THE ROLE OF THE HEALTH AND SAFETY OFFICER IN EMS
FIRE SERVICE EMS
In the late 1980s, the fire service began to champion the position of safety officer. Many EMS organizations now also recognize the wisdom of this idea. Just staying abreast of the federal and local mandates to promote worker safety in terms of hazardous materials and infection control alone can be overwhelming. Add the many other aspects of safety that must be addressed in the emergency services, and it is easy to see why the need for a dedicated safety officer exists. Even though safety is everyone’s responsibility, the safety officer holds the key to reducing injuries and deaths in the fire service and EMS workplace. Thousands—even hundreds of thousands—of dollars stand to be saved through the effective implementation of this position.
THE SAFETY OFFICER
Little guidance is available on the EMSrclated responsibilities of the safety officer. Fire service models for basic safety standards and the role of the safety officer can be found in the 1992 editions of NFPA 1500, Fire Department Occupational Safety and Health Program, and NFPA 1521, Fire Department Safety Officer. According to these standards, a person in this role is responsible for knowing the following:
- current local, state, and federal laws pertaining to occupational safety and health that apply to fire service and EMS professionals;
- factors related to physical and mental fitness and basic health, such as basic knowledge of exercise physiology, good nutrition, and stress management; and
- how to properly and effectively manage a program designated for safety and health.
The safety officer has a job that requires appropriate experience with and knowledge of emergency operations. It demands a certain degree of literacy, the ability to work with data and numbers for recordkeeping purposes, skills in personnel management, and interaction with and a knack for interagency relations.
A safety officer can be part of any size or type of fire or EMS organization. Small, volunteer, or rural services may rotate the administrative safety officer position and designate the incident safety officer (ISO) on a per-sccne basis. Medium-sized organizations may delegate safety officer functions to the training officer since there are many crossover tasks. A large organization can benefit tremendously by having a fulltime safety officer.
An important element of the safety officer’s role is to be able to report directly to whomever is the highest ranking leader of the organization. With so much responsibility for the well-being of personnel, the safety officer’s ability to do the job must not be jeopardized by others along the chain of command; this could compromise the mission if health or safety issues arise in the areas supervised by resentful or suspicious intermediate managers.
EMS SAFETY CONSIDERATIONS
EMS roles and tasks of the safety officer do not differ greatly from typical fire department safety officer roles, which consist of field operations and administrative functions. It is impossible for one person to be present at each EMS call even in the smallest organizations; therefore, one ongoing educational task is to permeate crews with a focus on safety. Safety practice must be continuously sought by each member of the organization. In addition, the safety officer can or should do the following:
- Respond —or send a trained designee—to major incidents or those that involve (or may involve) unusual safety hazards. At the scene, the ISO must not engage in patient care or triage activities but instead should remain dedicated to the safety function. This person’s job is to notice (and mitigate, where possible) hazardous or careless actions and to assess for changing conditions or circumstances that could increase the existing hazard level. The ISO should report to the incident commander on arrival at the site. These two people should work together closely on behalf of the field providers and the patients.
- Assess personnel at EMS scenes — especially those of prolonged duration — to determine who needs on-site rehabilitation. Even temporary relief of duties allows for rest and rehydration. The ISO can arrange for a rehab area away from the action and for an EMS crew (and the local critical incident stress management team, if needed) to staff’ it.
- Attend postincident critiques, adding positive and negative reviews of the safety angle, where appropriate.
- Identify and correct safety hazards in the workplace. This includes hazards in the organization’s offices, training sites, stations, vehicle repair shops, supply rooms, and so on. The safety officer is responsible not only for field providers but for support staff and office workers, as well.
- Know the applicable laws, regulations, and requirements as written by federal and state government bodies (such as OSHA) and national standardsmaking groups (such as ASTM and NFPA). Routinely assess departmental policies, procedures, and operations for compliance. When compliance is not achieved, members of the organization need to be educated about the risks: There may be large fines or other penalties. Worse, someone could be seriously injured or killed.
- Investigate all on-the-job injuries, illnesses, and exposures (both hazardous materials and infectious diseases). Document the event and take (or recommend) appropriate follow-up action to minimize the chances that similar events could occur again.
- Keep accurate personnel records, including a confidential health database that documents medical examinations, occupational injuries, illnesses, exposures, and medical testing and treatment. These records arc vital to support workers’ compensation claims. In addition, the safety officer should have records of physical fitness training requirements and achievements.
- Maintain inspection and service records on equipment and facilities used by the organization, including items such as seldom-used personal protective equipment and monitor-defibrillators. The safety officer should know what records are being kept by the vehicle maintenance department and whether those records are thorough and accurate.
- Investigate emergency vehicle crashes and keep records of follow-up information. Substance-abuse testing sometimes may be needed. The safety officer must know the correct procedures to follow.
- Keep records of situations that pose potential liability to the organization. They may include threats to sue, actual lawsuits, and other service complaints.
- Act as the safety liaison to other agencies. In addition, the safety officer should be the liaison with equipment manufacturers (including vehicles), standard-setting authorities (such as protocol committees), and other regulatory agencies (such as OSHA and in-state equivalents). By doing so, the safety officer can maintain a global view of the safety’ issues faced by the organization and make appropriate recommendations to the safety committee or the organization head.
Act as a two-way information resource. Listen to suggestions and recommendations of employees and introduce them to , management. Relay new information and programs from managers or outside regulatory agencies to field personnel.
THE INCIDENT SAFETY OFFICER
EMS incidents can be as hazardous as fire incidents and may dictate the need for* an ISO to respond or be appointed. A few individuals may need to be trained to act as the safety officer, ensuring that someone is available at all times. An effective ISO understands that the primary responsibility of an ISO is not that of an enforcer, who dictates to others. Rather, the ISO’s duties at any incident (EMS or fire) are to support the incident commander and the ncident management system to ensure that safety is an important component of the incident action plan and that the responders are operating as safely as conditions at the incident allow. This person, however, must have the authority to stop unsafe acts.
An effective ISO for EMS incidents must know the dangers that may be present at such EMS incidents as confined-space rescues, hazardous-materials emergencies, and mass-casualty incidents. Some examples of knowledge required include infection-control procedures; scene-security measures; personal protective equipment requirements; critical incident stress indicators; the types of safety lines needed at water rescues; and shoring needed at trench collapses.
The individuals designated as ISOs at these and other incidents must understand their personal limitations and recognize that no one individual can be expected to be an expert in every facet of every type of emergency incident. Not only should an ISO get help when needed — “Trom a technical specialist or outside expert, for example —but the ISO also can have the incident commander appoint pothers to assist with the safety function at large incidents, when necessary.
JHE HEALTH AND SAFETY OFFICER
The administrative functions of the safepry officer are performed by an individual that more and more departments are calling a health and safety officer (HSO). The HSO is a department-level, primarily administrative position that encompasses responsibility for coordinating the safety and wellness aspects of organizational Activities. The HSO guides department policy as it applies to occupational safety practices and member welfare issues. The HSO is responsible for interpreting rules, regulations, and standards and their applications to safety and health issues in EMS. xamples include bloodborne and airborne pathogen regulations; hazardous materials, infection control, and confinedspace rescue training requirements for EMS personnel; personal protective equipment for EMS personnel; and civil unrest and violent situation protocols.
The HSO must have appropriate EMS functional authority. It does no good to create the position of safety officer (or piiSO) or to expand the role to include EMS without empowering this individual to make difficult, and sometimes unpopur, changes on behalf of safety. Without top-level administrative support (both verbal and financial), the task sometimes may be unreasonably troublesome or even impossible.
The basic duty of the safety officer (ISO and HSO) is to protect the safety of responders. This individual is, in effect, a risk manager, consultant, adviser, and leader and must address EMS issues as well as fire issues; in most fire departments, EMS accounts for about 70 percent of the response volume.
The safety officer essentially has two separate functions: that of the ISO and that of the HSO. Typically, the ISO is another trained officer appointed at specific incidents. while the HSO is primarily an administrative position. Regardless of which approach is taken, the bottom line is that safety is as important to EMS providers as it is to firefighters —something that seems to have been forgotten along the way.
The views expressed in this column are strictly those of the author and do not necessarily reflect those of the U.S. Tire Administration or the Fairfield Community Fire Company.