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Making responder fitness a national priority

We need to incorporate cutting-edge engineering, mandatory physical abilities testing, fitness as job requirement

For a few years now, I have had the privilege of writing this column with the sincere hopes of advancing the health and wellness of our profession, of consulting with private companies, EMS, fire/rescue and law enforcement departments across the country.

I have helped new and existing companies launch cutting-edge products that will reduce injuries through better engineering. I even helped write what will be the first truly validated and legally defensible EMS physical abilities test.

Folks, the past five years have been a wild ride, and I truly look forward to the future.

Something is bothering me, though: Fitness and personal wellness across EMS is, for lack of a better term, pathetic. As a whole, most medics do not exercise at all, and those who would like to are often not given the opportunity to do so.

Those who try to establish healthy habits often fail from lack of follow-through and guidance.

To assist you, we have filmed simple on-duty fitness techniques you can do on the back of the truck, stretches that will help reduce injury and improve patient-handling mechanics.

I have given you advice and steps on how to eat to survive your career and how to burn calories through timed nutrition.

But that’s not really it.

Our national organizations and employers have thus far been impotent at taking a stand against the no. 1 cause of career-ending injuries: Back injuries.

There are ways to drastically reduce the rate and severity of these injuries. We owe it to ourselves and our profession to take a stand:

1. We as a profession must stop hiring our injuries! Anyone coming into the field must pass an EMS specific physical abilities test using EMS-specific gear and scenarios.

Testing potential employees in a “sterile” clinical environment using unrelated tasks and not accounting for specific energy systems and range-of-motion needs of a responder will continue to feed unfit and injury -prone medics into the system.

A physical abilities test has been written that can allow any department to administer a truly validated and job-linked pre-hire physical abilities exam and provide for yearly testing of all employees. Why? Because we have to!

2. Fitness is a job requirement! When I look at the biomechanics of EMS and fire, I see a “power athlete” or a “public safety athlete.” As a certified athletic trainer, a Certified Strength and Conditioning Specialist and a clinician, I see an athlete who must generate an exceptional amount of power to move heavy objects from point A to point B.

To generate this degree of power yet prevent injury requires what has been termed “MOSTABILITY,” consisting of functional flexibility, tissue mobility and core/spine stability.

Traditional exercises recommended by many professional organizations that have developed “public safety” certifications are actually reinforcing the high rate of injury by encouraging faulty motor patterns in the body.

We can look to what our fire brothers did a number of years ago by launching a massive fitness initiative across the industry. But fitness did not improve across the fire service overnight. They have realized the problem at hand and are righting the ship.

Are we destined to make the same mistake and follow the same erroneous path?

3. Embrace engineering! As a consultant and public safety ergonomics specialist, I can confidently say that two of the biggest causes of injury to EMS providers have been solved.

Spine board lifts are so dangerous that NIOSH recommends never lifting from below the knees, but before now, spine board design remained in the Stone Age.

  • EZ Lift Rescue Systems has finally solved that problem for us with a remarkable patient-handling system that will completely change how we lift, carry and transport patients requiring immobilization.
  • Powered stretchers have been a blessing and a curse since they hit the street. Sure, they solved one problem, but they have caused quite a few others. A new and truly revolutionary stretcher is going to hit the market in a few months. When I first had the privilege of previewing it, my jaw dropped! It is the perfect blend of engineering that solves the problems of traditional powered cots and a few more along the way.
  • Let me put this one bluntly: All services MUST use friction-reducing transfer sheets to move patients from bed to cot and cot to bed on ALL calls. Both responders should pull from the same side of the bed. Two medics pulling with ergonomic excellence is far superior to what we are currently doing as an industry. Follow this practice, and see almost immediate reduction in injury.

Responders, I do not mean to rant about the problems in EMS because as a whole, we accomplish amazing things every day. But we seem to be wandering with little direction.

I have had the awesome privilege of working with thought and influence leaders in our industry and others, but I am just one voice with a clear vision of how to advance EMS health, fitness and ergonomic safety.

By incorporating cutting-edge engineering, mandatory physical abilities testing and fitness as a job requirement, we can cause positive and lasting changes in EMS.

How can we advance fitness, embrace engineered solutions and ultimately reduce injury rates while increasing career longevity?

Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), dedicated over a decade to changing the culture of EMS from one of pain, injury and disease, to one of ergonomic excellence and provider wellness. He leveraged his 15-year career in sports medicine, athletic training, spine rehabilitation, strength and conditioning and as a paramedic to become an expert on prehospital patient handling/equipment handling and fire-EMS fitness. His company, Fit Responder, worked with departments to reduce injuries and improve fitness for first responders.

Bryan passed away in September, 2019, leaving a legacy of contributions to EMS health and fitness, safety and readiness.