First responder professionals are at high risk for work-related injuries (e.g., extreme temperatures, chemical and biological threats); boots are essential to ensure body protection since they have ...full contact with the ground in all scenarios. A substantial body of work has investigated the necessity of improvements in protective boots, but there is limited research conducted on boots with fit-adjustable fasteners for secure and adjustable fit within this context. Thus, this study explored the areas for improvement in boot design for the development of form-fitting and yet comfortable boots focusing on two different boot designs, prototype all-hazards tactical boots (lace-up) and rubber boots (slip-on). Findings indicated that the boot design should address participants’ concerns with the material choices of boots, specifically with bulkiness, weight, and flexibility. Our findings provide insights into boot material and design choices to improve protective boots for first responders.
Dispatching first responders (FR) to out-of-hospital cardiac arrest in addition to the emergency medical service has shown to increase survival. The promising development of FR systems over the past ...years has been challenged by the outbreak of COVID-19. Whilst increased numbers and worse outcomes of cardiac arrests during the pandemic suggest a need for expansion of FR schemes, appropriate risk management is required to protect first responders and patients from contracting COVID-19. This study investigated how European FR schemes were affected by the pandemic and what measures were taken to protect patients and responders from COVID-19.
To identify FR schemes in Europe we conducted a literature search and a web search. The schemes were contacted and invited to answer an online questionnaire during the second wave of the pandemic (December 2020/ January 2021) in Europe.
We have identified 135 FR schemes in 28 countries and included responses from 47 FR schemes in 16 countries. 25 schemes reported deactivation due to COVID-19 at some point, whilst 22 schemes continued to operate throughout the pandemic. 39 schemes communicated a pandemic-specific algorithm to their first responders. Before the COVID-19 outbreak 20 FR systems did not provide any personal protective equipment (PPE). After the outbreak 19 schemes still did not provide any PPE. The majority of schemes experienced falling numbers of accepted call outs and decreasing registrations of new volunteers. Six schemes reported of FR having contracted COVID-19 on a mission.
European FR schemes were considerably affected by the pandemic and exhibited a range of responses to protect patients and responders. Overall, FR schemes saw a decrease in activity, which was in stark contrast to the high demand caused by the increased incidence and mortality of OHCA during the pandemic. Given the important role FR play in the chain of survival, a balanced approach upholding the safety of patients and responders should be sought to keep FR schemes operational.
ABSTRACTde la Motte, SJ, Lisman, P, Gribbin, TC, Murphy, K, and Deuster, PA. Systematic review of the association between physical fitness and musculoskeletal injury riskpart 3—flexibility, power, ...speed, balance, and agility. J Strength Cond Res 33(6)1723–1735, 2019—We performed a systematic review and evaluation of the existing scientific literature on the association between flexibility, power, speed, balance, and agility, and musculoskeletal injury (MSK-I) risk in military and civilian populations. MEDLINE, EBSCO, EMBASE, and the Defense Technical Information Center were searched for original studies published from 1970 to 2015 that examined associations between these physical fitness measures (flexibility, power, speed, balance, and agility) and MSK-I. Methodological quality and strength of the evidence were determined after criteria adapted from previously published systematic reviews. Twenty-seven of 4,229 citations met our inclusion criteria. Primary findings indicate that there is (a) moderate evidence that hamstring flexibility, as measured by performance on a sit-and-reach test or active straight leg raise test assessed with goniometry, and ankle flexibility, assessed with goniometry, are associated with MSK-I risk; (b) moderate evidence that lower body power, as measured by performance on a standing broad jump or vertical jump with no countermovement, is associated with MSK-I risk; (c) moderate evidence that slow sprint speed is associated with MSK-I risk; (d) moderate evidence that poor performance on a single-leg balance test is associated with increased risk for ankle sprain; and (e) insufficient evidence that agility is associated with MSK-I risk. Several measures of flexibility, power, speed, and balance are risk factors for training-related MSK-I in military and civilian athletic populations. Importantly, these findings can be useful for military, first responder, and athletic communities who are seeking evidence-based metrics for assessing or stratifying populations for risk of MSK-I.
First responders experience intense and continuous stress because of their occupational duties. This stress has led to an increase in rates of posttraumatic stress disorder, depression, generalized ...anxiety, and suicidality among first responders, relative to the general population. Research suggests that psychological resilience is a buffer against these negative outcomes among first responders. However, there are dozens of validated resilience assessments that have different theoretical foundations. Another analytic approach, network analysis, offers a framework for investigating which constructs (nodes) may have the greatest influence on understanding the process of resilience. In this study, we used the Response to Stressful Experiences Scale-22 (RSES-22) assessment, which has been validated on first responders, and estimated two models: a regularized partial correlation network and a directed acyclic graph (DAG). Item-level question six (find opportunity for growth) started the cascade in the DAG and had direct effects on seven questions on the RSES-22. Results indicate that the process of resilience might be consistent with posttraumatic growth (PTG). Two item-level responses (find opportunities for growth and lean on my faith in God or a Higher Power) were highest in predictability, although their node strength did not significantly differ. These results are consistent with existing conceptualizations of PTG: the Janus-face model, action-based model, and meaning-making and religious faith. Though the DAG helps theorize causation, these data are cross-sectional. Given the findings of this study, researchers should model resilience longitudinally among first responders to ascertain if intervention length or treatment modality impacts resilience in different ways. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)
This practical guide about what first responders should do after a suicide, offers advice on identifying and recording a death as suicide, breaking the bad news and dealing with the impact of suicide ...in the short, middle and long term.Drawing on her own experience as a first responder and trainer, the author provides guidance and tips for best practice when responding to a suicide. These include what can happen to the body in the immediate aftermath, how to talk to the bereaved to limit or prevent secondary trauma, and how to manage suicide in public arenas such as schools. The scenarios covered include detailed scripts of how to deal with difficult situations. There are also sections that tackle complex issues such as religious or cultural customs, and unusual cases of suicide which can pose extra challenges.Straightforward and full of sage advice, each chapter includes real-world examples from the author's many years working as a first responder which highlight how suicide postvention techniques can be applied.
The monograph on improving the response of first responders to domestic violence in Europe aims to identify gaps in the cooperation of first-line responders and deliver recommendations, toolkits and ...collaborative training for European police organizations and medical and social work professionals. The goal is to improve integrate institutional response to domestic violence. Shared training and adequate risk assessment tools will create a positive feedback loop, increasing reporting rates of domestic violence to police, the medical profession, and community and social work practitioners.
First responders are routinely exposed to traumatic
critical incidents, placing them at higher risk for developing stress-related
psychopathology and associated health problems than the general ...population.
Interventions which could improve resilience to stress may help to protect the
health of this high risk population. We systematically reviewed such
interventions for first responders to determine which ones work and why. We
searched the Cochrane and Campbell Collaboration Library, EMBASE, IBSS, Medline,
PILOTS, PubMed, PsycINFO, and SCOPUS from January 1, 1980 to June 28, 2018 for
randomized and quasi-randomized controlled studies aiming to improve well-being,
resilience, or stress management for police, ambulance, fire, or search and
rescue workers using non-pharmacological interventions. Data were extracted from
published reports and obtained from authors. Within- and between-group effect
sizes were calculated for mental and physical health outcomes. Risk of bias was
assessed using the Cochrane Collaboration's Risk of Bias Tool. The
initial search identified 3,816 studies, 13 of which were eligible for analysis
(n = 634 cases,
n = 628 controls). Six studies demonstrated
intervention-related improvements. However, risk of bias was mostly unclear or
high. Within-group intervention effect sizes ranged from −0.82 (95% CI
−1.48, −0.17) to 2.71 1.99, 3.42 and between-group
intervention effect sizes ranged from −0.73 −1.25, −0.21
to 1.47 0.94, 2.01, depending on the outcome. Largest effects were seen for
interventions that targeted modifiable risk factors for trauma-related
psychiatric disorders. Targeting modifiable predictors of trauma-related
psychiatric disorders through training may protect the health of first
responders who routinely face trauma in their line of work.
Organizational resilience is considered essential not only for the survival of organizations but also for bouncing back from adversity and maybe even thriving in the aftermath of a crisis. While much ...is known about organizational resilience in different types of high-risk professions, less is known about the development and impact of organizational resilience within public first-response organizations. First responders are constantly coping with emergency situations and, therefore, must continually assess and reassess organizational resilience. To address this gap, this study explores the management of first-response organizations during the COVID-19 pandemic. Using visual methods and qualitative interviews with firefighters, police officers, emergency medical technicians, and paramedics working in the U.S. during the height of the COVID-19 pandemic, this study examines the impact of the internal and external context as well as specific organizational capabilities on the challenges and opportunities for organizational resilience. Common challenges impacting organizational resilience include inaction, inconsistent decontamination procedures, and a lack of perceived community support. Opportunities for promoting organizational resilience in first-response agencies include consolidating information, using equipment creatively, balancing protocol and patient needs, and sharing personnel and resources.
First responders—police officers, firefighters, emergency medical technicians (EMTs), and paramedics—experience significant job-related stressors and exposures that may confer increased risk for ...mental health morbidities (e.g., posttraumatic stress disorder PTSD, suicidal thoughts and behaviors) and hastened mortality (e.g., death by suicide). Inherent in these occupations, however, are also factors (e.g., camaraderie, pre-enlistment screening) that may inoculate against the development or maintenance of psychiatric conditions. Several reviews of the literature have documented the prevalence and potency of PTSD among first responders; the value of these extant reviews is considerable. Nonetheless, the literature has not been systematically described with regard to suicidality. In this systematic review, we present 63 quantitative studies examining suicidal thoughts, behaviors, and/or fatalities among first responders; identify population-specific risk and protective factors; and pinpoint strengths and weaknesses of the existing literature. Findings reveal elevated risk for suicide among first responders; however, studies utilizing more rigorous methodologies (e.g., longitudinal designs, probability sampling strategies) are sorely needed. First responders have an armamentarium of resources to take care of others; it is the duty of researchers, clinicians, and the public to aid in taking care of their health as well, in part by reducing suicide risk.
•Police, firefighters, and EMTs/paramedics experience significant stressors.•Suicide risk may be elevated among these first responders.•We review studies examining rates and correlates of suicide among first responders.
Purpose of review
Automated external defibrillators are a very effective treatment to convert ventricular fibrillation (VF) in out-of-hospital cardiac arrest. The purpose of this paper is to review ...recent publications related to automated external defibrillators (AEDs).
Recent findings
Much of the recent research focus on ways to utilize publicly available AEDs included in different national/regional registers. More and more research present positive associations between engaging volunteers to increase the use of AEDs. There are only a few recent studies focusing on professional first responders such as fire fighters/police with mixed results. The use of unmanned aerial vehicles (drones) lacks clinical data and is therefore difficult to evaluate. On-site use of AED shows high survival rates but suffers from low incidence of out-of-hospital cardiac arrest (OHCA).
Summary
The use of public AEDs in OHCA are still low. Systems focusing on engaging volunteers in the cardiac arrest response have shown to be associated with higher AED usage. Dispatching drones equipped with AEDs is promising, but research lacks clinical data. On-site defibrillation is associated with high survival rates but is not available for most cardiac arrests.
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