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6 low- or no-cost ways to improve safety

Improve safety for you, your crew, your patient and your community with these simple strategies anyone can implement

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Eliminate potential projectiles in the ambulance by securing supplies and always wearing a seatbelt.

Don Ryan/AP

This article originally posted in the Mar. 2, 2021 EMS1 Safety newsletter, “6 low/no-cost safety strategies; Video: How to avoid patient drops.” Subscribe today to receive safety best practices, lessons learned and training tips delivered straight to your inbox.

We can scroll through the archives – or even check daily for updates – on EMS1 to see headlines related to ambulance crashes, crew and patient safety or even violence targeted toward us as responders. The fact is, our job is certainly not without risk (but, that doesn’t that we can’t do what we can to reduce it whenever and wherever possible).

When I was undergoing my initial firefighter education and eventually advancing into a career firefighter/paramedic role, I recall a mantra that was engrained into my mind (and the minds of many others) that still resonates with me today: life safety, incident stabilization and property conservation. This was the essential equation (besides the fire tetrahedron) that drove what we did as professionals. It was all about going home after the call and about making a positive impact in an effort to combat any negatives. It wasn’t a complicated equation; it was quite simple and many of the steps that we took had either a low- or no-cost action associated.

The fact is, there’s a lot that we can do within the EMS industry to promote safety and to reduce the risk of injury, error and further harm. Here are 6 low or no-cost ways to improve safety.

1. Follow cot height guidelines

There’s a reason your ambulance cot, stretcher, or pram (for my former Colorado colleagues) has adjustable height settings, and it’s not necessarily to accommodate the height of you, as the provider. Just because your cot can adjust to the loading height of the ambulance floor doesn’t mean that it should always stay at that height, especially with a patient on board.

To reinforce a safer practice, wrap some colorful tape around the legs of your scissor-leg cot at its 50% height. This can serve as a reminder to your crews that whenever there’s a patient on board, you shouldn’t see the tape while you’re wheeling them around. Less height means less of a tip-over risk.

Read more: Reality training: Every patient move is a high-risk move

2. Protect your eyes

If the whole COVID-19 pandemic has taught us anything, it’s that eye (splash) protection should worn for every call, and donned to protect yourself from every patient. Personally, I can recall one call (only one) in my entire EMS career where I didn’t wear safety glasses (and I felt naked without them!). Keep your eyes safe and don this $3 piece of PPE all of the time!

Read more: Eye safety is important on every EMS response

3. Wear a brain bucket

This is a given within the fire service, but is hardly a common practice within EMS. A good rule of thumb is that whenever you see a firefighter on your scene wearing a helmet, you probably should, too. EMS helmets don’t need to be all-out structural firefighting helmets. A more simplified OSHA-compliant hard had or other form of safety helmet will suffice (and cut down on your cost, too).

Read more: 6 important PPE items paramedics should be wearing, but aren’t

4. Eliminate projectiles

Wear your seatbelt, wear your seatbelt, and – oh yeah – wear your seatbelt (this costs you zero extra dollars). Beyond that, eliminate the risk of other projectiles like stethoscopes, free-floating IV trays and garbage buckets by putting everything in a cabinet (which is free), or investing in a low-cost garbage bin that can be secured to the wall and comes with an actual cover (who wants bloody gauze, wrappers and sweaty gloves thrown around after a sharp turn – or crash?).

Read more: How to reduce ambulance collision death and injury

5. Use a reference

A key element toward promoting error reduction is not having to think (risking error) in some of those high-acuity, low-frequency situations. Don’t memorize your pediatric medication doses; create a laminated reference card that breaks down your doses by medication, patient age/weight, and the actual milliliter to draw. Reference cards can also be created to outline your rapid/delayed sequence intubation/induction (RSI/DSI) process in a checklist format. First, do this; then, do that (always in this order, and every single time).

Read more: Create barriers between patients and medical errors

6. Reduce lights and siren use

Last, but not least (but likely the most contentious), is making an effort to reduce your use of lights and siren for both your response and your transport operations. As an agency, truly analyze your time benefit with its use and establish some criteria for your crews to consider (use to justify) its use. Communicate these criteria with your other response partners in your area and make them aware of your increased safety practice. This, by the way, costs your agency nothing to develop – and arguably has the greatest safety return potential. After all, you, your patients and your community have the right to remain safe.

Read more: EMS lights and siren 911 response: First do no harm

Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at
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