Effect of individual and work characteristics of EMTs on vital sign changes during shiftwork

This study examines the effects of demographics, lifestyle, and work characteristics on burnout in EMTs, and then determines the interaction of various EMT risk factors on cardiovascular changes. In phase 1, EMTs voluntarily completed a demographic data sheet and the Masslach Burnout Inventory (MBI). The MBI results were broken down into subgroups of Emotional Exhaustion (EE), Depersonalization (DP), and Personal Achievement (PA); these were then compared to national averages. Subgroup analysis was performed on the basis of sex, race, marital status, years with the service, smoking, and caffeine drinking habits. In phase 2, EMTs carried logbooks for 1 month, during which they recorded preshift and postshift blood pressure and pulse. Other information recorded for each shift was the amount of caffeine and cigarettes used, the number of advanced life support (ALS) and total runs, and whether the shift worked was day or night. Per-shift average caffeine use, average number of ALS and total runs, and average cross-shift changes in MAP (deltaMAP) and P (deltaP) were calculated for each EMT. The deltaMAP and deltaP were compared for discrete variables (sex, race, training levels, smoker v nonsmoker, marital status, and shift worked) and continuous variable (age, years with the service, total runs, ALS runs, and MBI subscale scores). Continuous variables were split into two groups using the median as a separator. Differences were detected at P < .05 by confidence interval analysis. Sixty-nine EMTs enrolled in phase 1. The EMTs scored significantly lower on the PA scale than the national average (28.1 v 34.6). The low PA score was only seen in the subgroup of EMTs with the service longer than 3 years (26.1 v 30.0). Forty EMTs completed phase 2 of the study. There were no significant differences in deltaMAP detected in any subgroup. There was a significant difference in deltaP 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 deltaP changes. In conclusion, these results showed that 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 significant preshift to postshift changes in blood pressure in any subgroup. There was a statistically significant preshift to postshift decrease in pulse in unmarried EMTs and in those younger than 32 years of age. These results indicate little variation in stress between EMTs and the general population and do not indicate a need for more intensive intervention programs for the management of heart rate or pulse.