Measuring the levels of burnout syndrome and empathy of Spanish emergency medical service professionals.

BACKGROUND: to determine the prevalence of burnout syndrome among Spanish emergency medical service professionals and establish any possible relationships between their levels of empathy and sociodemographic and/or working conditions. METHOD: 550 professionals participated in this descriptive study by responding to the Maslach Burnout Inventory and the Basic Empathy Scale. RESULTS: respondents were, on average, 40.9 years old (SD=9.03) and 63.4% were female. Their average length of service was 11.6 years (SD=8.1); 57.9% were physicians, 22.4% nurses, and 7.2% technical staff. Of the 337 who said they had children, 51% said that parenthood affected their emotional state when attending emergency situations involving children. Participants generally considered themselves to be competent (x˙=4.2; SD=0.7) and occupationally motivated (x˙=3.8; SD=1.1). More experienced participants presented fewer signs of burnout and empathy and more signs of competence (p<0.001). Occupational category appeared to significantly affect the presentation of burnout syndrome (p<0.05). Prehospital emergency medical services (PEMS) staff tended to rate their ability to perform their work and interact professionally with their patients more positively than emergency department staff. CONCLUSION: Spanish emergency medical service staff present similar levels of burnout to other healthcare providers but have higher levels of empathy. We found no significant differences in the presentation of burnout between physicians and nurses, but compared to emergency department staff, PEMS professionals appeared to be more confident in their abilities. Educational activities are required to improve professionals' ability to cope with their work and structural workplace interventions could help reinforce healthcare professionals' ability to tolerate intense workloads and to maintain their sense that their work is rewarding.

Effectiveness of non-pharmacological measures for reducing pain and fear in children during venipuncture in the emergency department: a vibrating cold devices versus distraction. / Efectividad de medidas no farmacológicas para la disminución del dolor y el miedo en niños durante la venopunción en urgencias: dispositivos de vibración más frío frente a distracción.

OBJECTIVES: To assess the effectiveness of a physical method of managing pain and fear in children and anxiety in the accompanying adult during venous puncture in the emergency department. MATERIAL AND METHODS: Quasi-experimental study of 3 groups: one group used a combination of directed distraction by means of a vibration device with ice pack, a second group received only distraction, and no strategy was used in the third. RESULTS: Pain and adult anxiety were similar in the 2 groups in which a pain management strategy was applied. Pain and adult anxiety were greater when no strategy was adopted. We detected no differences in the level of the children's fear. CONCLUSION: Directed distraction can be useful for managing pain in children and it reduces the anxiety experienced by accompanying adults. The use of a vibration device with ice does not add benefits. Fear is not reduced by any of these measures.

OBJETIVO: Evaluar la efectividad de medios no farmacológicos en el manejo del dolor y el miedo en los niños, y la ansiedad del acompañante, durante la realización de venopunción en urgencias. METODO: Estudio cuasiexperimental con tres grupos: en uno se combinó distracción dirigida y dispositivo de vibración más frío, en otro solo se usó distracción dirigida y en otro no se usó distracción ni dispositivo alguno. RESULTADOS: El dolor y la ansiedad del acompañante fueron similares entre los grupos en que se usó alguna medida de control del dolor, y mayor en el que no se usó ninguna. No se encontraron cambios en el miedo. CONCLUSIONES: La distracción dirigida puede ser útil para el manejo del dolor en el paciente pediátrico, y disminuye la ansiedad de los acompañantes. Los dispositivos de vibración más frío no aportan beneficio adicional. El miedo no mejora con el uso de ninguna de estas medidas.

[Efficacy and safety of endotracheal intubation performed in moving vs motionless environments]. / Estudio comparativo de la eficacia y seguridad de la intubación endotraqueal en movimiento y en estático.

OBJECTIVES: To compare the efficacy and safety of endotracheal intubation (ETI) in a simulated clinical environment in motion vs a motionless one. MATERIAL AND METHODS: Clinical simulation trial of ETI with 3 endotracheal tubes (Airtraq, Fast-trach, Macintosh laryngoscope) in mannequins with realistic physiological responses (MetiMan) in 2 scenarios: an environment in motion vs a motionless one. Thirty-six physicians expert in prehospital ETI participated. Outcome variables were successful intubation, effective intubation, number of attempts, maximum apnea time, and total maneuver time. The safety variables were the presence of bradycardia, tachycardia, or high or low systolic blood pressures (ie, 20% variation from baseline); hypoxemia (decrease in oxygen saturation to <90% or 10% below baseline), tube placement in the esophagus or main bronchus, and dental trauma. RESULTS: No statistically significant differences between the 2 scenarios were found in the numbers of successful ETI (motionless, 71 [65.7%]; in motion, 67 [62.0%]; P=.277) or effective ETI (motionless, 104 [96.3%]; in motion, 105 [97.2%]; P=.108). Likewise, the number of attempts were similar (motionless, 91 [84.2%]; in motion, 90 [83.3%]; P=.305). Nor did we see differences in the mean (SD) maximum apnea times (motionless, 14.0 [5.6] seconds; in motion, 14.9 [8.1] seconds; P=.570) or mean total maneuver times (motionless, 236.7 [73.4] seconds; in motion, 210.3 [77.9] seconds; P=.164). The prevalences of bradycardia, tachycardia, high or low systolic blood pressure, hypoxemia, placements in the esophagus or bronchus, and dental trauma also did not differ significantly between the 2 scenarios. CONCLUSION: Neither efficacy nor safety variables differed significantly when ETI was performed in mannequins in a motionless environment vs one simulating ambulances in motion.

OBJETIVO: Evaluar la eficacia y seguridad de la intubación endotraqueal (IET) en movimiento en comparación con la realización en estático. METODO: Ensayo de simulación clínica con maniquíes con respuesta fisiológica MetiMan® que comparó la IET en dos escenarios, intubar en estático (IE) y en movimiento (IM), utilizando 3 dispositivos de IET (Airtraq®, Fast-trach® y Laringoscopio Macintosh®). Treinta y seis médicos expertos en intubación prehospitalaria fueron los intervinientes. Las variables de resultado fueron la intubación efectiva y exitosa, el número de intentos, el tiempo máximo de apnea (TMA) y el tiempo total de la técnica (TTT). Las variables de seguridad fueron la presencia de bradi- y taquicardia, hiper- e hipotensión, hipoxemia, tubo endotraqueal (TET) alojado en esófago o en bronquio y el traumatismo dental. RESULTADOS: No hubo diferencias estadísticamente significativas en el porcentaje de IET exitosa [IE: 71 (65,7%) vs IM: 67 (62,0%); p = 0,277] ni de efectividad (IE: 104 (96,3%) vs IM: 105 (97,2%); p = 0,108), en el número de intentos [IE: 91 (84,2%) vs IM: 90 (83,3%); p = 0,305], en la media de TMA [IE: 14,0 (DE 5,6) segundos vs IM: 14,9 (DE 8,1) segundos; p = 0,570], TTT [IE: 236,7 (DE 73,4) segundos vs IM: 210,9 (DE 77,9) segundos; p = 0,164]. Tampoco se demostró aumento o descenso de un 20% de las cifras iniciales de la frecuencia cardiaca o de la presión arterial sistó- lica, la saturación de oxígeno inferior a 90% o descenso de un 10% de la basal, intubación esofágica o bronquial ni trauma dental, entre ambos escenarios. CONCLUSIONES: No se encontraron diferencias significativas en términos de eficacia ni seguridad entre la IET en movimiento y en dinámico en un escenario simulado.