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EMS News in Focus
by Arthur Hsieh

Does EMS value safety?

There are so many ways we take risks that we don't think about it anymore

By Art Hsieh
EMS1 Editorial Advisor

EMS has been described as a hazardous occupation. The potential for serious physical injury, illness, infection or death is significant. Yet, even though we are required to undergo annual training and testing, we often view it as a necessary evil. Why? We tell ourselves that we are of no use to our patients if we are hurt, but do our behaviors reflect our philosophy?

I recognize that there are great organizations out there that really promote safety for their personnel. It's not just the equipment, or placards on the wall, either. It's getting people like us to value safety as a precious commodity.

Makes sense, doesn't it? Getting to a call safely; not contracting an illness; not spraining a back or having a heart attack on the job — by not experiencing these events, we can go home at the end of the day, some of us with paychecks in hand but all with the satisfaction of being able to help others in need.

Peers at risk
As a rule, however, I don't think we value safety. We think about it, we talk about it, we teach it — but you and I both know how our peers put themselves at risk.

Not a blame game really; after all, if you have managed hundreds if not thousands of patients over a career and not gotten sick or hurt, taking safety shortcuts now and then hasn't been a problem, right?

Being overweight or physically unprepared, not washing hands after every run, driving faster than is reasonably prudent — there are so many ways we take these safety risks that we don't think about it.

I think that's the crux of the issue — in our drive to "adapt and overcome" we believe that it's okay to play the benefit versus risk game, which is decidedly risky when it comes to matters affecting our own physical wellbeing.

I don't subscribe to the notion that hazards are simply part and parcel of our profession. I think our industry has taken some steps to mitigate some of the safety concerns. It's been haphazard, though, without data to fully support the actions and more importantly, a strategy that promotes effective and efficient methods across the board.

Push for safety culture
The National Highway Transportation and Safety Administration (NHTSA), under the Department of Transportation (DOT), last week began inviting organizations from around the country to submit proposals to fund a conference that will look at ways to promote a "culture of safety."

The cooperative agreement between NHTSA and DOT for developing and promoting a national "culture of safety" strategy in EMS reads:

The lack of a comprehensive EMS injury data system, capable of collecting, cataloging and reporting standardized EMS crash and non-crash related injury data, severely limits the EMS industry’s ability to develop, test and implement mitigation strategies to protect EMS personnel. The task of identifying injury causative factors becomes far too speculative without timely, accurate, complete, integrated and accessible data that includes location, cause, contributing factors, and related activities associated with injuries involving EMS personnel.

There are limited sources of existing data that identify threats to personnel and patient safety. Evidence suggests that non-vehicle crash related injuries are by far the most numerous and their cost to the EMS industry and society is staggering. Non-vehicle crash injuries also present the biggest challenge for researchers as there are few established data definitions and repositories for the collection and analysis of these types of incidents.

An essential element in creating a "culture of safety" in EMS is establishing a baseline of known hazards and injuries. Existing Federal and non-Federal systems for measuring worker, patient and public injuries and fatalities fall short of meeting the current needs of the EMS industry.

The National EMS Advisory Council, consisting of national EMS system stakeholders, has recommended to NHTSA that developing a "culture of safety" is one of the top priorities in strengthening the nation's EMS system.

Up to 30 participants will be involved in building a national strategy to identify key safety issues and develop ways to mitigate the hazards. This information will then be spread widely, targeting both organizations and individuals to increase awareness and fostering local and state level safety practices.

It's an urgent issue we must come to grips with. We say that safety is everyone's business. Let's take a few steps to make that a reality.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
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