Personal Protection and you!

Today I was working with a Paramedic student, who has just started his field rotation last month. He had been an EMT before he went to P-school and gained a good years experience during that time. We took over the ambulance from the early shift and as per usual I would step outside with them and have a cup of coffee and a cigarette and we would chat a little. My student went straight to the ambulance and started inspecting and checking the gear and medical supplies.

A few minutes later, after having finished my coffee, I joined him at the ambulance. And, like I do every day, I hung my jacket on the little hook next to my seat and started my daily paperwork. I looked over to his seat and didn't see his was nowhere to be seen. He had just finished checking the back of the rig and came to me, so I asked him where his jacket was. He told me it was upstairs in his locker, "why do you ask, it's summer and I won't be needing it" he continued. I was a little taken aback by that and told him that if I were to catch him at an MVA without his jacket, we would need to have a serious talk.

A few days back I was chatting with a paramedic from Texas and she asked my why we were all wearing our jackets at an MCI call in 100° F (39°C) weather. My immediate response was to ask her why I wouldn't be wearing one and if they don't wear jackets during MCI or MVA situations, to which she replied no. I was shocked and here is why.

Our jackets are a vital part of our Personal Protective Equipment for a number of reasons, all of which are standardized by the European Commitee for Standardization (CEN) in so called Euro Norms (EN). Firstly and most obviously it has to protect us from weather influences, mainly the rain and the cold (EN 343). Then they need to fulfill certain high visibility requirements (EN 471) in regards to background color (usuallay a bright red, yellow or green) and reflective striping, giving us the necessary proctection to work in flowing traffic without the need to wear additional (traffic) vests. Something I have yet to see in the US, where EMS uniforms are typically composed of dark colored materials - usually navy. Uniforms that I would not feel comfortable working with on any street, road, or highway.

Sample image of a typical German EMS jacket, like the one my service uses.

Another, to me, important fact is that it protects me from mechanical influences to a certain degree. Especially on an MVA scene there will be glass and metal parts scattered around and all sorts of sharp edges that I don't want to cut myself on. Our jackets are made from sturdy materials in order to prevent that from happening. I remember all to well an incident in my first days on the job. It was summer and we were called to an MVA with a person pinned in their car. I don't remember the exact particular, but what I do remember is that Fire had to take down the roof of the car in order for us to extricate the patient. After they had done so the b-pillars, half cut off, stuck up in the air and while I was leaning into the passanger cabin I cut my forearm pretty badly on the sharp edges of said pillar, leaving me bleeding like a stuck pig. That thought me to always wear my jacket on sites like that.

The same is true for helmets. Rarely do I ever see my colleagues wear helmets. Granted the situations were the use of helmets is actually waranted are few and far between, but even then the changes of seeing EMS personnel wear helmets are next to none, in my experience.

An MCI drill. One of the rare occasions, where everyone turns up in full PPE.

I have always been wondering why things are how they are, in that respect. Maybe it's lazyness. Maybe it's because it doesn't look cool - yes our helmets do look ridiculous. Maybe it's something a lot of people don't give it a lot of thought, because in the vast majority of medical calls, those kinds of precautions don't have to be taken. Maybe, sadly, something has to happen first, in order for them to rethink.

Maybe we should take a look at the Fire services. Whenever they turn up on a scene they will generally wear they full bunker gear and helmets. Be it waranted or not, no questions asked. Even in 100 degree weather. And they will keep in on until their commanding officer allows them to take it off. I realize, that this is not the case everywhere on the globe and yet I have the feeling that firemen, in general, show up dressed for the worst.

Firemen - full PPE even while just standing around.

In fact, many times, when not working a fire I would say that they tend to go overboard. Leaving us with another problem alltogether: heat exhaustion. Naturally their bunker gear is not only a whole lot heavier than our clothing, but keeps a whole lot warmer. Yet, they somehow make it work by taking turns, taking rest breaks to hydrate whenever necessary.

I would very much like to hear about your views, protocolls, guideslines, recommendations.