Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Patient and provider safety is paramount in all aspects of emergency medical services (EMS) systems. The leaders, administrators, and policymakers of these systems must have an understanding of situations that present potential for harm to patients or providers. ⋯ This EMS safety incident reporting system identified situations that occurred in many categories of EMS care. These potential dangers represent opportunity to assess, and ultimately change, policy and procedures to reduce potential safety events and medical errors and improve overall safety. A substantial number of cases were excluded to maintain the promise of anonymity within the system.
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A common tenet in emergency medical services (EMS) is that faster response equates to better patient outcome, translated by some EMS operations into a goal of a response time of 8 minutes or less for advanced life support (ALS) units responding to life-threatening events. ⋯ These results call into question the clinical effectiveness of a dichotomous 8-minute ALS response time on decreasing mortality for the majority of adult patients identified as having a life-threatening event at the time of the 9-1-1 call. However, this study does not suggest that rapid EMS response is undesirable or unimportant for certain patients. This analysis highlights the need for further research on who may benefit from rapid EMS response, whether these individuals can be identified at the time of the 9-1-1 call, and what the optimum response time is.
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Recent research efforts in emergency medical services (EMS) has identified variability in the ability of EMS personnel to recognize their level of stress-related impairment. Developing a better understanding of how workplace stress may affect EMS personnel is a key step in the process of increasing awareness of the impact of work-related stress and stress-related impairment. ⋯ These findings indicate that exposure to both chronic and critical incident stressors increases the risk of EMS providers' developing a posttraumatic stress reaction. Higher levels of chronic stress, critical incident stress, and alcohol use significantly related to an increased level of PTSS. Further, for those reporting high levels of alcohol use or critical incident stress, interactions with high levels of chronic operational stress were associated with higher rates of PTSS. For those interested in the impact of work-related stress in EMS, these findings indicate that attention must be paid to levels of stress associated with both critical incident exposure as well as the chronic stress providers experience on a day-to-day basis.
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Abstract The out-of-hospital setting is unique to health care and presents many challenges to providing safe, high-quality medical care in emergency situations. The challenges of the prehospital environment require thoughtful design of systems and processes of care. The unique challenges of ambulance safety may be met by analyzing systems and incorporating process improvements. ⋯ The agent of injury refers to the energy exerted during the course of an injury, and may be modified to include unrestrained equipment that contributes to the injury. The physical environment refers to the characteristics of the setting in which the injury takes place, such as the roadway or the physical design of the ambulance. Finally, the social environment refers to the social, legal, and cultural norms and practices in the society, such as peer pressure and a culture that discourages the use of safety equipment.
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To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among emergency medical services (EMS) workers. ⋯ In this sample of EMS workers, poor sleep quality and fatigue are common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes.