Street Medicine – Assessment Work Strategies of Paramedics on the Front lines of Emergency Health Services

This article is based on an institutional ethnographic inquiry into the work of paramedics and the institutional setting that organizes and coordinates their work processes in a major City in Canada. Drawing on over 200 hours of observations and over 100 interviews with paramedics (average length of 18 minutes) and other emergency medical personnel, this article explores the standard and not so standard work of paramedics as they assess and care for their patients on the front lines of emergency health services. The multiplicity of interfacing social, demographic, locational, and situational factors that shape and organize the work of paramedics are analyzed. In doing so, this article provides insights into the complex work of an understudied yet ever-important profession in healthcare.

Street Space—North Street, Belfast

The Belfast city center is fractured, divided by motorways, parking lots, empty buildings, and big box stores. Its 19th-century heyday put it on the international map of textile production, which transformed and enriched its built structure. This tight architectural fabric was slowly destroyed in the 1940s by the Blitz, in the 1970s by road plans and “the troubles” and in the 1990s by large retail buildings. Few pedestrian streets traverse Belfast, and among them, most are recently-developed conduits for the passage of shoppers from one chain store to the next.Within this seemingly bleak urban landscape, there remain a few areas that offer a richer, more architecturally and socially diverse, more memory-laden conception of public space. Current redevelopment plans, however, threaten the mere existence of these few remaining historic streets in Belfast.This reality inspired the current project of one of the Masters in Architecture design units at Queen’s University Belfast. Our team (led by urban designer Michael Corr and myself) has been exploring North Street, one of the main arteries in Belfast City Center. Although North Street has a reputation for being run-down, derelict, and in need of redevelopment, it is one of the few intact 19th-century streets left in the area, and as such is worthy of study as an example of public space that is not strictly synonymous with commercial space.

Gaze behavior of the visually impaired during street crossing.

PURPOSE:

This study explored the gaze patterns of fully sighted and visually impaired subjects during the high-risk activity of crossing the street.

METHODS:

Gaze behavior of 12 fully sighted subjects, nine with visual impairment resulting from age-related macular degeneration and 12 with impairment resulting from glaucoma, was monitored using a portable eye tracker as they crossed at two unfamiliar intersections.

RESULTS:

All subject groups fixated primarily on vehicles and crossing elements but changed their fixation behavior as they moved from "walking to the curb" to "standing at the curb" and to "crossing the street." A comparison of where subjects fixated in the 4-second time period before crossing showed that the fully sighted who waited for the light to change fixated on the light, whereas the fully sighted who crossed early fixated primarily on vehicles. Visually impaired subjects crossing early or waiting for the light fixate primarily on vehicles.

CONCLUSIONS:

Vision status affects fixation allocation while performing the high-risk activity of street crossing. Crossing decision-making strategy corresponds to fixation behavior only for the fully sighted subjects.