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Signa Vitae

Journal of Intensive Care and Emergency Medicine

Assessment of the implementation of step-by-step adult basic life support sequence by emergency medical technicians and drivers during regular annual training

Abstract

Objective. Evaluation of the efficiency of practicing step-by-step (SBS) BLS/AED (basic life support/automatic external defibrillator) sequence by emergency medical technicians (EMT) and ambulance drivers (AD) working in medical transport teams.

Methods. A prospective two-month study was conducted in which EMTs and ADs working in medical transport teams performed their regular 4-hour annual training (1 h of lectures, 1.5 h of practical training and 1.5 h of testing). Each participant performed SBS of BLS/AED sequences in front of a three-member team of instructors. The implementation of BLS/AED sequence was evaluated by scoring from 0 to 2 (0 – not, 1 – partially, 2 – properly), separately for EMTs, ADs and in total. The final analysis compared a properly implemented SBS sequence (S1-S36) of actions: IA – initial assessment (S1-S10), BLS (S11-S18), AED (S19-S25), RP – recovery position (S26-S32) and FBAO – foreign body airway obstruction (S33-S36) for use by the BLS/AED between EMTs and ADs. The criterion for a completed regular training was at least 47 (65.0%) of the total number of points won for properly implemented procedures.

Results. The study involved 31 EMTs and 63 Ads, regardless of gender and average age, with EMTs having slightly longer work experience (p>0.05). The results of our study show that EMTs are more skilled at IA, cardiopulmonary resuscitation (CPR) and AED, whereas ADs were better at implementing RP and performing the Heimlich maneuver (p<0.001).

Conclusion. Although EMTs and ADs implement SBS BLS/AED procedures correctly and satisfactorily in more than 65.0%, future research should focus on finding more efficient, shorter and cheaper BLS/AED trainings.

Key words: basic life support, step-by-step, sequence, emergency medical technicians, ambulance drivers

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The impact of changing work schedules on American firefighters’ sleep patterns and well-being

Abstract

Across the nation, fire departments are adopting the 48/96 work schedule, in which firefighters work 48 consecutive hours with the following 96 hours off. Our study objective was to explain and quantify the impact of switching from the Kelly schedule to the 48/96 schedule by measuring changes in sleep, feelings of daytime function, as well as perceptions of professional and personal well-being for American firefighters. Sleep diaries and self-reported surveys were administered to firefighters at an urban fire department. Sleep diaries measuring the number of hours slept and feelings of refreshment were compared one month before and four months after implementation of the 48/96 schedule. The self-reported surveys measured sleepiness levels via the Epworth Sleepiness Scale. Secondary study objectives included changes in professional and personal well-being time for personal schedules, satisfaction, and health habits before and after the 48/96 schedule was implemented. The 59 firefighters included in the study reported an increase in sleep on-shift after the new schedule implementation (5.8 to 6.6 hours/night, p < 0.001). Participants also reported increased feelings of refreshment on days off (p < 0.001) and decreased daytime sleepiness (p < 0.001). We also found a general trend of improved perceptions of satisfaction, less shift interference with personal schedules and decreased feelings of burnout. American firefighters appeared to benefit from a 48/96 schedule, with short-term improvements in sleep patterns, feelings of burnout, and time for personal schedules.

Key words: firefighters, shift-work sleep disorder, emergency medical technicians, workplace, sleep, fatigue, burnout, professional, organizational culture

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