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Quick Take: Keynote Gordon Graham

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


Gordon Graham, delivering EMS Today keynote address, explains importance of training 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

“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.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.