June of every year marks the beginning of National Safety Month. Created in 1996 by the National Safety Council, a non-profit organization, its aim is to increase workplace safety awareness, identify health hazards, and reduce the overall amount of workplace injuries and fatalities.
Working in EMS it is extremely important that we pay strict attention to not only the needs of our employees, but also our patients. The journey of a patient from pick up to drop off can vary greatly and often include numerous challenges that our crews must overcome to ensure that the patient arrives timely and safely. We thought that it would be important to provide a few examples of these challenges and discuss safe practices in overcoming these obstacles.
The first step of ensuring the safety of our crews starts with providing accurate information. We receive calls from a wide variety of people, doctors, nurses, case managers, transport facilitators, and even the patients themselves. Often it can be difficult to gather the necessary information. A doctor for example calling on behalf of a patient is unlikely to know how many stairs are at that patients residence. By being proactive and looking at satellite map images of a residence we can identify these and other potential safety issues such as parking or entrance access.
Having a consistent set of questions to gather patient information also ensures that demographics like the weight and diagnosis are collected so that when the crew arrives on scene the appropriate personnel are on hand to support patient safety and the crews are protected by donning isolation gear if necessary.
After an initial patient assessment has been completed it’s time to transfer the patient. According to statistics 67% of all work related injuries in EMS result in sprains and strains, and are mostly the result of improper lifting techniques. EMS is a physically demanding job. Patients and equipment can be very heavy and when the lifting is being done multiple times daily it is essential that proper technique is used.
EMT-Training.org offers some general guidelines to help with lifting techinque.
1. Reposition before lifting to avoid awkward positions
2. Keep the body stacked and straight. Avoid twists and awkward positions.
3. Keep the weight as close to the body as possible
4. Never use your back muscles to lift. Instead use your legs, hips and glute muscles with your abdominal muscles tensed.
5. Never rush or hurry a lift. Make sure everyone is ready before you begin.
Other things that can be helpful are practicing various lifting techniques such as sheet transfers and identifying when it is possible to use items like backboards and stair chairs to make the job easier. On the job experience helps with knowing when these tools are applicable but our managers, safety and training departments can all help provide more information on these techniques.
Once the patient is loaded and secure the main focus should be on safe driving practices. One of the things that makes EMS so exciting is that every day is different, and comes with its own set of unique challenges. Transports can vary from a few blocks to hundreds of miles but some basic safety techniques apply to all medical transports.
It might sound silly but wearing a seatbelt is one of them. In a recent study by the National Highway Traffic Safety Administration of 4,500 vehicle crashes involving an ambulance, 84% of EMS providers in the patient compartment were not restrained and only 33% of patients were secured with lap and shoulder restraints. Whenever possible..buckle up!
Using your partner for help when it comes to things like backing up, identifying potential hazards while driving, and checking GPS maps for things like traffic and weather conditions can pay off big in terms of safety. Also because of the size, ambulances tend to have large blind spots that can be easily overcome by asking your partner for assistance when needed.
Avoid distractions like eating, drinking and using your cell phone or the communications radio. Experts maintain that avoiding distractions reduces the chances that you will be involved in an auto accident for any reason by 6%.
Lights and sirens should be limited to only the circumstances that actually require their use. Accident rates go up significantly not only for the ambulance, but also for passenger vehicles who are attempting to clear the path for EMS personnel. It is best to be cautious and have clear guidance from a dispatcher or EMD who has assessed the information or has instructions from a doctor or nurse that lights and sirens are necessary.
One last attribute that greatly increases safety is Situational Awareness. Simply put this is understanding what is going on around you at all times. It is also important to understand that it can be negatively affected by things like lack of sleep, stress, and personal issues that we need to identify and resolve before the shift in order to create the best possible outcomes in EMS. Situational Awareness is the key to understanding your personal safety, your co-workers safety, and the patients safety. For more information on workplace safety or National Safety Month please visit the National Safety Council at nsc.org