By practicing good personal habits, implementing safe practices and procedures when responding to vehicle collisions or other traffic hazards, and correct response and procedures when faced with a hazardous materials situation, it is possible to prevent most EMS injuries.

GOOD PERSONAL HABITS

Good personal habits include getting enough sleep and allowing time for recovery after a busy shift, making sure to eat a nutritious diet (that means limiting fast food), keeping immunizations current, and staying fit.

SAFE PRACTICES AND PROCEDURES

Safe practices and procedures that should be implemented any time EMS responds to incidents involving motor vehicles include

• identifying traffic hazards such as blind corners,
• using reflective vests when in the line of traffic,
• parking considerations,
• considering the deployment of airbags--or worse--the airbag that hasn’t deployed,
• live power lines that are down or could come down to the ground,
• vehicle stability (let the fire department stabilize any vehicle before an EMS provider comes into close contact with it--you never know when a vehicle may be unstable),
• other hazards such as fire or leaking fluids, violent or potentially violent persons, risk factors for violence, and safe response.

Law enforcement should be requested any time the potential for violence is expected or any time violence is encountered. A competent EMS provider shall remain aware at all times of their surroundings and exhibits restraint to allow for safety.

Hazardous materials are any items or agents (biological, chemical, radiological, and/or physical) which have the potential to cause harm to humans, animals, or the environment, either by themselves or through interaction with other factors.

EMS providers should assess each motor vehicle scene for signs of hazardous materials if they are suspected, prior to arrival on the scene and from a great distance. Using binoculars to look for placards and then notifying dispatch prior to arriving at the scene is ideal. It is important to not approach the scene if there has been a suspected hazardous material release. EMS providers should remain uphill and upwind, a safe distance from the scene, while awaiting specialized resources.

Preventing Injury While Lifting and Moving Patients

Correct body mechanics are the best deterrent to on-the-job injuries caused by lifting and moving patients.

• Providers should always keep their backs straight, maintain a firm grip on the stretcher or patient, and avoid twisting of the body.
• Firm footing should be maintained and every next move should be communicated clearly between partners or teams.
• EMS providers should always remember to keep their heads up and use good posture.

Everyone has physical limitations--each provider should be aware of his or her own and should not attempt to exceed those limitations. Request assistance early and at any time it is needed to prevent injury. Often, fire departments or other ambulance personnel are deployed for a lift assist. When lifting, either solely, with a partner, or with a team, remember to use safe lifting techniques during cot and stretcher lifting.

POWER GRIP AND SQUAT LIFT: The power grip and squat lift are safe lifting techniques that are ergonomic (easier on the body) and produce maximum stability.

The power grip is the term that describes gripping the handles of the stretcher or the cot with the EMS professionals palms up and thumbs wrapped around the handles and is the best way to hold a stretcher or other patient moving device with the intent to lift.

The squat lift is performed when a provider stands with the feet shoulder-width apart, keeps the back straight and head up, squats at the knees, and grasps a device with the power grip, making sure to keep the arms fully extended and as close to their sides as possible, and then extends the legs, returning to a standing position.

To carry a patient or stretcher, first determine the weight that needs to be lifted, keeping in mind personal limitations, communicate with a partner or team, keep the weight close to the provider’s body (do not attempt to lift with arms extended), and flex at the hips and bend at the knees, not the waist.

EMS providers should be sure to follow the same general guidelines during reaching, including when log rolling (log rolling is when a patient is rolled to one side with the intention to assess for injury, to assist in airway management, or to facilitate movement), and remember to keep backs straight, heads up, and use effective communication between partners or team members. Pushing and pulling techniques employ the same body mechanics and communication.