Firefighter who flunked physical injured 10 days into job

akflightmedic

Forum Deputy Chief
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If you need to routinely call for a lift assist for patients as light as 200# you're doing it wrong (male or female), and need to question if you belong in EMS from a physical standpoint. I don't feel that this is particularly harsh, as any normal person can achieve those above benchmarks if they just put in the damn work.

I mostly agreed with you except for this part. I have a few points to make about calling for lift assists.

1. We do NOT call enough because it is stigmatized, made fun of during or after the fact, or is seen as "less manly" in a machismo culture.
2. There needs to be far more education and focus/encouraging the use of extra hands...even for patients #200 or less.
3. It has NOTHING to do with the weight of the patient, it has everything to do with the extraction. Are there any questionable angles, descents/ascents, or maneuvers which could potentially harm the provider? All about risk mitigation.

*Even if there was ONE part which had me questioning myself or my partner based on that particular patient's cooperation, understanding and acuity, then I would call for an assist.

4. So what if another unit or engine has to come assist. We are all on duty and we should look out for each other. I would come assist any of you in a second if you call for it. I would never question why you called for it, I would never judge you for calling.
5. I have made risky and harmful lifts in my career. Some I deemed necessary in that moment, others were stupid decisions based on my ego or being pressured by a partner who challenged me (either by jokes, looks or comments) or who did not want to wait on incoming assistance. Yes, I caved to peer pressure, even when I was senior man on scene.

Because of this, I have injured myself. There have also been times where I let the injury go unreported. I strongly suspect I am not the only one in this industry who did or is doing the same.

It is time to change the mindset, change the culture.
 

johnrsemt

Forum Deputy Chief
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I have called for assistance on 200lb patients and not on 300lb patients; Depends on who my partner is, and where the patient is.

Yes AK people do get made fun of, and it does need to change.

We should always look out for each other; and anyone who makes fun of anyone who needs help should be punished for that not the ones calling for help
 

AtlasFlyer

Forum Captain
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My (male) partner and I called for lift assist on an older guy who probably was about 200. He was wedged in a very awkward position between a chair and a wall with a bed in the way. We needed more people to safely get him out of there. If he'd been on the floor in the middle of the room we wouldn't have needed help, but he wasn't. Once the engine crew arrived we all worked together and the man was safely removed and all of us left that run with no injuries or strains.
 

Seirende

Washed Up Paramedic/ EMT Dropout
891
429
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Where I used to work, they've been hiring females like crazy. If they aren't on their knees or back with male co-workers, they are on light duty due to injuries. That or crashing rigs. Just adding a fact. I've worked with a few awesome female medics and EMTs and too many terrible male medics and EMTs.

What an interesting work environment, where the multitudinous female employees seem to be incapable of activities more complicated than sex, crashing ambulances, and hurting themselves. Please clarify; are you implying that their sex has anything to do with their inability to do any work that requires intelligence and skill? As an aside, it seems that the flip side of females engaging in sexual activities with male coworkers is males engaging in sexual activities with female coworkers.

Posts such as the above quoted detract from the conversation.
 

46Young

Level 25 EMS Wizard
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Okay, when I say routinely calling for lift assists, I'm not talking about picking someone up from a bathtub, navigating through a hoarding environment, getting someone over a motorized stair lift, or using a Reeves down winding stairs, wet/icy terrain, etc. I'm sure that everyone can come up with a few examples of difficult lifts to prove a point about requesting a lift assist. What I'm talking about is typically calling for anyone 200# or so that can't stand and pivot, that needs to be sheet transferred to the cot, or lifted up on a board or Reeves from the floor. I've been called to lift a 200# person from the bed to the stair chair, for example. We typically should not be asking for help to get someone 200# from the floor to a chair or cot, or from a bed to a chair or a cot, or to load that same cot into the ambulance. I've worked with people (not talking about females only) that have made it a habit to call frequently for each of these scenarios. I've had situations where we have a patient rapidly decompensating, interventions on board, that don't have the time to wait for another crew to help them get into the ambulance.

National EMS Education Standards, page 5, "Directions and Commands" 3 of 3 says this:

"Adults often weigh 120-220 lb. Two EMT's should be able to safely lift this weight. If patient weighs over 250 lb, use four rescuers. Place strongest EMT at the head":

https://code1.us/cow/10eppt/Chapter35.pdf

That sounds about in-line with typical hiring requirements of lifting 150# unassisted (basically a deadlift), and 250# with assistance. In the field, when lifting a patient off of the floor, the one at the head will have more weight, so with a 200# pt, the person at the head will be lifting as if it were a 250# patient with load even distributed between the two crew members. That's why I was being lenient and saying to not automatically call for any 200# patient that needs to be lifted, and not a 250# person.

You shouldn't need more than two people for a stair chair job in most cases for a 200# person. I've had real problems working with weak people when the chair is treadless or we can't use the treads for some reason (going up the stairs for example) - the weak person will insist on taking the bottom, and refuse to take the top lift. What then occurs is that the bottom person holds the handles with fully extended arms, which makes the top person have to lean forward, which puts tremendous pressure on the L-spine. I've maintained a 445# - 495# DL for the last 20 years, and I would've surely blown my back out in that scenario had I been any weaker. A strong person can grab the bottom handles, pull their elbows backwards and upwards to lift the chair as they carry, which lets the top person stay mostly upright, which is much easier on the back, and much safer. I've refused to work with certain partners that play those stair chair shenanigans, and who always have an excuse as to why I should load/unload the cot instead of them. Yes, I may be more capable, but it's reasonable to spread out lifting duties. The stronger person shouldn't be penalized for being more physically capable by being made to do the lion's share of the lifting. All of these lifts add up over time. Two person sheet transfers where I'm obviously doing 85% of the pulling is bad for the patient, and bad for me as well. This species of person that must take the bottom of the stair chair, never loads/unloads the cot, will also ensure that they're positioned at the cot, "lifting" the patient away from them towards the bed, letting their partner do most of the work. This oftentimes makes the transfer a 3 step process.

We all know a few of these people at every EMS job. Again, if you cannot lift a 200# patient with assistance under normal, uncomplicated circumstances, you need to reevaluate whether you belong in EMS from a physical standpoint. Being fit for duty in EMS is one part KSA's, one part physical preparedness, and one part psychological health. All three must be present. Or, if you have little regard for your partners and your patients, and feel that you have a right to be on the job regardless, then do whatever.
 

SandpitMedic

Crowd pleaser
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1,260
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Why is this devolving into lift assists. The game is simply played: if you can't do the job (mentally or physically) then you shouldn't get the job.

Be smart enough to know when to call for help, but be able to meet the physical standards.
 

triemal04

Forum Deputy Chief
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NO. Physical and mental standards are judgemental, racist, exclusionary and designed to benefit white men only. They have no place in America, where everyone can and should be allowed to do whatever they want. :rolleyes:

Side note, maybe we should come up with a color to use when sarcasm is in play...makes it much clearer.
 

46Young

Level 25 EMS Wizard
3,063
90
48
Why is this devolving into lift assists. The game is simply played: if you can't do the job (mentally or physically) then you shouldn't get the job.

Be smart enough to know when to call for help, but be able to meet the physical standards.

The subject of the thread failed FDNY physical standards, and was still allowed to graduate the academy. Strength standards, which directly translate to lifting ability in the field was a natural progression to the conversation.

What do you and others think reasonable physical standards for EMS should be?
 

gotbeerz001

Forum Deputy Chief
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For EMS? Weighted stair (or stair mill) climb, 220lb dummy lift (2 person) on backboard from ground to gurney followed by single person gurney load with same backboarded dummy.
 

CALEMT

The Other Guy/ Paramaybe?
4,524
3,348
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CALEMT

The Other Guy/ Paramaybe?
4,524
3,348
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Maybe 45 lbs... Closer to reality for first-in bag and a monitor.

45 lbs for 3 minutes at X amount of steps per minute would get the juices flowing.
 

SandpitMedic

Crowd pleaser
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1,260
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I think the FDNY standards are probably fine... It's the fact that they let her graduate after failing to meet them. It isn't the standard of fitness (unless they changed them) but rather the politics involved that are the problem.

As far as EMS goes... If you are not mentally and physically fit to perform your duties you shouldn't be on the job... Same as any other physically demanding profession. Do you see tiny chicks that are lumberjacks swinging and sawing away? No, because they can't handle that... It's reality, not sexism. (I'm not comparing being an EMT to being a lumberjack, nor am I suggesting women can't be in EMS... It's just an illustration of my point).

Most private EMS physical fitness standards are a joke... I know a lot of fat bodies that shouldn't be on the job, but I don't make those kinds of policy decisions.
 
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