Vicarious Traumatization Among Emergency Medical Service Personnel: A Systematic Review

Emergency medical services (EMS) professionals are exposed to the trauma experienced by their patients regularly. This exposure to others’ traumatic experiences is known as vicarious trauma or indirect trauma. When it becomes problematic for the worker’s well-being, the resulting symptoms are referred to as vicarious traumatization or secondary traumatic stress. Existing literature highlights the importance of recognizing vicarious trauma and subsequent symptoms experienced by these professionals, as well impacts this may have on their workplaces. However, comprehensive reviews of vicarious traumatization among those involved in responding to prehospital emergency medical situations are limited. A four-phase Preferred Reporting Items for Systematic Reviews and Meta-Analyses selection process was employed to identify publications from 1995 to 2022 that considered the epidemiology of vicarious traumatization among EMS professionals. Trained reviewers screened articles based on inclusion criteria: (a) EMS professionals; (b) vicarious traumatization/related terms; and (c) analysis of epidemiological data on prevalence, risk/protective factors, or manifestations. Initially, 4,147 unique manuscripts were identified. After removing duplicates, one reviewer screened titles, and additional articles were identified through bibliography searches. Two reviewers independently screened abstracts, resolving disagreements during full-text screening, where a third reviewer settled any conflicts. A total of 31 articles were included in this review. Findings regarding the epidemiology of vicarious traumatization are summarized. The occupational hazard of vicarious/indirect trauma is unavoidable, but vicarious traumatization/secondary traumatic stress can be mitigated with improved workplace measures.