Paramedics Slower to Respond After Deadly Incidents, Study Finds



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When emergency workers handle a serious call during the course of a shift it can have a nearly immediate negative affect on job performance, according to new research.

For emergency workers like firefighters, police officers and ambulance crews, responding to traumatic situations can take an emotional and psychological toll, contributing to difficulties like professional burnout, post-traumatic stress disorder and depression.

New academic research finds that these sorts of events can also have a nearly immediate effect on how well people can perform their jobs. This is something managers of these types of workers should keep in mind when assigning duties, the authors of the study suggest.

The research was co-authored by Jónas Oddur Jónasson, a professor at the Massachusetts Institute of Technology Sloan School of Management, and Hessam Bavafa a business school professor at the University of Wisconsin-Madison.

They looked at about 902,000 ambulance calls in London during 2011, zeroing in on “critical incidents,” where patients had a high probability of dying at the scene, and how responding to those affected the performance of paramedics throughout the rest of their shift.

Of the total number of calls the researchers analyzed, 8,404 included critical incidents.

To measure the effects of the incidents, they looked at the amount of time it takes a crew to complete an ambulance “activation” and certain related processes. An activation includes driving to an emergency scene, picking up a patient, and handing them over at a hospital.

What the study authors found is that for crews who encountered one critical incident, subsequent completion times for activations during their shift rise by about 1.9 minutes, or 2.6%. For crews responding to two critical incidents, the increase was greater: 5.5 minutes, or 7.5%, compared to a shift without any of the incidents. 

This kind of lag has the potential to be serious in emergency response, where a few extra minutes getting to a hospital could be the difference between life or death for a patient.

Part of what makes the study results notable, according to the authors, is that encountering events that can overwhelm a person’s coping mechanisms is a regular part of a paramedic’s job—occurring at least once in 5% of shifts, according to their analysis.

In other words, the incidents are affecting the performance of “precisely the workers who should be best equipped (through training and experience) to deal with such events.”

There are a few more detailed findings as well. For instance, Jónasson and Bavafa found a strong effect from critical incidents when it comes to tasks where paramedics have a substantial amount of autonomy to make decisions, as opposed to where they have more outside support.

And while they conclude that greater paramedic experience levels help staunch the detrimental effects critical incidents can have on performance, this effect is offset by another finding—that older paramedics, likely to have more experience, were more affected.

So what’s the implication for agencies with workers who encounter these high stress situations? 

Jónasson and Bavafa say their results indicate that managers may want to avoid assigning new jobs during the course of a shift to teams who have responded to critical incidents. If that’s not possible, they say it’s advisable to assign them to lower priority calls.

The research paper, titled “Recovering From Critical Incidents: Evidence From Paramedic Performance,” is forthcoming in the INFORMS journal Manufacturing and Service Operations Management. More about the paper can be found here.

Bill Lucia is a Senior Reporter for Route Fifty and is based in Olympia, Washington.

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