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Best way to prevent injury?

Discussion in 'EMS Talk' started by emtj21, Aug 18, 2018.

  1. emtj21

    emtj21 Forum Ride Along

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    Greetings all! I am new to the forum here. I have just recently obtained my EMT Initial cert. and got a conditional offer from a local agency. I am excited about starting this new path and I know it will be such an amazing journey. However, I can’t help but be worried that I am going to injure myself on the job and ruin my future career as a nurse (currently in school). I have a lot of teachers who have told me some pretty pessimistic things like: you will get hurt one day it’s just a matter of when, this job will destroy your body, etc.
    I am 5’11” and weigh 168 lbs so I am in pretty decent shape, but I plan to start lifting a little at the gym (maybe deadlifts and squats?) to try to condition my body for the trials ahead. The agency I got an offer at is a private company that mostly does transports, so I will likely be dealing with a lot of bariatric patients. Is it really as bad as I have heard or are my teachers just overly negative? Also, if any of you have any recommendations for exercises or preventative measures that will decrease the likelihood of injury that would be awesome. Thanks and I hope you all have a great weekend!
     
  2. mgr22

    mgr22 Forum Asst. Chief

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    Not sure what the best exercises are, but one out of four EMS providers suffers a career-ending back injury within their first four years on the job. Learn to lift correctly and make use of ergonomic devices.
     
    Aprz and emtj21 like this.
  3. Underoath87

    Underoath87 Forum Asst. Chief

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    Get hired by a company that uses the Stryker Powerload system. It has been wonderful for my back :)
     
  4. Chimpie

    Chimpie Site Administrator Community Leader

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    This ^. If this agency doesn't have one, find one that does.

    As you start working and connecting with others in the field, check out their equipment. Network. And when you're interviewing at the next job, and it comes time to ask questions, ask about what equipment they use. Ask to see one of their vehicles. Discuss how you're looking to work for an agency that is concerned about the safety and well being of their staff. That you're in it for the long haul (even if you're not) and want to protect yourself.
     
  5. Gurby

    Gurby Forum Asst. Chief

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    The stronger you are, and the better your form, the less likely you are to get injured. I'm sure I had minor sprains and strains along the way, but I can't recall ever having a real injury during my ~3 years in EMS. I'm sure a big part of that was being on the larger/athletic side to begin with at 6'2" 180lb. You will notice that many of your coworkers are not in great shape and do not work out - I think it's no surprise that they have a rough go of things.

    If you can squat/deadlift >250 pounds and you're careful when lifting, you'll probably be fine.
     
    Qulevrius likes this.
  6. MMiz

    MMiz I put the M in EMTLife Community Leader

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    Congrats on the new gig! Powered cots make life easier, but proper exercise and conditioning is key.

    It's easy to think of bariatric calls as the biggest challenge, but I was much more sore after transferring a patient to the cot/a bed without proper assistance, extricating a patient from awkward locations (toilet, shower, etc.), and not lifting properly on easy lifts.

    Here are some resources:
    Good luck!
     
    Gurby likes this.
  7. StCEMT

    StCEMT Forum Deputy Chief

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    Lift heavy ****. A lot.

    I've never injured myself anyway I can recall. The only injuries I've had were outside of work. I'm sure this job is harder on my body than others, but I make sure I eat relatively healthy, workout 4-5 days a week, and pay attention to how I move people. Worked for me so far.
     
    Gurby likes this.
  8. Aprz

    Aprz Forum Deputy Chief

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    Good lifting techniques. Good posture. Pick up things off the ground properly. Don't try to tough things out lifting more than you should; Ask for or get help. If it is questionable, assume the worst, and get more help. Use a sliding sheet or patient mover/redi-bed whenever you can. Good communication, especially with things like the stair chair (ie explain to the patient that you will tilt them back, it'll feel like they are about to fall, make it clear for them not suddenly move position or grab things, communicate with your partner when you are ready, maybe have someone watch/hold your back to let you know when you are approaching the bottom). Good communication is very important. Plan how you are going to move the patient. This is also important to minimize unnecessary movement or having unexpected things. Usually the head is in charge of moving/saying moving instructions.

    If you do get hurt, don't tough it out making it worse. Get a hot pack and take Tylenol. Notify work/call out. Workman comp if it was an on the job injury. Don't tough things out cause you'll make things much worse. Nobody will be judging you.

    I am 5'6" and 140 lbs... Never hurt my back before *knock on wood*. My partner and I use an electronic gurney and always two person it (although she is about my height too). Most times, it seems someone will have improper lifting earlier in the day, maybe they felt or knew something was wrong, and then hours later, hurt their back moving some small/light eg picking up a pencil off the ground, but bent with their back instead of their legs.

    It shouldn't be "It isn't if, but when injury will happen." I think that is a poor thought process that is often said among motorcyclist too.... Most injuries are totally avoidable. There will be moments that there will be a call to action or was difficult to see coming, but not everyone or most will exeprience it.
     
  9. DrParasite

    DrParasite The fire extinguisher is not just for show

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    damn, I'm 4 inches taller, and 60 lbs heavier..... now I feel really fat...... thanks buddy :(:(:(

    It's been 20 years since I first stepped food on an ambulance... I've been out of work due to injuries twice, both for back injuries. I also started when we had the stairchairs without treads, two man stretchers (I was thrilled when we upgraded to 1 1/2 man stretchers), and routinely ran calls with just 2 people and no other responders. I love the stryker stairchair with treads, the powerlift cots were initially seen as a luxury, but now are standard, and the FD goes on almost every EMS call.

    The main way to avoid back injuries is good form, keep heavy stuff close to your body, and don't lift more than you can handle (IE, call for help). Many injuries are avoidable this way.... but when the 300 lb patient is wedged between the toilet and tub, or your CHF patient is supine on the floor and struggling to breath... sometimes the patient's position don't always allow for idea positioning, especially when they are sick.

    If you are dealing with bariatric patients, call for help, and call for the right equipment. if the patient is 400lbs, and it's a non-emergency transport, wait until enough manpower arrives before you start moving.

    Bryan from Fitresponder has some good stuff; he's also a paramedic who transitioned to a pretty popular injury prevention system.
     
    Gurby likes this.
  10. Qulevrius

    Qulevrius Nationally Certified Wannabe

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    Pretty much what others said. Watch your form, understand body mechanics, keep in shape & don’t be a hero. It’s not worth it throwing your back for a Basic’s salary. And don’t be afraid to advocate for yourself when/if needed; if anyone either in your system or supporting agencies tells you to do something that you know can hurt you, don’t let them.
     
  11. johnrsemt

    johnrsemt Forum Deputy Chief

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    Watch what you are doing: not just lifting; worst injury I had was moving a bariatric patient from cot to bed. Bed wasn't locked in place and when 10 people moved her the bed trapped my knee between the bed and nightstand that was in the corned and couldn't move anywhere else.
    That put me in Dispatch for 3 months.
     
  12. Lo2w

    Lo2w Forum Captain

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    Lift with your firemen, not your back.
     
    johnrsemt, bigbaldguy and luke_31 like this.
  13. luke_31

    luke_31 Forum Asst. Chief

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    Do this any you’ll never worry about your back again :)
     
  14. bigbaldguy

    bigbaldguy Former medic seven years 911 service in houston Premium Member

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    Make your partner do everything.
     
    johnrsemt likes this.
  15. johnrsemt

    johnrsemt Forum Deputy Chief

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    Have a crew with 2 cute ladies on it; send them to every heavy person; and have them stop at the closest fire house on the way., Never need extra help that way
     
    Gurby and Lo2w like this.
  16. MSDeltaFlt

    MSDeltaFlt Forum Deputy Chief

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    Technique is everything. Technique is more important than the amount you can lift. If you don't believe me just ask any kinesiologist, physical therapist, or personal trainer.

    Lift with your legs never with your back.

    Keep your back straight as a board always.

    Even your line of vision will influence your body posture. Looking down will cause your back to bow causing you to lift with your back risking severe injury. Find a spot on the top of the wall if not the ceiling. Keep your eyes focused on that one spot throughout the lift. Where the eyes go the body follows.

    Lift as one unit, you and your partner(s), slow and steady maintaining your center of gravity not too low and not too high but just right. Find your Goldilocks zone. If I'm on the pulling side and I'm pulling onto a bed I will kneel on my right knee on the bed and drop my left leg off the bed lowering my CG. I will look at a spot on the ceiling. And on MY count we will lift slow and steady. The only person who will ever trump the primary puller on patient moving is the one holding Airway/C-Spine.

    Never rush the lift. Never jerk. All it takes is a steady pull/push.

    When it comes to moving patients there are certain exercises that you will do on nearly every patient move:

    One the pushing side of moving patient from bed to bed: bench press

    On the pulling side: wide grip row.

    Picking patient up from the floor two man technique when you're at the legs: deadlift.

    When you are behind the back: straight leg deadlift (very advanced exercise - if you do this wrong you WILL injure yourself).

    Picking up patient on long spine board/manual stretcher: deadlift.

    Lifting patient on stretcher over objects on the floor: shoulder shrugs.

    Setting patient on long spine board onto raised stretcher: shoulder shrugs.

    CPR: I cannot come up with a single exercise to mimick CPR. Only suggestion I have is to roll up a blanket or sleeping bag, straddle one end, and compress the other for cardio. That is an entire body cardio as any paramedic who has transported a code from 15-30 miles out can attest.

    In the 23 years I have been in EMS I have never not once hurt my back lifting a patient. I had to injury my back becoming a lawn dart in a helicopter crash 11 years ago. And even afterwards I have still not injured my back lifting a patient. And the Mississippi Delta is the heaviest region in the county. My personal limit on loading a bariatric patient into a van ambulance by myself if 520lbs. If you don't believe me come get on the truck with me. I'll take you to her house. She's 30 minutes away from this very computer I'm typing on right now.
     

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