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Based Upon the EMS Forward Report, Lee Varner, NSEMS, EMT-P, Project Manager, EMS Services for the non-profit Center for Patient Safety, and a Just Culture trainer, presented ten signs that an EMS agency many not be as safe as they think if they are not addressing each area.

  1. Avoid ambulance crashes – The data show there is no need for lights and sirens on all calls;

  2. Airway – Capnography, checklist/cognitive aids and airway vigilance were recommended to ensure compliance and proper procedures.

  3. Device failures – With the influx of new technology and devices, we must properly train our personnel to use it and trouble shoot it. Simulation was noted as a positive approach in this area.

  4. Medication errors – The use of charts, guides and checklist were noted as helpful as well as routine use of cross-checking process prior to medication administration was recommended.

  5. Pediatrics – Encourage EMS providers to review equipment and procedures frequently.

  6. Behavioral Health Patients – Realize that no encounter is the same and every patient is different; vigilance must be practiced to protect yourself and your patient;

  7. Transition of care – Make sure there are no poor communication aspects in your operations that can result in misunderstandings, mistakes or errors.

  8. Mobile Integrated Health Care – Establish measures to ensure safety is considered,

  9. Second Victim – when a provider experiences a stressful situation or patient-related injury and become affected by it. (First death witnessed, pediatric cases, MCIs, etc) Getting to the provider immediately after an event has been shown to be highly effective in mitigating emotional damage.

  10. Culture is the Key – You must promote a model of shared accountability to ensure you have a culture of safety in your organization.

Written by A.J. Heightman, MPA, EMT-P Editor-in-Chief, JEMS
Editor-in-chief of JEMS, A.J. Heightman is a former EMS director and EMS operations director who has researched and specialized in MCI management training for 30 years.

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