Beatrice Thielmann¹, Jin Ye Yeo²

¹Institute of Occupational Medicine, Faculty of Medicine, Otto von Guericke University Magdeburg, Saxony-Anhalt, Germany; ²JPHE Editorial Office, AME Publishing Company

Correspondence to: Jin Ye Yeo. JPHE Editorial Office, AME Publishing Company. Email: jphe@amegroups.com

Expert introduction

Dr. Beatrice Thielmann (Figure 1) is a Guest scientist at the Institute of Occupational medicine at the Otto von Guericke University of Magdeburg, Saxony-Anhalt, Germany, since 2012. She is also in residency training in occupational medicine in Hamburg, Germany. She is a member and co-author of the current Association of Scientific Medical Societies in Germany (AWMF) guideline “Heart Rate Variability in Occupational Medicine” and leads the “EMS Research” and “Psychocardiology” working groups. She is also a specialist in internal medicine and cardiology (since 2017), an active emergency physician (since 2014), and former chief emergency physician of the Segeberg district in Schleswig-Holstein (2016-2018).

Figure 1 Dr. Beatrice Thielmann

Interview

JPHE: What drove you to pursue occupational medicine and emergency medicine?

Dr. Thielmann: I was drawn to occupational medicine because I have a passion for improving the health and safety of workers. This specialty focuses on preventing workplace injuries and illnesses, promoting safe work environments, and ensuring compliance with health regulations. Occupational medicine offers the opportunity to work in a variety of settings, including industrial sites, corporate offices, and healthcare facilities. This diversity appeals to me because I enjoy working in different environments. In occupational medicine, I often work with other health care professionals, safety experts, and management teams, providing a collaborative and multifaceted approach to health care.

What appeals to me about emergency medicine is the speed and dynamism of the work. Unpredictable and urgent situations are exciting and a constant challenge. In emergency medicine, I can make life-saving decisions immediately. The opportunity to provide critical care to patients in acute situations and see the immediate results of my interventions motivates me to give my best. Many patients with different conditions are treated in the prehospital emergency medicine, so you get to see a wide range of medical problems. This diversity is intellectually stimulating and enhances my clinical skills. Emergency medicine is a lot about teamwork, working with nurses, paramedics and other specialists. This team-oriented environment is very fulfilling for me as I feel comfortable in a collaborative environment. The field of emergency medicine is constantly evolving, so I always need to be up to date with the latest medical and technical developments. This continuous learning process is very appealing to me as a lifelong learner.

By practicing both specialties, I gain a unique perspective on patient care. The skills and knowledge from occupational medicine enhance my understanding of work-related injuries and illnesses in the emergency setting, while the acute care experience from emergency medicine informs better management of occupational health crises. This blend results in a comprehensive approach to both immediate and long-term patient care.

JPHE: Could you share a brief overview of the current publication landscape in emergency medical services (EMS)?

Dr. Thielmann: The EMS publication landscape is dynamic, reflecting the ongoing changes in the field. Researchers are constantly exploring new technologies, improving clinical practices and addressing the well-being of EMS personnel to improve the overall effectiveness of EMS. Here's a brief overview of the current publication landscape in EMS:

There is significant interest in integrating telemedicine and mobile health into EMS, especially for remote consultations and pre-hospital care. Research is focusing on the use of wearable devices to monitor vital signs and predict medical emergencies.

Comparative studies continue to evaluate the outcomes and efficacy of Advanced Life Support (ALS) and Basic Life Support (BLS) interventions. The use of portable ultrasound devices, such as point-of-care ultrasound (POCUS), in the field is gaining traction, with research supporting their utility in the diagnosis and management of various conditions.

Studies are analyzing the impact of various dispatch protocols and technologies on response times and patient outcomes. There is a growing body of literature on the use of data analytics and machine learning to optimize EMS operations and improve patient outcomes.

Research is underway to update and refine clinical guidelines based on the latest evidence, covering a wide range of emergency medical conditions. Efforts to standardize EMS protocols and improve training are frequently discussed in the literature.

Research is increasingly focusing on the mental health challenges faced by EMS personnel, including studies on burnout, post-traumatic stress disorder (PTSD), and the effectiveness of various support programs. Intervention studies to strengthen resilience and stress management are becoming increasingly popular. Publications also address the physical and psychological safety of EMS personnel, particularly in the context of violence against EMS personnel. Emergency medical service organizations are becoming increasingly aware of safety culture, which is reflected in the increasing number of publications.

There is notable interest in the evolving role of paramedics, including community paramedicine programs that extend care beyond traditional emergency response. Research is exploring how EMS can better integrate with broader health care systems to provide more seamless and continuous care.

Studies examine the differences in EMS systems around the world, looking at best practices and outcomes in different countries. Publications focus on the role of EMS in disaster preparedness and response, including case studies from recent natural disasters and large-scale emergencies.

JPHE: What are some emerging technologies that hold significant promise in the field of EMS? Could you elaborate on their potential enhancement on EMS?

Dr. Thielmann: Possible examples of emerging technologies in the future include:

1) Telemedicine allows EMS personnel to consult with remote physicians during emergencies. This can lead to faster decision-making, improved diagnosis and treatment options. In rural or underserved areas, telemedicine can bridge the gap between patients and specialized medical care.

2) Wearable devices can monitor vital signs in real time and alert EMS teams to changes in a patient's condition. This continuous monitoring can provide critical data prior to EMS and can provide important data in advance, before the emergency services arrival in the emergency room or shock room, allowing for better preparation and more accurate treatment upon arrival.

3) Drones can deliver medical supplies, such as defibrillators or medications, to the scene of an emergency faster than ground vehicles. They can also provide aerial views of disaster areas, helping EMS teams assess the situation and plan their response more effectively.

4) Artificial intelligence (AI) can analyze large amounts of data to predict emergency trends, optimize EMS deployment, and improve decision-making. Machine learning algorithms can assist with triage, helping to prioritize patients based on the severity of their condition.

5) Augmented reality (AR) can assist EMS personnel by overlaying critical information in their field of view. This can include anatomical guides, procedural steps, or real-time data from wearable devices.

6) Mobile apps can provide EMS teams with quick access to medical protocols, patient records and real-time communication with hospitals. This connectivity ensures a more coordinated and informed approach to patient care.

7) Advanced simulation training: High-fidelity simulators and virtual reality (VR) environments allow EMS personnel to train in realistic scenarios. This type of training can improve skills, decision-making and preparedness for real-world emergencies.

8) 3D printing can produce customized medical tools and equipment quickly and inexpensively. In emergency situations, EMS teams could print splints, casts, or other necessary medical devices on the spot, tailored to the specific needs of the patient.

9) Intelligent ambulances equipped with advanced diagnostic tools and real-time communication systems can improve patient care during transport. Features such as integrated CT scanners, automated medication dispensers, and real-time data transmission to hospitals can significantly improve patient outcomes.

JPHE: Do you foresee any emerging challenges in EMS that encompass these new technologies?

Dr. Thielmann: Yes, there are several emerging challenges in EMS that encompass these new technologies, particularly regarding the cost explosion of emergency medical services.

Implementing advanced technologies such as telemedicine, wearable devices, drones and AI can be prohibitively expensive. This can strain EMS budgets and lead to higher costs for emergency medical services. Increased costs can put financial pressure on healthcare systems, potentially limiting the accessibility and availability of these technologies. Smaller or rural EMS providers may struggle to adopt these innovations due to budget constraints.

Integrating new technologies into existing EMS workflows requires a significant investment in education and training. EMS personnel must be adequately trained to effectively use these advanced tools. The cost of training programs and the time required for EMS staff to become proficient can be significant. This can lead to initial disruptions in service delivery and increased operational costs. High-tech equipment requires regular maintenance and updates to function correctly. This adds to long-term costs and operational complexity. The ongoing costs of maintaining and upgrading technology can accumulate, adding to the cost burden of EMS systems.

The use of technologies such as telehealth and wearable devices generates a large amount of sensitive patient data. Ensuring data security and privacy can be complex and costly. Investing in robust cybersecurity measures is essential but can significantly increase overall costs. Data breaches can result in legal and financial consequences.

JPHE: EMS played a significant role in the response and management of the SARS-CoV-2 pandemic. Could you share what insights you have derived from the research conducted on the physical and psychological health of staff during the SARS-CoV-2 pandemic? How can these insights be applied to better manage the wellbeing of healthcare staff?

Dr. Thielmann:The SARS-CoV-2 pandemic placed an immense burden on healthcare workers, highlighting significant challenges to their physical and psychological health. Research, including studies by our research group (1-5), provides valuable insights into these challenges and offers strategies to improve the well-being of health care workers. Overall, I see the topic of "safety culture in the emergency services" as strengthened and as an important player against the shortage of skilled workers and the challenges of demographic change. Safety Culture can also promote the well-being of emergency services personnel in the workplace.

EMS personnel face an increased risk of infection, fatigue, and physical exhaustion due to long working hours and the need for continuous use of personal protective equipment (PPE). To mitigate these problems, it is critical to provide adequate rest periods, rotating shifts, and an adequate supply of quality PPE. Regular health assessments and physical fitness programs can help maintain physical health.

The psychological impact of the pandemic on EMS personnel included increased levels of stress, anxiety and burnout. Implementing robust mental health support systems, such as counseling services, stress management workshops, and peer support programs, can help manage mental health. Encouraging open communication and debriefing sessions can also reduce stress and provide emotional support.

Studies have shown that excessive workloads during the pandemic were a significant stressor. Developing efficient staffing models and using technology to streamline operations can help balance the workload. Ensuring that EMS personnel have access to necessary resources and support can reduce the burden on individuals.

Proper training and preparedness have been identified as critical factors in managing the pandemic. Regular training programs on infectious disease management, proper use of PPE, and emergency protocols can improve preparedness. Simulation exercises and continuing education can improve confidence and reduce anxiety among EMS personnel.

Organizational support was found to be a key determinant of EMS personnel’s well-being during the SARS-CoV-2 pandemic. The studies highlighted the need for strong leadership and organizational commitment to personnel well-being. Organizations should prioritize staff well-being by providing clear communication, recognizing efforts, and fostering a supportive work environment. Financial incentives and recognition programs can also boost morale and motivation.

JPHE: Could you share what are some ongoing projects you are involved in? What knowledge gaps do you hope to fill through these projects?

Dr. Thielmann: I am currently concentrating on psychological stress at work in the German EMS. Our research group EMS Research is currently investigating the long-term course of mental stress and recovery during different waves of the SARS-CoV-2 pandemic in cross-sectional studies (we cannot guarantee that all participants participated in all survey dates). However, Dr. Heiko Schumann is the team leader for the aforementioned research. My leading studies deal with the status quo of occupational health care in the German emergency services, resilience and its influence on psychological distress. A study of emotion regulation in the German EMS is planned.

JPHE: How has your experience been as an Editorial Board Member of JPHE?

Dr. Thielmann: As the Editorial Board Member of JPHE, the experience has been highly enriching and multifaceted. I have had the following experiences so far: contributing to the dissemination of quality research and advancing the field of public health and emergency medicine is extremely rewarding. Participating in the scientific community's efforts to improve public health outcomes provides a deep sense of purpose and fulfillment.

JPHE: As an Editorial Board Member, what are your expectations for JPHE?

Dr. Thielmann: My expectations would be:

Participation in editorial decision-making allows you to influence the direction of the journal. This includes selecting high-impact articles, shaping special issues, and setting standards for publication. This responsibility provides a sense of accomplishment and contribution to the field, as well as an understanding of broader trends and emerging issues.

Serving on an editorial board provides many opportunities to network with leading researchers, clinicians, and professionals in the field. Building these connections can lead to collaborations and further professional growth.

The role contributes significantly to professional development. It involves continuous learning and exposure to diverse research methodologies and topics. This ongoing education will help you stay at the forefront of your field and enhance your own research and clinical practice.

I expect the journal to attract and publish high-quality, original research that advances the field of public health and emergency medicine. Ensure a rigorous peer review process to maintain the highest standards of scientific integrity and accuracy.

The journal should cover a wide range of innovative and diverse topics that reflect current trends and emerging issues in public health and emergency medicine. Submissions that address global health challenges, novel interventions, and multidisciplinary approaches are encouraged.

Adherence to the highest ethical standards in publishing, including transparency, disclosure of conflicts of interest, and respect for. Implement clear policies and guidelines to maintain ethical practices in all aspects of the journal's operations.

Reference

1. Schumann H, Thielmann B, Botscharow J, et al. Recovery and stress of control center dispatchers in the first waves of the SARS-CoV-2 pandemic. Wien Klin Wochenschr. 2023;135(9-10):228-234. doi:10.1007/s00508-022-02144-6
2. Thielmann B, Schwarze R, Böckelmann I. A systematic review of associations and predictors for job satisfaction and work engagement in prehospital emergency medical services—challenges for the future. IJERPH. 2023;20(5):1-16. Available online: https://ideas.repec.org//a/gam/jijerp/v20y2023i5p4578-d1087814.html
3. Schumann H, Böckelmann I, Thielmann B. Relaxation and strain among Emergency Medical Service Personnel and Emergency Control Center Dispatchers During the first two Waves of the SARS-CoV-2 Pandemic. Medycyna Pracy. 2023;74(5) 353-362. doi:10.13075/mp.5893.01401
4. Thielmann, B., Böckelmann, I., Schumann, H. Entwicklung des Alkoholkonsums zu Beginn und während der ersten Wellen der SARS-CoV-2-Pandemie: Ergebnisse einer systematischen Literaturrecherche. Notfall Rettungsmed. 2023;26(5):349-355. doi:10.1007/s10049-022-01031-x
5. Thielmann B, Schumann H, Ulbrich R, et al. Bedeutung der Einfluss- und protektiven Faktoren bei der psychischen Belastung von medizinischem Personal in Zeiten der SARS-CoV-2-Pandemie. Der Notarzt. 2022;38(02):86-94. doi:10.1055/a-1557-9088