Playing it Safe

Why every EMS agency needs a safety program

EMS is an inherently risky job. On any given shift, EMS practitioners may be called to respond to emotionally charged, potentially life- threatening situations.

These may be quickly followed by a routine patient transport, with little time for recovery. Research shows that rapidly cycling between high and low intensity routine work can lead to exhaustion and errors— whether it’s forgetting to be careful when lifting a gurney or making a small driving error that leads to serious consequences.

Even when fully alert, long hours spent driving on roadways, in all kinds of weather and traffic conditions, at all hours of the day and night, exposes EMS practitioners to the potential of motor vehicle collisions. EMTs and paramedics have also been injured while responding to accidents by the side of the road. EMS practitioners are also put into harm’s way every time they respond to a call that involves interacting with members of the public who are highly stressed, under the influence of drugs and alcohol or in a mental health crisis. Surveys of EMS practitioners have found that assaults, either intentional or unwitting, are all too common.

So what steps can EMS agencies take to protect the health and well-being of EMS practitioners and their patients? One of the most important steps is implementing a comprehensive workplace safety program.

A comprehensive workplace safety program establishes policies and procedures that reduce risks, a plan of action when accidents or occupational exposures occur, and the steps to take to conduct investigations and ensure that the same type of incident does not occur in the future.

To make it more feasible for EMS agencies of all sizes to establish safety programs, in late 2017 the National EMS Safety Council published the Guide for Developing an EMS Agency Safety Program. Available free of charge on the NAEMT website (, the guide covers the many potential risks faced by EMS professionals and how to mitigate them.

Recognizing that EMS agencies have differing levels of resources available for safety programs, the guide provides tools and templates that EMS agencies can use, including:

  • Specific steps and guidance on recommended policies and protocols to be included in a comprehensive safety program.
  • Sample policies currently in use by some of our nation’s most highly respected EMS agencies.
  • Other resources for educating yourself and your workforce about safety issues and injury prevention.


In 2013, the National EMS Culture of Safety Strategy, funded by the National Highway Traffic Safety Administration (NHTSA), brought together the EMS stakeholder community to identify what constitutes a safe environment for EMS patients and practitioners; barriers to achieving a safe EMS environment; and a strategy to overcome these challenges.

One of the central concepts of the Culture of Safety Strategy was the concept of “just culture,” which encourages EMS agencies to foster an environment in which employees are urged to report near-misses and errors, and to share safety concerns, without the fear of punishment. This openness allows the agency to identify issues and take action to prevent future incidents.

The strategy also envisioned the establishment of a national level organization to coordinate national EMS safety efforts and serve as a repository for information, data and resources. In 2015, 12 leading national EMS and safety organizations, including NAEMT, came together to form the National EMS Safety Council. The goals of the council are to:

  • Ensure that patients receive emergency and mobile healthcare with the highest standards of safety.
  • Promote a safe and healthy work environment for all emergency and mobile healthcare practitioners.

The first initiative, funded by NAEMT, the American College of Emergency Physicians (ACEP), and American Medical Response (AMR) was to develop a guide to help EMS agencies start safety programs.


Mitigating fatigue, reducing the risk of collisions, promoting scene safety and preventing violence against practitioners are among the major issues that the guide addresses. But there are many others, including facility safety and security, infection control, substance abuse prevention and all aspects of personal safety, from lift injury prevention to the mental health of practitioners.

The guide is divided into main topic areas, some of which are particular to EMS and others that could apply to many types of businesses, both within healthcare and outside of it. Chapters include:

  1. Facility Safety and Security
  2. Vehicle Operator Safety
  3. Scene Safety
  4. Infection Control
  5. Personal Health and Safety
  6. Patient Safety

By implementing policies that protect the health and well-being of EMS practitioners, agencies ensure that their employees can continue in their chosen line of work and continue to serve our nation’s communities for many years to come.