EMS World

FEB 2019

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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Page 22 of 53

EMSWORLD.com | FEBRUARY 2019 21 Finally the authors investigated the method of suicide. The three most com- mon methods were firearms, suffocation, and poisoning. A higher proportion of EMS professionals had mechanisms listed as fire - arm (67% vs. 57%) and suffocation (24% vs. 21%). Non-EMS professionals had a listed mechanism of poisoning more often (10% vs. 17%); however, none of the differences in mechanism were statistically significant. Context The authors did a good job of putting their results into context. Previous research has shown exposure to suicide has been found to independently increase the risk of suicidal thoughts. The authors note that EMS profes- sionals are exposed to suicide attempts and completions at a much higher rate than the general population. They also note that the risk based on exposure is cumulative, citing a study of firefighters that found those exposed to more suicides had an increase in their sui- cidal ideation rate of approximately 30%. The authors also rightly discuss the impacts of stress and its relationship to sui- cides. They acknowledge recurrent exposure to occupational stress and traumatic events among EMS professionals may contribute to their findings. They highlighted other stud- ies indicating that post-traumatic stress disorder and alcohol use, both of which have been shown to be elevated in EMS professionals, are recognized risk factors for suicide. The authors listed their most challenging limitation as reliance on a free-text field to identify occupations. Further, they had no way to identify volunteers, those who may have worked part-time as an EMS profes- sional, or those who held an EMS certifica- tion but did not work in the profession at the time of their death. Also, about 2% of records had nothing listed in their occupa- tional field. Vigil and company were also not able to account for other suicide risk factors such as previous attempts, substance abuse, or mental health issues. This is an important study that looks at an issue that is not discussed enough in our field. Many of us know a colleague who has attempt- ed or committed suicide. EMS is a stressful job, and we must start focusing on taking care of ourselves while we care for our patients. Author's note: There are many resources avail- able for those struggling with suicidal thoughts, from the National Suicide Prevention Hotline (800/273-8255) to dedicated first-responder help lines such as Safe Call Now (877/230- 6060) and the National Volunteer Fire Council's Share the Load (888/731-3473). ABOUT THE AUTHOR Antonio R. Fernandez, PhD, NRP, FAHA, is research director at the EMS Performance Improvement Center and an assistant professor in the Department of Emergency Medicine at the University of North Carolina–Chapel Hill. He is on the board of advisors of the Prehospital Care Research Forum at UCLA. NEW Evidence-Based Trauma Education PHTLS is developed in cooperation with the American College of Surgeons' Committee on Trauma, incorporating ATLS 10 th edition guidelines. NEW Focus on XABCDE PHTLS reinforces control of exsanguinating hemorrhage and mirrors the principles of the MARCH assessment. TAKE THE 9 TH EDITION OF PHTLS… The global leader in prehospital trauma care. PHTLS courses improve the quality of trauma care and decrease mortality by treating the unique needs of the multi-system trauma patient. NAEMT.ORG/EDUCATION /NAEMTFriends /NAEMT_ 1-800-346-2368

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