BackgroundFatigue is a complex phenomenon that has effects on physical characteristics, cognition, behaviours, and physical and mental health. Paramedicine crosses the boundaries of many high-risk industries, namely medicine, transport and aviation. The effects of fatigue on paramedics thus need to be explored and considered in order to begin to identify appropriate interventions and management strategies.AimThe aim of this article was to provide an overview of fatigue in paramedics and its potential effects on various areas of paramedic practice and paramedic health, and to outline potential solutions to assess and manage the risk of fatigue in paramedics as suggested by the literature.MethodsWe conducted unstructured, non-systematic searches of the literature in order to inform an overview of the literature. An overview is a summary of the literature that attempts to survey the literature and describe its characteristics. We thematically structured the review under the following headings: defining occupational activity and health status; clinical performance and patient safety; shift length and time at work; effects on paramedic health; effects on driving abilities; fatigue risk management; and, fatigue proofing.DiscussionFatigue should be considered in the context of overall paramedic health status and paramedic occupational activity. The nature of paramedic shift work, and the associated occupational activity place paramedics at increased risk from fatigue. Shift work may also contribute to sleep disorders among paramedics. Fatigue is associated with increased errors and adverse events, increased chronic disease and injury rates, depression and anxiety, and impaired driving ability.ConclusionThe issue of fatigue in paramedicine is complex and has serious consequences for patients and paramedics. Paramedic services and paramedics need to work collaboratively to identify and action appropriate measures to reduce the effects of fatigue on the wellbeing of the workforce and mitigate its effects on clinical performance and safety.

Background: Paramedics are among the most frequently injured health professionals in Australia. A lack of physical capacity may contribute to injury risk in this occupational population.Aims: This study sought to describe and compare the physical fitness of male and female paramedics across age groups to ascertain differences in physical capacity.Methods: A group of regional Australian paramedics (n = 140; 78 males; mean ± SD 37.4 ± 9.9 years; body mass index 28.1 ± 4.9 kg/m2) underwent a fitness assessment. Measures included upper, lower and core-body muscular strength and flexibility. Outcomes were compared between genders and across age groups using two-way between-groups analysis of variance.Results: Male paramedics had greater upper body strength (P < 0.05; push-ups) mean (95% CI): 22.6 (19.4–25.9) versus 18.7 (15.2–22.3); similar lower body strength (single-leg wall squat): 39.0 (32.6–45.3) s versus 36.7 (27.1–46.3) s; greater core strength (P < 0.05; prone plank hold): 87.9 (77.6–98.3) s versus 73.8 (63.7–83.8) s; similar upper body flexibility (back scratch): −4.0 (−6.7 to −1.3) cm versus −0.3 (−2.2 to 1.7) cm; and similar lower body flexibility (sit and reach): 20.4 (18.2–22.6) cm versus 26.1 (23.5–28.7) cm to female paramedics. Core, upper and lower body strength all decreased with age (P < 0.05).Conclusions: Core, upper and lower body strength and upper body flexibility were poorer for older compared to younger regional paramedics in New South Wales, Australia. Future research should investigate whether these outcomes are associated with occupational injury risk. This information would assist in the design of injury prevention interventions for paramedics such as tailored workplace exercise programs.

The aim of this commentary is to outline a case for student paramedics as a potential solution to the operational resource issues ambulances services and other healthcare institutions are expected to experience during high demand situations, such as pandemics.

This commentary aims to provide an overview of the current state and territory ambulance service cardiac arrest management recommendations to paramedics during the COVID-19 pandemic and highlight relevant risks to personnel.

Introduction: Levels of physical activity and health status are substantially influenced during the early adulthood years. The purpose of this research was to evaluate the health and physical activity characteristics of undergraduate paramedic and nursing students. Methods: This research comprised a descriptive and inter-discipline survey of a sample of university students enrolled in healthcare programs. The health status and physical activity patterns of paramedic and nursing undergraduate students were assessed using the 36-item Short Form Health Survey (SF-36) and the International Physical Activity Questionnaire (IPAQ), respectively. Statistical comparisons for health status — total, eight health dimensions and weekly metabolic equivalent were performed. Results: A total of 226 undergraduate students were surveyed with 66.4% enrolled in the paramedic, 17.7% in the nursing, and 15.9% enrolled in the double degree nursing/paramedic Bachelor programs. Results for the SF-36 total show a significant difference in health status between the undergraduate programs (p=0.001). Reduced health dimensions were also revealed among first year students. Results for the IPAQ shows a significant difference in physical activity between the programs (p=0.03). Comparison between IPAQ and year of study show a significant difference between groups (p=0.03). Conclusion: Substantially reduced health status and physical activity patterns were shown in nursing students compared to paramedic students and among first year university undergraduates. This research highlights the need to further investigate the health status and physical activity patterns within university healthcare students.

Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator. We recruited 28 non-paramedic participants to complete a simulated baseline drive with no task and a cognitive load manipulation using the 1-back task. We also recruited 18 paramedicine students who completed a drive while considering two cases they were travelling to: cardiac arrest and infant seizure, representing varying difficulty in required treatment. The results indicated that both cases imposed considerable cognitive load, as indicated by NASA Task Load Index responses, comparable to the 1-back task and significantly higher than driving with no load. These findings suggest that contemplating cases and treatment plans may impact the safety of novice paramedics driving ambulances for emergency response. Further research should explore the influence of experience and the presence of a second individual in the vehicle to generalise to broader emergency response driving contexts.