Applying organisational behaviour theory to aid emergency staff retention

The purpose of this theoretical concept article is to spark a dialogue on the use of organisational behaviour theory to address emergency responder retention. In the United States, emergency medical services (EMS) appear to be burdened with continuing problems of retaining staff. Poor responder retention affects the ability of EMS to deliver high-quality services; without trained, educated and experienced first responders, the EMS system struggles, and what suffers is the ability to provide medical care. The authors set out to construct a pathway for addressing the underlying issues leading to the exodus of professionals using organisational behaviour theory. To develop the idea, an inductive logic approach was used to address underlying negative factors influencing poor retention and discuss the promise of organisational behaviour theory in improving the retention of responders.

PP28 Volunteer emergency responder response to the COVID-19 pandemic surge

BackgroundThe London Ambulance Service (LAS) runs an Emergency Responder (ER) scheme, where trained volunteers respond to 999 calls in blue-light rapid response vehicles (RRVs), alongside the statutory ambulance service response.The COVID-19 pandemic caused an unprecedented surge in call volume which, combined with reduced staffing of double-crewed ambulances (DCAs) due to illness, severely impaired the service’s ability to respond to calls.In response to this, as well as increasing volunteer RRV shifts, ERs were given additional up-skill training to work with regular ambulance service clinicians on DCAs, thus increasing the number of DCAs available to attend calls.This study aims to review the response to the COVID-19 pandemic provided by ERs.MethodA retrospective review was conducted of all ER shifts on volunteer RRVs and the service’s front-line DCAs. Data from the same time period (March 1 – April 30) was compared between 2019 (pre-pandemic period) and 2020 (pandemic period). The statistical significance of proportions was calculated using the χ2 test.ResultsThe absolute number of RRV hours volunteered by ERs increased by 34.2% (2,017 to 2,707), resulting in a 21.2% increase in RRV shifts (227 to 275) during the pandemic period. Furthermore, the proportion of C1 (life-threatening) incidents attended by ER RRVs doubled (32.4% vs 61.1%, p < 0.0001). In addition to RRV shifts, ERs volunteered 1,222 hours on DCAs during the pandemic, resulting in 125 additional DCA resources available. The combined total hours provided by ERs (RRV/DCA) increased by 94.8% (2,017 to 3,929).DiscussionVolunteer responders are a valuable resource during times of surge. In addition to volunteer RRV shifts, they have to the potential to assist ambulance service clinicians on DCAs. Future pandemic or winter-pressure plans should incorporate volunteer responders. This study predominantly looked at volunteer capacity, and further work is required to investigate patient-centred outcomes.

The impact of emergency responder musculoskeletal injuries in the State of Ohio

BACKGROUND: Emergency personnel operate in environments that put them at higher risk of injury to the musculoskeletal system. These injuries result in lost workdays, medical costs, and decreased productivity, all which impact emergency response systems. OBJECTIVE: This study serves to assess the causes, costs, and disability of common work-related musculoskeletal injuries within the police, emergency medical service (EMS) workers, and firefighters of Ohio based on data from the OBWC (Ohio Bureau of Workers’ Compensation). METHODS: Our dataset included all OBWC injury claims involving a shoulder, low back, or knee from 2010 through 2014. Police and Firefighter leaders were analyzed separately from those not in a leadership role, and workers with combined Firefighter/EMS roles were analyzed separately from “pure” Firefighters and EMS personnel. Data were organized through univariate analysis of variance with post-hoc Tukey tests and analyzed based on the job of the individual and whether the individual was in a leadership role. RESULTS: Police officers had the highest number of total injuries in the dataset, followed by Firefighters and Firefighters/EMS workers. Police officers and Firefighters injured their back and knees more often than their shoulders, while EMS workers injured their backs and shoulders more often than their knees. CONCLUSIONS: The mechanisms through which injuries occur are also dependent on the job. Police officers experienced a higher percentage of motor vehicle related back problems, while firefighters had a higher percentage of injuries from overexertion. Musculoskeletal injury claims in these emergency personnel resulted in opioid prescriptions approximately 10%of the time.

Factors That Affect Emergency Responder Wellbeing: Considerations for Public Health Responders

Purpose: The purpose of this study is to identify key risk factors that could negatively affect public health emergency responders’ health and wellbeing. We seek to use this information to provide recommendations and strategies to mitigate such risks. Design/Methodology/Approach: A narrative review of the peer-reviewed literature on wellbeing of military personnel and other responders was conducted. Data was grouped and categorized according to overarching domains. Findings: Factors associated with wellbeing were categorized into 5 domains: (1) demographics; (2) mental health concerns; (3) social networks; (4) work environment; and (5) postdeployment life. The strategies identified to promote wellbeing included mental health assessments, preparedness trainings, debriefs in the field, postdeployment debriefs, resources in the field, and further postdeployment decompression strategies. Originality/Value: This study provides a unique understanding of the risk factors associated with poor health and wellbeing outcomes in public health emergency response work by extending the body of knowledge that focuses on other types of emergency and military response.

Global assessment of flood impact on emergency service provision to vulnerable populations under climate change

&lt;p&gt;Flooding is a major global hazard that accounts for one-third of all reported natural disasters and over 500,000 fatalities since 1980. Globally, vulnerable populations (very young, elderly, medical special needs individuals, etc.) are disproportionately affected by flooding and predominantly encompass the majority of flood associated injuries and fatalities. This is caused by their low self-reliance, weak political voice and insufficient inclusion into climate adaptation and emergency response plans.&lt;/p&gt;&lt;p&gt;Vulnerable individuals are largely reliant on Ambulance and Fire &amp; Rescue Services due to flood induced injuries, exacerbated medical conditions, and requiring evacuative assistance. These services are primary emergency responders to flooding that provide rescue and relief efforts. However, during flood events, the demand for Ambulance and Fire &amp; Rescue Service often exceeds the potential capacity and limits service provision, whilst flooded road networks and short emergency responder-timeframes decrease accessibility, service area and population coverage.&lt;/p&gt;&lt;p&gt;Therefore, an important step towards resolving these social inequalities and emergency responder strains from flooding is to understand the geographic, spatial, temporal, and demographic distributions of vulnerability. This will be undertaken by identifying vulnerability &amp;#8216;hotspots&amp;#8217; of global populations in terms of emergency service provision during times of flooding of various magnitude under climate change.&lt;/p&gt;&lt;p&gt;The research will use Big Geographical and Climate Data and a &amp;#8216;hotspot&amp;#8217; approach to investigate how the global extent and distribution of flood hazards and vulnerable population hotspots vary spatially and temporally, based on differing global fluvial and coastal flooding (at 10-year and 100-year return periods), and present and future flood conditions (present-day and 2050, under RCP 4.5 and RCP8.5 climate scenarios). Network Analysis modelling will be used to investigate the impact of this on Ambulance and Fire &amp; Rescue accessibility from service stations to vulnerable populations based on restrictions of road network inundation and emergency response-times (8-, 15-, and 60- minutes). Finally, comparisons will be made to highlight how vulnerability and emergency service accessibility compares demographically between different vulnerable population groups.&lt;/p&gt;&lt;p&gt;It is expected that there will be significant geographical and temporal differences in social vulnerability and emergency service provision between countries and regions globally. Although to what extent is currently unknown. Ultimately, the framework of this research may provide real-world applications for informing strategic planning of emergency response operations and resolving social inequalities to flood hazards. These applications could include the production of more detailed flood hazard and evacuation maps that highlight vulnerability hotspots, the prioritisation of vulnerable population groups in emergency response plans to minimise geographic and population disparities of flood injuries and fatalities, and the allocation of emergency service hubs in regions of high-vulnerability but low-emergency response provision.&lt;/p&gt;

Review of Tunnel Fire Damage Assessment Methods and Techniques

Major tunnel fires can have catastrophic consequences, including loss of life, property damage, and long-term service disruptions. The rapid rise of gas temperature in excess of 1,000°C (1,832°F) inside a confined tunnel space as well as long fire duration because of limited emergency responder access necessitate special design considerations when evaluating the structural response to fire. Although tunnel stability is not challenged in most cases, severe damage to the concrete lining is observed after major fire events. This paper provides a detailed review of assessment methodologies and techniques of fire damage in concrete tunnel linings, including guidance on the determination of fire scenarios, concrete spalling, and tunnel safety from existing codes and guidelines, experiments, and numerical models. Based on the review, the need to develop relevant guidelines is emphasized, the knowledge gaps in the existing research are identified, and future research directions are proposed.