Holmes 1

Calista Holmes
Mrs. DeBock
English 4 Honors
September 24, 2015
Annotated Bibliography
Essential Question: What are the psychological and physiological effects of firefighting and
emergency medicine?
Working Thesis: Psychological and physiological effects affect firefighters and emergency
medical responders.
Refined Thesis: Firefighters and emergency medical responders are exposed to many stressors
that cause psychological and physiological effects such as Post-Traumatic Stress Disorder, sleep
deprivation, poor health and development of bad habits that can all result in work-stress burnout.

Beaton, Randal, et al. Exposure To Duty-Related Incident Stressors In Urban Firefighters And
Paramedics. Journal Of Traumatic Stress 11.4 (1998):821. Advanced Placement Source.
Web. 21 Sept. 2015.
One hundred and seventy-three professional firefighter/paramedics took part in a test to
show the measure of duty related incident stressors. The rescaled incident stressor ratings were
divided into five distinct components; Catastrophic Injury to Self or Coworker, Gruesome Victim
Incidents, Render Aid to Seriously Injured, Vulnerable Victims, Minor Injury to Self and Death
and Dying Exposure. The participants were asked to rank each incident stressor, how stressful an
event would have been assuming they were present and to indicate how many times they had
experienced a given stressor within the past six months. This article was crucial to my research

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paper because it provided me with two charts not only providing a list of incident stressors that
firefighter/paramedics encounter but also the severity of stress deemed by each event along with
how often they are experienced.

Corrigan, Malachy, et al. A Computerized, Self-Administered Questionnaire To Evaluate

Posttraumatic Stress Among Firefighters After The World Trade Center Collapse.
American Journal Of Public Health 99.S3 (2009): S702-S709. Business Source Premier.
Web. 21 Sept. 2015.
Eight thousand eighty-seven firefighters participated in a test that assessed their exposure
on September eleventh to the Fire Department of New York, World Trade Center Intensity Index.
This test evaluated the total Post-Traumatic Stress Disorder symptoms present in all participants,
as well as the total per category, and the breakdowns within each category. The main categories
were broken down into re-experiencing (flashbacks and nightmares), avoidance and numbing
(distancing, feeling numb, dazed, difficulty remember incident and avoiding memory devices),
arousal (insomnia, irritability, anxiety, and anger) and functional impairment (home, work). This
article is crucial to my research paper because it provides two graphs as well as two charts that
show data on the results as well as the severity of the Post-Traumatic Stress Disorders diagnosed.

Haslam, Cheryl, and Krissie Mallon. A Preliminary Investigation Of Post-Traumatic Stress

Symptoms Among Firefighters. Work & Stress 17.3 (2003): 277-285. Business Source
Premier. Web. 21 Sept. 2015.
This research showed prevalence of Post-Traumatic Stress Disorder among emergency
service personnel, as well as the common disorders related to the disorder such as substance

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abuse, social dysfunction, depression, intrusive memories and sleep problems. This research
team also took a different outlook and included nine specific traumatic events relevant to
firefighting in their questionnaire. These events included: serious fire or explosion; serious
accident; natural disaster, such as flooding; other rescue operations; military combat or war zone;
life threatening illness in the firefighters family; situations involving adult fatalities (over 16
years); situations involving child fatalities (under 16 years); and other category. This article was
crucial for my research because it included a chart including the experienced events and the
event bothering them most, it was also crucial because it had quotes from firefighters that helped
bring reality and personalization into my research.

Schmitz, Gillian, et al. Strategies For Coping With Stress In Emergency Medicine: Early
Education is Vital. Journal of Emergencies, Trauma, And Shock 1 (2012): Academic
OneFile. Web 17 Sept. 2015.
The main focus was burnout in emergency medicine and what defined being burnt out,
along with the study that emergency medicine had a much higher burnout rate than any other
profession in the medical field. Negative psychological impacts of circadian disruption such as
sleep pattern disruption, health and psychological mood were discussed as well as the effects of
burnout on the individuals ability to perform in relation to malpractice law suits and fear of
litigation in the profession. The article include informational text on emergency medicines
exposure to infectious disease as well as difficulty maintaining exercise and nutrition and patient
mortality. This article was beneficial to my paper because it provided a summary chart of all
challenges that cause a change to wellness along with solutions, and the informational text

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provided in detail explanations of each, along with the negative impacts that accompany the
challenges.

Vettor, Susan M., and Frederick A. Kosinski Jr. Work-Stress Burnout In Emergency Medical
Technicians And The Use Of Early Recollections. Journal Of Employment Counseling
37.4 (2000): 216. Business Source Premier. Web. 21 Sept. 2015.
This article goes in depth on the fact that emergency medical technicians cannot save
everybody which may leave them susceptible to burnout, and that an emergency medical
technician that feels a need to be good may experience guilt as a result of being unable to save
patients, which may turn to affect job performance. It also looks into the three components of
burnout and not only looks at the stressors firefighters experience, but also states their immediate
environment is not always preferable and can hold physical dangers. The affect that firefighting
puts on overall work performance as well as the thick skinned approach many learn to develop.
This article is crucial to my article because it includes the components of burnout and its effects,
along with experiences of emergency medical technicians and a long list of symptoms indicative
of Post-Traumatic Stress Disorder, along with the not so favorable characteristics they pick up
along the way.

Wolkow, Alexander, et al. Effects of Work-Related Sleep Restriction On Acute Physiological

And Psychological Stress Responses And Their Interactions: A Review Among
Emergency Service Personnel. International Journal Of Occupational Medicine &
Environmental Health 28.2 (2015): 183-208. Academic Search Complete. Web 21 Sept.
2015.

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This article looks into the evidence that periods of partial and total sleep
deprivation/restriction can impair immune function, hormone secretion, instigate adverse
psychological changes, and has been associated with metabolic diseases and cardiovascular
disease. In correspondence, also shows evidence that an increase in stress exposure
simultaneously induces both physiological and psychological changes and that these responses
can be positively or negatively correlated with one another. It discusses the effects of early start
times and shift work that can cause a misalignment to the circadian rhythm. Unlike any other
article, it mentions the constant state of readiness that personnel have to respond to an emergency
alarm. The shocking data also discussed that increased cortisol levels have been associated with
insulin resistance. This article is crucial because it not only gives information of psychological
and physiological effects of firefighting, but also compares those effects to those experienced in
other professions which are exposed to stress, it also includes many charts containing important
quantitative data.