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Everyday EMS
by Greg Friese

Take a Time-out for Safety

This week is 2009 Fire/EMS Safety, Health and Survival Week. Many fire and EMS agencies are taking a time-out from regular training activities to have a department safety stand down. My own department is substituting our monthly training meeting with a review of the International Seatbelt Pledge and a cook-out.

As you know, safety should not be isolated to a single training meeting, evening, day, or week. Safety is an integral component of all response and training activities. As you review safety procedures and practices this week, consider how EMS — like other healthcare providers — can more regularly add a "Time-out for Safety" to EMS calls and fire incident response.

My running and cycling partner is a general surgeon. At the start of every procedure, he leads his surgical team in a time-out for safety to confirm these important details:

      • Correct patient identity
      • Correct side and site
      • Agreement on the procedure to be done
      • Correct patient position
      • Availability of correct implants and any special equipment or special requirements

A time-out for safety would be appropriate in many EMS calls and fire incidents. Checklists or confirmation criteria would make sense for:

      1) Patient extrication from motor vehicles, collapsed structures, and unstable surface
      2) Rapid sequence intubation to secure a patient airway
      3) Application of pharmacological restraint to excited delirium patients
      4) Transferring patient care to an air or ground ALS intercept crew

I would like to see a checklist like this before initiating code 3 — red lights and sirens — patient transport:

      1) Patient condition meets protocol indications for code 3 transport
      2) Patient secured to cot with lap, leg, and shoulder restraints
      3) All patient care providers wearing seatbelts
      4) Equipment — like cardiac monitor — secured with brackets, netting, buckles, or belts
      5) Experienced driver trained and authorized for code 3 transport
      6) Receiving hospital notified of code 3 transport and prepared to promptly receive patient
      7) Weather, road conditions, and other vehicle traffic suitable for code 3 transport

Does your EMS service use checklists before high-risk procedures? Please share links in the comments area. Also see an additional post at EverydayEMSTips.com for Safety, Health, and Survival Week.


About the author

Greg Friese is the Director of Education for CentreLearn Solutions, LLC. He is also an e-learning designer, writer, podcaster, presenter, paramedic, and marathon runner. Read more from him at the EverydayEMSTips.com blog. Ask questions or submit tip ideas to Greg by e-mailing him at greg.friese@ems1.com.

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