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International Journal of Paramedicine

International Journal of Paramedicine

Auteur(s): International Journal of Paramedicine and NEMSMA
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 The Official Podcast of the International Journal of Paramedicine (IJOP) is an international forum for scholarly contributions and state-of-the-art research relevant to patient care and the growth and advancement of paramedicine. This will include the areas of paramedic leadership, management, education, operations, culture, and professional and clinical practice. The IJOP encourages exploration of paramedicine from diverse theoretical and practical views from all disciplines including business and economics; the natural, basic, and applied sciences; and the humanities, social sciences, and arts. Priority will be given to submissions that use sound theoretical or conceptual frameworks, apply strong methodological design, and have relevance to the international paramedic community. All methodologies (e.g., quantitative, qualitative, mixed methods, knowledge syntheses) will be considered. The Journal is published and copyrighted by the National EMS Management Association (USA)(c) 2025 Développement commercial et entrepreneuriat Entrepreneurship Gestion et leadership Science Économie
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  • Episode 5: Mental Health Symptoms, Stressors, and Coping: An Exploration of First Responder Experiences Working in Rural, Suburban, and Urban Areas

    Episode 5: Mental Health Symptoms, Stressors, and Coping: An Exploration of First Responder Experiences Working in Rural, Suburban, and Urban Areas
    Aug 5 2025
    International Journal of Paramedicine's Editor-In-Chief, Mic Gunderson, interviews lead author, Chelsey N. Torgerson, PhD, about the manuscript entitled, "Mental Health Symptoms, Stressors, and Coping: An Exploration of First Responder Experiences Working in Rural, Suburban, and Urban Areas." It appeared in the July-September 2025 (#11) issue.

    Manuscript Link https://internationaljournalofparamedicine.com/index.php/ijop/article/view/3131

    Manuscript Discussion Thread
    You are invited to ask question and make comments about this paper on the NEMSMA listserv. Access and join the NEMSMA discussion group at: https://groups.google.com/g/nemsma/. Look for the message thread starting with [IJOP 3131] and make your voice as a paramedicine professional heard.

    Abstract
    EMS first responders provide essential services to communities in rural, suburban, and urban locations across the United States. While the mental health experiences of first responders have been generalized across all geographic locations, less is known about the mental health differences among rural, suburban, and urban first responders. This study explored mental health symptom profiles, job stressors, coping mechanisms, and mental health resource availability of 118 first responders providing services in rural, suburban, and urban locations throughout Oregon. First responder agencies across Oregon were contacted by researchers and asked to distribute the electronic survey. First responders who received a survey link volunteered to anonymously participate in the study. Findings indicate common challenges as well as unique differences among first responders in different geographic locations. First, mental health profiles of the participants were provided. Symptoms of depression, generalized anxiety, suicidal ideation, PTSD, and bipolar disorder were present in participants. Depression, generalized anxiety, and PTSD was more evident in first
    responders in urban/suburban areas, while risk of suicide was more prevalent in rural first responders. Second, three primary themes of stressors were identified (along with a fourth “other” category): 1) larger societal stressors impacting first responders; 2) job-related stressors; mental health, relational, and 3) financial stressors from being a first responder. Sub-categories within themes ranged from organizational, patient-related, and position-specific stressors to financial, intrapersonal, and interpersonal stressors. Two themes of stress management were identified: function/
    purpose of coping strategies and coping strategies without an identified function/purpose. Suggestions, from respondents and authors, for EMS agencies are provided throughout. Future research is outlined.

    International Journal of Paramedicine website: https://InternationalJournalOfParamedicine.com
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    16 min
  • Episode 6: Strengthening EMS in Malawi: Piloting World Health Organization Basic Emergency Care for Prehospital Providers in Zomba, Malawi.

    Episode 6: Strengthening EMS in Malawi: Piloting World Health Organization Basic Emergency Care for Prehospital Providers in Zomba, Malawi.
    Aug 5 2025
    This podcast interviews co-author Siyaphera Makunganya, MSc, about the manuscript entitled, " Strengthening EMS in Malawi: Piloting World Health Organization Basic Emergency Care for Prehospital Providers in Zomba, Malawi." It appeared in the July-September 2025 (#11) issue of the International Journal of Paramedicine (IJOP). The interview was conducted by IJOP's Editor-In-Chief, Mic Gunderson. Manuscript Link: https://internationaljournalofparamedicine.com/index.php/ijop/article/view/3231 Questions and Comments You are invited to ask questions and make comments about this and other papers in NEMSMA's online discussion group at: https://groups.google.com/g/nemsma/. Look for the messages with the [IJOP 3231] header. Abstract Background - Malawi has no country-wide emergency medical services, with prehospital care majorly provided by laypersons, with transport of patients typically provided by private car or taxi and less than 2% of emergency patients receiving transport by ambulance. Zomba Private Ambulances is currently the only private ambulance group operating in south-eastern Malawi. Despite not having formal prehospital provider education in Malawi, Zomba Private Ambulances makes use of mid-level care practitioners, nurses, and first-aid-only providers to provide prehospital care. This study examined the use of an existing emergency training course to educate prehospital providers in Zomba, Malawi. Methodology - This study used a pilot study, consisting of an educational intervention trial conducted in Zomba, Malawi. Prehospital providers from Zomba Private Ambulances underwent training in WHO Basic Emergency Care including lectures and skills workshops led by an emergency medicine registrar. Participants completed a pre- and post-course survey and assessment measuring demographic information and knowledge and confidence of basic emergency skills. Results - 9 total prehospital providers underwent training, consisting of nurses, mid-levels, and providers with first-aid-only. Overall confidence increased significantly after completing the course (83.3 to 96.8% confidence). Knowledge retention varied across participant training levels (post-course scores being: mid-levels 80%, nurses 73%, and first-aid-only 42.6%). Overall, providers displayed increased knowledge post-course, however, post-course knowledge varied amongst domains (e.g., trauma, altered mental status, shock). Barriers to training were identified including lack of transport, other occupational responsibilities, and lack of understanding of course applicability for first-aid-only providers. Conclusion - Using education tools such as WHO BEC assists in the knowledge and confidence of prehospital providers in Malawi. Further studies are required to assess the retention of knowledge and effective use in the field. Additional training should be more easily accessible to improve prehospital triage in Malawi. The expansion of prehospital care in Malawi should utilize contextually relevant training. International Journal of Paramedicine website: https://InternationalJournalOfParamedicine.com
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    10 min
  • Episode 4: Ambulance deserts: A critical challenge for EMS leadership in achieving equitable emergency care access

    Episode 4: Ambulance deserts: A critical challenge for EMS leadership in achieving equitable emergency care access
    Aug 5 2025
    This podcast interviews lead author Raphael Barishansky, DrPH, about the editorial entitled, " Ambulance deserts: A critical challenge for EMS leadership in achieving equitable emergency care access." It appeared in the July-September 2025 (#11) issue of the International Journal of Paramedicine (IJOP). The interview was conducted by IJOP's Editor-In-Chief, Mic Gunderson. Manuscript Link: https://internationaljournalofparamedicine.com/index.php/ijop/article/view/3414 Questions and Comments You are invited to ask questions and make comments about this and other papers in NEMSMA's online discussion group at: https://groups.google.com/g/nemsma/. Look for the messages with the [IJOP 3414] header. Abstract The growing prevalence of ambulance deserts—geographic areas where residents live more than 25 minutes from the nearest ambulance station—poses a critical threat to health equity and public safety in the United States. Rooted in systemic underinvestment, workforce shortages, and fragmented policies, these deserts disproportionately affect rural and underserved communities, where response times can exceed 30 to 60 minutes during life-threatening emergencies. This paper examines the structural determinants of ambulance deserts, including the lack of statutory recognition of EMS as an essential service, outdated reimbursement models, and the absence of coordinated sustainability planning. Drawing on two decades of leadership experience across EMS, public health, and government, the author outlines five strategic actions for EMS leaders: securing essential service designation, advancing statewide sustainability plans, advocating for readiness-based funding, expanding Medicaid reimbursement pathways, and strengthening the EMS workforce. The paper also explores global parallels, offering key lessons for international health and emergency systems. Ultimately, ambulance deserts must be reframed as a public health emergency requiring bold leadership, integrated policy reform, and sustained public investment. EMS leaders are uniquely positioned to drive this transformation—if they act decisively and strategically. International Journal of Paramedicine website: https://InternationalJournalOfParamedicine.com
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    13 min
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