Building a Culture of Safety

It seems like no matter where we turn in EMS there is some discussion about provider safety. From the overarching idea of the EMS Culture of Safety, to providing ballistic protection for all EMS and fire personnel or concern for scene safety in the wake of attacks on EMS professionals. We know we want to make a change but many organizations struggle with how to make sweeping safety changes. Just like with any major overhaul, it starts with a series of simple steps that we can do today as services and providers to make sure that we are a safer profession.

One of the simplest changes any organization can make is increase the focus on seatbelts. It seems like such a simple thing and we know that many injuries and deaths in EMS occur because of unrestrained passengers, yet you look in the back of almost any ambulance today and you will find unbelted personnel. Most of our organizations have taken the necessary steps to ensure patients are properly secured on stretchers using five points of contact. Why aren’t we doing the same to ensure a culture and environment were seatbelts are not only accepted but expected. For young EMS professionals, they’ve always lived in a world where it is expected that a seatbelt would be worn in any passenger vehicle, yet they step in the back of our ambulances and follow the lead of senior providers and remain unbelted.

Like any safety change, we want to avoid making it punitive and we want to empower our providers to work in a safer environment. The most effective way to make a change like this is to start with the small step of educating our providers on the dangers of remaining unrestrained in the back of an ambulance and remind our senior staff, especially training personnel, of the importance of role modeling. It may be challenging for us to enforce a seatbelt guideline with all providers, but certainly enforcing it in training staff can help to set the tone for the rest of the organization.

Another area where we may be able to affect change is regarding situational awareness and self-preservation for EMS professionals. We may even find, by talking to partner organizations in law enforcement that this training already exists and just needs to be utilized and adapted for EMS professionals. Do your providers know the types of dangers to look for on scenes and how to evaluate a patient who may becoming aggressive? Can they recognize the verbal and body cues of the patient who is preparing to switch into an attacker? Do they know the very basics of protecting themselves when put in a situation where their safety may be in danger? If the answer to even one of these questions isn’t a definitive yes then we have work to do.

These are just two of what can be many areas to improve safety, but we want to start in areas that will affect the most change and gain buy-in from the organization. We certainly want to show our providers that safety isn’t simply something to be talked about in classes and academic papers but something we really should be living as professionals every day. In just taking basic steps, we can show them that our organization is committed to change and committed to safety and as we begin to make larger changes in the culture and management of our organization; they will see a real focus by our organization.

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