Navigating Paramedics' Safety: Unraveling Factors in Emergency Service Vehicle Incidents

Background: Ambulance drivers are more likely to be involved in fatal or injury collisions compared to other professional drivers. Study Objective: This study is a retrospective study aimed to describe factors involved in paramedics’ collisions. Method: Spanning over 10 years of data (2010-2019) from a paramedic agency covering Montreal (Qc, Canada), links between the number of ambulance injuries and non-injury collisions and diverse characteristics like experience, sex, and age of paramedics, day and time of the collision, weather and surface conditions, type of environment, and type of driving activity. The distribution of characteristics involved in the severity of collisions is presented with descriptive analysis. The evaluation of trends of monthly and yearly ambulance collisions is conducted using the Mann-Kendal test. The logit model is also used to examine the effect of such factors on the odds of collision severity. Results: The results show although there is no significant reduction trend for the monthly ambulance collisions, the trend of incidence of annual non-injury collisions per paramedic is significantly decreasing. Also, young drivers with less experience are more involved in multiple collisions compared to their experienced colleagues. Furthermore, 62% of injury collisions happened when paramedics are responding to an emergency call. The logit model confirms a decrease in the odds of injury collisions (odds ratio: 0.48) during non-emergency activities. Also, intersections and traffic lights are the riskiest locations regarding injury collisions (43.5%, and 51%, respectively). In this case, collisions occurring at traffic lights can increase the odds of severity by 597%. Conclusion: This study exemplifies that preventive policy regarding paramedics (e.g., training programs) should focus on younger and less experienced paramedics, and risky locations, especially while driving on emergency calls. More oriented awareness and training programs for emergency respondents are required to reduce the number of work-related collisions. -- Keywords: ambulance crashes ; drivers’ characteristics ; environment ; emergency/non-emergency activities ; work-related collisions ; emergency medical services ; EMS paramedicine

Identify successful restrictions in suppressing the early outbreak of COVID-19 in Arizona, United States : interrupted time series analysis

COVID-19 was responsible for many deaths and economic losses around the globe since its first case report. Governments implemented a variety of policies to combat the pandemic in order to protect their citizens and save lives. Early in 2020, the first cases were reported in Arizona State and continued to rise until the discovery of the vaccine in 2021. A variety of strategies and interventions to stop or decelerate the spread of the pandemic has been considered. It is recommended to define which strategy was successful for disease propagation prevention and could be used in further similar situations. This study aimed to evaluate the effect of people’s contact interventions strategies which were implemented in Arizona State and their effect on reducing the daily new COVID-19 cases and deaths. Their effect on daily COVID-19 cases and deaths were evaluated using an interrupted time series analysis during the pandemic’s first peaks to better understand the onward situation. Canceling the order of staying at home (95% CI, 1718.52 to 6218.79; p <0.001) and expiring large gatherings (95% CI, 1984.99 to 7060.26; p<0.001) on June 30 and August 17, 2020, respectively, had a significant effect on the pandemic, leading to the daily cases to grow rapidly. Moreover, canceling the stay at home orders led to an increase in the number of COVID-19 daily deaths by 67.68 cases (95% CI, 27.96 to 107.40; p<0.001) after about 21 days while prohibiting large gatherings significantly decreased 66.76 (95% CI: 20.56 to 112.96; p = 0.004) the number of daily deaths with about 21 days’ lag. The results showed that strategies aimed at reducing people’s contact with one another could successfully help fight the pandemic. Findings from this study provide important evidence to support state-level policies that require observance of social distancing by the general public for future pandemics

Identify successful restrictions in suppressing the early outbreak of COVID-19 in Arizona, United States: Interrupted time series analysis

COVID-19 was responsible for many deaths and economic losses around the globe since its first case report. Governments implemented a variety of policies to combat the pandemic in order to protect their citizens and save lives. Early in 2020, the first cases were reported in Arizona State and continued to rise until the discovery of the vaccine in 2021. A variety of strategies and interventions to stop or decelerate the spread of the pandemic has been considered. It is recommended to define which strategy was successful for disease propagation prevention and could be used in further similar situations. This study aimed to evaluate the effect of people's contact interventions strategies which were implemented in Arizona State and their effect on reducing the daily new COVID-19 cases and deaths. Their effect on daily COVID-19 cases and deaths were evaluated using an interrupted time series analysis during the pandemic's first peaks to better understand the onward situation. Canceling the order of staying at home (95% CI, 1718.52 to 6218.79; p<0.001) and expiring large gatherings (95% CI, 1984.99 to 7060.26; p<0.001) on June 30 and August 17, 2020, respectively, had a significant effect on the pandemic, leading to the daily cases to grow rapidly. Moreover, canceling the stay at home orders led to an increase in the number of COVID-19 daily deaths by 67.68 cases (95% CI, 27.96 to 107.40; p<0.001) after about 21 days while prohibiting large gatherings significantly decreased 66.76 (95% CI: 20.56 to 112.96; p = 0.004) the number of daily deaths with about 21 days' lag. The results showed that strategies aimed at reducing people's contact with one another could successfully help fight the pandemic. Findings from this study provide important evidence to support state-level policies that require observance of social distancing by the general public for future pandemics. Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Road traffic mortality in Iran : longitudinal trend and seasonal analysis, March 2011-February 2020

Road traffic mortalities (RTMs) and injuries are among the leading causes of human fatalities worldwide, particularly in low-and middle-income countries like Iran. Using an interrupted time series analysis, we investigated three interventional points (two government-mandated fuel price increases and increased traffic ticket fines) for their potential relation to RTMs. Our findings showed that while the overall trend of RTMs was decreasing during the study period, multiple individual provinces showed smaller reductions in RTMs. We also found that both waves of government-mandated fuel price increases coincided with decreases in RTMs. However, the second wave coincided with RTM decreases in a smaller number of provinces than the first wave suggesting that the same type of intervention may not be as effective when repeated. Also, increased traffic ticket fines were only effective in a small number of provinces. Potential reasons and solutions for the findings are discussed in light of Iran’s Road Safety Strategic Plan

Molecular regulation of auditory hair cell death and approaches to protect sensory receptor cells and/or stimulate repair following acoustic trauma

International audienceLoss of auditory sensory hair cells (HCs) is the most common cause of hearing loss. This review addresses the signaling pathways that are involved in the programmed and necrotic cell death of auditory HCs that occur in response to ototoxic and traumatic stressor events. The roles of inflammatory processes, oxidative stress, mitochondrial damage, cell death receptors, members of the mitogen-activated protein kinase (MAPK) signal pathway and pro- and anti-cell death members of the Bcl-2 family are explored. The molecular interaction of these signal pathways that initiates the loss of auditory HCs following acoustic trauma is covered and possible therapeutic interventions that may protect these sensory HCs from loss via apoptotic or non-apoptotic cell death are explored

Evaluating the impact of increased fuel cost and Iran’s currency devaluation on road traffic volume and offenses in Iran, 2011–2019

Trends and underlying patterns should be identified in the timely distribution of road traffic offenses to increase traffic safety. In this study, a time series analysis was used to study the incidence rate of road traffic violations on Iranian rural roads. Road traffic volume and offenses data from March 2011 to October 2019 were aggregated. Interrupted time series were used to evaluate the impact of increasing fuel cost in June of 2013 and July of 2014 and the currency devaluation of Rial vs. US dollars in July of 2017 on trends and patterns, traffic volume, and number of offenses. A change-point detection (CPD) analysis was also used to identify singular changes in the frequency of traffic offenses. Results show a general decline in the number of overtaking and speeding offenses of −24.31% and −13.23%, respectively, due to the first increase in fuel cost. The second increase only reduced overtaking by 20.97%. In addition, Iran’s currency devaluation reduced the number of overtaking offenses by 26.39%. Modeling a change-point detection and a Mann-Kendall Test of traffic offenses in Iran, it was found that the burden of violations was reduced

Prevalence and Characteristics of Ambulance Collisions, a Systematic Literature Review

The risk of dying or being injured as a result of traffic collisions is higher for medical emergency responders than for other professional drivers. This systematic review synthesizes the literature regarding the collisions of ambulances, focusing on the prevalence and characteristics surrounding such events. Keywords including paramedics and traffic collisions were searched in papers available in PubMed from January 1990 to July 2021. Two independent reviewers screened the abstracts of 2494 papers and ended up with 93 full-text articles to assess for eligibility, of which 26 papers were finally kept for this review. There was a total of 18 studies conducted in the United States, followed by 3 in Turkey, 2 in Taiwan, 1 in both the United States and Canada, 1 in France, and 1 in Poland. There is a high record of injury and fatal collisions for ambulances compared to other commercial or similarly sized vehicles. Drivers less than 35 years old with low experience and a history of citations are more likely to be involved in such collisions. Ambulance collisions are more likely to happen in urban areas and intersections are the riskiest locations. Most collisions occur when the ambulance is responding to an emergency call (i.e., going to the patient or the hospital) and using lights and sirens. Tailored preventive policies and programs for improving paramedics’ safety should be sought to reduce the burden of these occupational collisions