Measuring trauma symptoms in paramedicine

Background
The trauma experienced as a paramedic can have a devastating psychological impact on both professionals and students in training, and increases the risk of developing post-traumatic stress disorder (PTSD). Paramedics are often placed in high-risk situations involving multiple or sustained trauma and also experience high levels of occupational stress, which can produce adverse psychological and physiological responses. Despite these risks, understanding trauma and its various manifestations in paramedicine has not been well documented.

Methods
This narrative review describes the history and changes in diagnostic criteria, and contrasts the methods of measuring PTSD symptomology with the current criteria.

Results
PTSD was first defined in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) in 1980, however the diagnostic criteria and associated measurement tools failed to reflect the repeated and vicarious traumatic events experienced by paramedics.Currently, the majority of the measurement tools used to assess post-traumatic stress are still aligned with superseded diagnostic criteria and many only classify the symptoms of PTSD as present or absent with little consideration given to symptom severity. Consequently, these existing measurements of PTSD are out dated and inefficient in their ability to identify and measure PTSD using the revised criteria.

Conclusion
The development of a more specific measurement tool, which reflects the DSM-5 diagnostic criteria of trauma-related stressors within this population, will allow for a more comprehensive measurement of symptoms. Future research undertaken in this specific field will also help to inform education and training programs to assist with the negative impacts of trauma and aid in management and treatment of PTSD in paramedics.