Stop making excuses for responder fitness

Wow, let me thank you for the comments, emails and even phone calls from everyone about last month's column. It's long overdue that we bring this issue to light.

As many of the numerous comments said, the issue of fitness in EMS is multifaceted. From high call volumes, poor pay and old equipment to lack of time and sheer laziness, there is no one quick fix to reduce injury in EMS.

My mind immediately goes to the one thing that EMS as a whole has lacked for a long time: A fitness standard.

Sure, some departments have made up their own or borrowed one from fire or law enforcement, but until now, no physical abilities test had been written, designed and validated just for EMS.

The last column mentioned the physical abilities portion of the test written by yours truly. The rest of the immense data collection, correlation, validation and administrative work was done by a group called Avesta. 

So let's break down some of the comments you made:

1. "There is no time to eat." Often you'll have very little time to eat. But as some folks pointed out, the hospital cafeteria has quick and healthy options. Plus the best defense against lack of time to find healthy food is to bring your food with you.

When I was on the street, I always brought a cooler with everything I needed for my entire shift. By eating every three hours to keep my metabolism revved up, staying hydrated and not having to rely on fast food, I did — and you will be able to — eat healthy and make good choices because you are in control.

2. "The call volume is killing us." First, that is what you signed up for: To run calls. The high call volume will not be such an obstacle when you are conditioned both physically and nutritionally.

Believe what you want, but you are an athlete — a power lifter, to be exact. You lift, move, carry, push and pull heavy things every call yet you do almost nothing to condition your body to do it safely.

Along with the great folks here at EMS1, I went so far as to film an entire exercise routine, including injury prevention stretches, on the back of your truck. Make all the excuses you want, but you can always find some time to stay fit on- and especially off-duty.

The fitter you are, the less injury your department will have. The fitter you are, the fewer sick days will be used.

Wellness is so important in correcting many of the internal ailments in EMS, from scheduling and stress management to turnaround time and injury rates, that departments and EMTs can no longer afford to pretend it's not an issue.

A word to the field providers: You and only you are ultimately responsible for your health, wellness and career longevity. Sadly, less than 1 percent of you reading this will get out of EMS without an injury, and more than 50 percent of you will have an injury in the next 6 months.(Crawford) It's a sad fact of our job, but it does not have to be that way!

As we discussed in last month's column, there is enough content in past articles to keep you fit and healthy. I even wrote an entire book on the subject to make it as easy as possible to be fit and avoid injury.

Make time to exercise either before or after your shift; get your partner or co-workers involved to keep each other accountable and motivated, but you have to do it. You owe it to yourself to stay fit and injury-free — besides, pain sucks.

A word to the EMS administrators: As I travel around the county consulting and training departments on injury prevention and fitness programs, I have noticed some very interesting themes.

1. Leadership: Forward-thinking and forward-acting departments, both big and small, with good morale and proactive command staff have outstanding and very involved leaders. The departments that have exceeded in reducing injury, improving wellness and boosting morale all have leaders who are not just involved in the program; they champion it as well. These folks are early adopters, and they are often the thought leaders in our industry.

2. A clear path: Departments that succeed in change initiatives (and fitness is a change initiative) always have a clear path and a clear message. Instead of a complicated process and lots of hoops to jump through, the best departments and leaders always have a clear path and a simple yet effective process to get it done. It does not have to be fancy or expensive, just effective.

3. Embracing BOTH training and engineering: Training only goes so far. At some point, we must consider combining engineered solutions with human movement. We have discussed how new products, like the EZ Lift Rescue Systems, and tried-and-true technology, like a simple slide sheet, will reduce injury and offer any department an outstanding ROI.

Add in ergonomic excellence with stretcher mechanics and direct patient handling taught from employee orientation and then retaught every year, and we can change ergonomic behaviors. Frankly, ergonomics and nutrition must be an integral and frequent part of an EMT's education.

4. Making time for fitness: Let's keep this one simple. Make time for your medics to exercise. I am a huge fan of a regimented and directed pre-shift stretching program. Heavy industry does it with great success, and EMS can easily do it as well.

Fitness facilities do not have to be fancy or expensive, but they do have to be used! My favorite county department with whom to work made on-duty fitness training mandatory and has yearly fitness testing.

How did the department achieve such a lofty achievement? As the EMS director so aptly put it, "We could not afford to not do it, and we just had to get out of our own way to get it written into policy."

What do you and your agency need to do for change to occur?