What are the common safety and risk occur in pre hospital care services? What are the most likely event occur? Risk management for the pre hospital care services?
Thanks Alan. Yes its complex to identify risk in pre hospital. Thanks for the suggestion and it help to write my thesis. Thanks again.
There are a few books on safteyu for EMS - most provide a good overview. Risks include: violence, being hit by vehicles, crashing when within a vehicle, exposure to bodily fluids, terrorist attack, CBRN/HAZCHEM, fall from height, confined space, manual handling, stress/PTSD, shift work damage, sleep disturbance, poor diet,
Responder or provider safety is of paramount concern in the delivery of pre-hospital medicine. Unlike the clinical setting, hazards abound given the environment the patient presents in. It is the responders first priority to ensure the scene is safe to proceed and remains safe. A simple acronym for scene safety and immediate size-up or assessment is P.E.N.M.A.N.
P=Personal & Personnel Safety. Am I safe, am I wearing my personal protective equipment (PPE). Is my partner and team wearing their PPE?
E=Environmental Hazards. What is in the area that can reach out and hurt me?
Inside environments can include living rooms, kitchens, and bathrooms where space restrictions can result in not being able to “lift properly” or deliver care in a normal physical position. Least I forget the angry relative or friend plus the trusty pet seeking to protect its owner. Other inside settings can include such diverse areas as industrial and commercial sites which include expected and unexpected hazards depending on the code compliant and nature of the business.
With responses outdoors, the number one killer of responders is traffic. Turning your back on moving vehicles without a safety person in place is asking for tragedy. Once there, get out of that area as quickly as possible, don’t invite injury by needlessly lingering. Weather concerns play a major part in creating a safe place to work. Other risks may be down threats as diverse as powerlines or angry insects or angry/belligerent bystanders.
N=Number of victims. Your potential patients are all “victims” until you begin rendering care, then they become “patients”. Do you have the resources on hand to care for the afflicted at the scene?
M=Mechanism of injury or manner of illness. Stay ahead of your patient by anticipating services and modalities that may be required to mitigate the scene and manage your patient.
A=Additional resources from YOUR employer. For most responders, the simplest additional services and resources to access are from their own agency or company. Order what you think you may require; over estimate.
N=Need for resources outside your agency or company. To manage and mitigate the scene and appropriately treat the patient, what do you require from outside your agency or company? Air transportation? The coroner? Law enforcement (scene and traffic control)? A chaplain? Fire response?
Scene safety is not easy but, methodically and visually assessed, most scenes can be rendered safe to enter and treat.
The three most important hazards are as follows:
1. Injury from motor vehicle collision that typically occurs when driving lights and sirens thru an intersection and often associated with lack of sleep.
2. Suicide secondary to PTSD from caring for critically ill and injured
3. A far far distant third is the risk of contracting diseases including Hep B, HIV, TB, SARS, Ebola.
https://www.ncbi.nlm.nih.gov/m/pubmed/30648537/?i=3&from=ems%20crash
https://www.ncbi.nlm.nih.gov/m/pubmed/12625499/?i=3&from=/10155502/related
https://www.ncbi.nlm.nih.gov/m/pubmed/30136908/?i=1&from=suicide%20risk%20ems
Slips, trips and falls. Getting in and out of the cab/vehicles.
Back injuries from lifting, moving, carrying equipment.
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