背景:在2021年夏天,一场致命的,前所未有的多天热穹顶吞没了加拿大西部。由于这种极端高温事件(EHE),紧急调度员收到了无与伦比的911救护车电话,警察,和消防(作为急救人员)服务,以照顾数百名屈服于高温的热脆弱社区成员。在此EHE期间,打破了103项历史高温记录,室内温度接近40°C,参加这些电话的第一响应者面临着广泛的工作需求和极具挑战性的运营条件。初步调查已经探索了卫生系统层面的影响;然而,几乎没有做什么来探索对第一响应者本身的影响。因此,本研究旨在提高我们对EHEs对急救人员操作能力和健康影响的理解,特别是警察,火,救护车,和调度服务。
方法:对加拿大2021年热穹顶上发表的媒体文章进行了系统化的回顾和内容分析(n=2909),并开发了四个基于媒体的复合叙述,突出了警察,火,救护车,和调度服务。工作需求-资源(JD-R)模型被用作职业倦怠的理论框架。
结果:基于媒体的复合叙述强调,第一响应者面临破纪录的呼叫量,与心理健康相关的索赔增加,和力竭的热相关的生理应激。使用JD-R模型作为职业倦怠的理论框架,我们确定了三种压力工作需求的衡量标准:工作过载(例如,通话量激增,消防员应对医疗紧急情况),情感需求(例如,严重的医疗紧急情况,突然死亡,反应迟钝的病人,心烦意乱的家庭成员),和物理需求(例如,个人防护设备的复苏,与热有关的疾病)。
结论:所描述的经验强调了在极端高温条件下工作期间支持第一响应者的重要性。这些发现对于解决公共卫生危机期间和之后的职业倦怠率上升具有重要意义。比如EHEs,这个问题越来越被认为是对加拿大公共医疗系统的威胁。
BACKGROUND: During the summer of 2021, a deadly, unprecedented multiday Heat Dome engulfed western Canada. As a result of this extreme heat event (EHE), emergency dispatchers received an unparalleled increase in incoming 911 calls for ambulance, police, and fire (as first responders) services to attend to hundreds of heat-vulnerable community members succumbing to the heat. With 103 all-time heat records broken during this EHE and indoor temperatures of nearly 40°C, the first responders attending these calls faced extensive job demands and highly challenging operating conditions. Initial investigations have explored the health system-level impacts; however, little has been done to explore the impact on the first responders themselves. Therefore, this study aimed to improve our understanding of EHEs\' impacts on the operational capabilities and health of first responders, specifically police, fire, ambulance, and dispatch services.
METHODS: A systematized review and content analysis of media articles published on the 2021 Heat Dome in Canada was conducted (n = 2909), and four media-based composite narratives were developed highlighting police, fire, ambulance, and dispatch services. The Job Demands-Resources (JD-R) model was applied as a theoretical framework for occupational burnout.
RESULTS: The media-based composite narratives highlighted that first responders faced record-breaking call volumes, increased mental-health-related claims, and exhaustive heat-related physiological stress. Using the JD-R model as a theoretical framework for occupational burnout, we identified three measures of stressful job demand: work overload (e.g., the surge in call volume, firefighters responding to medical emergencies), emotional demands (e.g., severe medical emergencies, sudden deaths, unresponsive patients, distraught family members), and physical demands (e.g., resuscitation in personal protective equipment, heat-related illness).
CONCLUSIONS: The experiences described underscore the importance of supporting first responders during work in extreme heat conditions. These findings have important implications for addressing rising rates of burnout during and following public health crises, such as EHEs, a problem that is increasingly being recognized as a threat to the Canadian public healthcare system.