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Thesis (Ph. D.)--University of New South Wales, 2002. / Also available online.

This study aimed to investigate and describe perceptions Fire Fighters and Platoon Commanders from Johannesburg Emergency Services have of educational offerings offered by and / or deemed applicable to the emergency service, with specific reference to their vocational applicability and value in relation to promotion. It is argued in this report that such perceptions may affect the motivation experienced by adult learners to engage in further study and thus may influence the learning process as a whole. An understanding of how emergency service workers feel about the various courses and or qualifications that are on offer becomes important for managers, trainers and educators not only within the Johannesburg Emergency Service but also within industry as they plan and structure future educational offerings and training programmes. To collect data on the perceptions described above in-depth face to face interviews were conducted with a purposefully selected sample of Fire Fighters and Platoon Commanders. During these interviews the participants were required to respond to questions which were specifically designed to elicit their views and perceptions on the vocational applicability of courses and qualifications relevant to their daily work within the emergency service and the value of further study for promotion. The interviews were audio recorded producing raw data, which could be later transcribed verbatim. Once sufficient data was collected, this data was analysed and interpreted. The analysis and interpretation yielded a number of significant findings relating to the participants’ perceptions of the vocational applicability of various courses and qualifications linked to the service as well as the perceived value or link between further study and promotion. The findings relating to vocational applicability emphasised that perceptions about which courses and / or qualifications had higher levels of vocational applicability were most often linked to the participant’s position within the service as well as their own personal preference for a particular specialist area or vocational discipline. In addition, the frequency with which the participants utilised a learning outcome or skill appeared to play a significant role in determining their perception regarding the vocational applicability of learning events. Although the courses currently on offer were largely seen as being vocationally applicable there was a perception that significant deficits existed in their levels of training and preparation for particular incidents and components of the participants’ vocational activities. The study also found a perception among the participants that they were not afforded an equal opportunity to study further in each of the three main vocational disciplines. Regarding further learning and promotion within the service, this study found that the participants did not perceive a clearly identifiable link between further study and promotion and that promotion was not the main driving force behind their desire to study further. There also appeared to be confusion and a lack of consensus about which courses are best for promotion. The rescue courses specifically receive little recognition from the service in terms of promotion. Based on these findings a number of recommendations were made. It was recommended that the service consider the introduction of new learning programmes to supplement the learning outcomes of existing qualifications and courses. The employer was also encouraged to provide better clarity and guidance for staff about how all the different courses and qualifications are to be recognised and managed within the service. In order to do this, the employer was encouraged to carefully reflect on the role of further study within the service as well as the envisaged linkages between particular courses and qualifications and the workers operational duties, promotion, specialisation and career development. / Dr. K. Steenekamp Prof. A. Swart

Introduction Air ambulances transport patients to their home country or to centres of medical excellence when they are critically ill or injured. From stranded hikers to cancer patients, individuals worldwide use air ambulance transport when they need care that cannot be provided in the country or area where they are situated. Aim The overall aim of this study was to explore the challenges experienced by health care professionals during air ambulance transport of patients in sub-Saharan Africa. Research method A quantitative, non-experimental, descriptive, exploratory design was used. The study was conducted in three phases. Phase 1 was the planning of the questionnaire, Phase 2 was the pre-testing of the questionnaire and Phase 3 was the execution phase in which the questionnaires were distributed, and data were captured and analysed. Results The researcher used the data generated from the questionnaires to indicate short falls within air ambulance transport services in sub-Saharan Africa. Conclusion The researcher made recommendations in order to increase the level of air ambulance services in sub-Saharan Africa. / Dissertation (MCur)--University of Pretoria, 2011. / Nursing Science / unrestricted

Objective: To determine the factors associated with an increased risk for PTSD in ambulance personnel and the barriers faced in accessing support for work related stress (WRS). Methods: A cross-sectional study of voluntary participants comprising 388 ambulance personnel was conducted. Participants completed self-administered questionnaires: Impact of Event Scale-Revised (IES-R), EMS Critical Incident Inventory (CII), EMS Chronic Stress Questionnaire (EMSCSQ), SF-36 Quality of Life questionnaire (SF-36) and Connor-Davidson Resilience Scale (CD-RISC) which were used to assess PTSD and level of occupational stressors. Results: The prevalence of PTSD in the study population was 30%. Participants were predominantly female (55%), median age 38 (IQR; 31 - 44) years with a professional qualification (83%). Those with PTSD were more likely current smokers (OR=1.76, 95% CI: 1.05 - 2.95), current illicit drug users (OR=16.4, 95% CI: 1.87 - 143.86) and problem drinkers (OR=3.86, 95% CI: 1.80 - 8.23). A self-reported mental health condition (OR=3.76, 1.96 - 7.21), being treated for a medical condition (OR=1.95, 1.22 - 3.11), exposure to chronic WRS (OR=1.05, 1.04 - 1.07) and high critical incident stress score (OR=1.03, 1.02 - 1.04) were positively associated with PTSD risk. Barriers to seeking help for WRS included concerns that services were not confidential, and that the participant's career would be negatively affected. Conclusion: The PTSD prevalence in ambulance personnel is considerably higher than that found in previous studies conducted among this occupational group in the Western Cape. Identified risk factors should inform interventions designed to support ambulance personnel and a greater focus on addressing barriers to accessing care is needed.

Traumatic injury is a major burden in global healthcare systems, ranking among the leading causes of morbidity and mortality worldwide.1 Patients are first encountered at the pre-hospital scene by providers of varying levels of expertise, such as emergency medical technicians (EMTs) and paramedics, who provide temporizing measures while patients are transported to receiving hospitals to receive definitive care.2 Ultrasound is an ever-improving medical imaging modality which is increasingly portable, low cost, and provides diagnostic imaging rapidly without the harmful effects of radiation. The objective of this study is to determine whether introduction of prehospital ultrasound (PHUS) for use on ground ambulances by prehospital providers in order to improve choice of destination hospital and aid in needle thoracostomy for tension pneumothorax will have a positive impact on mortality rate of trauma patients in an urban EMS environment. In the proposed study, trauma patients in the city of Boston, Massachusetts receiving care from Boston Emergency Medical Services (EMS) prehospital providers will be recruited over a 12-month period with a minimum goal of 2,500 patients in total. Emergency responses coded as trauma by EMS dispatch will be randomized at a 1:1 ratio to either utilize PHUS or to refrain from utilizing PHUS. A z-test will be used to analyze primary outcome of 30-day mortality rate in patients who receive PHUS care as needed compared with patients who do not receive PHUS care. Study data will be collected directly from Boston EMS Electronic Medical Record (EMR). This study will be the first of its kind to randomize at the patient level, and the first to investigate a major clinical outcome of ultrasound in prehospital medical care: 30-day mortality. Point-of-care Ultrasound is an intriguing diagnostic modality that is becoming increasingly feasible in the prehospital environment, and may improve outcomes in trauma patients. Current studies provide convincing evidence for the diagnostic accuracy of these devices, especially in evaluating hemoperitoneum and pneumothorax. If an improvement in mortality rate of patients treated with prehospital ultrasound (PHUS) is demonstrated, this will be convincing evidence for the implementation of PHUS in ground ambulances and air medical services across the United States and worldwide.

Background: One million emergency cases, which includes any type of ambulance transportation, are handled each year in Sweden. Ambulance personnel are required to have the ability and knowledge to identify all patients’ individual needs in different environments. Therefore, the ambulance nurse holds a great responsibility in the ambulance service whereby incorrect treatment could result in a catastrophic outcome. Aim: To describe how ambulance personnel experience and cope with their work situation. Another purpose was to review the sampling of the studies. Methods: This descriptive literature review is based on twelve scientific articles which was searched through the databases Cinahl and PubMed, and then compiled under three main themes and six sub-categories. Main results: Ambulance personnel use to a large extent their experiences based on prior knowledge and experiences to cope. Ability to interact and co-operate with other was elementary, both before, during and after the encounter with the patient. The ability of maintaining a balance between presence and distance, which is required to nurture the patient in an integrated way, was difficult in demanding situations. Through reflection, especially with the support of others, difficult experiences could be processed, resulting in both professional and personal development. Conclusion: Ambulance personnel meet and take care of their patients based on their previous knowledge and experiences. Therefore, further research should aim at finding how lived experiences could be transformed into valuable knowledge. / Bakgrund:En miljon akutfall, som innefattar någon typ av ambulanstransport, hanteras varje år i Sverige. Ambulanspersonalförutsätts ha förmåga och kunskapatt kunna identifiera alla patienters individuella behov i olika typer av miljöer. Således innehar ambulans-sjuksköterskanett stort ansvar, då felaktiga behandlingsåtgärder kan få katastrofala följder. Syfte:Att beskriva hur ambulanspersonal upplever och hanterar sin arbetssituation. Ytterligare ett syfte varatt granska hur studiernas urval skett. Metod:Den deskriptivt designade litteraturstudien bygger på tolv vetenskapliga artiklar som söktes via databaserna Cinahl och PubMed. Artiklarnasammanställdes under tre huvudteman samt sex subkategorier. Huvudresultat:Ambulanspersonal hanterade i stor utsträckning sina upplevelser utifrån tidigare kunskaper och erfarenheter. Förmåga till interaktion och samarbetemed andra var elementär, både före, under och efter mötet med patienten. Att upprätthålla den balans mellan närhet och distans,som erfordrades för att vårda på ett fullt integrerat sätt,upplevdes svårt i krävande situationer. Genom reflektion, särskilt med stöd av andra, kunde svåra upplevelser bearbetas vilket resulterade i både professionell och personlig utveckling. Slutsats:Ambulanspersonal har setts hantera sina upplevelser och det vårdande mötet med patienten utifrån tidigare kunskaper och erfarenheter, därförär det angeläget att fortsatt forskning syftar till att finna hur levd erfarenhet kan omsättas till värdefull kunskap.

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No description available.

År 2011 uppgick antalet personer som suiciderat i Sverige till 1387. Studier visar att den suicidbenägna patientens första kontakt med sjukvården är avgörande för hur det kommande vårdförloppet kommer att utvecklas. Ambulanspersonal är en av många yrkesgrupper som möter suicidbenägna patienter. Studier visar även på att om patienten möts av dåliga attityder så kan det medföra negativa konsekvenser för patienten. Syftet med studien var att översätta, re översätta och validera en engelsk enkät: the Suicide Behavior Attitude Questionnaire (SBAQ): för användning i den svenska ambulanssjukvården. Metoden i att översätta, re översätta och validera SBAQ följde de tio stegen som tagits fram av the translation and cultural adaptation group. Elva ambulanssjuksköterskor medverkade i valideringen av den svenska SBAQ. Resultatet åskådliggör att det är möjligt att översätta och validera den engelska enkäten SBAQ till svenska. Studien kan därför ligga till grund för en mer omfattande studie inom ambulanssjukvården med den svenska SBAQ som instrument. Det här kan bidra till ökad uppmärksamhet och vid behov förbättringar avseende ambulanspersonalens bemötande i framtida situationer med suicidbenägna patienter. / In 2011, the number of persons who committed suicides in Sweden amount to 1387. Studies show that the suicide-prone patient's first contact with health services is crucial for how the future care process develops. Ambulance personnel is one of many professional groups that meet suicide prone patients and studies make clear that if the patient is met with bad attitudes it can result in negative consequences for the patient. The aim of the study was to translate, retranslate and validate an English questionnaire: the Suicide Behavior Attitude Questionnaire (SBAQ) for use in the Swedish ambulance service. The method to translate, retranslate and validate SBAQ followed the ten steps developed by the translation and cultural adaptation group. Eleven ambulance nurses participated in in the validation of the Swedish translated SBAQ. The results illustrate that it is possible to translate and validate the English SBAQ survey to Swedish. The study can therefore be the basis for a more comprehensive study within the ambulance service with the Swedish SBAQ as tool. This may help increase attention and, if necessary, improvements by ambulance personnel treatment in future situations with suicidal patients.