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With EMS fitness habits, change is good

Stay in public safety long enough and a few predictable things happen: stress, call volume, fatigue, and poor nutrition all take a cumulative toll

When I entered the world of public safety over 12 years ago there was a persona or a strut, call it a calm and cool street smart.

As a young medic it was something I envied yet did not fully understand but it was something that I craved to have. Having grown up in a busy urban EMS system, I was taught and directed by a steady stream of wise and experienced paramedics, firefighters and EMTs.

I was taught the way it’s done and, as I have learned, it’s the way that it has always been done. After a few years on the street as a part-time Paramedic, I came to realize that the way that things are done are definitely not the way things should be done.

For instance, the stretcher was a source of trepidation because no one had taken the time to teach me the proper way to handle it. Using the cot seemed to be an assumption on the part of my teachers and field training officers, and many of us green medics just had to figure it out. The same held true for patient handling, specifically transfers and the arduous task of lifting a patient from the floor onto the stretcher; we just got it done and that means as fast as possible. I think we caused a lot of lateral whiplash to out infirmed patients.

Fast forward to present day and I have become one of the few voices out there calling for change. We as a profession must stop doing things because that is the way we have always done them.

Doing the same thing again and again expecting a different result is pure insanity. Take a look around, look at your friends, co-workers, and maybe yourself. Stay in public safety long enough and a few predictable things happen. Stress, call volume, fatigue, and poor nutrition all take a cumulative toll.

You are no longer a lean, mean EMS or Fire fighting machine; you have slowly morphed into an overweight and sedentary professional. You possess all the necessary tools to get the job done: experience, street skills, a sixth sense honed from thousands of calls, and that swagger that you so desired as a newbie. But achieving all that has also taken its toll on your health, fitness and wellness.

There is a big push nationally to improve responder wellness, fitness, and safety and it cannot come at a better time. But is it possible to simply write a curriculum, train some facilitators, teach some courses and expect ingrained change to occur? It’s not, in my humble opinion. Sure, there may be some outliers and obvious successes but, as I have found in countless discussions, after a short time the crews will fall right back into those old habits.

Responders, we need to look at this problem differently. First, responders must be taught and encouraged to not eat the foods that they do. I have heard countless excuses and justifications about why responders eat as they do, and I have to tell you it is nothing but laziness. I teach an entire course on how to stay healthy, eat well, and keep the pounds off while on duty, and I can attest that it’s not difficult, expensive, or time consuming. Responders must be taught how to survive their job through integrating good nutrition while on duty.

Second, responders need to be taught some basic on-duty fitness tricks. There are six stretches that must be done throughout the shift. By doing these simple stretches between calls (using the back of the truck as your stretching station) you can drastically reduce your chance of injury. As an added benefit, teaching responders public-safety-specific exercises will reduce soft tissue injury.

Responders can also do a series of exercises on-duty and in uniform that will help them stay fit. Worried about equipment or having to secure a grant? No problem! A gym can be put into a station for less than $300.00. A resistance band, a stability ball, some dumbbells, a tennis ball and a Frisbee are all you need.

Exercising on duty must be considered standard operating procedure. For those administrators or HR folks worried about liability from an on-duty injury, I ask: what does all those back injuries, medical claims, overtime, shift differentials, un-manned units cost? Worrying about an employee getting injured while exercising totally misses the point.

Responders, we as a profession have to accept the fact that a national fitness standard must be put in place for EMS. Fire and Law Enforcement have them, and so should we. Every medic needs to be tested every year for the basic ability to perform their job. On top of that, medics and firefighters need to be screened for the potential for injury, or what I call a BIPA (Biomechanical Injury Potential Analysis). Add the BIPA to a well-designed fitness test and our injury rates will drop, wellness will improve, stress will lessen and our jobs will become awesome again.

Change must start at the EMT-class level with a new curriculum. Change must come from the top, with HR and administration support; change needs to come from within in the form of pride and self responsibility.

Change is coming, and when it does it will be for your own good and the good of the public you serve.

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, works nationally 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.

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