Safety Discussion

[croaker260]

Hey all,

As I was perusing the internet (EMSnetwork.org) I was astounded the number of EMS assaults that made the headlines in the last 5 days alone, and even more over the past month. While most of the assaults were minor, one involved a gun and another was quite serious involving a crew getting beat with there own toughbook (A coworker of mine would claim this is another reason to go iPad).

Anyway, I thought this would be a good time to review our own safety procedures on scenes and around patients of all types, as well as just raise our own situational awareness with some just in time discussion.

I have enclosed just a few of the links below. As an old crusty sergeant said on Hill Street:

Be careful out there.

-Steve

.

Psych Patient Flips Out In Ambulance, Assaults EMT, Steals Car: http://gothamist.com/2011/05/16/psych_patient_flips_out_in_ambulanc.php

Honolulu man charged with punching female paramedic: http://www.staradvertiser.com/news/breaking/117845823.html

Drunken limo passenger punches female paramedic: http://www.newsok.com/drunken-limo-passenger-punches-female-paramedic-oklahoma-city-police-say/article/3572916?custom_click=headlines_widget

Police: Man Attacked EMS Crew In Moving Ambulance:

http://www.wfmz.com/web-exclusive/28085494/detail.html

Man Fires Shot After Ambulance Crew Enters Wrong Apartment Pennsylvania: http://www.emsnetwork.org/artman2/publish/article_45609.shtml

Edited June 2, 2011 by croaker260

[paramedicmike]

...and another was quite serious involving a crew getting beat with there own toughbook (A coworker of mine would claim this is another reason to go iPad).

Ok. I know this is supposed to be a serious thread. But this made me laugh out loud.

Well played!

[croaker260]

Ok. I know this is supposed to be a serious thread. But this made me laugh out loud.

Well played!

The best education is done with a grin on your face. Just sayin'

[Suburban/Rural Medic]

I think the safety discussion is something that we in EMS have far too infrequently. Most of us, afterall, are still providing care to our patients in the back of speeding ambulances from a side facing bench-seat position without a seatbelt on. The backs of our ambulances have sharp edges and head-strike hazards everywhere, non-latching cabinets and inadequate means of securing our heavy equipment. Our stretchers don't stay put during collisions, nor do they do a good job of containing our patients on them when they become projectiles. We never gown up, rarely wear our eyewear, and almost never put our N95s on when we should. We go to car accidents and leave our helmets and vests hanging up inside the ambulance. The only thing we do well is diligently wear our steel-toed boots and nitrile gloves.

I don't have statistics to prove it, but I feel that psych patients and belligerent drunks are far less of a threat to us than our industry's lack of concern for workplace safety.

For years, fire departments have preached the message of fire safety and fire prevention at home and at work. It's about time the EMS industry got serious about safety in the industry and started preaching the home and workplace safety message to the public.

As for me, I'll do as much care on scene as possible to minimize the amount of time I spend in the back of the ambulance with my seat belt off. I'll put the cardiac monitor in its mounting (that we're lucky enough to have) every time. I'll secure all my patients to the stretcher as well as possible, using all the straps. I'll wear my helmet, face sheild and vest at every car accident, even if it makes me look silly. I'll use safety IV catheters (once again, that we're lucky enough to have) and make sure a sharps container is always close at hand. I'll keep an N95 in my pocket, and continue to use it often.

As for the violent patients, I'll continue to do the same thing; rely on my police counterparts for their expertise. Also, I will continue to ask for police response on calls I don't feel right about, and wait for police before I enter places I don't get a good feeling about.

[NYCEMS9115]

Scene Safety needs to be taught & re-taught, continually discussed & addressed. It can't be just something that is a critical point in our Patient Assessment Practical. We need to pay attention at all times. Anticipation, preparation, and awareness is the key to Scene Safety. It needs to be reassessed constantly. However, it is impossible to predict every act of violence, no matter how prepared you are...

[flamingemt2011]

I appreciate your concern, but how many millions of EMS calls were run this week, and we had 5 problem calls....................................................... just saying.

[croaker260]

Flaming:

Your missing the point of "just in time" discussion. Cardiac arrests are typically less than 1% of total call volume, and actual ROSC far less than that, yet how much training do we do to save the life of a stranger? I would argue that the lives of those we know is worth at least equal attention.

Now, the purpose of this is not to boo hoo the topic, or to shock and awe a rookie into compliance with P&P, its to generate discussion in real time and among our peers followed by "critical self review".

Why? Because I believe that "just in time" 10-15 minute reviews save more lives than any merit badge course or P&P out there, that small-unit peer-led training (in what ever discuise you want to take it)is as useful as a refresher course...and that hopefully these discussions will refill the "gut feeling" tank enough that someone somewhere will wait that extra second, take that extra step , that saves their ass or their partner's ass.

Thats why I posted it.

Now in a perfect world, we would all go back and on our next shift casually say..."Hey did you hear about that paramedic..." and see where the discussion takes you.

If your an FTO, hand one of these articles to your intern and say "Hey, did you hear about..." and guide the discussion a bit

If your the captain you would casually say over the breakfast table to your crews..."Hey..did you hear about"..and push the discussion a bit..

As Gordan Graham would say..."Every day a training day"

Edited June 7, 2011 by croaker260

[uglyEMT]

For the naysayers about scene safety or to the rookies especially and even some of the veterans. Here is a perfect example of never turn your back.....

Dispatched to a domestic violence call. PD is on scene (3 officers) plus their Sargent. Husband is in another room being "interviewed". Wife is on the floor in the kitchen with head and neck trauma. My two partners are working the patient while I assist. "Gut feeling" or "hairs on the back of the neck" or "street sense" whatever you want to call it says keep an eye on the other room. My partners are so involved with the patient a pink elephant could walk in the room and they wouldn't know. A second (well seemed like it) later here comes hubby mad ass all hell charging my partners screaming "I'll kill the B----" PD is doing there best but he is still coming. In my best hockey style manner (I played in college) I checked him to the wall. PD did there thing and he was restrained, cuffed and placed in a squad car. When I brought it to the attention of my crew they were astonished it happened because they had no idea.

After the call the QA basically went down the road of feeling too secure at a scene because PD was there, having blinders on, glad we have someone watching our back.....

Folks seem to get complacent when PD is on scene and don't keep situational awareness. Hopefully with this call and the others previously mentioned we get a dose of reality and remember situational awareness, scene safety, and keeping an eye on your partner(s)

[EMS Solutions]

Here is a recent podcast on "When Patients Attack"

EMS Office Hours

[Happiness]

I appreciate your concern, but how many millions of EMS calls were run this week, and we had 5 problem calls....................................................... just saying.

I can honestly say you make my head hurt. So you totaly missed the point of the OP. Scene saftey is the first thing we as paramedics tend to become compliant with, and I as a medic that has been around for a long time will admit to that. I have lately been trying to make sure the new ones comming down the pipe are aware of it all. It isnt always a violent person, your saftey can be anything.

http://www.ctvbc.ctv.ca/servlet/an/local/CTVNews/20101020/bc_paramedics_101020/20101020?hub=BritishColumbiaHome

It is now policy that we state our employee numbers when we answer a call. In this case they didnt even know the names of the crew involved. Also it is not good practice to be sleeping on the cot while your partner is driving. You should be both in the front keeping each other awake. Also let it be know that the stretch of the highway is horibble and there will always be questions on the cause.

http://www.newswire.ca/en/releases/archive/July2007/06/c4458.html

You cant always see the hazard, smell or sense it. We dont go into any confined space EVER.

http://www.apbc.ca/fallen-members/

Could all of these one's been prevented. The ones that died in the medivac were ITT and everytime I go through my hospital I look up at the plaque dedicated to them and wonder if the pilots did something different these people would be with there families today. Flamming if even there is One PREVENTABLE accident in the millions of calls everyday, it is one to many......... Just saying................