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Dual Duty: October 2013

I could hardly believe my eyes in July as I watched the breaking news on CNN . . . Airliner crash in San Francisco . . .

September 27, 2013 
By Lee Sagert

I could hardly believe my eyes in July as I watched the breaking news on CNN . . . Airliner crash in San Francisco . . . As the first images of the scene were broadcast, I thought, how could one of the safest and most modern airliners possibly fall short of the runway and burst into flames? As theories began to circulate, I knew this without a doubt: lack of situational awareness on the flight deck would surely be found as a contributing factor in the crash.

Ongoing evaluation of the progress of any operation ensures clarity and a strong understanding of what is occurring around us. With this knowledge, we can then feel confident in accurate decision making. When was the last time you evaluated situational awareness within your department? Could it be that all the rapid changes in emergency services are opening opportunities for a crash landing of our own?

Let’s take a step back and evaluate our situational awareness of EMS within the fire service. We will discuss recent happenings and challenges to ensure we are focused on the correct priorities for our mission of protecting life and property in our communities.

At no other time in emergency services has change been so fluid. We all read articles about the latest respiratory treatments, we study rescue and extrication, and we keep up with the latest in cardiac arrest trends. It seems like a nonstop flow of information. New trends such as community paramedicine and home-based treatment continue to challenge emergency responders. If you’re feeling overwhelmed by the constant delivery of information, you’re not alone.

As an industry focused on excellence, how is the fire service to keep up? It seems as if we must adapt to daily requests for change just to satisfy those latest trends. Managing statistics, hurrying to meet chute times, and applying evidence-based medical treatments define our level of professionalism. Yes, the latest and greatest is important for progress, but we must remember to check our situational awareness. If we step back to look at the big picture, it appears as if keeping statistics, meeting required benchmarks and satisfying decision makers has maxed out our resources to the point that we may be overlooking our most valuable assets: our patients. Have we lost the human touch? Have statistics and figures overshadowed our doing what’s best for those in need? It appears that doing what’s best for our patients has taken a back seat to bureaucratic demands.

It was recently suggested by one Alberta Health EMS manager that we remove the letter E from EMS. It was explained that response times are no longer as critical as once thought. His train of thought was that true measurement of good patient care is based on final outcomes after hospital discharge. Some EMS leaders are suggesting delayed responses for certain call types, because studies show that early EMS intervention has no bearing on final outcomes.

Although this is important to note, we as emergency responders must realize that Mrs. Smith is not concerned with statistics or benchmarks. When Mrs. Smith dials 911, she expects rapid professional response. Citizens in crisis feel immediate comfort upon the quick arrival of any emergency vehicle – period. Public perception of an emergency differs from that of trained personnel.

That being said, early response is a sure way to calm emergency situations. When was the last time your department received a thank-you card that read. “We appreciate you for meeting your required benchmarks this month”? We all know that the most common themes in thank-you cards are quick response and reassuring care. By checking your situational awareness, you can ensure your patients’ needs come first and that your department has not become overly focused on numbers, charts and graphs. Please remember that no amount of science or data can mend public confidence and satisfaction. Most often, simply holding a patient’s hand and using comforting words pays big dividends for your service. I would encourage everyone to use situational awareness to ensure your department is continually putting patients first.

We live in a fast-moving society with rising health-care costs and government leaders are mandating rules to stretch taxpayer dollars. As experts in our fields, we must balance new ideas while still being advocates for our patients. EMS responders of all types must realize that we have become an integral part of the health-care system. There is no better time to display our strengths and abilities, as we are the first contact into the chain of survival. We must be flexible enough to embrace change, yet ensure we protect what we do best: rapid, professional and compassionate patient care.

The pilots involved in the San Francisco 777 crash should have used more situational awareness. We must do the same by monitoring and embracing change and putting our patients first. Situational awareness is another tool used by pilots, fire crews, paramedics and police officers. Using this technique will protect our industry, protect our patients and keep us all from falling short of the runway.

Until next time . . . be safe out there! 

Lee Sagert is a career paramedic/firefighter with the City of Lethbridge in Alberta and a volunteer lieutenant with Coaldale Emergency Services. Lee is a former flight paramedic with S.T.A.R.S. and has trained at Oregon Health Sciences University in Portland. He resides in Coaldale, Alta., and enjoys photography and spending time with family. Contact him at

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