NAEMT and ACE Publish EMS Fitness Guidelines

In an effort to reduce injuries from patient movement, improve practitioner health and create a safer EMS work environment, NAEMT established a formal relationship with the American Council on Exercise (ACE) to create the Task Performance and Health Improvement Recommendations for Emergency Medical Service Providers. The NAEMT Board of Directors endorsed these fitness guidelines on January 18.

ACE sent a team of exercise physiologists to five sites across the country: Memphis Division of Fire Services, Tenn.; Austin-Travis County EMS, Texas; Charleston County EMS, S.C.; Upper Pine River Fire Protection District, Colo.; and North East Mobile Health Service, Maine. The sites offered a variety of service delivery models, environments, populations served, and geography. Most importantly, a diversity of EMS practitioners was represented. The team used the site visits, ride-along encounters and staff interviews to generate initial observations and a practitioner task analysis. The results of the efforts were found to be consistent from site to site. Consequently, they are reliable and reproducible.

What about practicality? Common concerns, requests, obstacles and possible solutions were uncovered among the supervisors and staff. Concerns included work-related injuries, general health issues, the avoidance of a forced retirement, the desire for a good quality of life post-retirement, and the additional costs from lost time due to injuries. They were also interested in weight management, stress management, and the promotion of healthy lifestyles.

Commonly cited was the need for physical competencies and requirements for EMS practitioners—but the feasibility of such standards was questioned. Common obstacles were identified as lack of resources, lack of knowledge, work demands, lack of healthy eating options, and low motivation to make healthy lifestyle changes.

ACE has helped address these issues with guidance to achieve the following primary outcomes:

1)    Improve job-related physical capacity;

2)    Improve overall wellness;

3)    Create self-reliance.

Improve job-related physical capacity

To improve job-related physical capacity, ACE developed specific physical ability assessment and general exercise guidelines as a result of a biomechanical analysis of specific motions required to perform EMS tasks. Physical ability assessment includes waist circumference, standing posture, core function and stability and mobility. Within the EMS Fitness Guidelines, Appendix A: Physical Assessment provides detailed instructions for objectives, equipment, test protocol, administration and evaluation, with a score sheet for each component.

Improve overall wellness

For the outcome improve overall wellness, Appendix B: Exercise Program Recommendations and Guidelines provides general physical-activity recommendations. The purpose of this assessment is to identify postural deficiencies, physical deficiencies and activities that cause pain. The goal of the exercise program is to strengthen and lengthen muscle groups to improve the body’s structure and function, and concomitantly decrease the risk of injury, pain and dysfunction.

Create self-reliance

What do we do with all this information? We must take control by making good decisions, setting goals and self-monitoring our progress.

ACE provides a process in which goal setting is specific, action-oriented and time sensitive. The guidelines delineate methods to promote social connection among EMS personnel, maintain an environment that fosters success and use technology to encourage self-reliance.

Culture of caring

Agencies helping their employees implement these changes can achieve significant financial benefit when insurance premiums, overtime, attrition, equipment and training costs all improve. Employee retention will be better not just because employees are uninjured, but because the culture of our organizations is better.

If we do a better job of caring for ourselves, we’ll do a better job of caring for our patients, our families and our industry. Let’s get started—together.

Michael Szczygiel is a Senior Loss Control Specialist for THOMCO, a Markel Company, and a member of the NAEMT EMS Safety Program Committee.