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Head protection: Are there solutions for EMS?

Editor's note: This summary details a lecture that was presented at the American Public Health Association (APHA) Convention on Dec. 14, 2005.

Head protection is a neglected area of PPE for ground EMS, as was described by researchers Levick and Garigan, from Maimonides Medical Center at the American Public Health Association (APHA) Convention in Philadelphia. Head injury is a serious occupation hazard in EMS. The researchers demonstrated helmets to be well-accepted by medics when the risks and hazards of EMS transport are understood. Safety in EMS transport is an integrated system, of which helmets are a simple and potentially life-saving component. EMS transport safety must be treated as an automotive safety issue with the involvement of automotive safety experts along with EMS providers, researchers and the industry.

Having conducted extensive research on key aspects of ambulance safety from epidemiological, biomechanical and automotive safety perspectives, it was clear that many predictable and preventable injuries occur in EMS transport. Although it's understood that it takes time to implement safer vehicle design changes for a fleet, a number of simple solutions could protect EMS providers from these hazards: safe driving, use of seat belts and even helmets.

Helmets are a simple solution that is easy to implement. However, their research showed that while helmet standards exist for firefighters, air EMS, and search-and-rescue personnel, no standard exists for ground EMS providers. Levick's current research addresses design elements to meet the unique hazards in the ground EMS environment.

When surveyed, EMS providers were initially resistant to the idea of wearing a helmet, yet became overwhelmingly supportive of helmet use after becoming aware of the significant risks associated with riding in the back of an ambulance.„

The EMS profession is showing an increased focus on addressing EMS transport safety with a number of safety initiatives being established. EMS transport safety is an automotive safety issue, although it has yet to be included as part of the automotive industry. Safety is part of a system, and automotive safety is an integrated system in which different safety devices work seamlessly together. EMS transport safety must bridge EMS practice and policy, vehicle crashworthiness, vehicle interior design, driver safety and performance, and occupant protective equipment. As Levick has strongly encouraged over a number of years, the key is collaboration between all the involved disciplines. Levick strongly encourages the establishment of a multidisciplinary EMS transport safety advisory panel to provide expertise and guidance and for there to be substantive input from leaders in automotive safety.

Levick's team is working with Dan Shipp, the president of the International Safety Equipment Association (ISEA) to draft a relevant helmet standard for ground EMS.„

And to quote Fred Trotta, a key supporter of Levick's project and a provider of legal support to a major EMS company: "We just want everyone to come home at night."„

A link to a live recording of Levick's presentation will be available online at„www.objectivesafety.net.

Nadine R. Levick, MD, MPH, and Meave Garigan, BS are associated with the Department of Emergency Medicine at Maimonides Medical Center.

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