Volume 15 Issue 8

Contemporary portrait of the working lives of ambulance services staff in Wales

Background: Ambulance services staff are under more pressure than ever. Inadequate numbers face unmanageable workloads. For the first time in more than three decades, these employees in England and Wales have taken industrial action over wages and working conditions. Aims: This study aimed to understand the wellbeing and working environment of ambulance services staff in Wales. Methods: An online survey of 594 ambulance services staff was carried out. Data were analysed using standard quantitative and qualitative research methods. Findings: Key factors impacting wellbeing include work intensification, burnout and a lack of trust in management, which were increasing intentions to leave the profession. Conclusion: Ambulance services in Wales are reaching a critical tipping point. If the issues raised in this study are not addressed, the outcome will most likely be an accelerating departure from the profession of highly skilled people who are expensive and difficult to replace.

Raised levels of depression and PTSD in ambulance staff: causes and solutions

Background: Ambulance staff are reported to have higher levels of mental health problems, including post-traumatic stress disorder (PTSD), than the general population. Vicarious trauma has been attributed to the increased prevalence of depression and PTSD in ambulance service staff. Aims: This literature review explores the causes of the greater prevalence of PTSD and discusses interventions to lower these high rates. Methods: A literature review was carried out and four relevant studies were selected. A critical appraisal tool was then used to produce a systematic analysis. Findings: PTSD in the ambulance service is up to 10 times greater than in the general public, higher than in both the police and fire services and equal to that in the military. The cause of this higher prevalence of PTSD lies not only in vicarious trauma but also in the toll of shift work and in biological predisposition. Conclusion: There is a paucity of research on PTSD in ambulance staff; research is needed into post-exposure treatments as well as into pre-exposure interventions.

Prehospital use of the paediatric observation priority score

Background: In the prehospital setting, the incidence of seriously unwell children is low and emergency medical staff have repeatedly expressed concerns about their confidence and knowledge with regard to assessing children. The paediatric observation priority score (POPS) was designed in response to concerns about the identification of seriously unwell children. The ambulance service in this study began to implement POPS in 2018. Aim: To examine the use and documentation of POPS by ambulance staff in a Welsh health board. Methods: A retrospective cross-sectional study was carried out, covering 121 paediatric patients over 3 months with data collected from patient clinical records. Findings: Patient observations were well documented (77.7%), score accuracy was high (82%) and the majority of patients were pre-alerted appropriately (80% of POPS 7). Statistically significant associations were drawn between patient age and observations as well as between POPS and patient outcomes. However, compliance with POPS was only 32.3%. Conclusion: Although the use of POPS is relatively low, children mainly did have relevant observations recorded and when POPS was used, it was accurate. Education and training would improve compliance. Future research recommendations include investigating the education and confidence of emergency medical staff regarding paediatric patients.

The effect of ambient outside temperatures on scoop stretchers

Background: Scoop stretchers are commonly used in the prehospital care of trauma patients. Patients' clothing is often removed early in the care pathway. There may be unidentified risks if scoop stretchers are particularly cold. Aims: The primary aim of this research was to establish if there is a positive correlation between scoop temperatures and outside temperatures when this equipment is stored without access to vehicle heating. Methods: The authors recruited volunteers at ambulance locations across Scotland to measure scoop temperatures using infrared thermometers. These were compared to outside temperatures at that time. Data were subject to bivariate quantitative analysis to assess correlation strength. Findings: Results demonstrated that there was a moderate-to-strong correlation between scoop temperatures and outside temperatures (mean +3.0°C; P<0.001). There was no significant difference for other variables measured. Conclusion: Without active heating, scoop stretchers will be only marginally warmer than the outside temperature, sometimes colder than the outside temperature and sometimes below freezing point.

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