Hostname: page-component-f554764f5-rvxtl Total loading time: 0 Render date: 2025-04-18T14:13:55.677Z Has data issue: false hasContentIssue false

Review of Powered, Safe Patient-Handling Equipment for Emergency Medical Services via an Insurance Safety Intervention Grant Program

Published online by Cambridge University Press:  15 April 2025

Marie A. Hayden*
Affiliation:
Division of Field Studies and Engineering, NIOSH, Cincinnati, Ohio USA
Audrey A. Reichard*
Affiliation:
Division of Safety Research, NIOSH, Morgantown, West Virginia USA
Brian D. Lowe
Affiliation:
Division of Field Studies and Engineering, NIOSH, Cincinnati, Ohio USA
Steven J. Naber
Affiliation:
Ohio Bureau of Workers’ Compensation, Columbus, Ohio USA
Steven J. Wurzelbacher
Affiliation:
Division of Field Studies and Engineering, NIOSH, Cincinnati, Ohio USA
*
Correspondence: Marie A. Hayden, MS Division of Field Studies and Engineering National Institute for Occupational Safety and Health (NIOSH) Cincinnati, Ohio USA E-mail: [email protected] Audrey A. Reichard, MPH Division of Safety Research National Institute for Occupational Safety and Health (NIOSH) Morgantown, West Virginia USA E-mail: [email protected]
Correspondence: Marie A. Hayden, MS Division of Field Studies and Engineering National Institute for Occupational Safety and Health (NIOSH) Cincinnati, Ohio USA E-mail: [email protected] Audrey A. Reichard, MPH Division of Safety Research National Institute for Occupational Safety and Health (NIOSH) Morgantown, West Virginia USA E-mail: [email protected]

Abstract

Background:

Powered equipment for patient handling was designed to alleviate Emergency Medical Service (EMS) clinician injuries while lifting patients. This project evaluated the organizational rationale for purchasing powered equipment and the outcomes from equipment use.

Methods:

This project analyzed secondary data obtained via an insurance Safety Intervention Grant (SIG) program in Ohio USA. These data were primarily in reports from EMS organizations. Investigators applied a mixed-methods approach, analyzing quantitative data from 297 grants and qualitative data from a sample of 64 grants. Analysts abstracted data related to: work-related injuries or risk of musculoskeletal-disorders (MSD), employee feedback regarding acceptance or rejection, and impact on quality, productivity, staffing, and cost.

Results:

A total of $16.67 million (2018 adjusted USD) was spent from 2005 through 2018 for powered cots, powered loading systems, powered stair chairs, and non-patient handling equipment (eg, chest compression system, powered roller). Organizations purchased equipment to accommodate staff demographics (height, age, sex) and patient characteristics (weight, impairments). Grantees were fire departments (n = 254) and public (n = 19) and private (n = 24) EMS organizations consisting of career (45%), volunteer (20%), and a combination of career and volunteer (35%) staff. Powered equipment reduced reported musculoskeletal injuries, and organizations reported it improved EMS clinicians’ safety. Organization feedback was mostly positive, and no organization indicated outright rejection of the purchased equipment. Analyst-identified design advantages for powered cots included increased patient weight capacity and hydraulic features, but the greater weight of the powered cot was a disadvantage. The locking mechanism to hold the cot during transportation was reported as an advantage, but it was a disadvantage for older cots without a compatibility conversion kit. Around one-half of organizations described a positive impact on quality of care and patient safety resulting from the new equipment.

Conclusion:

Overall, organizations reported improved EMS clinicians’ safety but noted that not all safety concerns were addressed by the new equipment.

Type
Original Research
Creative Commons
This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine.
Copyright
© Center for Disease Control and Prevention, 2025.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

National Association of State Emergency Medical Service Officials. 2020 National Emergency Medical Services Assessment. https://nasemso.org/wp-content/uploads/2020-National-EMS-Assessment_Reduced-File-Size.pdf. Published May 2020. Accessed June 1, 2022.Google Scholar
EMS & Fire Monthly Certification Report: Active Certification Totals July 2022. Ohio Department of Public Safety web site. https://www.ems.ohio.gov/certifications.aspx#gsc.tab=0. Accessed August 8, 2022.Google Scholar
Data Center EMS Incident Reporting System EMS Ohio Emergency Medical Service. Ohio Department of Public Safety web site. https://www.ems.ohio.gov/data-center.aspx#gsc.tab=0. Accessed August 2, 2021.Google Scholar
Reichard, AA, Marsh, SM, Tonozzi, TR, Konda, S, Gormley, MA. Occupational injuries and exposures among Emergency Medical Services workers. Prehosp Emerg Care. 2017;21(4):420431.CrossRefGoogle ScholarPubMed
Maguire, BJ, Smith, S. Injuries and fatalities among emergency medical technicians and paramedics in the United States. Prehosp Disaster Med. 2013;28(4):376382.CrossRefGoogle ScholarPubMed
Reichard, AA, Al-Tarawneh, IS, Konda, S, et al. Workers’ compensation injury claims among workers in the private ambulance services industry—Ohio, 2001–2011. Am J Ind Med. 2018;61(12):986996.Google ScholarPubMed
Armstrong, DP, Ferron, R, Taylor, C, McLeod, B, Fletcher, S, MacPhee, RS, Fischer, SL. Implementing powered stretcher and load systems was a cost-effective intervention to reduce the incidence rates of stretcher related injuries in a paramedic service. Appl Ergon. 2017;62:3442.CrossRefGoogle Scholar
Studnek, JR, Crawford, JM, Fernandez, AR. Evaluation of occupational injuries in an urban emergency medical services system before and after implementation of electrically powered stretchers. Appl Ergon. 2012;43(1):198202.CrossRefGoogle Scholar
Cooper, G, Ghassemieh, E. Risk assessment of patient handling with ambulance stretcher systems (ramp/(winch), easi-loader, tail-lift) using biomechanical failure criteria. Medical Engineering & Physics. 2007;29(7):775787.CrossRefGoogle ScholarPubMed
Jones, A, Hignett, S. Safe access/egress systems for emergency ambulances. Emerg Med J. 2007;24(3):200205.CrossRefGoogle ScholarPubMed
Lavender, SA, Conrad, KM, Reichelt, PA, Johnson, PW, Meyer, FT. Biomechanical analyses of paramedics simulating frequently performed strenuous work tasks. Appl Ergon. 2000;31(2):167177.CrossRefGoogle ScholarPubMed
Fredericks, TK, Butt, SE, Kumar, AR, Amin, SG. Biomechanical analysis of EMS personnel using stair chairs with track systems. Paper presented at: 11th Annual International Journal of Industrial Engineering Theory, Applications & Practice; October 24-27, 2006; Nagoya, Japan.Google Scholar
Mehta, JP, Lavender, SA, Hedman, GE, Reichelt, PA, Park, S, Conrad, KM. Evaluating the physical demands on firefighters using track-type stair descent devices to evacuate mobility-limited occupants from high-rise buildings. Appl Ergon. 2015;46(Part A):96106.CrossRefGoogle ScholarPubMed
Safety Intervention Grant. Ohio Bureau of Workers’ Compensation Web site. https://info.bwc.ohio.gov/for-employers/safety-and-training/safety-grants/safety-intervention-grant. Accessed August 8, 2022.Google Scholar
Wurzelbacher, SJ, Bertke, SJ, Lampl, MP, et al. The effectiveness of insurer-supported safety and health engineering controls in reducing workers’ compensation claims and costs. Am J Ind Med. 2014;57(12):13981412.CrossRefGoogle Scholar
Lowe, BD, Albers, J, Hayden, M, Lampl, M, Naber, S, Wurzelbacher, S. Review of construction employer case studies of safety and health equipment interventions. J Constr Eng Manag. 2020;146(4):04020012.CrossRefGoogle Scholar
Park, RM, Bushnell, PT, Bailer, AJ, Collins, JW, Stayner, LT. Impact of publicly sponsored interventions on musculoskeletal injury claims in nursing homes. Am J Ind Med. 2009;52(9):683697.CrossRefGoogle ScholarPubMed
Fujishiro, K, Weaver, JL, Heaney, CA, Hamrick, CA, Marras, WS. The effect of ergonomic interventions in healthcare facilities on musculoskeletal disorders. Am J Ind Med. 2005;48(5):338347.CrossRefGoogle ScholarPubMed
Wurzelbacher, SJ, Lampl, MP, Bertke, SJ, Tseng, C-Y. The effectiveness of ergonomic interventions in material handling operations. Appl Ergon. 2020;87:103139.CrossRefGoogle ScholarPubMed
Lowe, BD, Hayden, M, Albers, J, Naber, S. Case studies of robots and automation as health/safety interventions in small manufacturing enterprises. Human Factors and Ergonomics in Manufacturing & Service Industries. 2023;33(1):69103.CrossRefGoogle Scholar
Schneider, S. Ergonomics: OSHA’s draft standard for prevention of work-related musculoskeletal disorders. Appl Occup Environ Hyg. 1995;10(8):665674.CrossRefGoogle Scholar
Scopes® of Basic Manual Classifications 2021: NCCI (National Council on Compensation Insurance. National Council on Compensation Insurance web site. https://www.ncci.com/enterprise/search/Pages/manuals_results.aspx?k=basic+manual+2021. Accessed July 2, 2022.Google Scholar
2013 Rural-Urban Continuum Codes. US Department of Agriculture Economic Research Service Web site. https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/. Accessed January 1, 2019 and April 30, 2024.Google Scholar
Sommerich, CM, Lavender, SA, Radin Umar, RZ, Li, J, Park, S, Dutt, M. A biomechanical and subjective comparison of two powered ambulance cots. Ergonomics. 2015;58(11):18851896.CrossRefGoogle ScholarPubMed
Lavender, SA, Conrad, KM, Reichelt, PA, Gacki-Smith, J, Kohok, AK. Designing ergonomic interventions for EMS workers, Part I: transporting patients down the stairs. Appl Ergon. 2007;38(1):7181.CrossRefGoogle ScholarPubMed
Tycho, K. Fredericks SEB, & Ashley Hovenkamp. The Impact of Gurney Design on EMS Personnel. Paper presented at: XXIst Annual International Occupational Ergonomics and Safety Conference; June 11-12, 2009; Dallas, Texas USA.Google Scholar
EMS Incident Reporting System. Ohio Department of Public Safety website. https://ems.ohio.gov/ems-trauma-data/ems-incident-reporting-system. Access June 8, 2020.Google Scholar
Table 1.1.9. Implicit price deflators for gross domestic product 2000-2019. U.S. Bureau of Economic Analysis web site. https://www.bea.gov/. Accessed June 8, 2020.Google Scholar
NVivo Pro. 12 edition: Lumivero; Denver, Colorado, USA. https://lumivero.com/products/nvivo/. Accessed June 8, 2020.Google Scholar
Crowe, RP, Bower, JK, Cash, RE, Panchal, AR, Rodriguez, SA, Olivo-Marston, SE. Association of burnout with workforce-reducing factors among EMS professionals. Prehosp Emerg Care. 2018;22(2):229236.CrossRefGoogle ScholarPubMed
Rivard, MK, Cash, RE, Mercer, CB, Chrzan, K, Panchal, AR. Demography of the national Emergency Medical Services workforce: a description of those providing patient care in the prehospital setting. Prehosp Emerg Care. 2021;25(2):213220.CrossRefGoogle ScholarPubMed
Occupational Outlook Handbook EMTs and Paramedics. Unites States Bureau of Labor Statistics Web site. https://www.bls.gov/ooh/healthcare/emts-and-paramedics.htm. Accessed March 16, 2023.Google Scholar
Du, B, Boileau, M, Wierts, K, Hignett, S, Fischer, S, Yazdani, A. Existing science on human factors and ergonomics in the design of ambulances and EMS equipment. Prehosp Emerg Care. 2019;23(5):631646.CrossRefGoogle ScholarPubMed
Prairie, J, Plamondon, A, Larouche, D, Hegg-Deloye, S, Corbeil, P. Paramedics’ working strategies while loading a stretcher into an ambulance. Appl Ergon. 2017;65:112122.CrossRefGoogle ScholarPubMed
Cash, RE, Rivard, MK, Chrzan, K, Mercer, CB, Camargo, CA, Panchal, AR. Comparison of volunteer and paid EMS professionals in the United States. Prehosp Emerg Care. 2021;25(2):205212.CrossRefGoogle ScholarPubMed
Congressional Letter on the EMS Workforce Shortage. American Ambulance Association web site. https://ambulance.org/2021/10/04/workforceshortage/. Accessed August 19, 2022.Google Scholar
Adult Obesity Facts: Centers for Disease Control and Prevention Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion web site. https://www.cdc.gov/obesity/data/adult.html. Accessed June 22, 2022.Google Scholar
Supples, MW, Vaizer, J, Liao, M, Faris, GW, O’Donnell, DP, Glober, NK. Increased weight in patients with time-sensitive diagnosis is associated with longer prehospital on-scene times. Am J Emerg Med. 2022;53:236239.CrossRefGoogle ScholarPubMed
Xu, Y, Lavender, SA, Sommerich, CM. The efficacy of a lifting strap as an ergonomic intervention for EMS providers: does it make it easier to raise a supine patient to an upright sitting posture? Appl Ergon. 2021;94:103416.CrossRefGoogle Scholar
Lavender, SA, Sommerich, CM, Bigelow, S, et al. A biomechanical evaluation of potential ergonomic solutions for use by firefighter and EMS providers when lifting heavy patients in their homes. Appl Ergon. 2020;82:102910.CrossRefGoogle ScholarPubMed
Potvin, JR, Potvin, AW. Ergonomics demands associated with combinations of manual and powered emergency medical service cots and ambulance loading systems: a work simulation study. Int J Ind Ergon. 2019;73:102831.CrossRefGoogle Scholar
Lad, U, Oomen, NMCW, Callaghan, JP, Fischer, SL. Comparing the biomechanical and psychophysical demands imposed on paramedics when using manual and powered stretchers. Appl Ergon. 2018;70:167174.CrossRefGoogle ScholarPubMed