Nine New Year’s Resolutions for EMS

According to a 2017 study by the Marist Institute for Public Opinion, about 40% of Americans surveyed make New Year’s resolutions, and only 47% of those keep them! There are no statistics available for EMS providers, but if you are one of those 40% of the people vowing changes in 2019, consider one of these nine (plus one) EMS-themed resolutions!

9. Use the pit crew model for CPR, especially for pediatric cardiac arrest.

According to a January 2018 EMS World article by Phillip Friesen, DO, et al., “Many recent studies of EMS systems implementing high-quality CPR, especially with team-focused or ‘pit crew’ models, have observed improved survival outcomes for OHCA… Team-focused and pit crew models are highly choreographed approaches to high-quality CPR emphasizing AHA guidelines.” These guidelines include:

• Minimize interruptions to chest compressions;
• Maintain a rate of 100–120 compressions per minute and compress to a depth of at least 50 mm in adults and at least one-third the anterior-posterior dimension of the chest in infants and children;
• Allow for full chest recoil after each compression;
• Avoid excessive ventilation (no more than 12 per minute).

8. Get or be a mentor.

In a February 2018 article, I outlined the importance of mentors in EMS—you never know who will put their fingerprints on your future or whose future you might influence in a positive way. Things to help promote for new folks in your organization:

• Being a role model to emulate in dress, punctuality, attitude, and professionalism;
• Giving newer folks as much of a chance as possible to get hands-on with patients and experience to build their confidence. Your goal is to make your guidance obsolete for them;
• Teaching folks to take initiative for their own knowledge. Model lifelong training. Be the first one to get up and empty the trash. Be the one who says, “Let’s wash a rig.” Grab a piece of equipment from the truck and practice with it as a crew. Inspire your folks;
• Always advocate for your patient;
• Don’t look down on anyone in your organization. Everyone is there to help in their own way.

7. Promote innovation.

Over 2018 author Matt Zavadsky advocated in several articles that EMS should strive to be more innovative in our approach to patient care and treatment. He outlines three main principles:

• Have (or be) a leader who’s willing to move your agency forward—want to be the best in your field;
• Be willing to take calculated risks to get there;
• Have a high level of organizational readiness to embrace these innovations.

6. Avoid preventable injuries.

In April 2018 Bryan Fass wrote about research-based practices that can be employed to reduce preventable injuries. Highlights included:

• Get (or keep) in physical shape;
• Sit less, move more;
• Use your legs, not your back to lift patients;
• Don’t pick up patients by hand to put them on the cot.

5. Don’t drop patients.

In April 2018 Michael Brown provided several suggestions for how crews can reduce (and hopefully eliminate) dropped patients on calls. They include:

• Use proper lifting techniques (again, legs, not back);
• Get help if the patient’s weight or size exceeds your crew’s resources;
• Get stronger;
• Keep your focus on the task at hand—don’t be distracted.

4. Don’t text, talk on the phone, or eat while driving.

Most providers acknowledge this is the right thing to do, but we think, Well, how do I eat during my shift? or How do I contact medical control? or How do I let my family know I’m going to be late to dinner? In a 2012 EMS World article, I outlined several practices to maintain a “sterile cockpit” approach while driving an emergency vehicle. Despite knowing it’s wrong, many of us still contaminate our safety environments. In 2017 330,000 accidents that led to severe injury or death were caused by texting while driving. The call or snack can wait.

3. Work and play well with other agencies.

In March 2018 EMS World’s Valerie Amato wrote about the importance of collaboration between and among first responders. Make 2019 the year you look to improve your working relationships with fire, law enforcement, mutual aid agencies, emergency management, dispatchers, and other groups and agencies you work with (or might). Remember, we’re all on the same team when the tones drop.

2. Plan with your local schools.

Last year saw a ramping up of active-shooter training for EMS. This training is good, and advances in trauma care and bleeding control should be embraced. However, the value of training is limited if you don’t preplan with locations where these events might take place, like houses of worship, entertainment venues, and schools. In a September 2018 article, I outlined several areas in which local EMS can plan with their schools, including physical plant assessment, equipment, training, and communication.

1. Hit the gym or try some yoga.

A theme of 2018 was our need to establish a culture of safety and make sure we’re fit enough to do our jobs. A big piece of this is physical fitness, whether you join a gym, start running, or perhaps, as Heidi Wiegand suggested in her August 2018 article, try some yoga. There are many benefits to yoga, including improved focus, a sense of calm, awareness of breathing, stress reduction, and improved flexibility. Whether you take a class or try an app on your phone between calls, give it a try!

Plus 1: Be good to yourself.

You know what they say on airplanes: Put on your own oxygen mask before helping others with theirs. You can’t be a fully effective provider and help others if you don’t take care of yourself. This means resolving to:

• Eat better. Think less fat and less sugar and more vegetables, fruits, and water;
• Move more. Less sitting, more movement, and get on an exercise program;
• Sleep more. Especially with shift work it’s hard, but do your best to get more sleep and use good practices to help you sleep better, like reducing or eliminating screen time before bed and not sleeping with your phone on your nightstand;
• Talk it out. PTSD is a real thing. Depression is a real thing. As EMS providers we see a lot of uncomfortable things. Talk to someone. Share if you’re having trouble. There are lots of ways to get help. Remember, you’re never alone.

Have a happy, healthy, fulfilling, and, most important, safe 2019!

Barry A. Bachenheimer, EdD, FF/EMT, is a frequent contributor to EMS World. He is a career educator and university professor, as well as a firefighter and member of the technical-rescue team with the Roseland (N.J.) Fire Department and an EMT with the South Orange (N.J.) Rescue Squad. He is also co-owner of Jump Bag Training Company, LLC. Reach him at barry@jumpbagtraining.com.