Sunday, September 20, 2009


In 2000 and 2001 while I was the Chairman of the National Paramedic Division for NAEMT, I authored a report on occupational injuries in our profession. If you would like a copy of this report, please email me at The scope and purpose of this report was to survey ALL of the nation’s EMS offices and various departments of labor, to try and find out the answer to these pressing questions:

How many EMT’s and Paramedics are injured in the line of duty?

How many EMT’s and Paramedics die in the line of duty?

How are they injured or killed?

The report, in summary, stated that we do not collect critical information and we don’t know how EMT’s and paramedics are injured in the line of duty. Now I know what you are going to say, ‘But Dan, guys are injured from lifting and moving and generally get killed from motor vehicle collisions’.

True, from my gut feeling I would tend to agree, but if we don’t measure numbers, how do we know when we do institute measures to reduce injuries, that what we are doing is effective?

We need to make comparisons within our own organizations, but also between other organizations as well.

If we were to compare injury rates in one location, to injury rates in another location, with similar populations, similar call volumes, and we found one had a significantly lower EMS occupational injury rate than the other, wouldn’t you want to know why?

EMT’s and paramedics are our most precious asset for any organization. We need to protect them, take care of them, provide as safe an environment for them as possible.

Let me ask another question: How many EMT’s and paramedics were injured due to acts of intentional violence?

I don’t know, no one does.

Even more important, what can we do that is effective in limiting career ending injuries and line of duty deaths?

Another excellent question.

If you or anyone else were to ask the National Institute of Justice, which is the scientific research arm for law enforcement nationwide (which would be nice if EMS had something comparable…) they will tell you that since the mid-1970’s, body armor has reduced line of duty deaths by over 600%.

Was the investment and development of life-saving body armor worth the time and effort?

Without good data, we cannot even begin to assess if the methods we are employing are working or aren’t working. Let me give you an EMS example. A member based organization developed a poster to reduce an aspect of EMS occupational injuries. They disseminated the poster.

That was it.

Some people will say, what was wrong with that?

In a better designed program, you would measure injuries associated with what you are trying to reduce for a 6 months to 2 period prior to implementing the poster.

You would create an EDUCATIONAL piece to go with the poster, incorporating the information from the prior 6 months to 2 year period. You would then deploy the poster, and then collect information for the next 6 months to 2 year period. You would then compare the results.

In this example of the poster, none of this was done.

Was the poster effective? We will never know. If you can’t tell me there is a correlation between your poster and injury reduction, then you probably just wasted your members money.

If you talk to the National Institute of Justice, their body armor program was a resounding success. In 2006, the last year complete data is available, motor vehicle collisions exceeded penetrating trauma as the leading cause of death for law-enforcement officers in the United States.

What area of law enforcement occupational injury do you think the National Institute of Justice is concentrating on now?

Even better, why can’t EMS have that same information?

A good question…

I always thought it was interesting that this national EMS organization choose a poster. It is almost like they are out of touch with how we communicate. Is a poster how we communicate most effectively?

EMT’s and paramedics Tweet, watch YouTube, have Facebook and MySpace pages. They text message one another. They email and surf the net at least once a day. The best PSA of the year was done by an EMS agency in Scotland, which was then posted on YouTube and has gone viral around the world ( ). I know guys who have it bookmarked on their PDA’s so that they can show people during impromptu educational sessions.

A poster? Is that how they are trying to get their message out?

We are talking about the lives of our brother and sister EMT’s and paramedics. THAT was their best effort?

This same organization is developing an EMS Safety Officer Course. Again, how will we know the course is success if we don’t measure injuries from year to year? How will I, or you, or your organization KNOW that the EMS Safety Officer is doing a good job?

An EMS Safety Officer Course? Why develop a course for one person? Why not a program for an entire organization? How about a complete program for reducing injury, hazard, and death in our profession? How about working with other agencies, who may have programs of excellence to develop a complete program that we could distribute?

EUREKA! What we need is an EMS Safety PROGRAM!

A comprehensive program that will incorporate safety into it all aspects of the organizational culture, where all managers and staff members are empowered with and tasked with being a part of the Safety Team. That was part of the original proposal to the Association. Give organizations the tools for a comprehensive approach for safety, and how to measure success, how to incorporate safety into all phases of the organization, from orientation, to training, to response, on-scene, during a large scale incident. Again this was part of my original set of recommendations for the Association, to identify programs of excellence, and then look to incorporate what they have accomplished into a COMPREHENSIVE program.

For some strange reason, after I wrote my report to NAEMT, my recommendation to examine programs of excellence was not acted upon.

Yet everyday EMT’s and paramedics are still being injured or losing their lives in the line of duty.

EMS need’s a program, with a toolbox full of tools for organizations large to small, volunteer to paid, to help reduce EMS occupational injuries. Something that encompasses all phases and flavors of what we are. We could partner with insurance companies to develop meaningful programs to identify hazards, reduce risk, and eliminate line of duty death and disability. This will reduce the cost for program development, in addition to we can leverage the knowledge of insurance companies to develop MEANINGFUL programs for injury prevention. In addition they will provide us with tools to measure our success.

If this sounds like I have done this before, I have, with the Royal and Prudential Insurance Companies back in NJ.

Let us have an honest discussion. If you can’t tell me that you have made any inroads in reducing death and disability, because you don’t have a quantifiable number of how many people are being injured, we will never know if our efforts are effective because we won’t have any information to compare it to.

If anyone read my report, and if we followed my recommendations, we would have had 8 years worth of data by now, 8 years worth of information in order to develop programs to reduce death and disability. All we needed was one or two years worth of data to begin identifying and working toward reducing death and disability.

Wow. 8 solid years of working on reducing injuries and deaths in our profession. How many people could we have helped...

The first question I think of when I think that SOMEONE or SOME ORGANIZATION is going to develop an EMS Safety Officer Course is: how much money is this organization going to charge for this program?

Most of the EMT’s and paramedics in our field pay to take courses like ACLS, PALS, PHTLS, AMLS, PEPP, and EPC out of their own pocket because they want quality education. What will someone charge to give them the requisite training to protect their lives and the lives of their co-workers?

Yet no national organization or even anyone in the federal government still cannot answer the fundamental questions:

How many EMT’s and paramedics were injured and killed in the line of duty last year?

How did they get injured or killed?

No national EMS organization can say that their injury reduction efforts have made any impact on EMS occupational injuries, and they never will be able to say that. Right now who suffers? EMT's and paramedics in the field are suffering and we as a profession aren’t doing anything effective.

I have been to funerals for EMS personnel. We owe it to them and their families to get this one right.






I am Dan Gerard, and I am running for the Region IV Director for NAEMT.

I am not interested in a travel a club or free trips, I want to work hard for you the dues paying member.

I know this issue thoroughly. I authored the first two reports on EMS occupational injuries for NAEMT. I know the topic and the national leaders for EMS occupational injuries. I will follow through on the initial recommendations for reducing EMS occupational injuries by:

Working with the U.S. Dept. of Labor to develop a unique coding mechanism for EMS Occupational Injuries. Then we can begin to collect meaningful, useful data to analyze on how we are injured in the field.

Partner with one of the 13 Injury Control Research Centers funded by the National Center for injury Prevention and Control at the Centers for Disease Control and Prevention, in order to analyze our data and develop programs for reducing workplace hazards and improving health and safety

Develop a program in concert with our partner Injury Control Research Center/CDC to identify and recognize programs of excellence. From these programs, develop the tools and guides for organizations to incorporate so that they too may be able to reduce occupational injuries and deaths.

Don’t let another EMT or paramedic suffer a needless injury. Stand TOGETHER with ME, TOGETHER vote for ME, and TOGETHER WE will carry the banner to a new tomorrow.

Daniel R. Gerard, MS, RN, NREMT-P

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