High Visibility

Every day, EMS professionals put themselves in harm’s way when working on busy roads and highways throughout the country. Although there to provide care for ill and injured patients, EMS professionals often become victims themselves when inattentive drivers fail to see them, striking them with their vehicles. Over the years, thousands of EMTs, paramedics and first responders have been injured or killed while helping others along busy roadways and highways.

To help address this growing epidemic, a federal regulation went into effect in 2008 mandating that anyone working in the right-of-way of a federal-aid highway must be wearing high-visibility clothing that meets the American National Standards Institute  standards. The law applies to all emergency responders, regardless of whether they’re paid or volunteer.

Still, many responders are woefully lax when it comes to donning safety vests and other apparel to keep them highly visible and safe when working on roadways. Scott Matin, MBA, NREMT-P, vice president, and Peter Dworsky, MPH, CBRM, NREMT-P, corporate director at MONOC Mobile Health Services, decided to get the word out about the necessity of wearing such safety apparel.

“MONOC is an organization that is safety conscious. Over the years, we have seen the numbers climbing of EMTs and paramedics who get struck on roadways at the scene of an EMS call,” Matin said. “And that number is growing. So we thought about how to reduce the risk of those getting injured or killed on scene.”

Scott Matin

Scott Matin

The two took a hard look at high-visibility safety vests as an effective way to provide more safety to prehospital responders, since so many elect not to wear them. “We wanted to think of a way that we could make this more evident and get people to understand why it’s so important to wear these vests,” said Matin. “We thought, a picture is worth a thousand words. If we could show how visibility changes in both day and night, with a vest versus without a vest, it might get people to wear the vests like they should.”

One of the barriers to wearing the safety vests, according to Dworsky, is a lack of knowledge about how effective they are in providing visibility, both day and night. “They don’t realize that the vest actually does what it’s supposed to do in making them visible,” he said. “That this simple piece of material can actually protect them in a high-hazard environment.”

The dominance of dark-colored clothing provided to most prehospital providers doesn’t help matters either. “In the EMS community, we tend to wear dark uniforms, dark pants and jackets,” Dworsky said. “If you look across Europe and Australia, their standard uniform is made of high-visibility materials, and they’re always wearing it. We’re slowly moving toward adopting the philosophy of always being visible, but we’re still behind the curve in the U.S.”

To combat the potentially deadly mindset, Matin and Dworsky decided to produce another free safety video (their last free video, about the misconceptions of emergency light and siren use, earned them EMS 10 recognition last year) aimed at EMS providers that would not only explain the importance of wearing a high-visibility safety vest, but also show the difference in how prehospital workers look wearing one versus not wearing one, during the day and at nighttime.

With the help of their team, Scott and Peter produced a video called “High Visibility Safety Vests: Be Safe–Be Seen.” Creating the video took months of preparation and planning.

“First we needed to make sure we had our facts straight, and we needed to make sure we conveyed in a short amount of time the exact benefits of wearing a vest,” said Matin. “We needed to show them visually why they should be wearing a vest.”

The two raised $4,000 through donations, conducted research about the issue, wrote and revised scripts, developed a list of scenes to be shot and created a shooting schedule. They had to line up ambulances and other vehicles as props and recruit staff within MONOC to participate as actors. The actual filming took two days, followed by weeks of editing. “Coordinating the details and the logistics is the hardest part,” Matin said. In fact, the date of the shoot had to be changed twice due to bad weather.

Peter Dworsky

Peter Dworsky

Without preplanning, the production would’ve taken much longer and cost more. “We came up with a shot list ahead of time, so we knew exactly what we wanted to do as the day progressed,” said Dworsky. “We have a preset list of shots, and we stick to those as best we can. We’ve learned that guidance from the production staff is key.”

Matin and Dworsky secured permission from the State Highway Authority to access a roadway that had been shut down because of construction. On the day of the shoot, they captured all the inside images they needed and then traveled to the roadway the next day for the outdoor shots. Because they wanted to illustrate the difference between providers in their standard uniforms wearing and not wearing a vest, day and night, the shooting went from
8 a.m. to 11 p.m.

“We were really able to show that even in the daytime, people with a safety vest were markedly more visible than ones not wearing a vest,” Matin said. “We did the same thing at nighttime and it was obvious.” In fact, one of the nighttime shots in the video shows EMTs and paramedics walking away from the camera. The two not wearing safety vests become almost invisible, even in headlights.

Upon completion, the video was posted on MONOC’s website (www.monoc.org/safetyVestPSA.cfm). “We made the video public domain,” said Dworsky. It can be downloaded for free by any agency. So far, the video has been downloaded or sent to agencies throughout the United States, Canada and Europe.

Matin emphasized that wearing a safety vest is an important part of a multicomponent approach in prehospital providers staying safe on the streets. “One of the things we stressed in the video is that we can’t control every variable every time,” he said. “There are so many variables when it comes to provider safety: weather, the amount of lights on a vehicle, the type of roadway, what you’re wearing, the number of people on scene. But we thought the safety vest is something that everyone should be wearing automatically, and we really pushed that during the video.”

Dworsky echoed the sentiment of offering providers numerous avenues of education, which comprises a “toolbox of safety.”  “In that toolbox are memos, policies and educational programs. The video is one of the programs, and the actual safety vest is another tool in the box,” he said. “No one item is going to fix the problem, but this video is a true visual representation. You can’t talk about this in a memo or email. You have to be able to see it.”

Both have been heartened by the positive response the video has received from the EMS community, especially since many agencies are now including the video as a viewing requirement. “These are being written into the policies for agencies throughout the world. That says a lot for the EMS community,” Matin said. “They realize these things are important, and that they are going to take the time to train and educate their people to keep them safer. They realize the video is something everybody should be seeing.”

While the two are pleased with the reaction the video has received, what they want others to understand is just how important it is to take the message of the video to heart by dumping the “It will never happen to me” attitude and donning the vest. It takes only a minute to put it on, and that simple act may one day save your life.

“We’ve been fortunate not to have anybody struck by a vehicle on a roadway,” said Dworsky. “We’ve been lucky over the years, and we would like to stay fortunate. Part of that is everyone taking responsibility for themselves.”

Matin agrees. “There’s a lot of luck that’s involved in provider safety. But we don’t want to rely on luck, we want to rely on science,” he said. “There is a lot of luck in keeping us safe, and we’ll take it when we can. But we don’t want to count on it.”

View all of the 2014 EMS 10 Innovators here.

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