IntroductionParamedics are health care workers who respond to medical emergencies. Paramedics exhibit high rates of injury and illness with markers of poor health. The aims of this study were to explore the self-reported health status of paramedics in New South Wales, Australia, and to compare it with that of the Australian general population and to examine paramedics' attitudes towards exercise. MethodsIn 2015, paramedics employed by NSW Ambulance were invited to complete a web-based survey composed of the Medical Outcomes Survey Short Form 36 (SF-36), measures of attitudes towards exercise and demographic information. Normative comparator data for the Australian general population (BMI and SF-36 scores) were sourced from the Household Income Labour Dynamics in Australia 2015 survey. ResultsOf the approximately 3,300 paramedics invited to participate, 747 completed the survey (507 male, 240 female). Mean age and mean years of service were 41.5 ± 9.5 (SD) and 13.6 ± 9.0 respectively. Male paramedics scored higher than females (p<0.001) in the Vitality domain of the SF-36, and regional paramedics had a higher General Health domain score than metropolitan paramedics (p<0.05). Regional male paramedics had higher BMIs than their metropolitan counterparts (28.04 kg/m2 ± 3.99 vs. 26.81 kg/m2 ± 4.67, p = 0.001). Compared to the Australian population, paramedics scored higher in the Physical Function domain (p<0.001) but lower in summary scores for mental and physical health (p<0.001). Paramedics' BMIs were slightly higher than the general population (27.10 ± 4.30 kg/m2 vs. 26.47 ±5.42, p<0.001). Paramedics reported lack of time, family commitments, and lack of motivation and in regional postings: distance to fitness facilities and shift patterns as barriers to exercise. ConclusionsParamedics scored lower on the SF-36 than the general population, which can indicate a lower health-related quality of life. High BMI and low SF-36 scores may be related to a perceived inability to engage in regular exercise. Increasing BMI can be associated with the development of markers of poor health. Attention is needed to ensure that paramedics are "fit for duty". Ambulance management should foster innovative health promotion programs and paramedics need to recognise and value good health.
<p><strong>Background</strong></p><p>Fatigue is a complex phenomenon that has effects on physical characteristics, cognition, behaviours, and physical and mental health. Paramedicine crosses the boundaries of many high-risk industries, namely medicine, transport and aviation. The effects of fatigue on paramedics thus need to be explored and considered in order to begin to identify appropriate interventions and management strategies.</p><p><strong>Aim</strong></p><p>The aim of this article was to provide an overview of fatigue in paramedics and its potential effects on various areas of paramedic practice and paramedic health, and to outline potential solutions to assess and manage the risk of fatigue in paramedics as suggested by the literature.</p><p><strong>Methods</strong></p><p>We conducted unstructured, non-systematic searches of the literature in order to inform an overview of the literature. An overview is a summary of the literature that attempts to survey the literature and describe its characteristics. We thematically structured the review under the following headings: defining occupational activity and health status; clinical performance and patient safety; shift length and time at work; effects on paramedic health; effects on driving abilities; fatigue risk management; and, fatigue proofing.</p><p><strong>Discussion</strong></p><p>Fatigue should be considered in the context of overall paramedic health status and paramedic occupational activity. The nature of paramedic shift work, and the associated occupational activity place paramedics at increased risk from fatigue. Shift work may also contribute to sleep disorders among paramedics. Fatigue is associated with increased errors and adverse events, increased chronic disease and injury rates, depression and anxiety, and impaired driving ability.</p><p><strong>Conclusion</strong></p><p>The issue of fatigue in paramedicine is complex and has serious consequences for patients and paramedics. Paramedic services and paramedics need to work collaboratively to identify and action appropriate measures to reduce the effects of fatigue on the wellbeing of the workforce and mitigate its effects on clinical performance and safety.</p>
<p>This article draws on our experiences in project-based learning and in particular our experiences in facilitating a group of paramedicine students tasked with the responsibility of evaluating clinical simulation debriefing sessions.</p><p>Using critical reflection as the research methodology, we unearthed and reworked our experiences in this project, especially the experiences of one of us, Sandy, who took on role of project facilitator. The article identifies the importance of alignment between student and teacher in project-based learning and a set of principles are offered to guide and support this in project-based teaching. These principles include open communication and respect, the suspension of conventional belief, and reflection on professional practice.</p><p> </p><p> </p><p><strong> </strong></p><p> </p>
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