Calculated Risk and Letters in the Files

Before you get too excited to hear what I think about the politician and the ambulance company at the shooting scene, close the door and take a seat.
Before you go ripping into scene safety and how this guy has no idea what it is we do, take a deep breath.

Because half of you are hypocrites.

How many of you race lights and sirens without wearing your seat belts? According to NIOSH studies and reviews of fatal and non fatal ambulance accidents…HALF. Yes, half.
Half of you are not wearing your seat belts in your ambulance.

So when you complain that some politician thinks you are invincible and should go racing into an unsafe scene, I almost gag knowing full well HALF of you already do that on a daily basis. And for even more minor incidents than the one in the press.

Yes, this is a letter in YOUR file. Those of you not wearing your seat belts in the cab of the ambulance. Patient care in the back does not even enter into this or the data I’m finding, this is only about in the cab.

So many were so fast to jump on the politician, yet how many of you really pay attention to yourselves on a daily basis?
Worried about a wrinkled shirt? Can’t reach the radio? Go ahead, try to give an excuse for not wearing your seat belt, the same thing you preach about to unrestrained drivers at wreck scenes. You can’t. There is no excuse for not wearing your seat belt in the cab of the ambulance. None.

Then why is not wearing one killing so many EMS responders?

We’re not a stupid group, stubborn perhaps, but we seem to understand kinematics and mechanism of injury, at least to the point it guides our treatment, but to not apply those standards to our own flesh and blood is insane.

Stop shaking your head and muttering that you already do wear it. Half of you are lying. Lying to yourselves.

I’ve had enough. You have made me unHappy.

Buckle up. I’m getting annoyed reading these studies about line of duty deaths and the lack of a simple click that could have made a difference. And if you are a LODD from not wearing a seat belt, should it really be a Line of Duty Death or should it be renamed Lack of Due Diligence?

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41 thoughts on “Calculated Risk and Letters in the Files”

  1. Excellent post Justin.

    “- we seem to understand kinematics and mechanism of injury, at least to the point it guides our treatment, but to not apply those standards to our own flesh and blood is insane.”

    Apply that to the fire service with “sizeup” and “risk analysis” and we raise lack of due diligence there as well. Then again, I have a strong stance on redefining firefighter LODDs.

    Bill Carey

  2. Excellent post Justin.

    “- we seem to understand kinematics and mechanism of injury, at least to the point it guides our treatment, but to not apply those standards to our own flesh and blood is insane.”

    Apply that to the fire service with “sizeup” and “risk analysis” and we raise lack of due diligence there as well. Then again, I have a strong stance on redefining firefighter LODDs.

    Bill Carey

  3. It seems that most people responding to that post are missing the point. We all have taken calculated risks – sometimes getting “away” with it and sometimes not. But in the case of the MS Councilman, the question should be what was the mitigating circumstances cause the 23 minute delay in making the scene safe. It could be something as simple as a train delay to system call overload for the police. Instead of pointing fingers and second guessing the medics, why not find out what cause of the 23 minutes was and go from there to fix the problem. I think you and Justin make good points as well.

  4. It seems that most people responding to that post are missing the point. We all have taken calculated risks – sometimes getting “away” with it and sometimes not. But in the case of the MS Councilman, the question should be what was the mitigating circumstances cause the 23 minute delay in making the scene safe. It could be something as simple as a train delay to system call overload for the police. Instead of pointing fingers and second guessing the medics, why not find out what cause of the 23 minutes was and go from there to fix the problem. I think you and Justin make good points as well.

  5. as an elected public official and a Paramedic most elected officials have no clue about EMS. It only costs money. I also know that as an elected official I have to decide that if I pay more for this item I have to take it away from something else. That is the only thing that elected officials want to know, The statement made by this official is most likely one that is about him trying to get reelected either so the manicipality would take over the service or that there is a competing company that is offering something. It is politics at the most negative but you have to know the source and the the political party affiliate.

    1. As an elected official then, how much did the Police Department recover in costs last year? Did City Hall cover expenditures with billings? The Fire Department? Animal Control? What about Building Inspections? Why does EMS have to cover costs but no other departments do? When we answer that question we’ll be golden.
      Thanks for reading.

  6. as an elected public official and a Paramedic most elected officials have no clue about EMS. It only costs money. I also know that as an elected official I have to decide that if I pay more for this item I have to take it away from something else. That is the only thing that elected officials want to know, The statement made by this official is most likely one that is about him trying to get reelected either so the manicipality would take over the service or that there is a competing company that is offering something. It is politics at the most negative but you have to know the source and the the political party affiliate.

    1. As an elected official then, how much did the Police Department recover in costs last year? Did City Hall cover expenditures with billings? The Fire Department? Animal Control? What about Building Inspections? Why does EMS have to cover costs but no other departments do? When we answer that question we’ll be golden.
      Thanks for reading.

  7. Very good point! Flipping on the lights & sirens increases the possibility you’ll be in an accident TENFOLD! We’ve all seen seatbelts save lives. There’s no excuse to not wear it.

  8. Very good point! Flipping on the lights & sirens increases the possibility you’ll be in an accident TENFOLD! We’ve all seen seatbelts save lives. There’s no excuse to not wear it.

  9. HappyMedic, You have just lost a faithful reader by your blog post. 1. NIOSH only does studies with a certain amount of agencies throughout the country. 2. How can you even come close to turning this into a type of “witchhunt” and come close to comparing your blog topic to the ignorance of said politician? Especially with his political record of proven ignorance. 3. Who are you to accuse the bloggers that responded to that particular blog of your specific topic? 4. Why are you calling people liars? Dear Sir, I can truely respect your personal opinions on certain topics as we are all intitled to them, however, MY opinion is you got this one completely wrong. There is a right way to get an opinion and information across and there is a wrong way to do so. There needs to be more positivity when you try to get a point across for the good of our extended family’s safety. Hopefully it was just your emotions getting the best of you, because I have respected your previous blog posts. Good luck with your persuits Sir.

    1. I think you missed the point and the boat as well. I didn’t see this post as a way to let this politician off the hook, but rather a way to draw attention to another safety issue in the EMS community. EVERYONE is ready to call for this guy’s head, myself included. However, HALF of survey respondents didn’t buckle their seatbelts when going to calls. I fully realize that I am much more likely to be involved in a fatal MVC at work than I am to be shot on scene of a call. Did this councilman overstep his bounds expecting EMS to enter an unsecure scene? Absolutely. Do half of our EMS brothers and sisters willing place themselves in unsafe situations merely driving to calls? Absolutely.

      Again, I’ll summarize, I don’t think HM was accusing bloggers of incorrectly characterizing this councilman as clueless. But it’s a bit of a “pot calling the kettle black” situation to vilify someone for expecting us to enter unsafe scene when we operate in an unsafe manner daily.

      1. Thank you for your comment. My whole reason for my previous post was more about how HM went about making his point. He made it sound more like a scolding by telling his readers that thier actions make him “gag” and calling half his readers “hypocites” and “liars.” Meanwhile using the actions of an ignorant politician to make his point. If there is a point to make, then simply make it and do it in a positive light. I do not believe I “missed the boat” on this one. I wear my seatbelt in the cab at all times because it is my company’s policy and if we are caught without them through our interactive drivecams, then I will be fired, however according to HM I am a liar or am I? In the back of the unit, how am I to render proper care to my patients if I am strapped to a seat? When they come forth with a proper alternative, then I will wear my restraint. My whole point of my comment is that HM needs to do as the first paragraph of his blog says, “take a deep breath” and then calculate what you are about to say and how you go about saying and furthermore, make it a positive statement instead of an accusation.

        1. “I wear my seatbelt in the cab at all times because it is my company’s policy and if we are caught without them through our interactive drivecams, then I will be fired…”

          I wear my seatbelt because I am concerned about my personal safety and getting home to my family every night. We don’t have drivecams and I still do it. If responders continue to undertake safety measures only to keep from getting fired, they deserve a scolding. The point is that there is clearly a cavalier approach when it comes to safety precautions. If we don’t have a safety-minded culture in EMS and make our safety a top priority, how can we get up in arms over someone outside of EMS not making that same safety a priority.

    2. Nineteen years, 25,000 calls, just started wearing my seat belt religiously. HM is right, and just may make some of us think. And furthermore, while I’m on my soapbox, I used to fly into shooting scenes without police back-up. I thought I was a hero or something. What an idiot.

      I’m lucky to be alive.

    3. Kristopher, I’m sure if you re-read the post, you’ll know exactly who I’m talking to. I am not letting the politician off the hook, as you say, but reminding everyone when they call for his head for demanding we risk our lives when unsafe to do so, we already are, yet seem not to make the correlation. I am glad your company has a policy, but I am even more worried that they have to have one. I’m also amazed mine does as well. Seems like a no-brainer.
      If everyone who responds to this is wearing their belt, then why are half of all ambulance fatalities inside the rig a result of not being restrained? We’re not doing it. US. All of us. if it makes you feel better I’ll include my backwards riding always belted butt too.

      I’ve tried being my usual happy self, but reading through these statistics, which until 1997 weren’t even collected Nationally, made my stomach turn. there has been more study about obesity in truckers than seat belt use in ambulances.

      NIOSH and the CDC are he only agencies keeping records of likely cause of fatality and injury in ambulance crashes and, even then, only on roadways. Not when stopped, on private property or at a large industrial site etc etc.

      We have been ignored for too long and my calm demeanor snapped this morning. Sorry if you expected my usual self, but seeing how many of us could be alive today with a simple click will make your head spin. Over 387. In the cab alone. In the 10 years between 87 and 97 as collected by Kuhn, cite forthcoming.

      If you have to go because you think I’m giving a politician a pass, please note I never mentioned the place, or the name, or my opinion on it, because I don’t think it deserves anymore attention other than to focus us on what is important: Calculated Risk.

      48%. Half.

      Try back after Expo, I’ll be happy again, I promise. As always, thanks for reading.

  10. HappyMedic, You have just lost a faithful reader by your blog post. 1. NIOSH only does studies with a certain amount of agencies throughout the country. 2. How can you even come close to turning this into a type of “witchhunt” and come close to comparing your blog topic to the ignorance of said politician? Especially with his political record of proven ignorance. 3. Who are you to accuse the bloggers that responded to that particular blog of your specific topic? 4. Why are you calling people liars? Dear Sir, I can truely respect your personal opinions on certain topics as we are all intitled to them, however, MY opinion is you got this one completely wrong. There is a right way to get an opinion and information across and there is a wrong way to do so. There needs to be more positivity when you try to get a point across for the good of our extended family’s safety. Hopefully it was just your emotions getting the best of you, because I have respected your previous blog posts. Good luck with your persuits Sir.

    1. I think you missed the point and the boat as well. I didn’t see this post as a way to let this politician off the hook, but rather a way to draw attention to another safety issue in the EMS community. EVERYONE is ready to call for this guy’s head, myself included. However, HALF of survey respondents didn’t buckle their seatbelts when going to calls. I fully realize that I am much more likely to be involved in a fatal MVC at work than I am to be shot on scene of a call. Did this councilman overstep his bounds expecting EMS to enter an unsecure scene? Absolutely. Do half of our EMS brothers and sisters willing place themselves in unsafe situations merely driving to calls? Absolutely.

      Again, I’ll summarize, I don’t think HM was accusing bloggers of incorrectly characterizing this councilman as clueless. But it’s a bit of a “pot calling the kettle black” situation to vilify someone for expecting us to enter unsafe scene when we operate in an unsafe manner daily.

      1. Thank you for your comment. My whole reason for my previous post was more about how HM went about making his point. He made it sound more like a scolding by telling his readers that thier actions make him “gag” and calling half his readers “hypocites” and “liars.” Meanwhile using the actions of an ignorant politician to make his point. If there is a point to make, then simply make it and do it in a positive light. I do not believe I “missed the boat” on this one. I wear my seatbelt in the cab at all times because it is my company’s policy and if we are caught without them through our interactive drivecams, then I will be fired, however according to HM I am a liar or am I? In the back of the unit, how am I to render proper care to my patients if I am strapped to a seat? When they come forth with a proper alternative, then I will wear my restraint. My whole point of my comment is that HM needs to do as the first paragraph of his blog says, “take a deep breath” and then calculate what you are about to say and how you go about saying and furthermore, make it a positive statement instead of an accusation.

        1. “I wear my seatbelt in the cab at all times because it is my company’s policy and if we are caught without them through our interactive drivecams, then I will be fired…”

          I wear my seatbelt because I am concerned about my personal safety and getting home to my family every night. We don’t have drivecams and I still do it. If responders continue to undertake safety measures only to keep from getting fired, they deserve a scolding. The point is that there is clearly a cavalier approach when it comes to safety precautions. If we don’t have a safety-minded culture in EMS and make our safety a top priority, how can we get up in arms over someone outside of EMS not making that same safety a priority.

    2. Nineteen years, 25,000 calls, just started wearing my seat belt religiously. HM is right, and just may make some of us think. And furthermore, while I’m on my soapbox, I used to fly into shooting scenes without police back-up. I thought I was a hero or something. What an idiot.

      I’m lucky to be alive.

    3. Kristopher, I’m sure if you re-read the post, you’ll know exactly who I’m talking to. I am not letting the politician off the hook, as you say, but reminding everyone when they call for his head for demanding we risk our lives when unsafe to do so, we already are, yet seem not to make the correlation. I am glad your company has a policy, but I am even more worried that they have to have one. I’m also amazed mine does as well. Seems like a no-brainer.
      If everyone who responds to this is wearing their belt, then why are half of all ambulance fatalities inside the rig a result of not being restrained? We’re not doing it. US. All of us. if it makes you feel better I’ll include my backwards riding always belted butt too.

      I’ve tried being my usual happy self, but reading through these statistics, which until 1997 weren’t even collected Nationally, made my stomach turn. there has been more study about obesity in truckers than seat belt use in ambulances.

      NIOSH and the CDC are he only agencies keeping records of likely cause of fatality and injury in ambulance crashes and, even then, only on roadways. Not when stopped, on private property or at a large industrial site etc etc.

      We have been ignored for too long and my calm demeanor snapped this morning. Sorry if you expected my usual self, but seeing how many of us could be alive today with a simple click will make your head spin. Over 387. In the cab alone. In the 10 years between 87 and 97 as collected by Kuhn, cite forthcoming.

      If you have to go because you think I’m giving a politician a pass, please note I never mentioned the place, or the name, or my opinion on it, because I don’t think it deserves anymore attention other than to focus us on what is important: Calculated Risk.

      48%. Half.

      Try back after Expo, I’ll be happy again, I promise. As always, thanks for reading.

  11. A lot of EMTs and Medics that I know seem to think that they’re invincible when they’re in their rig. It’s ridiculous. I’ve never understood how you can feel safe in a vehicle running LS when you’re unrestrained. But then again, I’m the type of person that wears full safety gear while riding a motorcycle too, so I’ve been called paranoid before.

  12. A lot of EMTs and Medics that I know seem to think that they’re invincible when they’re in their rig. It’s ridiculous. I’ve never understood how you can feel safe in a vehicle running LS when you’re unrestrained. But then again, I’m the type of person that wears full safety gear while riding a motorcycle too, so I’ve been called paranoid before.

  13. Good points HM. I was once the guy who drove between frequent post moves at night and often didn’t buckle up. Now, however, I put my seat belt on even moving in the parking lot. In the back, however, is another story. Wearing a seatbelt definitely makes it harder to move around for patient care, particularly on Code 3 returns (when we’re at the highest risk anyway). I don’t really have a good answer for that one, but would love to hear what others do.

  14. Good points HM. I was once the guy who drove between frequent post moves at night and often didn’t buckle up. Now, however, I put my seat belt on even moving in the parking lot. In the back, however, is another story. Wearing a seatbelt definitely makes it harder to move around for patient care, particularly on Code 3 returns (when we’re at the highest risk anyway). I don’t really have a good answer for that one, but would love to hear what others do.

  15. I can honestly say I don’t leave the garage until I’m buckled up and ready to go, nor do I let my partners, no matter where they sit on the way to or from the call. If I have the ability, I even wear it while going to the hospital. Am I saying I wear it 100% on the way to the hospital? No, but when I can, I do.

  16. I can honestly say I don’t leave the garage until I’m buckled up and ready to go, nor do I let my partners, no matter where they sit on the way to or from the call. If I have the ability, I even wear it while going to the hospital. Am I saying I wear it 100% on the way to the hospital? No, but when I can, I do.

  17. I also buckle up every time I am in the front of the ambulance. I cringe when I am driving and my partner isn’t buckled… I feel empty if I am not buckled in a car, I guess my parents trained me right in that aspect :) That said, I don’t always wear it in the back, trying to get better on that one.

  18. I also buckle up every time I am in the front of the ambulance. I cringe when I am driving and my partner isn’t buckled… I feel empty if I am not buckled in a car, I guess my parents trained me right in that aspect :) That said, I don’t always wear it in the back, trying to get better on that one.

  19. We need to design better patient care areas. Smaller ones, ones where almost everything can be reached from a seat in which your buckled. Do you really need a 160″+ long box on a medium duty truck to take care of a single ALS patient? We need to take head strike envelopes into account, look at eliminating sharp edges, crash testing and coming up with real, usable ways to secure equipment. Most of all, the bench seat needs to go, ASAP. In addition, anyone who doesn’t routinely use their seatbelt IN THE CAB is a freaking moron. I make no apologies for that generalization either.

    Justin, I’m tired of seeing good people die for stupid reasons as well. Seatbelts, inapproprite HEMS use, fires in which nothing was at risk but a bunch of crap that was probably too burned to recognize anyway, folks having MIs because they were too lazy to spend 30min a day on the treadmill. It’s all wearing on me. I tell the folks I work with constantly, don’t be the statistic. There is nothing heroic about death when it could and should have been prevented.

  20. We need to design better patient care areas. Smaller ones, ones where almost everything can be reached from a seat in which your buckled. Do you really need a 160″+ long box on a medium duty truck to take care of a single ALS patient? We need to take head strike envelopes into account, look at eliminating sharp edges, crash testing and coming up with real, usable ways to secure equipment. Most of all, the bench seat needs to go, ASAP. In addition, anyone who doesn’t routinely use their seatbelt IN THE CAB is a freaking moron. I make no apologies for that generalization either.

    Justin, I’m tired of seeing good people die for stupid reasons as well. Seatbelts, inapproprite HEMS use, fires in which nothing was at risk but a bunch of crap that was probably too burned to recognize anyway, folks having MIs because they were too lazy to spend 30min a day on the treadmill. It’s all wearing on me. I tell the folks I work with constantly, don’t be the statistic. There is nothing heroic about death when it could and should have been prevented.

  21. In most of Europe, wearing seat belts is compulsory. I’m not sure, though, whether this applies to ambulance personnel attending an emergency. It probably does, as I’ve always seen them wearing belts.

    As ambulance officers, have you never been called to a vehicle crash where someone has made a hasty exit through the screen? Didn’t that make you want to wear the belt?

    In most of the world, the “one size fits no one” belt has been replaced with ones that adjust to your size and movement until your vehicle decelerates fast. Do you not have these in the USA?

    Making your injuries worse in a road traffic collision (RTC) is simply a form of masochism and should get you certified as mentally defective! Anyone so injured in an RTC should not get treatment paid for in any way by someone else’s insurance (or by the state). Their own insurance should have an option as to whether they will wear a seat belt. That would soon change attitudes, as few would want to pay the (substantial) extra charge.

    A couple of times, I’ve been a bit preoccupied when getting in the car and forgotten to fasten the belt. One time, whilst waiting at the lights, the driver next to me saw what I’d forgotten and signalled to me to faten the belt. I was really grateful; he could have been saving my life.

    The other time, I got all the way home (3-4 miles). I felt sick when I realised.

    I’ve seen people, who had been wearing belts, walk away from what looked like a serious crash. Similarly, I’ve seen the scars on the face of someone who “forgot” to wear his belt. (He was actually so arrogant about his own driving skills that he never bothered to buckle up. Unfortunately he never thought about the other person’s skills.)

    Please, PLEASE, wear your seat belt. When they became compulsory in the UK, the seriousness of RTC injuries in the UK dropped significantly.

  22. In most of Europe, wearing seat belts is compulsory. I’m not sure, though, whether this applies to ambulance personnel attending an emergency. It probably does, as I’ve always seen them wearing belts.

    As ambulance officers, have you never been called to a vehicle crash where someone has made a hasty exit through the screen? Didn’t that make you want to wear the belt?

    In most of the world, the “one size fits no one” belt has been replaced with ones that adjust to your size and movement until your vehicle decelerates fast. Do you not have these in the USA?

    Making your injuries worse in a road traffic collision (RTC) is simply a form of masochism and should get you certified as mentally defective! Anyone so injured in an RTC should not get treatment paid for in any way by someone else’s insurance (or by the state). Their own insurance should have an option as to whether they will wear a seat belt. That would soon change attitudes, as few would want to pay the (substantial) extra charge.

    A couple of times, I’ve been a bit preoccupied when getting in the car and forgotten to fasten the belt. One time, whilst waiting at the lights, the driver next to me saw what I’d forgotten and signalled to me to faten the belt. I was really grateful; he could have been saving my life.

    The other time, I got all the way home (3-4 miles). I felt sick when I realised.

    I’ve seen people, who had been wearing belts, walk away from what looked like a serious crash. Similarly, I’ve seen the scars on the face of someone who “forgot” to wear his belt. (He was actually so arrogant about his own driving skills that he never bothered to buckle up. Unfortunately he never thought about the other person’s skills.)

    Please, PLEASE, wear your seat belt. When they became compulsory in the UK, the seriousness of RTC injuries in the UK dropped significantly.

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