Any safety professional that has to deal with the seemingly constant exposure to risk from EMS and fire-rescue first responders has no doubt struggled with finding solutions. The Center for Disease Control (CDC) and the National Institute for Occupational Safety and Health (NIOSH) released recommendations detailing the 5 root causes of exposure in the field. These include:
- Body Motion injuries form excessive physical effort, awkward posture & repetitive motion.
- Slips, trips and falls
- Motor vehicle incidents from sudden stops (unrestrained in the ambulance), swerves and crashes.
- Violence & assaults
- Exposure to harmful substances
The CDC/NIOSH goes on to make recommendations for handling these five areas of exposure, in turn addressing the question: How do we truly reduce exposure to these risks in such a dynamic environment?
EMS and fire-rescue have the best patient-handling (lifting, moving, pushing, pulling, carrying, sliding) technology ever. Yet the root cause of many injuries to emergency personnel stem from transporting the patient to and from the engineered solution (e.g. cot or stair chair). First responders must adhere to a methodology that facilitates safer use of the patient-handling tools at their disposal. Resource
The effectiveness of any safe patient-handling methodology is minimized when the first responder has poor biomechanics. Obesity, poor mobility and poor job specific strength are all huge contributing factors to risk exposure. Here is a mantra to take heed to in an effort to promote wellness, especially while on the job: “You have to move well before you can move patients/gear well.”
Many wellness programs fail to meet the needs of shift workers, as they are geared to the 9-5 crowd. Driving errors, medication errors, soft tissue traumas and simple human errors (such as those that result from fatigue) serve as common risks that are rarely addressed. It is vital to teach responders how to make educated decisions regarding food choices in an ever-changing environment, how to employ sleep hygiene strategies and, most importantly, how to manage their health. Shift work and working in high stress environments can prime first responders to commit the aforementioned errors and may also result in PTSD and resiliency issues.
Assaults against EMTs are under-reported yet they are a major cause of exposure, injury and PTSD. There are validated training systems that teach responders how to deescalate, evade and, as a last resort, defend against an attacker. Resource
Ambulances should be fitted with modern restraint systems with forward facing 4-point harnesses that have the ability to keep the EMT seated at all times. Up-to-date ambulance specifications are recommending this standard. In a call back to overall wellness, employees should also be educated on fatigue mitigation and effective sleep practices to reduce exposures related to operating a motor vehicle.
In an effort to address the potential complex nature of any given risk, it is important to work with your safety staff and get in front of the crews. Talk to them, find out their needs and concerns and work as a team to determine the best plan to help these dedicated first responders thrive, survive and ultimately reduce their risk in such a hazardous profession.