provider. Half of that number was from lifting and moving the patient. 1
These numbers from the Centers for Disease Control and Prevention
(CDC) don’t include the injuries sustained from lifting and moving
that aren’t seen in EDs.
According to U.S. Department of Labor, the risk of injury among
EMS providers is more than three times greater than risks among
other private industry occupations (349.9/10,000 vs. 122.2/10,000). 2
These numbers have remained largely consistent over the course of
the last 10 years, and the lack of improvement suggests that it’s time
for a change in our archaic system.
In this article, we begin by discussing a possible reason behind our
significant injury rates. We then discuss possible changes in three separate domains that, if implemented, could serve to decrease the incidence of injury among EMS providers.
THE LIFTING EQUATION
In 1994, the National Institute for Occupational Safety and Health
(NIOSH) published a revised lifting equation consisting of six factors, including the load constant, the distance the object is from the
person who’s lifting and the vertical height the object is lifted. This
equation was later revised to have greater application to other industries, including healthcare. When calculated out, the revised equation
equals approximately 35 lbs. 3, 4
This number may seem shockingly low because the weights EMS
providers routinely lift on a call easily may be double, triple, or even
quadruple this weight. (See Table 1.) Such great weight, when it’s lifted
call after call and year after year, may be why injury rates in EMS have
remained unacceptably high.
Furthering this point, a 1999 study published by the Journal of
Applied Ergonomics showed that even with a cooperative 110-lb. ( 50 kg.)
patient (who had no use of his legs), the compression force exerted on
the spine far exceeded the recommendations set by NIOSH of approximately 3,400 newtons, above which the risk of a lower back injury is
increased by over 40%. The newton (N) is the International System of
Units (SI) derived unit of force. It measures the force that produces an
Table 1: Weights of commonly used EMS equipment
Ferno iNX patient transport and loading system 192 lbs.
Ferno EZ Glide evacuation stair chair 37 lbs.
Stryker Power-PRO XT powered ambulance cot 125 lbs.
Stryker Performance-PRO XT manual cot 89 lbs.
Philips HeartStart MRx monitor/defibrillator 13. 2 lbs.
Physio-Control LIFEPAK 15 monitor/defibrillator 18. 9 lbs.
ZOLL X Series monitor/defibrillator 11. 7 lbs.