IT`S TIME FOR AN EMS HEALTH AND SAFETY AGENDA FOR THE FUTURE

     Association Minutes features commentary from various EMS associations. In this issue, the National Association of EMTs addresses health and safety issues for EMS personnel.

     For the last decade or so, the federal government has guided the development of EMS through consensus documents such as the EMS Agenda for the Future. These guidance documents share shelf space with other important position papers, journals and research reports that have sought to define the challenges faced by EMS and propose solutions to them.

     Unfortunately, none of these documents adequately address the health and safety issues faced by the EMS workforce.

     Published in 1996, the EMS Agenda for the Future called for occupational health studies regarding EMS personnel, but failed to include any specifics or recommendations.

     Likewise, the Institute of Medicine (IOM) three-part report on the Future of Emergency Care, published last year, included a chapter on the EMS workforce, but it focused primarily on educational requirements, standardizations and national certification. The four IOM EMS workforce recommendations were limited to:

• a common scope of practice with state licensing reciprocity;
• national accreditation of paramedic programs;
• national certification as a prerequisite for state licensure; and
• a physician subspecialty certification in EMS.

     The IOM report barely addressed many of the other concerns of EMTs and paramedics, such as recruitment and retention, salary and benefits, volunteerism and workforce safety, and it offered no recommendations in these areas.

     The most recent federal consensus document, which is expected early this year, is the EMS Workforce for the 21st Century Project from the University of California San Francisco. Initial findings of the multi-year, NHTSA Office of EMS-funded project were released in September to stakeholder groups and participants. NAEMT participated in a workshop to discuss those initial findings, and yet again found that the forthcoming report does not include any significant insights into the challenges faced by EMS personnel.

     The focus of the workforce report is primarily on supply and demand and other labor-related issues. Wellness and safety are barely touched upon, and only as they relate to planning for adequate numbers of EMS workers to meet the demand for around-the-clock prehospital care.

     At NAEMT, we believe that the health and safety of EMS professionals deserve more attention. It's time for the federal government to dedicate adequate resources to providing a national resource center for EMS health and wellness. This could be an electronic library, similar to the Rural EMS Technical Assistance Center, where EMS workers from around the globe could learn how to improve their health and working conditions.

     Our national leaders also should come together to create a new consensus document that will improve the health and safety of EMS personnel. NAEMT would be honored to lead an effort to create an EMS Health and Safety Agenda for the Future, in which, in cooperation with other national EMS associations and stakeholders, we could explore improvements to personal protective equipment for EMS, EMS health and wellness efforts, violence against EMS workers, roadside safety and ambulance safety.

     Actions must be supported by data. For that reason, NAEMT strongly advocates for the creation of a National EMS Injury Database that can be used to quantify all injuries to EMS providers, including all EMS vehicle crashes. We also encourage academic institutions to fund significant scientific studies to determine appropriate restraint and protection systems for the EMS providers, patients and passengers of all emergency response vehicles.

     NAEMT has already made strides in these areas. In 2005, we surveyed more than 1,300 members and found that:

• More than one in two (52%) have been assaulted by a patient;
• One in two (50%) have been exposed to an infectious disease;
• Almost one in two (47%) have sustained back injuries while performing EMS duties; and
• One in five (21%) have contracted an illness from a patient.

     This level of injury to the EMS workforce on the job is unacceptable.

     More recently, we issued a position paper advocating for the use of available safety restraint systems on the ambulance. To promote this position, we published a four-color, pull-out poster in the September issue of EMS Magazine encouraging everyone to buckle up.

     We can and plan to do more to improve the health and safety of the EMS workforce in the coming year and encourage our colleagues in government and business to do the same. If we don't save our own lives, who will?

     For more information on NAEMT programs and projects, visit www.naemt.org.