In this module, we will provide a very brief
overview of the need to focus on paramedic safety and well-being.
Once completed with this module, you should be able to discuss broad concepts of safety
and wellness as they apply to the paramedic. EMS is a great profession, but it obviously
comes with some significant risks not faced by those in a typical workplace. As reported
by the National Institute for Occupational Safety and Health, more than 22,000 EMS providers
visited emergency departments annually for work-related injuries for a five year period
from 2010 through 2014. Lifting patients and equipment, treating patients with infectious
illnesses, handling hazardous chemicals and body substances, along with providing emergency
transport of patients in ground and air vehicles routinely results in sprains, strains, significant
exposures to blood and body fluids, and falls. As a matter of fact, a study published in
the May 2013 issue of Prehospital and Disaster Medicine found that the rate of injuries in
EMS are almost 2.9 times greater than they are for general private industry occupations.
Of the non-fatal injuries suffered by EMS workers, a study published in 2016 by the
American Journal of Industrial Medicine found that one to two percent of those injuries
were a result of patient-initiated violence against the EMS provider. This same study
also recognized that healthcare workers in general are almost ten times more likely to
suffer injuries as a result of workplace-related violence than those who work within other
industries. With these statistics in mind, it is no surprise that the Centers for Disease
Control and Prevention estimated that approximately 2,600 EMS workers received hospital treatment
in 2014 alone for injuries resulting from work-related violence. Unfortunately, many
suspect these numbers are also underreported. Beyond intentional acts of violence, numerous
EMS providers are also injured and killed every year due to ambulance crashes. According
to NHTSA data, there are approximately 4,500 ambulance crashes per year within the United
States with just over a third resulting in injuries. These crashes are responsible for
approximately 33 deaths per year. 25 percent of those fatalities are either the driver
or a passenger within the ambulance. Beyond physical injuries, protective services
professions in general are now beginning to recognize the prevalence of psychological
injuries suffered within the firefighting, law enforcement, and EMS professions. A 2017
study out of the University of Phoenix found that 84 percent of first responders admit
to experiencing a traumatic event on the job, 85 percent have experienced symptoms related
to mental health issues, 69 percent have experienced a lack of sleep, 46 percent have experienced
anxiety, 34 percent have been diagnosed with a mental health disorder, 27 percent have
been diagnosed with depression, and ten percent have been diagnosed with post-traumatic stress
disorder. Additional studies, such as a 2013 study published in the World Journal of Emergency
Medicine, have also recognized and validated this disturbing trend. While approximately
3.5% of the adult population in general suffers from PTSD, the paramedic group in the study
had a PTSD prevalence rate of 20 to 22 percent. In addition to this emotional trauma, EMS
providers routinely struggle with poor sleep quality and fatigue (as documented in another
study published in the April 2010 volume of Prehospital Emergency Care). 44.5 percent
of those who participated in the research reported experiencing severe fatigue while
at work with that percentage increasing as the provider’s years of experience increased.
This fatigue is problematic as numerous agencies and bodies (such as the Institute of Medicine)
have held that healthcare provider fatigue can be dangerous to patients and a 1997 study
by Dawson and Reid demonstrated that higher levels of fatigue reduce reaction time to
that similar of being legally intoxicated for the purposes of operating a motor vehicle.
This same fatigue study also found that almost 85% of the 119 EMS providers who participated
in the study were considered to be overweight or obese given their body mass index. While
that may sound unbelievable, a study published in 2009 by the Obesity journal evaluated 370
candidates for firefighting and EMS jobs within Massachusetts to find that 33 percent of those
candidates (with an average age of 26.3 years) were obese and an additional 43.8 percent
were overweight. This caused some significant concern for the study’s authors as obesity
is a strong predictor of premature disability and emergency responders are already at risk
for cardiovascular problems given the stressors of their jobs. If we struggle to take care
of ourselves as emergency responders, how can we hope to help others and serve as role
model for them? Unfortunately, with all of this being said,
exposure to these traumatic experiences, compounded by poor sleep quality and fatigue, has also
resulted in another shocking and troublesome statistic. The combination of fatigue, poor
sleep, mental health issues, and relationship problems were all related to higher risks
of suicide in active US military personnel in a study published in the March 2012 edition
of the American Journal of Public Health. To tie this all together, a 2018 study published
in Prehospital Emergency Care, determined that EMS providers are 2.4 times more likely
to die as a result of suicide compared to non-EMS providers. The study authors attributed
this higher rate of suicide to constant exposure to acute and chronic stress, as well as higher
rates of depression and substance abuse. Needless to say, safety, health, and wellness
are critical subjects for paramedics looking to enjoy long and productive careers within
the EMS profession. With that information in mind, this particular
presentation was produced to provide a very brief overview of the need for paramedics
and EMS managers to focus on provider safety, health, and wellness. Subsequent modules will
delve much deeper into different aspects of paramedic safety, health, and wellness. The
specific topics we will be covering include standard safety precautions, personal protective
equipment, stress management, prevention of work-related injuries, lifting and moving
patients, equipment, disease transmission, and other wellness principles that apply to
EMS providers. While we will be exploring EMS provider safety,
health, and wellness in greater depth within subsequent modules, as this information is
provided as part of the larger paramedic curriculum, we will not be delving too deep into these
topics. These modules are designed to expose the paramedic to general principles of EMS
provider safety, health, and wellness. For a more comprehensive look into EMS safety,
health, wellness, and risk management, it is highly recommended that you pursue additional
education on the topic. If you are not sure where to begin in pursuing
such education, WCTC has a 100 percent online EMS Leadership and Management program that
has a course that deals specifically with the topic of EMS safety and risk management.
Designed around the National Fire Academy’s FESHE model curriculum, this eight-week accelerated
online course explores principles of EMS safety and risk management with an emphasis on safety
from the perspective an EMS field provider. WCTC also makes the online lectures for this
course available for free on our YouTube EMS channel. You can find these resources (along
with others) at under the EMS Leadership and Management Safety & Risk
Management playlist. Given this brief overview, you should now
be able to discuss the concepts of safety and wellness as they apply to the paramedic.
In upcoming modules, we will delve into this broad topic with greater detail.
This presentation was prepared by Waukesha County Technical College in Pewaukee, Wisconsin
and is distributed with an attribution, non-commercial, share alike 4.0 international Creative Commons
license. Copyright 2018, Waukesha County Technical College. For information on WCTC’s numerous
fire and EMS educational offerings, please visit us online at