By Ariel Jenkins, Director – Risk Control, Safety National and Brian Fass, President & Founder, Fit Responder
EMS and Fire Rescue is, by definition, a high-risk profession. Patients are generally getting larger, while the profession is challenged to stay physically fit. The long hours and volume of calls in some urban areas can be overwhelming for understaffed EMS districts. The profession’s educational focus on dealing with combative patients is inconsistent, which can lead to injured first responders and liabilities as a result of dealing with these patients. In some cases, the procurement of patient handling equipment can be misguided. Overexertion injuries from patient handling, dropped stretchers and the constant revolving door of soft tissue traumas are very prevalent in the first responder community.
There are three primary factors that contribute to the high risk of injury and liability for first responders.
- Many responders have never had a scientifically accurate system of patient handling; specific to the pre-hospital environment. Many responders also have never been taught how to truly use and operate patient handling equipment properly. As a profession bad / dangerous habits are typically handed down from generation to generation creating a revolving door of risk.
- Many responders have never been taught a system of self-care to manage minor musculoskeletal symptoms while improving job specific physical ability to allow them to safely do the job, especially in challenging environments.
- As a culture, responders typically underreport and that could lead to significant injury down the road.
Data consistently proves that injuries are underreported or outright unreported which can lead to an increased risk of major soft tissue trauma. Responders often work in pain which has a significant cascade effect of poor biomechanics and poor patient handling skills. Pain is distracting and can even lead to driving and medication errors. By simply removing pain from the equation while reducing the occupational load on responders a culture of safety and personal responsibility can be achieved. Tie that personal responsibility (a just culture) into training excellence along with being fit for duty and departments will finally be able to move away from what the data shows will happen if they do nothing. There is a variety of patient handling equipment on the market for first responders that claim to reduce risks to the user and the patient. First responders will be the ones to validate if these claims of risk reduction hold true in their “real-world” work environments. The success of using patient handling equipment will ultimately depend on how well it increases the capabilities of the first responder to handle the patient safely. The approach to procuring patient handling equipment for first responders must include the candid feedback and buy-in from the individuals that will ultimately use the equipment. Otherwise, an organization can end up spending and wasting money on equipment that the intended users refuse to use. For this reason, patient handling equipment should be implemented on a trial basis with the end users before full scale purchase and implementation of the use of the equipment.
Use of patient handling equipment will also have underachieving results if the approach to implementing use does not first educate and indoctrinate first responders in the principles of body mechanics. In most cases, equipment alone will not effectively address the high risk of patient handling. Unless the equipment completely eliminates the need for individuals to lift, lower, transfer, push, pull or carry patients, effective body mechanics training will remain relevant and essential. Consistent practice of body mechanics requires first responder leadership to set the climate and reinforce body mechanics after initial training. Reinforcement of body mechanics and safe patient handling practices will ultimately help indoctrinate first responders to the point of being cognizant of the hazards they face in each situation and take action to mitigate risks to themselves and to the patients. In this sense, consistent use of body mechanics would become a part of first responders’ values and culture. A first responder workforce that is highly educated in body mechanics will be able to make the best decisions on what equipment to purchase to support their safe patient handling efforts.
Ariel Jenkins, CSP, ARM, MBA, ARM-E
Ariel Jenkins is a Director of Risk Control with over 20 years of experience. He is responsible for technical direction of risk control at Safety National. This includes technical development of the risk control team and the content of deliverables. He also leads the public entity risk control practice at Safety National. Ariel has a broad base of knowledge and experience in the areas of workers’ compensation, fleet safety, auto liability, general liability and safety culture and is regularly called upon to speak and write on these subjects by industry associations and publications.
About Safety National
Safety National is a leading provider of alternative risk funding products such as excess workers’ compensation, deductible casualty, loss portfolio transfers and reinsurance. Safety National is a member of the Tokio Marine Group and is rated “A+” (Superior), FSC XIV by A.M. Best. Learn more at www.safetynational.com.
About Bryan Fass, ATC, LAT, CSCS, EMT-P(ret)
Bryan Fass is president and founder of Fit Responder, where he works nationally with departments, corporations, state and local governments to design and run scientifically valid injury prevention and wellness programs. He is frequently contacted for expert opinion and content contribution for all aspects of public safety fitness, ergonomics and wellness. Bryan authored the Fit Responder book used by departments and schools plus writes for numerous web and peer-reviewed journals including the National Strength & Conditioning Associations Tactical Strength & Conditioning journal, officer.com, ems-1.com, firerescue1.com & JEMS.
About Fit Responder
Fit Responder’s Injury Free training is a liability conscious, risk management best practice approach to preventing training, patient & equipment handling injuries in EMS, fire-rescue and law enforcement departments. This program introduces a complete system of pain management, job specific mobility, wellness, tactical fitness and patient handling that will reduce the rate and severity of injury. Learn more at https://www.fitresponder.com.