5 critical lessons from Va. medic LODD investigation

Read the report and apply the lessons learned to improve your policies, training, and operations

I’d like to call out this post-incident report regarding the line of duty death of a Virginia paramedic that occurred two years ago. The report is lengthy and full of details; because of this, there is a lot of good information and “lessons learned” that every EMS provider must be familiar with, regardless of the operational situation. Here are some key points I took away from reading the report:

1. Training is essential

There are hazards on every call we respond to, from the worst hazardous materials event to the routine interfacility transfer. In our initial training everyone is told about the “BSI, scene safety” dance; how many of us trained to actually verbalize potential hazards, and demonstrate a true scene size up. EMS education programs must do more to promote excellent scene safety habits. The military approach to training is appropriate: 'Train as you work; work as you train.'

2. Maintain situational awareness

It is really easy to become complacent and let your guard down on scene. We become focused on the patient’s medical condition, or mitigating a specific hazard like a car fire or hazardous material. Yet there are clearly other opportunities for us to become injured or killed, that can be overlooked.

If you have the luxury of a multi-person crew, one must be the designated safety officer, whose prime responsibility is to protect the remainder of the crew. If it’s just you and your partner, recognize it’s that much more difficult to maintain situational awareness. Regardless of your crew composition, it’s everyone’s responsibility to keep everyone else safe. (Learn more about applying the L.C.E.S. method to car accident scenes). 

3. Slow and steady wins the safety race

Professional responders walk into situations – they  don’t run. It gives us time to size up environmental conditions, looking for things that could hurt or kill us in an instant. If the scene is not safe, it is not time to be the hero. I know that is a painful conflict – we  exist to rescue people. But it’s even more important to go home in one piece at the end of the day, to your family, your friends and your colleagues. 

4. It is safer when everyone knows

See a hazard? Communicate it. Let your partner know, and make other team members aware of the issue. It might feel silly to point out the wet floor, but you might prevent someone from falling and being out of work for weeks. If you spot a critical hazard, call for a "safety stop” – everyone  stops for a few moments while the hazard is identified and if possible, mitigated. 

5. Follow safety SOPs

Agencies establish policies and procedures covering many aspects of the job. Safety procedures must be at the top of the list. It establishes consistency and predictability of behavior. While it’s true no two scenes are ever exactly the same, a well-developed, standardized SOP will cover the vast majority of issues. Rehearse the procedures so that they become second nature. 

The death of any EMS provider while on the job is tragic. It’s made even worse if we don’t try to learn from the incident and apply its lessons to our daily work practices. If what we learn from this LODD investigation prevents even one injury or death, then his death will not be in vain.

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