Making EMS Safer

EMS isn’t a safe profession. By now we’re all well aware of that. But as a profession, it’s only been relatively recently that we’ve become aware just how unsafe it really is for providers out there.

Among the many efforts underway to improve provider safety comes a novel idea from down under—a degree program in EMS Occupational Health and Safety.

Developed by Dr. Brian Maguire, a professor of paramedic science at Central Queensland University, the EMS Occupational Health and Safety bachelor’s degree program is the first of its kind anywhere, and Maguire thinks it can have a major impact on the way we address and prevent injuries and fatalities among EMS providers.

“In my research I saw that this is a large problem for the paramedic profession—injuries among the profession are among the highest of any profession and fatalities are a very serious problem for paramedics,” Maguire says. “Instead of reinventing the wheel I partnered with an existing occupational health and safety program that prepares people in general for occupational health and safety. They’re doing all the basic occupational health and safety courses, the introduction and all the foundation courses on how you monitor occupational health and safety, and do analysis of occupational health and safety issues. And then we have specialty courses that are the capstone part of the program and they will focus on EMS-specific issues.”

According to Maguire, the EMS-specific courses are based on the latest research on how EMS providers are getting injured and killed, much of it his own. “EMS has a lot of unique characteristics. For example, with other occupations it’s perfectly appropriate to do analysis based on hours worked. So you can say how many injuries for how many hours worked. That’s a perfectly reasonable thing to do for a lot of other professions. But for EMS there’s a lot of unique exposures, so we need unique ways of analyzing those exposures.”

In Maguire’s opinion, the risks inherent in EMS probably haven’t changed dramatically overall but what has changed dramatically in recent years is now we’re much more aware of them.

“My 2002 study on fatalities was the first time we ever looked at occupational fatalities among paramedics and measured them in the same way they were measured by every other occupation,” he says. “We showed at that point that the fatality rate was very similar to the fatality rates for police officers and firefighters. That was a big surprise to people in the profession. Nobody ever realized before how dangerous it was before in terms of fatalities. And in the study I published a few years later on occupational injuries, it showed the injury rate was much higher than the rates for police officers and firefighters. My newest study reinforced a lot of those earlier findings that EMS is a very dangerous occupation and it started also to reinforce the types of things we’re seeing. Back injuries, as people would expect, are a big problem. Transportation injuries are a big problem, both fatalities and non-fatal injuries from transportation incidents. And also assaults. Assaults are something that we are becoming more aware are a significant problem for paramedics—in the U.S. we have a dead paramedic a year from homicide and we have many paramedics seriously injured from assaults on duty. And we’re seeing the same things in Australia, that the assault rate is growing and people are being seriously injured in these assaults.”

Maguire strongly believes research will be the key to preventing injuries and fatalities among providers. “Right now everything we’ve done is essentially showing us we have a patient with a fast pulse, but we don’t know if it’s because the patient was shot or is having a heart attack or just ran a marathon. The next steps in this research needs to be done in partnership with ambulance agencies. And we need to be able to look at the data closely enough that we can come up with specific issues to focus on and to be able to develop interventions for those issues and be able to measure the outcomes. So today, for example, there’s lots of agencies anecdotally we’ve heard about who say, ‘Oh my gosh, assaults are a big problem,’ so they go out and buy bulletproof vests for everybody and then there’s no analysis done afterward. So we don’t know if the bulletproof vests have done anything and, in fact, we don’t know if the bulletproof vests have resulted in an increased rate of assault because people are going into places they wouldn’t have gone into without the bulletproof vests. So the next critical step has got to be ambulance agencies working with researchers to be able to closely analyze the data, to be able to interview injured workers, develop specific interventions, implement those interventions and measure the outcomes of those interventions.”

The EMS Occupational Health and Safety bachelor’s program aims to prepare people who will not only be aware of the problems in EMS safety but will have the tools to be able to do analyses, develop interventions and measure the effect of those interventions. Beyond that, providers who earn the degree, Maguire says, will be able to share that knowledge so every EMS agency in the world doesn’t have to experience the same growing pains as they try to address safety.

The program should also open new doors for EMS providers. The program, available entirely online and without any on-campus requirement, is open to people who are already paramedics and want to finish off their bachelor’s degree, says Maguire. They’ll be able to do it a shorter period of time because they’ll get credit for their prior learning as paramedics. And, he points out, it creates other opportunities with private companies, many of which, like in Australia’s mining industry, are recognizing the value of having a paramedic with an occupational health and safety background on site who can not only treat injuries but do things to prevent injuries among mine workers and help workers be healthier.

Already the second class of students is entering the program, says Maguire, and there are plans to grow it further. While it’s started off small, the university is already looking at developing a graduate degree program in EMS Occupational Health and Safety. And since EMS providers will continue to be put in risky situations daily, there’s little doubt the profession can use more providers who understand how to combat those risks and prevent injuries or worse.

Anyone interested in learning more about the EMS Occupational Health and Safety bachelor’s degree program can visit Central Queensland University’s website or contact Maguire at b.maguire@cqu.edu.au.