This module deals with general precautions
for the prevention of work-related injuries in EMS.
Once completed with this module, you should be able to identify ways to prevent EMS work-related
injuries. While this particular module is relatively
short as some of the topics either have been or will be discussed in other modules, the
information is still very important for EMS provider safety, health, and wellbeing.
If you remember from our introductory module, the CDC reports that more than 22,000 EMS
workers visit emergency departments each year for work-related injuries. In looking at EMS
holistically, there are several areas in which EMS providers are more at risk for sustaining
injuries. The first is ambulance crashes. While a previous module talked about some
statistics regarding ambulance crashes, the most pertinent to this discussion is that
unrestrained ambulance occupants are at greater risk of sustaining severe or fatal injuries
in serious crashes. As reported by NHTSA, EMS providers did not use safety restraints
in 80% of the crashes investigated by NIOSH. We know that seat belts save lives, yet EMS
providers, who should know better, are often complacent in wearing safety restraints, especially
in the back of the ambulance. Many states have seat belt laws and those laws routinely
apply to emergency vehicles just as they do to civilian passenger cars, trucks, and other
vehicles. Wisconsin law requires the use of safety belts in all emergency vehicles unless
such use could endanger the safety of an occupant. Even in the back of the ambulance, there are
not many scenarios in which the patient would be endangered by the crew members because
they are wearing their seatbelts. Using seat belts in the ambulance is one quick and easy
way to help prevent significant injury to EMS providers.
According to the CDC, the workplace injuries that occur with the most prevalence in EMS
are sprains and strains to the back and neck. Of the 22,000 EMS workers that seek treatment
in the ED each year for work-related injuries, more than a quarter of those ED visits are
for body motion injuries that include excessive physical effort, awkward posture, or repetitive
motion. Practicing safe lifting techniques is critical to reduce these injuries. As recommended
by the CDC, this requires providers to utilize proper body mechanics when lifting patients
(using the legs and not the back to do the work). Improving communication is also important
as some injuries occur when one provider attempts to lift a patient before the other providers
do. If mechanical devices can be utilized to reduce the physical exertion required by
EMS providers to lift patients, they should be employed. EMS providers should also call
for assistance from additional emergency workers if more lifting power is needed. (The more
providers you have to assist with lifting a bariatric patient, for example, the less
weight each individual provider must bear during the lift.)
Another emerging issue for EMS is that of sleep deprivation and inadequate sleep. As
reported by Industrial Safety and Hygiene News in 2012, the Harvard Medical School performed
some research on the link between insomnia and workplace accidents and injuries to find
that insomnia is responsible for approximately 274,000 workplace accidents and errors per
year (with a financial impact of approximately $31 billion in extra costs). The National
Sleep Foundation also reports that highly sleepy workers are 70 percent more likely
to be involved in accidents than non-sleepy workers and those with sleep problems are
nearly twice as likely to die in a work-related accident. Many professions, such as airline
pilots and truck drivers, already limit the amount of time a person can work within a
certain period and the trend is filtering over into healthcare as well where several
studies have documented a correlation between healthcare provider fatigue and increased
medical errors. Patient care concerns aside, however, fatigue can lead to injuries and,
within a profession that already has too many injuries, the prevalence of 24-hour shift
work in conjunction with inadequate undisturbed sleep given calls for service that interrupt
that sleep adds up to EMS provider injuries that could have potentially been avoided if
the provider was well-rested. Beyond traditional injuries, some studies have shown a link between
fatigue, sleep deprivation, and lack of sleep quality to other health problems like obesity,
diabetes, hypertension, cardiac disease, stroke, depression, anxiety, and PTSD. Thus, obtaining
adequate sleep is of critical importance within EMS for both the safety of the workforce as
well as the patients we treat. Beyond the lack of adequate sleep, the prevalence
of obesity and a lack of physical fitness is another area in which EMS would benefit
from some changes. A widely published 2009 study found that 77% of all new recruits for
fire and EMS services in Boston were either overweight or obese, which correlated with
other studies that found three-quarters of active emergency responders nationwide were
obese or overweight. Simply stated, EMS providers are failing to take care of themselves physically
though adequate physical fitness and proper nutrition. Many EMS providers are sedentary,
spending a lot of time sitting around the station or in the ambulance while eating fast
food, snacking on treats available at the station or in ED report rooms, and drinking
lots of soda, coffee, and other sugar-laden or caffeine-charged drinks. From the days
of their initial education within the profession, EMS providers must learn about and practice
tenants of proper nutrition and exercise for their own benefit, health, and longevity.
Being physically fit benefits providers in numerous ways, including a greater resiliency
to injury. Another important area of focus for reducing
injuries in EMS is for providers to have an awareness of hazards within their environment.
This can vary from the obvious, like passing traffic on the scene of a motor vehicle collision
and downed electrical wires, to hazards that may be easily overlooked, like a wet (and
slippery) floor at the station. Essentially, the work environment for an EMS provider is
ever changing and hazards abound. Uneven or slippery walking surfaces, hazardous materials
responses, violence against EMS providers, motor vehicle accidents, station hazards,
bloodborne pathogen exposures, environmental temperature extremes, and other potential
hazards are always present. EMS providers must be aware of their surroundings and the
environment in which they are functioning while taking reasonable and common sense precautions
to minimize exposure to and risk associated with numerous and various hazards.
As discussed in a previous module, ensuring adherence to standard or universal precautions
for healthcare providers while also following OSHA regulations (even if you are public employee
and not all OSHA regulations apply to you) can go a long way in preventing inadvertent
injury. This also recognizes the need to take steps to minimize both communicable and bloodborne
disease transmission through appropriate administrative controls, engineering controls, work practice
controls, and proper utilization of personal protective equipment.
Maintaining a safe and healthy workplace is an ongoing effort that requires the participation
of everyone within the organization. EMS providers in particular must be ever vigilant to various
hazards within the work environment and take steps to avoid those hazards and risks associated
with them. Given your completion of this short module,
you should now be able to identify some ways to prevent EMS work-related injuries.
If you would like to learn more about general practices to maintain a safe and healthy working
environment, you are strongly encouraged to seek additional educational offerings on the
topic. 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 2019, Waukesha County Technical
College. For information on WCTC’s numerous fire and EMS educational offerings, please
visit us online at WCTC.edu.