Background to the Research

Ambulance personnel across Australia and NZ in numerous ambulance services have taken their own lives. Anecdotal evidence suggests Critical Incident Stress (CIS) rates  
are high in the emergency service community. But how high? How many ambulance personnel within Australasia have indicators consistent with acute stress disorder (ASD)
and  post-traumatic  stress  disorder  (PTSD)  symptomology?  What  are  the  individual ambulance  services  doing  to  reduce these  potentially  high  figures?  And just as
importantly,  what do ambulance personnel  across the country believe should occur to reduce the  numbers of staff presenting with indicators of these conditions within their
own services.   

The research proposal put forward is to identify current rates amongst the Australasian Ambulance Services. To be able to discuss these numbers it is vital to compare rates
between ambulance personnel and the “normal population”  in order to ascertain if the emergency  service population present higher indicators  than individuals who are not
regularly subjected to traumatic situations.   

Aim of the Research

To identify  Acute Stress Disorder  (ASD)  and Post-Traumatic  Stress Disorder  (PTSD) indicators  and rates in  Australian/New Zealand  (NZ) ambulance  personnel and  to
observe the initiatives put in place by national ambulance services (inclusive of provisions to reduce the numbers affected).

The primary aim and outcome of this study is to;
  • determine  if there is a  staff perception  of shortfalls with  identifying and  treating  ambulance personnel  for  job related indicators of  PTSD or  ASD along  with other
    workplace stressors.

The secondary aims and outcomes of this study are;
  • to assess the current rates of ASD or PTSD indicators within ambulance personnel;
  • to identify  if there is an elevation in indicators of ASD or PTSD between students  in the various universities enrolled in Paramedicine and student ambulance officers,
    paramedics,  transport and communication  officers currently with  front line experience. This will be done by comparing the survey responses between the two groups.
  • to identify the causes of ambulance personnel stressors; and
  • to make recommendations into ambulance specific regions on where those shortfalls are.

Research Method

A survey with the  ability for all Australasian State  and Territory based  ambulance personnel to  answer will  be placed securely  online (and password protected) on Survey
Monkey. A letter explaining the study and a request for ambulance personnel to complete the questionnaire will be sent to Paramedics Australasia (PA), all paramedic based
teaching  universities and all  State and Territory ambulance services within Australasia,  and all State  and Territory ambulance  unions who represent ambulance personnel
throughout Australasia. Ambulance personnel will receive the Survey Monkey link to complete from the above various institutions.

Numerous  validated  ASD and  PTSD  surveys will  be  incorporated  into  one  specific ambulance  personnel  survey for  staff to complete. This  survey will  also be sent to
universities  for  any students above  the  age of 18 years  enrolled  in an  undergraduate or  post graduate  program to complete.  These  participants  will be  viewed as the
"general population". Paramedic students will represent a group who are not classed as the general population or classed as those within the ambulance personnel group as
they have had reduced "on road" exposures, that is either no on-road exposure (first year undergraduate students) or limited exposure (not qualified as a Paramedic yet, but
has worked on road).  Their data will  represent  the "middle ground" in  the research,  meaning we can  compare all three  groups. The survey will  also  obtain demographic  
data, time of service, location of participant (state only) and self-reported  data  on  feelings  towards  trauma  exposure  and  any symptoms  post  these  events.   A request  
to  all  ambulance services  for  staffing  levels  of  paramedics, communications staff and transport officers will also occur.

For this proposal, ambulance  personnel is a reference  in which all paid  career staff inclusive of paramedics,  communications officers and transport officers are included in
the data collection. Retired ambulance personnel, industrial/mine site paramedics and ambulance volunteers are not included in the data collection process.

Educators  and managers will  not be included  in the population.  ASD a nd  PTSD indicators are references  to individuals who possess  signs and symptoms or traits of the
condition but have not  been diagnosed  by a medical professional.  The included validated surveys  and the data obtained from them will  identify these traits;  in order to be
medically diagnosed with the condition a clinical based interview is required.

Study Design

The data for this research will come from the following areas;
  • Current ambulance personnel questionnaires
  • A letter  has been sent to Paramedics Australasia,  all individual State and  Territory ambulance services and all unions that provide  support to ambulance personnel,
    along with the Survey Monkey link to complete the questionnaire.
  • Data on  ambulance  employee  ASD and  PTSD  indicator rates  will  be collected and analysed.  Potential participants  will be approximately 12,976 paid ambulance
    personnel in Australia and 2,300 in NZ.

Student Paramedics

A letter has been  sent to the universities that have a current  paramedic program explaining the research and its  importance, along with the Survey Monkey link to complete
the questionnaire.  This stream of cohort’s will complete the  ASD/PTSD indicators questionnaire  and the data will be compared to those  with current on road experience.  A
letter  detailing the same information will also be sent  to all student body organisations that assist  with student ambulance officers  in their initial years of training before they
become  paramedics. The  data  will  identify  if any increases in ASD  or PTSD indicators are  evident  between  the  two cohorts.  CAA estimates that there  are about 6,000
paramedic students in Australia.

State and Territory Ambulance Services

A letter has  been  sent to all ambulance  services  explaining the  research  and its importance, with a request for employee  numbers along with  the Survey Monkey link  to
complete the questionnaire. The services have been asked  if they could email through  their servers, to gain  direct access to staff to be able to complete the questionnaire.
Potential participants will be all 7 State and Territory services within Australia and the two ambulance services from NZ.


It is hoped that with a better understanding of the data, recommendations can be made to potentially limit ambulance personnel paramedic ASD and PTSD symptomology. A
conclusion may  also be drawn as to how susceptible  new medical emergency responders  are too stressful incidents and  how those stresses may an impact upon them. By
performing  a  state  by  state comparison,  correlations may  be made  between r eported  ASD  and  PTSD rates  from  across  Australasia.  Data  from the  Survey Monkey
questionnaire may establish the concerns of ambulance personnel and may also ascertain what individual state and territories are doing to combat these issues.
The Proposal
Ambulance Workplace Stressors: The Health Impacts on our Ambulance Personnel Research and Results