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E.M.S. A Dying Breed

E.M.S. A Dying Breed. Colleen Ryan, Ph.D. student Walden University PH 8165 Dr. Raymond Thron Winter ‘09. Emergency Medical Services in the United States. Paramedics Emergency Medical Technicians First Responders Other Responders. The U.S. System Employs . Providers= 900,000

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E.M.S. A Dying Breed

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  1. E.M.S. A Dying Breed Colleen Ryan, Ph.D. student Walden University PH 8165 Dr. Raymond Thron Winter ‘09

  2. Emergency Medical Services in the United States • Paramedics • Emergency Medical Technicians • First Responders • Other Responders

  3. The U.S. System Employs • Providers= 900,000 • Full time= 180,000 • Paramedics=154,000 Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632

  4. Responses • 31 million response a year • 22 million patients a year Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632

  5. Fatigue Anyone? • 21 hours of Sleeplessness = .08 % Blood Alcohol Level • In the U.S. commercial drivers legal limit=.04% BAC Arnedt JT, Wilde GJ, Munt PW, MacLean AW. How Do Prolonged Wakefulness and Alcohol Compare in the Decrements They Produce on a Simulated Driving Task? Acid Anal Prev. 2001; 33 “3”: 337-44. CDC National Center For Chronic Disease Prevention and Health Promotion. Alcohol and Public Health

  6. Fact • EMS workers rate of illness and injuries is 6 times higher than the National average Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632

  7. Haddons Matrix for EV Collisions Chart Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632

  8. Occupational Risk Factors • Back/Neck Injuries 44.7% • Knees/Ankles 14.2%/ 9.1% • Over exertion 49.5% • Assault 2.6% • Fatalities 12.7% (per 100,000) National Highway Traffic Safety, Dept. of Labor, National EMS Memorial Service

  9. Deadly Crashes

  10. Crashes Continued

  11. What Kills EMS Workers? • 74% of deaths are transportation related • 20% are struck by moving vehicles • More than 65% of occupant fatalities involve closed head injuries • 70 % of fatal crashes are involve lights and sirens(code 3) transport • 82% of fatalities are unrestrained rear compartment occupants • www.emergencydispatch.org/articles/dispellingmyths1.htm • 11 year retro analysis- Prehospital Emergency Care, July-Sept. 2001

  12. Accident Incidence • 6,300 ambulance crashes a year • 10 injuries a person/day • Death of 1-2 persons/month

  13. Dr Maguire ‘s Notes • 50 fatalities /yr. • One in 300 services annually experience fatalities Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632

  14. Insurance Industry Reports • 50 million Transports annually • 1/2 are to the Emergency Departments • Less than 1/3 are classified as emergency calls • www.objectivesafety.net

  15. When do crashes occur??? • More than half of crashes occur during the day • Noon - 1800 = 39% • 0600- Noon =20% • 1800- 0000 =24% • Elling, B. Ambulance Accident Prevention Seminar

  16. Do more crashes occur on wet or Dry Roads??? • Dry road surface = 69% • Wet Surface = 23% • Frozen = 8% • Elling, B. Ambulance Accident Prevention Seminar

  17. Area of Impacts in a Crash occur ??? • Side swiped /angled crashes = 56% • Head on Collision 15% • Right angle = 41% • side swipe/over taking = 21%

  18. Fact !!!!! • More likely to crash at an intersection with a traffic signal @ 37% V. 18% approaching a Red Light Elling, B. Ambulance Accident Prevention Seminar New York State Dept. of Health

  19. Personal Injury Costs??? • Cost per year for 180,000 EMS workers is equivalent to 100,800,000 dollars • Average injury cost for 100 full time employees is $56,000/year Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632

  20. Impact of Ambulance Crashes • Loss of life and injury • Negative impact system wide • Decrease in available resources • Decrease in public perception of EMS and professionalism • Extended alert times • Increase in the public driving themselves • Extended and untreated maladies (MI worsening Dyspnea) • Levine, S. American Ambulance In House Training

  21. Collisions • Greatest liability cost exceeding: • malpractice or negligence • Criminal negligence (Brooklyn crash) New York Dept. of Health

  22. Broad Solutions • Professional demeanor/work ethic- ego in check • Recognize hazards • Slow down • Ambulance may not pass stopped school buses • Ambulance may not pass activated railroad crossings • Ambulance may exceed only 15 mph over the speed limit only in emergency mode • Ambulance driver must drive defensively • Levine, S. American Ambulance

  23. Solutions on a Personal Level • Appropriate hours of rest • Exercise accordingly • Healthy diet • Decrease the intake of alcohol • No smoking • Learn remedies to de-stress

  24. Questions?????

  25. Thanks for your time • Colleen Ryan MHA/MBA EMT-P Ph.D. candidate Walden University

  26. References Elling, B. Ambulance Accident Prevention Seminar Levine, S. American Ambulance Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational Fatalities in EMS: A Hidden Crisis. Annals of Emergency Medicine. 2002; 40(6): 625-632 http://www.nasemso.org/Meetings/MidYear/documents/Maguire-EMS-occ-risks-Jun09.pdf http://www.objectivesafety.net/2007BostonHO.pdf New York Department of Health Department of Labor Emssafetyfoundation.org

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