EMS is a dangerous job?

[DrParasite]

From the article on the study:

Finally a formal study confirms what we knew in our heavy hearts: EMS has far too many line-of-duty deaths and work-related injuries. The data examined from 2003–2007 comes from a series of credible national sources: The Bureau of Labor Statistics, Census of Fatal Occupational Injuries, the National Institute for Occupational Safety and Health and the occupational supplement to the National Electronic Injury Surveillance System.

The researchers discovered a total of 65 EMS fatalities (13 per year). The EMS fatality rate was 7.0 per 100,000 full-time equivalents (FTE) EMS workers with a 95% confidence interval (CI) of 4.7–9.3. By comparison, the average for all workers is 4.0 and 6.1 for firefighters in the same four-year period.

It’s also possible that not all line-of-duty EMS deaths [and non-fatal injuries] were reported as such due to lack of centralized tracking, or definition.

read more: http://www.jems.com/article/health-and-safety/studies-show-dangers-working-ems

 

[canadianparamedic]

Love it would not trade it for any other job.

 

[mycrofft]

67% due to "highway accidents" and being struck by other vehicles..

See my earlier thread quoting the Philadelphia statistics.

THIs tidy seems to be a pretty good one and cites the shortcoming you will find when you try to download the data yourself...there is no recognized division between "street EMS" and any other sort of medical worker. In fact, "EMS WORKER" per se does not appear to be a recognized category (as our frequent internecine rassling points out).

You are still more likely to succumb to bad driving on the part of your self or your driver, or other drivers, on slightly over a fifty-fifty basis. (I would hazard the other causes of death as vehicles incident in station, falls, slips, and leftover chicken salad).

 

[mikeward]

The original ground-breaking work done by Brian Maguire:

Occupational fatalities in emergency medical services: A hidden crisis
Maguire BJ, Hunting KL, Smith GS, Levick NR
Annals of Emergency Medicine - December 2002 (Vol. 40, Issue 6, Pages 625-632)

1) Motor Vehicle Accidents
2) Cardiovascular/cerebrovascular
3) Homicide

Keeping rescuers safe
Garrison HG
Annals of Emergency Medicine - December 2002 (Vol. 40, Issue 6, Pages 633-635).

Occupational Injuries among Emergency Medical Services Personnel Brian J. Maguire, Katherine L. Hunting, Tee L. Guidotti, Gordon S. Smith
Prehospital Emergency Care - October/December 2005 (Vol. 9, Issue 4, Pages 405-411).

 

[BF2BC EMT]

But the FD and their union go on and on about how they constantly risk their lives while pulling in a 100k+ a year but an EMT is lucky to get 40.

 

[Handsome Robb]

I'd say safety depends on your response area as well.

I don't have time to read the articles right this second, I'll read 'em when I get a chance and come up with a better response.

 

[usafmedic45]

Finally a formal study

There have been several prior studies on the subject. The most obvious being the one by Maguire (as previously mentioned) and the one that pointed out that working on HEMS has a mortality rate of about 3 times that of the next most dangerous jobs in the US (mining, commercial fishing, etc). Just because it finally made JEMS doesn't mean that the occupational safety folks haven't been paying attention.

 

[mikeward]

Just because it finally made JEMS doesn't mean that the occupational safety folks haven't been paying attention.

In talking to Professor Maguire, he has had no contact by worker compensation or industrial/occupational representatives.

Police and fire are required to pay more into their state worker compensation programs because of their claim (injury, long-term disability and death) experience.

Mike

 

[usafmedic45]

In talking to Professor Maguire, he has had no contact by worker compensation or industrial/occupational representatives.

There's more to occupational safety than workman's comp, etc. It's a huge part of injury epidemiology, probably only secondary to the mind-numbingly boring violence prevention part. When I mentioned it, I wasn't even thinking about that aspect of it because it's a secondary concern.

 

[Handsome Robb]

Again being quick, I'd love to see a study about back injuries and the compensation required associated with EMS. We use the Stryker Power Pros and are told they have reduced worker's comp claims due to back injuries from lifting. My agency is currently replacing our entire fleet and considered the new Powerload system referencing compensation due to back injuries as their number one motivator to spend the money. Personally I'd say the lift into the back of the unit is the safest one we do. It's controlled (for the most part) and on a pivot point acting as a fulcrum. I wonder how many injuries actually happen during this lift.

The PowerLoad looks cool but I feel like it's just something more that can go wrong, especially in some of the uneven surfaces we end up parked on here.

 

[usafmedic45]

I wonder how many injuries actually happen during this lift.

Contact Stryker. They should be able to provide those numbers based upon the marketing claims they are making.

 

[systemet]

The PowerLoad looks cool but I feel like it's just something more that can go wrong, especially in some of the uneven surfaces we end up parked on here.

I haven't used this model, but I did use (trial? I think) one of the earlier Ferno power stretchers.

It was a bit of a mixed bag. Yes, it saved you from the repetitive lift into the ambulance, and even from a lot of other lifts. But it weighed a ton. And while, in an ideal world, you'd move the stretcher as close to the residence as possible without having to lift, it just doesn't work that way in reality. Sometimes you have to lift the things, and then the extra weight is an extra load on the back.

For what it's worth, I don't recall anyone having issue with the stretcher falling over on an uneven surface. It seemed like a real concern when we first got them, as you don't feel like you're in control of the lift any more. But even working with a lot of snow and ice, I don't recall anyone having issues. That being said, I know several people who have done severe and potentially career-ending injuries from trying to grab falling stretchers.

Obviously this is just my (n=1) experience and a brief appeal to the experience of a few people I talked to.

 

[DT4EMS]

Taking the subject back to the OP.

Here is a recent one by Skip Kirkwood :
http://www.jems.com/article/training/ems-providers-need-scene-safety-training

and I can assure you there are way more injuries due to assaults than vehicle accidents:

My collection of EMS/Fire assaults are here:
http://dt4ems.com/forums/index.php?board=16.0

and against nurses here:
http://dt4ems.com/forums/index.php?board=39.0

 

[systemet]

and I can assure you there are way more injuries due to assaults than vehicle accidents:

Do you know if this has been recorded in the literature anywhere? I know that this is your area of expertise, but given the culture of not reporting assault and outright battery in EMS, I'd be surprised if the number of incidents was higher.

 

[DT4EMS]

Do you know if this has been recorded in the literature anywhere? I know that this is your area of expertise, but given the culture of not reporting assault and outright battery in EMS, I'd be surprised if the number of incidents was higher.

I can promise you......the numbers are way higher than what is reported. There is a main underlying reason for under-reporting........ "culture".

People that have been around a while like to sound tough and tell newbies "It's just part of the job". There is also a mentality of administrations to "advise against" prosecution/reporting of incidents.

OSHA, Bureua of Labor Statistics, CDC, Brian J. Maguire, Dr.PH, MSA, EMT-P, NAEMT, ENA, and others have released studies. I quote several of them during presentations.

Skip did a great job of pointing out some particulars in the article I linked previously.

 

[DT4EMS]

I can promise you......the numbers are way higher than what is reported. There is a main underlying reason for under-reporting........ "culture".

People that have been around a while like to sound tough and tell newbies "It's just part of the job". There is also a mentality of administrations to "advise against" prosecution/reporting of incidents.

OSHA, Bureua of Labor Statistics, CDC, Brian J. Maguire, Dr.PH, MSA, EMT-P, NAEMT, ENA, and others have released studies. I quote several of them during presentations.

Skip did a great job of pointing out some particulars in the article I linked previously.

Here are just a few........ (Notice the dates)

• EMS office received 113 reports of personnel being threatened, verbally assaulted or physically assaulted.
• 23% verbal.
• 15% actual physical.
• 6% victim of threat.
2002 Wyoming Study
Source: WY EMT Registry 4-03

• 14% of responding agencies reported having incidents of assaults in the 6 months prior to the survey.
1995 BEMS Study
Used with Permission of Greg Natsch

• More than one in two (52%) assaulted by a patient- NAEMT Survey 2005


• A June 2008 study showed that workers in the healthcare sector are 16 times more likely to be confronted with violence on the job than any other service profession. A study by the Emergency Nurses Association in the spring of 2007 found that more than 1/2 of emergency nurses reported experiencing physical violence on the job.

The risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers per year; the national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. The relative risk of fatal assaults for EMS workers is about three times higher than the national average.”
• Brian J. Maguire, Dr.PH, MSA

 

[usafmedic45]

and I can assure you there are way more injuries due to assaults than vehicle accidents:

But what's the actual morbidity associated with that?

• EMS office received 113 reports of personnel being threatened, verbally assaulted or physically assaulted.
• 23% verbal.
• 15% actual physical.
• 6% victim of threat.

So they actually received reports of 26 assaults, not 113. If I reported every time I got cussed at or threatened, I'd never get any real work done....and that's just counting the PMs I get on here from outraged/offended/twisted panty wearing newbies.

I'm not saying it's not a problem, I'm just saying that the acuity of these sorts of events is generally pretty low in my experience and I've not seen any substantial evidence to the contrary. "Lost work days" isn't exactly the same level of evidence as a evidence for serious or fatal injury from a MVC.

 

[DT4EMS]

I am not pointing out morbidity. I am saying more are injured due to assault than crashes.
I want the same attention given to assaults as te attention paid to crashes.

I have specifically spoken to provides that have been shot, stabbed, had limbs, ribs, jaw and noses broken..... It changes your perspective.

For crashes there are now driving courses, fancy reflective vests etc....

There is mandatory annual training for blood borne diseases....

There are back tests and proper lifting and moving of patients to prevent back injuries in EMS

Now re-read the studies on injuries and show me the logic in how we train entry level folks for what they face on the job.

No matter how many surveys, studies or recommendations get printed some folks will always scoff. I didn't write the studies. I have lives them and talked with others who have too

Rather than complain, I did something about it. For over a decade people stated there was no need to train in recognition, avoidance and escaping violent encounters for EMS. For the past six years.... Many have changed their mind.

It's not important to you until its important to you. Meaning once you or someone you care about is assaulted you will just think its a waste of time.

Remember a person doesn't have to die to be scarred/changed for life.



Sorry for the brevity. I am responding with my phone.

 

[usafmedic45]

I am not pointing out morbidity. I am saying more are injured due to assault than crashes.

Morbidity<=>injuries

Saying that more people are injured by X is meaningless if you're not quantifying the degree of injury. More EMS providers are probably injured by falling down and skinning their knees than anything else, but it's not counted or a valid comparison because of the difference in severity of injury. Like I said, not trying to be difficult just as someone with a love of injury epidemiology, I'd like to see something more substantial than crude statistics. I'm going to be a little more of a stickler on this because I also know that you have a job that relies on this sort of information and even thought I like you, I trust no one when it comes to these sorts of discussions.

 

[DT4EMS]

Morbidity<=>injuries

Saying that more people are injured by X is meaningless if you're not quantifying the degree of injury. More EMS providers are probably injured by falling down and skinning their knees than anything else, but it's not counted or a valid comparison because of the difference in severity of injury. Like I said, not trying to be difficult just as someone with a love of injury epidemiology, I'd like to see something more substantial than crude statistics. I'm going to be a little more of a stickler on this because I also know that you have a job that relies on this sort of information and even thought I like you, I trust no one when it comes to these sorts of discussions.

I get that, I really do. But I can also assure you, no one has researched this particular subject more than I have. You are correct with the "types" of injuries but the wording "lost work time" means more than just a skinned knee.


• According to Brian J. Maguire, Dr.PH, MSA, Clinical Associate Professor, University of Maryland, Baltimore County:

“The risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers per year; the national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. The relative risk of fatal assaults for EMS workers is about three times higher than the national average.”

Non-fatal is 30 times higher FATAL is 3 times higher.........
No one, to my knowledge has done a more extensive statistical gathering than Dr. Maguire.

The surveys abound........ but don't get any press......

Here is another one........

2006 survey conducted as part of a research project for the National Fire Academy’s Executive Officer Program (Source: firefighternation.com)
– 461 respondents
• 410 (88.9%) had been threatened
• 256 (55.5%) had been assaulted
• 41 (8.8%) had carried a weapon on the job for self defense

• 2009 survey of 518 Arizona firefighters (Source: firefighternation.com)
– 442 (85.3%) had been verbally threatened
– 283 (54.6%) had been physically assaulted
– 217 (42.8%) stated that violence is just part of the job


My point is...... we have failed as educators...... we are way behind the 8ball...... report after report after report...... are finally coming out about the assaults actually happening.

See........ obtaining numbers for something........when people don't want to report it (because they feel pressured not to) makes any study of the subject difficult to obtain.


With that said........... here are news reports of regular occurrences...

http://dt4ems.com/forums/index.php?board=16.0

Those have names, and actual incidents.... (well for as well as the media can get it)

If you can give me a better place to go than Dr. Maguire, I would quote them too

I don't think until their is actual recognition and reporting with a real database (nationally) like an the national database for auto accidents will there truly be a way to obtain true data.

Instead we have to go with the surveys and the reports from the respected ones out there.

EDIT* I wish I was well versed on obtaining statistics. I also wish I would have taped conversations (interviews) I had with victims over the years. I never thought a hobby would have become a passion. Plus if I would have realized there was such a reluctance for the profession to recognize the danger I would have approached things different over the years.

At least now, finally........ I have earned the respect of some pretty influential people in EMS who have now started referring people my way. Not because I am the smartest.......but I am passionate about the subject and about improving the breed of EMS....... leaving it better than the way I found it.

Thoughts?