| Abstract
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Healthcare workers are at an increasing risk of contracting Work-Related Musculoskeletal Disorders (WMSDs). While healthcare organizations are investing significantly in patient lifting and handling equipment, to reduce the risk of lower back injuries, the paramedics profession does not have full access to those benefits. Paramedics, a profession that is not only physically demanding, but also cognitively and emotionally challenging, plays a significant role in healthcare systems. The challenge posed by researchers and designers for this job family is the inclusion of three dimensions to ergonomics: the human (patient), the machine (patient lifting equipment), and the human (paramedic) interaction, in contrast to the traditional definition of human-machine interaction. Due to the difficulty in replicating the paramedics work environment in a laboratory setting, this research endeavor proposes a unique approach to study the dynamic environment encountered by paramedics through the use of Digital Human Modeling (DHM) technology. More specifically, to improve the ergonomics of the work environment for paramedics, this research effort presents and discusses the results of four simulated experiments. First, a validation study was conducted to replicate the "most frequently performed strenuous work tasks" using a DHM software called Jack. This experiment was important to ensure that the simulated environment used throughout this research mimics, to a large extent, the actual patient handling tasks encountered by paramedics in the real life. Second, patient lifting tasks were analyzed to study the impact of two factors on performance, namely paramedic height and patient weight. Third, the stretcher to gurney transfer was researched independently, due to the degree of freedom added from height adjustment, using a general factorial design. Though ergonomically designed equipment has an important role in reducing the effect of heavy lifting, lack of training in proper lifting procedures leads to awkward postures, thereby increasing the risk of contracting lower back injuries. Therefore, the last experiment in this research effort studied the impact of six upper-body postural variables on low back injury. The results of this research revealed that team roles were significantly different for different paramedic tasks performed. Though this partially aligns with previously conducted research, the reason for the difference is not only due to the roles assumed, but is also significantly dependent on the height of the paramedic. Furthermore, it was observed that the stretcher and gurney heights have different influence on lower back stress for paramedics with different heights. Finally, the results revealed that the postural variables assumed during patient transfer procedures may increase or decrease lower back stress in a combinatorial manner given different emergency scenarios. These results will therefore not only help squads form ergonomically efficient teams and preplan tasks before emergency calls, but will also help equipment manufacturers design cost effective patient lifting equipment. In conclusion, the research presented in this thesis further emphasizes the importance of human factors engineering and ergonomics in the healthcare industry. The application of principles of this important domain will not only improve the quality and safety of patient care, but will also reduce the risk of WMSDs for healthcare professionals. In some cases, the cost of low back injury, in terms of medical needs and worker compensation, can exceed the investment needed for a comprehensive ergonomics program. After all, paramedics and emergency medical technicians (EMTs) are an extremely important asset to our society.
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