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BioMed Research International
Volume 2014, Article ID 483140, 7 pages
Research Article

Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

1Department of Pychiatry, Mt. Sinai Hospital and the University of Toronto, Toronto, Canada M5G 1X5
2Public Health Ontario and Departments of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada M5G 1V2
3Sunnybrook Osler Centre for Prehospital Care, Toronto, Canada M4N 3M5
4Department of Psychology, Ryerson University, Toronto, Canada M5B 1X5

Received 26 January 2014; Accepted 10 April 2014; Published 4 May 2014

Academic Editor: Patrick Schober

Copyright © 2014 Janice Halpern et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 30 minutes and end of shift, with 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.