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对美国在新冠疫情期间紧急医疗服务(EMS)人员应对药物过量情况的经历与认知的定性分析

A Qualitative Analysis of Emergency Medical Services (EMS) Personnel Experiences and Perceptions Responding to Drug Overdoses in the United States (US) During the COVID-19 Pandemic.

作者信息

Won Nae Y, Palamar Joseph J, Mike Stephen A, Fitzgerald Nicole D, Cottler Linda B

机构信息

Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, USA.

New York University Grossman School of Medicine, Department of Population Health, USA.

出版信息

J Health Res. 2023;37(4):270-279. doi: 10.56808/2586-940x.1045. Epub 2023 Jan 20.

Abstract

BACKGROUND

The purpose of this work was to describe the experiences of EMS personnel in responding to drug overdose-related calls and the impact the pandemic has had to help better inform current response and treatment efforts.

METHODS

Semi-structured interviews were conducted with 99 EMS personnel across 18 areas throughout the United States that were designated as Early Warning Network sentinel sites by the National Institute on Drug Abuse-funded National Drug Early Warning System. Participants were asked about topics including the potential burdens from the pandemic and the opioid crisis. We coded the interview responses and identified themes through qualitative analysis. Multiple cycles of descriptive coding, recoding, subcoding, pattern-coding, and thematic coding of responses were conducted.

RESULTS

Responses were categorized into the following themes: 1) being over-worked from increased call volume; 2) increased risk for personal harm when responding to patients; 3) compassion fatigue due to long hours and repeat calls for the same people; 4) conflicting perceptions of the utility of naloxone; 5) the need for better treatment options to respond to opioid crisis on top of COVID-19.

CONCLUSIONS

The burden of the substance use disorder (SUD) crisis on EMS personnel has been compounded by the COVID-19 pandemic. These reports from EMS personnel throughout the US can help inform policy and procedures to better protect the mental health of EMS personnel and to ensure better care for patients with SUD. These experiences and recommendations may be of use for other countries as substance use and COVID-19 are global health issues.

摘要

背景

这项工作的目的是描述急救医疗服务(EMS)人员应对药物过量相关呼叫的经历以及疫情所产生的影响,以更好地为当前的应对和治疗工作提供信息。

方法

对美国18个地区的99名急救医疗服务人员进行了半结构化访谈,这些地区被美国国立药物滥用研究所资助的国家药物早期预警系统指定为早期预警网络哨点。参与者被问及包括疫情和阿片类药物危机可能带来的负担等话题。我们对访谈回复进行编码,并通过定性分析确定主题。对回复进行了多轮描述性编码、重新编码、子编码、模式编码和主题编码。

结果

回复被归类为以下主题:1)因呼叫量增加而过度劳累;2)应对患者时个人受到伤害的风险增加;3)由于长时间工作和对同一人群的重复呼叫而产生的同情疲劳;4)对纳洛酮效用的相互矛盾的看法;5)除了应对新冠疫情外,还需要更好的治疗方案来应对阿片类药物危机。

结论

物质使用障碍(SUD)危机给急救医疗服务人员带来的负担因新冠疫情而更加沉重。美国急救医疗服务人员的这些报告有助于为政策和程序提供信息,以更好地保护急救医疗服务人员的心理健康,并确保为患有物质使用障碍的患者提供更好的护理。由于物质使用和新冠疫情是全球健康问题,这些经历和建议可能对其他国家有用。

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