EMS Safety: Take a time-out


This week is the 2009 Fire/EMS Safety, Health and Survival Week. Many fire and EMS agencies are taking a time-out from regular training activities to have a department safety stand down. My own department is substituting our monthly training meeting with a review of the International Seatbelt Pledge and a cook-out.

As you know, safety should not be isolated to a single training meeting, evening, day, or week. Safety is an integral component of all response and training activities. As you review safety procedures and practices this week, consider how EMS — like other healthcare providers — can more regularly add a "Time-out for Safety" to EMS calls and fire incident response.

My running and cycling partner is a general surgeon. At the start of every procedure, he leads his surgical team in a time-out for safety to confirm these important details:

  • Correct patient identity
  • Correct side and site
  • Agreement on the procedure to be done
  • Correct patient position
  • Availability of correct implants and any special equipment or special requirements

A time-out for safety would be appropriate in many EMS calls and fire incidents. Checklists or confirmation criteria would make sense for:

  1. Patient extrication from motor vehicles, collapsed structures, and unstable surface
  2. Rapid sequence intubation to secure a patient airway
  3. Application of pharmacological restraint to excited delirium patients
  4. Transferring patient care to an air or ground ALS intercept crew

I would like to see a checklist like this before initiating code 3 — red lights and sirens — patient transport:

  1. Patient condition meets protocol indications for code 3 transport
  2. Patient secured to cot with lap, leg, and shoulder restraints
  3. All patient care providers wearing seatbelts
  4. Equipment — like cardiac monitor — secured with brackets, netting, buckles, or belts
  5. Experienced driver trained and authorized for code 3 transport
  6. Receiving hospital notified of code 3 transport and prepared to promptly receive patient
  7. Weather, road conditions, and other vehicle traffic suitable for code 3 transport

Does your EMS service use checklists before high-risk procedures? Please share links in the comments area. 

About the author

Greg Friese, MS, NRP, is Editor-in-Chief of EMS1.com. He is an educator, author, paramedic, and marathon runner. Ask questions or submit tip ideas to Greg by e-mailing him at greg.friese@ems1.com.

  1. Tags
  2. EMS Training
  3. Fire-EMS
  4. Safety
  5. Survivability

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