A Time-out for Safety

By Greg Friese

With Fire/EMS Safety, Health and Survival Week under way, many fire and EMS agencies are taking a time-out from regular training activities to have a department safety stand-down. My own department is substituting our monthly training meeting with a review of the International Seat Belt Pledge and a cook-out.

As you know, safety should not be isolated to a single training meeting, evening, day, or week. Safety is an integral component of all response and training activities. As you review safety procedures and practices this week, consider how EMS — like other health-care providers — can more regularly add a "Time-out for Safety" to EMS calls and fire incident response.

My running and cycling partner is a general surgeon. At the start of every procedure, he leads his surgical team in a time-out for safety to confirm these important details:

  • Correct patient identity 
  • Correct side and site 
  • Agreement on the procedure to be done 
  • Correct patient position 
  • Availability of correct implants and any special equipment or special requirements

A time-out for safety would be appropriate in many EMS calls and fire incidents. Checklists or confirmation criteria would make sense for:

1) Patient extrication from motor vehicles, collapsed structures, and unstable surface

2) Rapid sequence intubation to secure a patient airway

3) Application of pharmacological restraint to excited delirium patients

4) Transferring patient care to an air or ground ALS intercept crew

I would like to see a checklist like this before initiating code 3 — red lights and sirens — patient transport:

1) Patient condition meets protocol indications for code 3 transport

2) Patient secured to cot with lap, leg, and shoulder restraints

3) All patient care providers wearing seat belts

4) Equipment — like cardiac monitor — secured with brackets, netting, buckles, or belts

5) Experienced driver trained and authorized for code 3 transport

6) Receiving hospital notified of code 3 transport and prepared to promptly receive patient

7) Weather, road conditions, and other vehicle traffic suitable for code 3 transport

Greg Friese is an e-learning specialist, author, presenter and paramedic. He specializes in the design, production, and distribution of e-learning for emergency responders. You may submit tip ideas and discuss online EMS education with Greg by e-mailing him at greg.friese@ems1.com or by visiting EverydayEmsTips.com.

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