Fit for duty: shedding light on paramedics' health via research methodologies

MacQuarrie, Alex; Whitfield, Steve

doi:10.12968/ippr.2019.9.2.47

Cited by 3 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Paramedic services tend to have a higher proportion of overweight and obese paramedics according to BMI compared with the general population 35 . Furthermore, there is evidence of higher HR and MAP by overweight and obese paramedics when performing their duties compared with the participants of this study 30 . The paramedic academics who evaluated and scored clinical performance using the GRS, although blinded to treatment, may have known the identity of the participant because of interacting with them during their training.…”

Section: Limitationsmentioning

confidence: 75%

“…Although studies have examined the effect of alarms on physiological arousal for responding paramedics and firefighters, 28,29 the addition of physical tasks could be expected to increase HR, BP, and self-reported fatigue even further previous mentioned resting levels. This has been demonstrated in research involving paramedics responding to calls 30 . However, possible relationships between heightened physiological stress, fatigue, and decreased clinical performance have not before been empirically investigated in first responders.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Paramedic Student Clinical Performance During High-Fidelity Simulation After a Physically Demanding Occupational Task

et al. 2021

Self Cite

View full text Add to dashboard Cite

IntroductionParamedic duties include assessing, treating, and maneuvering patients in physically challenging environments. Whether clinical skills and patient care are affected by these occupational demands is unknown. High-fidelity simulation affords the opportunity to study this in a controlled setting.MethodsUsing a randomized crossover design, 11 regional paramedicine students and graduates (mean ± SD age = 23 ± 2 years) completed two, 20-minute high-fidelity simulations that included cardiopulmonary resuscitation (CPR) immediately after either an acute bout of occupational physical activity (OPA) or a rest period (REST). Heart rate, respiratory rate, and mean arterial pressure were measured throughout. Clinical performance was scored using the Global Rating Score and a patient care record. Measures of CPR efficacy were recorded in the manikin.ResultsThere were no significant differences in Global Rating Score (P = 0.07, ES = 0.03) or CPR efficacy between conditions. Patient care record accuracy was higher after the OPA versus REST simulations (mean ± SD = 61.8 ± 12.6% vs. 55.5 ± 12.0%, P = 0.03, ES = 0.5). Mean heart rate was higher during OPA simulations versus REST simulations (121 ± 14 vs. 84 ± 9 beats per minute, P < 0.01, ES = 3.1), as was mean respiratory rate (19 ± 3 vs. 16 ± 3 breaths per minute, P < 0.01, ES = 1.0). Mean arterial pressure was higher for OPA versus REST at simulation start (105 ± 11.3 vs. 95.8 ± 11.8 mm Hg, P = 0.01, Effect Size = 0.8), although not different after simulation.ConclusionsParamedicine students including recent graduates performed as well, or better, in a simulated clinical scenario immediately after occupation-specific acute physical exertion compared with a REST, despite higher physiological exertion. Whether this is the case for more experienced but potentially less physically fit paramedics in the workforce warrants investigation.

show abstract

Section: Limitationsmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Paramedic Student Clinical Performance During High-Fidelity Simulation After a Physically Demanding Occupational Task

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…We observed that paramedic practice is unique in that it can encompass all forms of clinical presentations, in unpredictable environments, and with diverse social and cultural contexts [52][53][54][55]. Paramedics are regularly subject to emotionally challenging work, violence [56,57], high rates of occupational injury [54,58,59], stress and mental health issues [60][61][62][63], poor physical health status [18,64,65], and the effects of shift-work [66][67][68][69]. In addition, paramedics are often required to make clinical decisions with limited information [70][71][72].…”

Section: Microsystem -Considering the Paramedic As A Personmentioning

confidence: 99%

Identifying Features of a System of Practice to Inform a Contemporary Competency Framework for Paramedics in Canada

Batt,

Lysko,

Bolster

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when revising a national competency framework for paramedics in Canada. Methods We used a systems thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macro system, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features. Findings When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person-receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts, and is subject to multiple levels of policy, regulatory, and legislative influence. Conclusion Using a systems thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada.

show abstract

“…We observed that paramedic practice is unique in that it can encompass all forms of clinical presentations, in unpredictable environments, and with diverse social and cultural contexts [46][47][48][49]. Paramedics are regularly subject to emotionally challenging work, violence [50,51], high rates of occupational injury [48,52,53], stress and mental health issues [54][55][56][57], poor physical health status [18,58,59], and the effects of shift work [60][61][62][63]. In addition, paramedics are often required to make clinical decisions with limited information [64][65][66].…”

Section: Microsystem-considering the Paramedic As A Personmentioning

confidence: 99%

Identifying Features of a System of Practice to Inform a Contemporary Competency Framework for Paramedics in Canada

Batt,

Lysko,

Bolster

et al. 2024

Healthcare

View full text Add to dashboard Cite

Introduction: Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when developing a national competency framework for paramedics in Canada. Methods: We used a systems-thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macrosystem, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features. Findings: When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts and is subject to multiple levels of policy, regulatory, and legislative influence. Conclusion: Using a systems-thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada.

show abstract

Fit for duty: shedding light on paramedics' health via research methodologies

Cited by 3 publications

References 18 publications

Paramedic Student Clinical Performance During High-Fidelity Simulation After a Physically Demanding Occupational Task

Paramedic Student Clinical Performance During High-Fidelity Simulation After a Physically Demanding Occupational Task

Identifying Features of a System of Practice to Inform a Contemporary Competency Framework for Paramedics in Canada

Identifying Features of a System of Practice to Inform a Contemporary Competency Framework for Paramedics in Canada

Contact Info

Product

Resources

About