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Sociologists have paid little attention to what people mean when they call themselves “professionals” in their everyday talk. Typically, when occupations lack the characteristics of self-control associated with the established professions, such talk is dismissed as desire for greater status. An ethnography of speaking conducted among several technicians’ occupations suggests that dismissing talk of professionalism may have been premature. The results of this study indicate that among technicians, professional talk highlights dynamics of respect, collaboration, and expertise crucial to the horizontal divisions of labor that are common in postindustrial workplaces, but have very little to do with the desire for occupational power.

In the USA, terrorist threats captured government attention following 11 September 2001. Cities remain the most likely setting for terrorist incidents. Many cities, building on a successful federal program begun in 1997, have developed metropolitan medical response systems (MMRS) to address the consequences of terrorist incidents. The basic system design has been tested both through drills and incidents – including the attacks on the World Trade Center – and appears to function well. This paper describes the philosophy and elements of the MMRS model. The model has considerable value as a readily exportable strategy for responding to municipal terrorist incidents.

A very limited number of studies have explored factors related to emergency medical services (EMS) workers leaving their jobs and the profession. This paper aims to investigate the correlates of intent to leave EMS jobs and the profession and compared two types of workers: emergency medical technicians (EMTs) and paramedics.

A national sample of 308 EMTs and 625 paramedics responded to a cross‐sectional survey. Independent variables were personal, job related, and work attitudes (job satisfaction). Outcomes were intent to leave job and profession. Analytic methods included factor analysis, t‐tests, correlation, and hierarchical regression.

Factor analysis identified a five‐item intrinsic job satisfaction measure and a four‐item extrinsic job satisfaction measure across both samples. Contrary to what hypothesis one predicted, paramedics had lower extrinsic job satisfaction than EMTs. There was no difference between these two groups on intrinsic job satisfaction. Consistent with the second hypothesis, after controlling for personal and job‐related perceptions, extrinsic job satisfaction was negatively related to intent to leave job and profession for both EMTs and paramedics. However, intrinsic job satisfaction was negatively related only to intent to leave the profession for paramedics.

Future research efforts might utilize stronger measures and incorporate longitudinal methodologies to further explore the career intention of EMS workers and similar occupational groups.

This paper examines job satisfaction and job and career intentions in a rarely studied occupation that provides critical prehospital emergency care to the population.

This paper's aim is to study a neglected relationship: testing the impact of emotional labor on the work exhaustion for samples of emergency medical service (EMS) professionals.

Three distinct samples of EMS professionals, i.e. emergency medical technician (EMT) – basic, EMT – intermediate, and paramedic, were surveyed to test the impact of three variable sets, personal (e.g. gender, age, health), work‐related (e.g. years of service, job satisfaction), and emotional labor (i.e. surface acting, deep acting) on work exhaustion.

Results across the three samples consistently showed that surface acting had a significantly stronger positive impact than deep acting on work exhaustion. In addition it was found that surface acting had a significantly stronger negative relationship to job satisfaction than deep acting. Surface acting also had a significant negative relationship to perceived health. Years of service were positively related to work exhaustion across all samples, while job satisfaction was negatively related.

Work exhaustion is an occupational risk for EMS professionals. Individuals considering EMS as a career must have realistic expectations and information about the rewards as well as challenges facing them. To help buffer the impact of emotional labor on work exhaustion and related outcomes, EMS stakeholders should consider facilitating mentor and/or peer support group programs to enhance the development of stronger camaraderie in different EMS‐based organizations (e.g. hospitals, fire services).

Prior research has not tested for the impact of emotional labor on work exhaustion for EMS professionals. Even after controlling for personal and work‐related variables, surface acting maintained a stronger positive impact than deep acting on work exhaustion. Key demographics for each of the three samples (type of work, community size, gender) indicate representativeness to previous cohort samples of nationally certified EMS professionals.

The research is an administrative case study based on an extensive review of Hawaii government documents and interviews with key personnel of the Hawaii Emergency Preparedness Committee, civil defense and other relevant officials. Describes the interagency coordination at the federal, state, county, and community level to improve capability. Also described and critically evaluated are the roles of interagency emergency preparedness training, disaster drills, and coordination and partnership with the private sector, such as medical centers and the Federal Emergency Management Agency’s designated “disaster resistant communities” in Maui and Hawaii County. Recommends that more frequent interagency drills, increased funding for family emergency preparedness and local community response teams, and continuous training by emergency response coordinators could improve state and county disaster preparedness and concludes that, overall, Hawaii is adequately prepared in emergency response capability, particularly in the areas of medical services and interagency coordination.

Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs).

To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case.

Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions.

By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.

The uniqueness of the pre-hospital setting and the need for quick decision-making confronts pre-hospital emergency personnel with various moral conflicts that can lead to moral distress (MD) in them. This study aimed to design a valid scale for the assessment of MD in emergency medical service (EMS) staff.

This exploratory mixed-method study was conducted among the EMS provider's community. In the qualitative section, data were gathered and analyzed with semi-structured interviews and conventional content analysis, respectively. The initial pool of items was formed and the primary scale was designed. In the quantitative section, a methodological study was carried out to determine the psychometric properties of the scale including qualitative-quantitative face validity, qualitative-quantitative content validity with content validity ratio and index (CVR/CVI), construct validity by exploratory factor analysis (EFA), and convergent validity, internal consistency (Cronbach's alpha/ Omega McDonald's/ floor and ceiling effect) and stability with intra-class correlation (ICC).

After interviews with 14 emergency technicians, the initial scale was designed with 60 items. Of the total items, 17 poor items were dropped during face and qualitative content validity. In the content validity phase, the items with CVR > 0.62, modified Kappa > 0.74 were retained, which eliminated 23 items. EFA was conducted with 20 items and lead to the 5 factors. The floor and ceiling effect for the whole scale was zero. Finally, the reliability of the scale was confirmed (a = 0.83, O = 0.86, ICC = 0.95).

The developed 20-item scale is a valid and reliable scale for the assessment of the MD in EMS providers.

Simple Triage and Rapid Treatment (START) is a unique triage system used by prehospital providers during disasters to quickly categorize and prioritize patient care according to severity. This study aims at evaluating knowledge about the START triage system among field emergency medical service (EMS) personnel working at the Saudi Red Crescent Authority (SRCA) in the stations of the city of Riyadh.

This is a cross-sectional study that examined data collected from August 2019 to January 2020. The statistical population is from all field EMS personnel working in the SRCA located in Riyadh, Saudi Arabia. Using simple random sampling, 239 field EMS personnel were assessed, and 235 completed the study (98.3% response rate). Data were collected electronically using demographics and 15 multiple choice emergency scenarios based on the START protocol.

The mean correct score is 8.21 ± 3.36 out of 15 questions of triage knowledge (score of 0–15 points), indicating that those respondents have moderate knowledge levels on the START triage tool. Physicians and paramedics have higher mean scores (10.13 ± 3.42 and 9.07 ± 3.22, respectively), which are significantly higher than emergency medical technicians and nurses (7.25 ± 3.15 and 5.63 ± 2.72, respectively; p < 0.05). The providers who attended the training course had higher mean scores (p < 0.05).

Based on the results of the study, field EMS personnel did not reflect full knowledge of START triage tool. An interdisciplinary approach that adopts reinforcement education and periodical training courses is highly recommended to improve the respondents' performance and productivity. Moreover, there was a noticeable correlation between performance of respondents on the one hand and their education levels and prior training on the other hand.

Most rescue squad members, both in the city and in rural areas, serve on a volunteer (unpaid) basis. It has been widely reported and observed that the number of Emergency Medical Technician (EMT) volunteers is falling in communities across the USA. Meanwhile, internationally, the need for emergency services volunteers is increasing as government support dwindles in these uncertain economic times. The purpose of this paper is to determine how to keep EMT volunteerism at desired levels and provide recommendations for increasing recruitment and retention.

The paper examines what motivates people and why people volunteer in general, beginning with a discussion of citizenship participation and international EMS, then reviewing general and volunteer motivation theories, and finally focusing on volunteer EMT motivation/retention theories in particular. Research studies in two diverse locations (one urban, one rural) are then implemented to survey volunteer EMT motivations and priorities, to find what stimulates EMTs to join and continue to participate in rescue squad operations.

Theoretical explanations and research results are analyzed to determine the implications for both recruitment and retention of volunteer EMTs.

Based on these findings, the remainder of the article is dedicated to the practical application of strategies which are easily implemented and cost‐effective for any volunteer EMT organization, regardless of locale or country of origin. Utilization of these strategies is both timely and relevant, because few communities' operational budgets can absorb the costs of hiring additional professional EMTs.