EFFECT OF INDIVIDUAL AND WORK CHARACTERISTICS OF EMTS ON VITAL SIGN CHANGES DURING SHIFTWORK

This study examines the effects of demographics, lifestyle, and work c haracteristics on burnout in EMTs, and then determines the interaction of various EMT risk factors on cardiovascular changes. In phase 1, EM Ts voluntarily completed a demographic data sheet and the Masslach Bur nout Inventory (MBI). The MBI results were broken down into sub groups of Emotional Exhaustion (EE), Depersonalization (DP), and Personal Ac hievement (PA); these were then compared to national averages, Subgrou p analysis was performed on the basis of sex, race, marital status, ye ars with the service, smoking, and caffeine drinking habits. In phase 2, EMTs carried logbooks for 1 month, during which they recorded presh ift and postshift blood pressure and pulse, Other information recorded for each shift was the amount of caffeine and cigarettes used, the nu mber of advanced life support (ALS) and total runs, and whether the sh ift worked was day or night. Per shift average caffeine use, average n umber of ALS and total runs, and average cross shift changes in MAP (D elta MAP) and P (Delta P) were calculated for each EMT. The Delta MAP and Delta P were compared for discrete variables (sex, race, training levels, smoker v nonsmoker, marital status, and shift worked) and cont inuous variable (age, years with the service, total runs, ALS runs, an d MBI subscale scores). Continuous variables were split into two group s using the median as a separator, Differences were detected at P < .0 5 by confidence interval analysis. Sixty nine EMTs enrolled in phase 1 . The EMTs scored significantly lower on the PA scale than the nationa l average (28.1 v 34.6), The low PA score was only seen in the subgrou p of EMTs with the service longer than 3 years (26.1 v 30.0). Forty EM Ts completed phase 2 of the study, There were no significant differenc es in Delta MAP detected in any subgroup, There was a significant diff erence in Delta P based on marital status (single, -4.5 v married, 2.6 ), and age (younger than 32, -4.5 v older than 32, 0.6), There were no other detected Delta P changes. In conclusion, these results showed t hat PA is lower in our EMTs than in the general population; EMTs with the service longer than 3 years had the lowest values. There were no s ignificant preshift to postshift changes in blood pressure in any subg roup. There was a statistically significant preshift to postshift decr ease in pulse in unmarried EMTs and in those younger than 32 years of age, These results indicate little variation in stress between EMTs an d the general population and do not indicate a need for more intensive intervention programs for the management of heart rate or pulse. Copy right (C) 1996 by W.B. Saunders Company