Improving EMS Safety
Throughout the United States, emergency medical services (EMS) professionals treat 22 million patients each year. EMS and other public safety professionals provide care in many challenging environments, from burning buildings to moving ambulances, all while working as part of a collaborative system designed to bring medical care to patients in any location. Such hazardous conditions, and the additional challenges of providing services 24/7, represent threats to patient and provider safety that a growing body of evidence aims to evaluate and address. The University of Pittsburgh Department of Emergency Medicine is leading the way in identifying many of these challenges. The latest issue of Prehospital Emergency Care (Jan-Mar 2012) highlights some of the work recently completed by our faculty related to patient and provider safety.
Dr. Patterson, has led several efforts exploring patient safety in EMS. His team assessed individual EMS worker perceptions of workplace safety culture and identified an association between safety culture and patient or provider safety outcomes (Prehosp Emerg Care 2012;16:43-52). Additional associations with safety outcomes were identified in a study of poor sleep and fatigue in EMS providers (Prehosp Emerg Care 2012;16:86-97). This study found a greater odds of injury, medical error or adverse event, and greater odds of safety-compromising behavior among fatigued respondents versus nonfatigued respondents. Dr. Patterson’s group went on to measure teamwork and conflict among EMS providers, developing a reliable and valid survey to evaluate teamwork between EMS partners (Prehosp Emerg Care 2012;16:98-108).
Dr. Martin-Gill collaborated on an initiative on behalf of the National Association of EMS Physicians (NAEMSP) to evaluate EMS provider and patient safety during response and transport (Prehosp Emerg Care 2012;16:3-19). Using a Haddon Matrix, the group identified the many challenges presented by the transport environment, as well as proposed solutions presented during an ambulance safety conference sponsored by NAEMSP.
Dr. Hostler’s team, which focuses on provider safety, studied temperature measurement using external devices after exertional heat stress in thermal protective clothing (Prehosp Emerg Care 2012;16:136-141). Based on testing of firefighters wearing thermal protective clothing during physical exertion, Dr. Hostler identified that external measuring devices failed to accurately predict the temperature in hyperthermic individuals following exertion. This highlights the need for improved methods of measuring the core temperature of firefighters who are regularly placed in strenuous situations and are at risk of exertional heat stress.