filtering cartridge that replaces a depleted SCBA regulator and offers at least 10 minutes of escape time. After using the device different ways, in different scenarios—switching from the SCBA regulator to the filtering cartridge, or using the filtering cartridge in place of the SCBA regulator while passively in a fire environment or actively working fires set during live-burn exercises in a large three-story wood-frame house destined for demolition—13 career firefighters (male, 33 to 54 years old) said they want to carry the respirator as part of their gear.
Air and vital sign monitoring showed the device protected against CO inhalation without physically impeding firefighters. However, the device does not supply oxygen, Cone’s team cautions, and will not help in oxygen-depleted environments. Cone’s team says the device should be tested in larger groups and for how well it filters other combustion-related toxins. Still, “each SCBA unit at my fire department has one,” Cone, who also serves as EMS section chief for Yale Emergency Medicine, told Research Monitor, “and we are all fully trained to use it.”
— Prehospital Emergency Care 14(4):433–438, October–December 2010.
