One of the key components of safety espoused in the NAEMT Safety Course is maintenance of proficiency. For clinical activities, if we do something that a physician or nurse deems inappropriate there is no doubt we’ll hear about it quickly. The didactic and psychomotor assessments inherent with ACLS, PHTLS, PALS and the like give objective evaluations of proficiencies. For a number of skills, we can estimate proficiency by immediate outcomes: we successfully perform endotracheal intubation or we don’t; we establish an IV or we don’t. What about non-clinical skills? There are two safety issues in medical transportation that have been described as “low hanging fruits”. They are driving and patient handling. When was the last time you honestly critiqued driving or patient handling skills? When was the last time a supervisor objectively critiqued driving or patient handling skills? If a supervisor did a critique, did the criteria employed match your perception of what was needed? The NAEMT Safety Course contains information that may serve as a basis for developing tool suitable for self-assessment or use by a manager.
Assessment of driving behaviors
Are vehicle inspection completed and documented properly? Are crews who perform mechanical inspections trained to do so in a uniform manner? Are seatbelts worn? Does co-driving occur? Are distractions minimized? Does the non-driver handle non-driving activities? Are Emergency Warning Systems activated and de-activated properly? Note the following:
Assessment of patient handling behaviors
At the beginning of the shift is all equipment inspected and tested for functionality? Does the crew practice loading the stretcher the stretcher at least twice while assessing the stretcher retention system? Are the following patient factors assessed as they relate to patient handling?
Are the following environmental factors assessed as they relate to patient handling?
Does the crew use the information from the patient and environmental assessments to properly form, communicate, and execute a plan. Which minimizes lifting, shares the load, and involves the use of appropriate engineering controls and personnel?
Does the crew lift using the following techniques?
As the stretcher is moved, the crew should use situational awareness, communicate and have full physical control of the stretcher at all times. The stretcher should be properly loaded or unloaded with the appropriate use of the stretcher retention system. If we think about driving or patient handling while performing them, we and our patients will be safer. We can also use these concepts as de-briefing assessment tools after an untoward event occurs. It’s easier to fix mistakes if we know from where they come.
Szczygiel, M. (Ed.), EMS Safety, Burlington, MA, Jones and Bartlett Learning, 2017.
The information provided in this article is intended for general informational purposes only and should not be considered as all encompassing, or suitable for all situations, conditions, and environments. Please contact us or your attorney if you have any questions.