What influences safety in paramedicine? Understanding the impact of stress and fatigue on safety outcomes.

Objective: The purpose of this study was to build on extant research linking fatigue to safety outcomes in paramedicine by assessing the influence of a multiplicity of workplace stressors, including chronic and critical incident stresses on safety outcomes.

Methods: A cross-sectional survey was deployed to 10 paramedic services in Ontario. Validated survey instruments measured operational and organizational chronic stress, critical incident stress, post-traumatic stress symptomatology (PTSS), fatigue, safety outcomes, and demographics.

Fatigue and Safety in Paramedicine.

Objectives: Extant research has established an empirical relationship between fatigue and safety-related outcomes. It is not clear if these findings are relevant to Canadian paramedicine. The purpose of this study was to determine if fatigue and shiftwork variables were related to safety outcomes in Canadian paramedics.

Investigational Overview of Supervised Clinical Practice Experiences.

Purpose: While the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) provides standards, there is variation allowed in design and implementation of supervised clinical practice experiences (SCPEs). Limited research has assessed for a correlation between SCPE design and program outcomes, including PANCE "First-Time Taker Pass Rate." The objective of this research is to evaluate for trends and best practices in clinical education design, as well as any correlation to PANCE pass rate.

Predictors of posttraumatic stress and preferred sources of social support among Canadian paramedics.

Objective: Emergency medical service (EMS) providers are exposed to a variety of stressors endemic to the profession. These exposures may contribute to stress reactions, including posttraumatic stress. The objective of this study was to evaluate the relationship between work-related stressors and posttraumatic stress.

The out-of-hospital validation of the Canadian C-Spine Rule by paramedics.

Study Objective: We designed the Canadian C-Spine Rule for the clinical clearance of the cervical spine, without need for diagnostic imaging, in alert and stable trauma patients. Emergency physicians previously validated the Canadian C-Spine Rule in 8,283 patients. This study prospectively evaluates the performance characteristics, reliability, and clinical sensibility of the Canadian C-Spine Rule when used by paramedics in the out-of-hospital setting.

BIPHASIC Trial: a randomized comparison of fixed lower versus escalating higher energy levels for defibrillation in out-of-hospital cardiac arrest.

Background: There is little clear evidence as to the optimal energy levels for initial and subsequent shocks in biphasic waveform defibrillation. The present study compared fixed lower- and escalating higher-energy regimens for out-of-hospital cardiac arrest.

Methods And Results: The Randomized Controlled Trial to Compare Fixed Versus Escalating Energy Regimens for Biphasic Waveform Defibrillation (BIPHASIC Trial) was a multicenter, randomized controlled trial of 221 out-of-hospital cardiac arrest patients who received > or = 1 shock given by biphasic automated external defibrillator devices that were randomly programmed to provide, blindly, fixed lower-energy (150-150-150 J) or escalating higher-energy (200-300-360 J) regimens.