From the article here:

Kudos to Brian Maguire, DPH, MSA, EMT-P, and Peter F. O’Meara, BHA, MPP, PhD, for their long-term commitment to occupational injury research for EMS. It was in 2002 that Maguire was the lead author of a paper published by the prestigious Annals of Emergency Medicine calling attention to “Occupational fatalities in emergency medical services: A hidden crisis.”

More than a decade later, this crisis continues. Both Maguire and O’Meara are tried and true street paramedics who have put their street smarts to work in the academic world by earning PhDs and dedicating their careers to studying improvements to our profession.

Loyal research fans may recall that our November 2011 column, titled “The Most Dangerous Job: Study raises awareness about the many hazards of EMS,” looked at a study by Reichard showing EMS workers had similar, if not higher, rates of serious injury and mortality than police officers or firefighters. Now, three years later, has anything changed?

The study’s new data, collected in 2014 from Australia and 2013 from the United States unfortunately confirms the 2011 study.

The Australian research comes from Central Queensland and La Trobe Universities, and shows EMS worker fatality rate of 9.3 per 100,000 workers (Reichard reported 7.0 in 2011 in the U.S.). Nationally among all careers, the Australian EMS fatality rate was 1.6 per 100,000.

Maguire and O’Meara performed a retrospective descriptive review of data from Safe Work Australia, a national data collection point, from 2000 to 2010, evaluating injuries in which greater than one week of work time was lost. The most common injury was muscular stress while lifting, carrying or moving objects at 44%; the overall rate of injury per worker was 80 per 1000 with a 95% confidence interval of 57.7 to 106.9 per 1,000 workers.

Significant injury rates among paramedics in Australia were more than double that of police officers. Interestingly, the rate fluctuated during the study period, but remained consistently higher than the national average. In 2000–2001 the injury rate was 81.4 workers per 1,000 compared to 94.6 per 1,000 in 2008–2009 and 85.0 per 1,000 in 2009–2010.

In Maguire’s 2013 article published in Prehospital and Disaster Medicine, he evaluated five years of data (2003–2007) data from the U.S. Department of Labor and Bureau of Labor Statistics and found 21,749 reported cases of injury and lost work time. Among those, 21,690 involved nonfatal injuries or illnesses that resulted in lost work days among volunteer, paid, full-time and part-time EMTs and paramedics in the private sector. Two thirds of reported injuries involved muscular sprains and strains, 43% involved back injuries, and 37% were listed as the patient being the source of injury. During the same study period, there were 59 reported fatalities among all EMTs and paramedics. Of these, 51 (86%) were related to transportation, and five were listed as the direct cause of assault or violent crime. This also works out to 349.9 cases of lost workdays per 10,000 full-time employees compared to 122.2/ 10,000 for all private industry occupations. The statistic shows a nearly threefold increase in injury rates among EMTs and paramedics when compared to the rest of the private sector.

However, the authors weren’t able to attain data on EMS workers employed in fire departments, which could mean EMS-related injuries and fatalities may actually be a greater problem than initial numbers report. We strongly suggest reading these two papers as this column can’t do justice to the volume of information they contain.

Discussion: So, what does this all mean? Simple: It’s time to take action. The American College of Emergency Physicians recently released a recommendation, available online at www.emscultureofsafety.org, for a culture of safety among EMS workers, and efforts to track dangerous events in real time are paying off through an anonymous reporting site at http://event.clirems.org. Readers are encouraged to report near-misses and safety-related events to better document and hopefully improve EMS safety.

Conclusion: From what we can see in this available research, EMS remains among the most dangerous professions in the world. Our industry can’t tolerate the unsafe practices we’ve become accustomed to. Safe workplace habits, lifting, lifestyle and driving improvements must win over cavalier, dangerous and old ways of doing our job. It’s vital providers and their leaders embrace a new culture.

Bottom Line
What we know: EMS ranks among the most dangerous jobs in the U.S.
What these studies add: Unfortunately, Australian EMS workers have a rate of injury that’s comparable to U.S. EMS and is seven times higher than the Australian national average.

I think 90% of the hazards that EMS face could probably be avoided though a healthier lifestyle (Healthier foods) as well as a decent workout regimen. Out of the 40 or so EMS I know none of them really hit the gym or worry about being healthy. Lots of binge drinking on those days off as well.


A lot of people think overweight/out of shape police officers is a problem, and it is. But realistically, around here maybe 5% of officers are fat as hell. Another 10-15% are out of shape. Maybe 10-15% are in excellent shape and are competing in either bodybuilding, PL, CF, triathlons/marathons, etc. Then the rest are in decent shape/workout but aren't really in mind blowing shape.

I'd say a good 75% of our fire guys are in good shape. The ones that aren't are the older guys who don't suit up anymore/are dressed nice taking care of the command/ppk. I think workload + Schedule + comradery with fire guys is very conducive to working out/being in good shape and good on them for that.

I'd say maybe 20% of our EMS are in decent shape but most of that is just genetic.  Most of them don't work out/aren't pushing it for fitness. The rest of them are chubby.



I can't think of any local EMS injury due to combative patients. Mainly because we tend to take care of them in that aspect.



I think its more an education/training issue then anything else. The only PT standard is being able to push this or lift X amount of weight and thats it. They lift X amount of weight while they are going through their academy and BOOM. No more training/PT encouragement/standards. Your average young guy who becomes a cop is expecting to run, fight, etc. and might even be looking for it. Your average young guy who gos fire is expected to maintain a PT standard. To be in good shape (Fire gear is heavy as hell + physical job) They know their or someone else's survival might depend on their physicality. Your average young EMT isn't planning on/intending on fighting/heavy lifting/grunt work.



So yeah, want those numbers to change, I think PT standards throughout the training period for sure. Educate them at that time on the health hazards. Let them freaking know that sitting on the couch eating cheeto's every day is an unacceptable life style as a first responder. There are HUGE health hazards with being EMS (Combative patients + dealing with sick/diseased people all the time). Biggest hazard is complacency with one's lifestyle though.

Construction.

Can't disagree with anything much that you're saying.

I'll just expand on your remarks by saying it's hard to work out on duty when your "station" is "go sit on the street corner of 4th and Main for a while" as opposed to a fixed station with workout equipment like the FD.

Also, because in many areas EMS pay hasn't caught up to PD/FD pay yet, guys are getting off of one 24 hour shift for company A, and immediately going to do another shift somewhere else for company B.  By the time we get a day off, you're right, it leads to drinking and sitting on the couch eating Cheetos because we're too tired to go out and do anything.

I can think of only one Paramedic killed on duty.   (car wreck) I can  easily remember at least five that keeled over from heart attacks.

While certainly the fitness thing is a huge proponent of EMS injuries, the majority of these are lifting type incidents. Fire on the other hand, has an extremely high rate of injury related to poor health and fitness. Heart Attack is the #1 killer of fire fighters. You don't see as much of this in EMS, simply because A) our jobs are not as strenuous as FD (some times) and most importantly B) We are rarely in this job for our entire careers. The average career length of a paramedic in EMS only is roughly 5-6 years. That means that our shitty health and diet habits, don't catch up to us and pop up on the studies.

All of that being said, the most dangerous aspect of EMS is the mileage that we put on the road....In one shift I have hit damn near 1000 miles of driving...This obviously increases the likelihood of being involved in a crash. Additionally, we are driving emergency traffic in the shittiest of weather, at all hours of the night and often on little to no sleep. I went to a safety presentation a few months back and they threw out a statistic that a study came out with (unsure of the exact study) that showed that someone in EMS is more likely to die in the line of duty than a fire fighter or LEO combined.

This is not a dick measuring contest by any stretch of the imagination, but the truth is, depending on your service, you spend more time on the road than any of the others, therefore are more likely to be killed in an MVC.

I used to work for a private transport company and we posted all around the city.  Working out became an issue because we had to stay within a quarter mile radius and we were on 14-hour shifts.  We clocked in at the station and we clocked out, but that was it.

 

I'm sorry, but I gotta call bs....unless yer shift is like 20+ hours.  On patrol, in a rural part of the county, on a slow night with no calls for service I put around 300 miles on my car in a 10hr shift. EMS ain't driving around patrolling in between CFS, so presumably all yer milage is to calls and transporting to hospital.

An average shift being 12 hours, that's an avg speed of 83mph, the entire 12 hours.

My shifts are actually 24 hours and the majority of the hospitals that I transport to are 50+ miles away from the call location, a couple of them are actually 80+ miles away. As you can see, it's actually very doable to put in those kinds of miles, but unsafe and shitty for sure.

ETA: We do have two local hospitals that are 15 and the other 25 miles away, but they are rural facilities and can only treat the most minor of injuries/illnesses. The big kicker with my area, is that while you can see that we are quite rural, we also have a rather high call volume, which lends itself to plenty of exhausting and well traveled shifts.

I used to work for a coastal ambulance company on the central OR coast and we would routinely do trips to Portland. 80-100 miles each way depending on the hospital. Shifts were 24hrs long (and if you got a transfer 5 min before your off time, you went for a 5hr drive). Average round trip time for transports was 4.5-5hrs. We had days where the only time we stopped was for fuel. Figure 4 transports in a shift, at 100 miles each way, gets you 800 miles in a shift. I worked a 36hr shift once and did 7 trips to Portland. Needless to say I'm glad I'm not there anymore.

We would average 8k miles on our ambulances in a single month.

Well...in terms of external hazards...not when you use a little common sense.  As for health concerns...all the time that I ran almost all of the "career" medics were pretty overweight. They showed for a 12 hr shift and sat in front of the TV after rig checks. I went next door to the high school track and ran laps every evening.

I don't need to go from company A to company B. I'm allowed to work up to 72 hours straight by company policy, though they usually cap us at 48's. I run 24hr shifts, have a station to sleep at, but even if I had workout equipment it doesn't mean I have time to use it. My days at work are my off days from the gym. I got a 20 minute jog around our parking lot and was stoked! Now I'm sitting on a recliner waiting for dispatch to call me out.

ETA: SOB! just got called out!

I don't think PT has much to do with it. When you're woken up at 3am, your muscles are cold and tight. You have a 300 pound whale that fell off the toilet in the worlds smallest bathroom. As the emt you go in there and you get her out. Deadlifting and squatting 300 pounds of dead, floppy weight and it causes injuries regardless of physical ability. My heaviest patient has been 650 pounds to be lifted by only 4 crew members.

New auto loading gurneys will help lessen the injuries, but the hardest and most dangerous part is getting the PT to the gurney. And the only way we will ever do that is with old school methods, draw sheeting, GS lift, backboards, stair chairs. I have had 2 friends seriously injured from being in the patient compartment and the ambulance getting in a car wreck. One friend had the ambulance flip on it's side, he left with 40 stitches to the face, and 3 pressure fractured vertebrae. The crappy part is there is no seatbelt or restraint system that allows you to perform your patient care in the back while keeping you safe. My seatbelts have dust bunnys on them. I see a new seatbelt design and requirement in the future of ambulance transports.

Just my experiences.

Got cancelled off the call! Back to my movie

ETA-2: don't get me started on the pay. I just got a $0.50 raise...because my minimum wage went up...

Ok, that makes sense....and those do sound like some dangerous and shifty conditions!

I spent 20 years as a Firefighter/medic. In that time i knew 1 person killed in the line of duty. I was a commercial fisherman for 15 years before the Fire Service and i knew people killed on the job every year.