In the relatively short history of what is known as the modern EMS design, the U.S. has seen exponential growth and development. This expansion in services has created an environment where EMS has become the safety net for the general public’s health and welfare.4
While the general public will often associate EMS to safety the question often brought up within the profession is who is watching out for our professionals and who is keeping EMS safe. A culture of safety is a popular buzzword within the profession, but what does that really mean in the day to day operations of an EMS department?
The commonly understood definition of a safety culture was penned in research conducted out of the University of Illinois at Urbana-Champaign. “The enduring value and priority placed on workers and public safety by everyone in every group at every level of an organization” (Weigmann, 2002).3 While easy to put out as a mission statement the practical application of this definition is more difficult and impacts several aspects of the population.
Three main areas of concern are considered when looking at safety for EMS, the risk to members of the community, risk to the individual patients and lastly the risk to EMS personnel.1 While the first two are often put over as a priority to the safety of the individual EMS provider at the core of EMS “BSI, Scene Safe” is drilled into the psyche of everyone who has ever take an EMS course.
EMS Week 2023: Health Wellness and Resilience
Research in Canada took 10 Paramedic level services and found a variety of factors were potentially impacting the overall safety. Ranging from chronic and acute stress being placed on the providers to sleep deprivation and fatigue EMS as a profession has a dilemma when ensuring safety to all parties involved on a daily basis (Donnelly, et al. 2020).
Eighty percent of paramedics reported individual injury or exposure to a pathogen, 95 percent reported safety compromising behaviors and seventy-six reported medical errors in the care of patients (Donnelly, et al. 2020). The contributing factors to all three of these findings were identified as stress and fatigue related. A common complaint in the EMS community fatigue in general has become a major issue with related safety concerns on the rise.
As we take the time this week to recognize those in the EMS profession, more focus needs to be placed on the safety of those providing this critical service. The National Association of Emergency Medical Technicians addressed the issue of fatigue in 2018 identifying that more than 50% of personnel reported severe mental and physical fatigue while at work with poor quality of sleep and limited time to recover between shifts.
Dr. Daniel Patterson lead a team of researcher looking into fatigue within EMS and provided recommendations to potential improve this phenomenon. From using fatigue surveys while on shift to limiting shifts to less than 24 hours at a time a more active approach is needed as EMS crews are being pushed like never before.2
References
Donnelly, E. A., Bradford, P., Davis, M., Hedges, C., Socha, D., Morassutti, P., & Pichika, S. C. (2020). What influences safety in paramedicine? Understanding the impact of stress and fatigue on safety outcomes. Journal of the American College of Emergency Physicians open, 1(4), 460–473. https://doi.org/10.1002/emp2.12123
- https://www.acep.org/siteassets/images/strategy-for-a-national-ems-culture-of-safety.pdf
- https://www.naemt.org/WhatsNewALLNEWS/2018/01/12/fatigue-in-ems-risk-management-guidelines-go-live#:~:text=Use%20of%20fatigue%2Fsleepiness%20surveys,and%20monitor%20EMS%20personnel%20fatigue.&text=Limit%20EMS%20shifts%20to%20less%20than%2024%20hours%20in%20duration.&text=Provide%20EMS%20personnel%20access%20to%20caffeine%20to%20help%20stave%20off%20fatigue.&text=Allow%20EMS%20personnel%20the%20opportunity%20to%20nap%20while%20on%20duty.
- https://www.nrc.gov/docs/ML1025/ML102500649.pdf
- https://one.nhtsa.gov/people/injury/ems/agenda/emsman.html
