Quick Take: Keynote Gordon Graham

EMS providers need to be more aware of and train regularly for high risk-low frequency events


Gordon Graham presented the keynote session, “Making the Right Decisions in a Fast-Paced World of EMS,” to packed room of EMTs and paramedics at EMS Today in Baltimore. Gordon's rapid-fire and light-hearted presentation kept the audience engaged and entertained.

Gordon introduced the Risk-Frequency analysis tool as a framework for his presentation. Events that are high risk and low frequency, and how to avoid them, were the focus of this session.

Most important quotes

Gordon Graham, delivering EMS Today keynote address, explains importance of training for high-risk low-frequency events.
Gordon Graham, delivering EMS Today keynote address, explains importance of training for high-risk low-frequency events.

"Vast majority of things you do you are doing right, BUT when they aren't done right there are significant consequences."

"Complacency is the kiss of death in a high risk job."

"Errors we are going to make are predicted by the errors we have already made."

Key takeaways: Making good decisions in high risk-low frequency situations

  • First step is to understand where problems come from. Are problems internal or external? Are problems intentional or unintentional?  
  • External and intentional misconduct, like assault on paramedics, is difficult to change, but fortunately occurs rarely.
  • Internal and intentional misconduct is our own people doing bad things on purpose.
  • The data tells us that most of our problems in EMS are good people that make honest mistakes. These are internal unintentional misconduct that can be addressed, fixed, and reduced.
  • Mistakes in EMS are most likely to occur and highest consequence in the area of "low frequency and high risk."
  • High frequency events become dangerous when we add complacency, fatigue, distraction, hubris, and or risk homeostasis.
  • Identify the high risk-low frequency events in your workplace by studying the tragedies of the past. A sub-set of those events give you no time to think. Immediate action, without thinking, is required.

Learn more about Gordon Graham at this website

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