Ask any EMT or first responder if they hurt, or if they have experienced pain in the last few months while at work, and almost all of them will slowly nod their heads yes. Some studies show that when anonymously surveyed, more than 57% of EMTs had a soft tissue injury (overexertion from lifting and moving patients) that they never reported. This is the part we need to be concerned about.
Pain while at work—i.e., pain from performing the normal tasks of the job—is a symptom of a much bigger problem. Symptoms should not be ignored, as they are your body’s way of warning you that there is a larger problem at play. It’s no different than a patient complaining of chest pain: We all know that chest pain is not normal and is a symptom of a much more lethal problem.
That is exactly how EMS must view provider injury and pain. Considering that EMS and fire-rescue are some of the highest injury-rate professions, we must step back and approach the problem from a different angle. Currently the solution to reduce provider injury is to turn to engineered solutions and technology, which is awesome. Powered cots, loading systems and self-loading cots are fantastic—and fantastically expensive. Tracked stair chairs, slide devices, lift devices are all great, but responders still must get patients on and off of these devices and that’s where we see so many injuries occur. To this point a 2008 article in the British Medical Journal concludes that there is little evidence to support only one intervention (technology, training, advice) in preventing injury. The author concluded that in order to reduce injury, a program must be comprehensive and include engineered solutions, prevention, training, monitoring and cultural change.1
Why does injury occur at such a frequent and often severe rate? Injuries are a consequence of three major factors: significant lifting forces (patient weight), repetitive movements and awkward positions. Consider a “normal” call where a patient is on the floor and non-ambulatory. There will be no less than five lifts if using a manual cot, 3–4 if powered. We need to understand the cumulative human factors that contribute to injury:
To avoid, reduce or remove the risk from all of the above factors, there are three things that every responder must do this year that they have never done before.
1. Make Ready: Step into other high-injury risk jobs such as beverage distribution, where employees will manually move over 10,000 lbs. of product a day in cramped spaces. Many of these high-risk professions will mandate beginning of shift and mid-shift stretching and mobility. All the data shows that this reduces the rate and severity of injury.
EMS mobility requires a blend of mobility and stability. The ankles/calves, hips and thoracic spine must move well. If they move well, risk of injury decreases and so does pain. The knee, lower back and neck are stable and should not move that much. So first, get that image of arm and neck circles out of your mind—they do not work. Modern movement-based stretching is fast, effective, feels good and reduces risk. You have to move well so you can move patients well.
2. Get Job Strong: While EMS is not the fire service, we can take some lessons from them. EMS providers and leaders must grasp the fact that fit employees get hurt less.2 Fit employees are also more resilient and tend to have better overall wellness.
Take it a step further—risk in EMS comes mostly from three areas: driving, patient handling and violence. Employee fitness can directly impact all three of these areas, as fit employees still outperform the unfit in all instances.
Being job strong means being good at pulling from the floor, so exercises like sumo-deadlifts, kettle bell training and just a good strength routine will boost EMT resiliency on both the physical and cognitive levels. See more…