National EMS Assessment: A series of posts, and soapbox moments. (Part 1)

First and foremost, many thanks to The Social Medic. I was reading his post on “Why Basics are More Important Than You Think.” Thru this blog post, my attention was brought to the Federal Inter-agency Committee for Emergency Medical Service’s Report on the “2011 National EMS Assessment Report” [CAUTION: It is a large PDF]. I got 7 pages into the 550 page report before I felt the need to hop on the good ol’ soap box. Be advised, statistically speaking…If I only made it 7 pages before I found something to talk about, I can assure you that it is safe to expect at least 78 more posts regarding this report. Maybe I’ll condense some of ‘em for ya.

This specific bullet point talks about data collection, as it relates to EMS Workplace Health and Safety. Anyone who has read more than one of my posts knows I am a hard ass for scene safety. Not in the sense of over bearing cowardliness, but more a self-awareness while on emergency scenes. According to this report that was published, the following points were made:

  • 12 (24%) of states have a formal recommended Wellness and Prevention Program for EMS Professionals.
    • How often are you complaining about the 350lbs patient in the 3rd floor walk up that you now have to carry down to the truck? Me…every time. The idea that we don’t actually recommend a fitness program for our employees is absolutely crazy. Does our hiring standards actually indicate any picture of physical health, or is it just a screening to see if we can do the tasks of the job? Most agencies it is the latter. Why are we not requiring our employees to maintain some sort of physical fitness standard?
  • Only one state currently monitors EMS on the job injury data.
    • THIS IS CRAZY! The idea that no one pays attention to job related injury is a little hard to believe. First and foremost I know it is done on a national level, because the Bureau of Labor statistics has information about, on average, how many providers go out on back injuries alone per year. My feeling is this report is designated to EMS specifically, and EMS Injuries usually get lumped into the same reporting system as all other work related injuries. It works but there really should be a separate reporting system. Having a separate reporting system will allow for easier monitoring of work environment’s and allow for faster developments of products and tools to protect us on a daily basis.
  • 18 (36%) states monitor EMS on the job fatalities.
    • Again, this blows my mind that there isn’t an entity responsible for monitoring such events. In all fairness, I can’t find information if this is the same case for all First Response agencies, or if it is just limited to EMS. Why wouldn’t we want someone monitoring this? After all we are all about QA/QI right? Then why are we letting this slip by?
  • 11 (22%) states monitor EMS Vehicle crash data.
  • 7 (14%( states monitor EMS blood-borne pathogen exposure data.

Again, this is the 7th point in the beginning of a VERY long document. My initial feelings after reading the first few pages of this expansive document are varied. I am very concerned that so little agencies monitor the statistics of the job. I am concerned that so much potential data for improvement is just going by the wayside and isn’t being analyzed. However, I am extremely optimistic that the document is released. It’s a grouping of ideas that show where we need to improve, and where we are excelling in the every day function of our jobs.

If you have a division of your states Office of EMS that is responsible for data collection and professional standards, that person can collect all this data that is being reported. That data is made public, available for all to scrutinize it. People realize that the number one cause of work related injury in EMS providers is back injuries. According to a study done by the American Journal of Industrial Medicine showed that about 10% of EMS providers are out because of back injury with lost time at work at any time in the country. The national average for the same statistic overall is only one percent.

This problem does not get solved on a national level. This needs to start from the ground up. First, we need to be sure we are using proper lifting techniques. Next, we need to make sure that we are physically fit enough to use said proper lifting techniques. In the event of an unfortunate work place injury, it needs to be documented. It needs to be sent to the states Dept of Labor, but also OEMS should start collecting such data. Then on a local level, we look at ways that we can prevent this from happening. We look at statistics and compare them to response patterns. What I would look for in response patterns are:

1) How many responders were on scene? Fire, PD, EMS etc.

2) How many of the responders aided with lifting the patient?

3) How many of the responders were not active in patient care?

  1. Why? Were they carrying equipment? Were they monitoring scene safety?

4) What is your opinion on how this can be corrected?

The most important part of that questionnaire, in my mind, is the fifth question. It is easy as supervisors, managers, and directors to “Monday Morning QB” a call, and judges the provider. It is a good way to provide some sort of self-evaluation to see if the employee truly sees the error of their ways. It could provide a great opportunity for them to voice their opinions and let them feel like they are needed. This information can also be passed up the chain of command and brought to EMS meetings to ensure proper safety is met with all the different entities responding to a scene.

I am looking forward to working through the National EMS assessment over the next few months (its 550 pages people, I don’t have THAT much free time). I hope it provides the powers that be on Capital Hill as much insight as it has for me thus far.

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