3 pre-shift tasks for every medic

Stretch, roll, train and eat like an athlete to thrive in your EMS career

It’s oh dark thirty as you trudge into the base for the start of another shift. You hope today’s shift won’t be as busy as yesterday’s and that maybe, just maybe you will get off on time. You clock in, grab a cup of coffee and begin checking off the truck.

As you go through the med bag you notice that your lower back is pretty sore; must have been all the calls yesterday. Once everything is ready, you climb into the front seat, radio in "on duty" and are immediately given a call – a fall with injury at the local skilled nursing facility. 

Upon arrival you assess the patient; thankful she will only require BLS care and non-emergent transport. As you and your partner grab a hold of the patient that little voice in the back of your head reminds you that this patient is frail and that your back still hurts. As you lift the patient, careful to not cause any more trauma to her, you feel a sharp pain in your back that shoots down your left leg.

Demonstration of a foam roller for stretching.
Demonstration of a foam roller for stretching. (Image courtesy Bryan Fass)

No warm up

EMS stands out from other occupations that require heavy lifting and labor. Many of those employers require pre-shift stretching. 

Data clearly shows that a structured pre-shift stretching routine reduces the rate and severity of soft tissue injuries from lifting. The most common warmup in EMS is a second cup of coffee. As a profession there is no way we can continue to do business the way we are and expect injury rates to drop.

"Check off the truck and check off your body" is the mantra I used as a medic and that we now teach to all our departments. Make your body ready to respond just as you make your truck ready. 

1. Pre-shift stretching

Pre-shift stretching is by far the most efficient and effective way to move better, feel better and reduce injury. Yet it is the most difficult concept to "sell" to management and medics. 

I recently had the privilege of working with a Fortune 500 company that has three massive distribution centers. I taught their workers the same pre-shift stretches we teach EMTs and in six months they had a 48 percent reduction in soft-tissue injuries. 

Over the past 10 years I have heard every excuse to not stretch, but the bottom line is that as a profession we have to come to terms with one simple fact: "We are in the moving business and just happen to provide awesome patient care in the process." EMS is all about moving and transferring people. One of the only ways to correct our catastrophic injury rates is to put wellness in to action.

2. Improve mobility

To move patients and gear effectively we have to move well and move often. Mobility is an integral part of injury prevention. There is a tool that is inexpensive, increases tissue temperature, breaks up spasms and improves range of motion at the same time – while watching TV…in uniform!

Enter the foam roller, the best eight minutes you can spend pre-shift, on duty and/or pre-exercise. Rolling the calves, hip flexors/inner thighs, glutes, laterals and thoracic spine gives your body the necessary mobility and flexibility to get the job done safely. Plus, the more consistent you are with foam rolling (3-5 times per week), the less pain you will have, the better you will move and the better you will feel.

To roll effectively spend about 60-90 seconds on each muscle area or body region. As you roll, seek and destroy by looking for the most painful spots as these are the areas that will most likely cause injury. After your foam roller session do some stretching, check on duty or get to work.

3. Fuel the lifting machine

I teach more than 200 classes a year to all types of EMS departments. The ignorance or indifference of responders on how to eat properly never ceases to amaze me. Why do responders feel that energy drinks, fast food and vending machines can provide them with the ability to heal and be healthy?

Fatigue and stress can make responders crave certain foods – high sugar, high salt, and high fat – even though they’re all bad for your health. Instead of having vending machines full of disease-causing foods, tell the vendors to only stock machines with healthy choices. Get rid of or reduce the soda choices and bring healthy foods – not donuts or bagels – to meetings.

Teach responders how to eat on the go, make good food choices and how to understand the disease implications of poor eating. Drink lots of water, bring your food with you, eat clean and green and above all educate yourself on the importance of nutrition. If you can help yourself you will be better equipped to educate your patients as well.

Motivation is like a shower – you cannot shower once a year. Every day, every shift check off the truck and check off your body. Act like an athlete, train like one and eat like one as it’s one of the few things that will help you thrive and survive a career in EMS. 

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