EMS World

MAR 2018

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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36 MARCH 2018 | EMSWORLD.com T here's no denying a career in EMS can be stressful. We are witnesses to gunshot victims, steel-bending motor vehicle collisions, unre- sponsive babies, and disturbing suicides and murders. As practitioners, what often affects us more even than what we see is our own personal associations—that suicide may remind us of our own child who struggles with mental health issues, or an elderly cancer patient may recall our grandmother battling the same diagnosis. As the years go by, calls have a way of accumulating in the mind-space and can affect us in insidious ways. To top it off, EMS workers have to walk a tightrope of work-life balance and attempt to keep work stress at bay in their personal lives. Left unchecked, stress can manifest into more severe con- ditions such as anxiety and depression or lead to stress disorders such as obsessive- compulsive disorder and post-traumatic stress disorder (PTSD). There has recently been widespread attention to mental health in first respond- ers, and it's about time: In Canada 46 first responders and 10 military members died by suicide in 2017 (and these are only the reported cases). 1 In Australia a study con- cluded that 37% of paramedics suffered from some form of depression. 2 In the wake of these alarming statistics, how do we protect ourselves and help ensure career longevity? Stress: What It Is Stress can be an ambiguous term applied to many situations. Saying "I'm feeling stressed out these days" is different than the immedi- ate physical response of a pounding heart and sweating when someone waves a knife at you; yet both mental perception of stress and its physical effects are interconnected. Stress is a necessary and fundamental part of being human. In a nutshell, acute stress kick-starts hormonal and behavioral responses that allow an organism to make adaptations to environmental pressures. Chronic stress, or dysregulation of the stress system, can greatly disrupt homeostasis and lead not only to debilitating mental health disorders but also to reproductive dysfunc- tion, growth disruption, suppressed immune function, decreased muscle and bone mass, atherosclerosis, visceral obesity, gastrointes- tinal disorders, and insulin resistance. 3 Stress and EMS In EMS, we have many stressors. They include workplace conflicts (colleagues, management), high call volumes, over- time, shift work, abuse of the 9-1-1 system, unstable and dynamic working conditions, skills proficiency and protocol changes. EMS workers also carry a high level of responsi- bility; a 2012 study of Ottawa emergency service workers found that paramedics carry WHAT ROLE DOES STRESS PLAY IN EMS? Laying the groundwork for resilience and career longevity By Veronica Ryl, EMT-P, CP-C This is the first in a multipart series on stress and resilience in EMS. Photo: Bob Bartosz. Courtesy Nash County (NC) EMS

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