Safe Patient Handling – Emergency Medical Services
Firefighters (FFs) and emergency medical services (EMS) personnel treat and transport people throughout their community as well as to and from health care facilities, including hospitals, long term care facilities and group homes. They regularly move and lift gurney’s that weight over 90 lbs without a patient and up to 500 lbs with a patient, through crowded rooms, up and down stairways and over rough surfaces.
As obesity increases in the US population many Fire & EMS departments are purchasing ‘bariatric ambulances’ with gurneys that can lift up to 1600 lb patients and use a winch and ramps to load the gurney. However, EMS personnel must still transfer the patient to the gurney and move the gurney to the ambulance. Working in these unique environments places these workers at high risk for sprains, strains and other musculoskeletal disorders (MSDs).
The International Association of Fire Fighters’ annual Death and Injury Survey indicates that sprains and strains routinely account for approximately 50% of all line-of-duty injuries and back injuries account for approximately 50% of all line-of-duty injury retirements each year (Viewed 012110 at:http://www.iaff.org/hs/Resi/BackPain.asp).
Safe patient handling (SPH) practices that take into account the unique work environment of Fire and EMS personnel must be implemented to reduce the risk of injury from overexertion. New equipment such as anti-friction devices to facilitate lateral transfers, soft med packs that can be carried closer to the body, stair chairs to assist with getting patients down narrow stairways, and hydraulic lifts on gurney’s to facilitate lifting the gurney into the ambulance can help reduce the risk of musculoskeletal injuries during patient transfer. There is also a need to coordinate EMS procedures with dispatchers, hospitals and other health care facilities to coordinate utilization of SPH best practices.
Take a look at the resources listed below for more information and tools to assist EMS to address patient handling issues.
Guidelines and Toolkits for Implementing SPH Programs in EMS
Fire Fighter and Emergency Medical Services Ergonomics Training Curriculum
An 8-hour ergonomics training program for fire and emergency medical personnel that includes curriculum, instructor guide, DVD with video and PowerPoint slides, and transparency masters. The program can be taught individually or as an entire class, and covers basics of ergonomics, hazard analysis and potential solutions, body mechanics and fitness, setting up an ergonomics program and ergonomics for command staff. The curriculum is available free of charge and was developed by the Labor Education and Research Center (LERC) at the University of Oregon with a grant from Oregon OSHA
Ergonomics for EMS: Solutions for safe patient handling and more. Ideas for ergonomics solutions to reduce the risk of MSDs in EMS personnel including equipment for safe patient handling. Prepared by Laurel Kincl, PhD and Jennifer Hess, DC, MPH, PhD, University of Oregon, LERC.
Ergonomics Issues In Paramedic Duties: A Case Study (PDF) A PowerPoint presentation by Steve Morrissey, Ergonomics Consultant, Oregon OSHA Consultative Services (2008).
Survey Results from Washington and Oregon: How are LTC and EMS handling heavy patients? (2005) Laurel Kincl, PhD and Jennifer Hess, MPH, DC, PhD, Labor Education Research Center (LERC) University of Oregon. Oregon. This PowerPoint presentation describes patient/resident handling practices and “heavy” patient/resident handling issues from the view point of EMS and Long Term Care facilities in Oregon.
Feasibility for an EMS Workforce Safety and Health Surveillance System (2007). The National Highway Traffic Safety Administration (NHTSA)
Articles & Publications
Biomechanical analyses of paramedics simulating frequently performed strenuous work tasks (2000). Lavender, S.A., et. al. Applied Ergonomics, (31)2:167-177.
Designing ergonomic interventions for EMS workers, Part I: Transporting patients down the stairs (2007). Lavender, S.A., et. al. Applied Ergonomics, (38)1:71-81.
Designing ergonomic interventions for EMS workers—part II: Lateral transfers (2007). Lavender, S.A., et. al. Applied Ergonomics, (38)2:227-236.
Designing ergonomic interventions for emergency medical services workers—part III: Bed to stairchair transfers (2007). Lavender, S.A., et. al. Applied Ergonomics, (38)5:581-589.
Designing ergonomic interventions for EMS workers: Concept generation of patient-handling devices.(2008). Conrad, K. et. al. Applied Ergonomics, (39)6:792-802.
Evaluation of manual handling tasks involving the use of carry chairs by UK ambulance personnel (2005). Ferreira, J., & Stanley, L. Health and Safety Executive, UK.
Evidence-Based Patient Handling, Tasks, Equipment and Interventions (2003). Sue Hignett et al. Ch 6, pp 77-81. Taylor and Francis http://www.tandf.co.uk/books/ Fire And Emergency Medical Services Ergonomics (1996). Available for order from FEMA. Publication No. 9-0208 FA 161. Go to www.fema.gov and search for “ergonomics”
Ergonomics and Usability (in EMS). Chris Fitzgerald, Risk and Injury Management Services. A presentation made at the 2009 Ambulance Transport Safety Summit Transportation Research Board (TRB).
Innovation (in EMS): Wayne Zygowicz, Littleton CO. A presentation made at the 2009 Ambulance Transport Safety Summit Transportation Research Board (TRB).
Postural analysis of paramedics simulating frequently performed strenuous work tasks (2000). Lavender, S.A., et. al. Applied Ergonomics, (31)1:45-57.