Emergency medical service (EMS) workers are the first to respond during a medical emergency. Professionals such as firefighters, police, and emergency medical technicians (EMTs) respond to 911 calls, assess the situation, act quickly to save lives, provide the necessary medical care and, when needed, transport the patient to the hospital.

EMTs, who provide basic healthcare from an ambulance, have a high rate of sprains and strains from overexertion. EMS workers often put in long hours, witness traumatic events, and may not get enough sleep. This puts them at risk of physical and mental stress. You can help your EMS workers by assessing the risks they face and help them find preventable solutions while on the job.

Risks for EMS workers

EMS workers are always on-call. When called to duty, they must move rapidly and make quick decisions.

Ergonomics risk can result from:

  • Forceful exertions or awkward postures
    • Lifting/carrying (patients and equipment)
    • Maneuvering equipment (gurneys, stair chairs, ladders, tools)
    • Being struck by objects
    • Getting on/off apparatus
  • Sustained postures
    • Patient care
    • Sitting/standing/bending/kneeling/crawling
    • Navigating in/out vehicle
  • Repetitive/prolonged activity
    • When loading/unloading equipment
    • While providing medical care (bending, crouching, pushing, pulling and lifting)

Due to the unpredictability and variation in this type of work, ergonomics solutions such as those below focus on guiding the tasks listed above. With these basics covered, emergency responders are physically prepared to handle unique and unavoidable situations that may come up. EMS workers who regularly practice and drill together create the muscle memory needed to perform their job tasks correctly.

Preparing for work and in the field

Preparing for work

  1. Improve awareness with education. Share the injury statistics and risk factors above with your employees to improve their understanding of how injuries can occur in their profession. You can do this during formal training and regular safety meetings.
  2. Learn and practice correct movements and positions. Practice good body mechanics for tasks that are predictable, such as loading and unloading the regularly used equipment and gurneys. Using your body in the correct position to improve strength and stability, reduces the likelihood of strains. The more you practice good techniques when in predictable environments, the more automatic it will be to use them during unpredictable events.
  3. Encourage physical fitness. Allow time and provide equipment for employees to exercise to improve cardio-vascular fitness, strength, and flexibility. Ensure that some fitness routines closely relate to the job specific tasks required for your work. For example, a fire fighter may use a stair-climbing machine while wearing all of their heavy turnout gear and oxygen tanks.
  4. Research and test when selecting new equipment. Finding the right tools to reduce the risks associated with injury from work tasks requires thorough research. Testing new equipment using a pilot or trial with a few people is an important step when determining whether it is the best solution to meet your needs.

Working in the field

  1. Proper bending mechanics using hip hinge. Courtesy of the Phoenix Fire Department

    Reduce forceful exertions by sharing the load.
    Lifting and carrying patients is hard work! Sharing the load with others reduces forces on the body. When possible, work together and use the hip hinge and squat method, which lowers your center of gravity and allows the strong leg muscles to provide the power. This method encourages you to bend at your hips and legs, while keeping your back upright.
  2. Reduce lifting forces when loading the stretcher. When manually loading the stretcher, always have two people assisting. To reduce the forces involved, lower the head of the gurney while loading the patient. When loading the gurney, move equipment such as oxygen tanks,

    Correct hip hinge mechanics for squatting to lift a backboard.

     medical bags, and monitors towards the ambulance end of the stretcher, this reduces lifting forces required. Consider investing in a powered stretcher, which research demonstrates reduces the risk for injury.
  3. Reduce compressive low back forces by raising the patient.
    Using portable transportation stretchers and chairs, helps reduce compressive forces in the lower back. These devices cocoon and secure the patients while also providing straps that reduce the distance the EMS workers have to bend to lift them. Additionally, use of straps can allow the response team to remain upright during transport reducing the compressive forces in the spine. Using stair chairs and mechanical lifts also reduce the forces

    Firefighters using the proper squatting mechanics for lifting using hip hinge. Courtesy of the Phoenix Fire Department

     required when lifting or moving patients.
  4. Use upright or good postures whenever you can, especially during non-emergency situations. Emergency care often requires EMS personnel to assume awkward positions. Unfortunately, these positions often occur in combination with forceful exertion, increasing the risk for injury. For that reason, when working in non-emergency situations, it is important to take the time and think about how you will position yourself when moving a patient or how you can avoid carrying equipment you need by placing it on a gurney and pushing it instead. Using correct posture and body mechanics whenever

    EMS crew using a portable transportation stretcher to move an injured patient.

     possible is the best way to avoid injury during the times that awkward postures are unavoidable.
  5. Stop, and take time to think about a plan, before you begin. Assessing the situation and responding accordingly is part of your regular job duties. Therefore, when problem solving what your plan of action will be, add ways to use good body mechanics and/or reduce the load or forces involved.
  6. Alternate your position frequently. Sustained postures, such as bending forward to provide CPR or while monitoring fire conditions, are often required while attending to an emergency. Alternate your position frequently, and when able, counteract the position by stretching or moving in the opposite direction you have been holding.
  7. Rotate tasks or activities. When possible, take time to switch job tasks or rotate the type of activity with your partner to avoid the risk for injury that comes from performing the same movement repeatedly.

Emergency response personnel have inherent hazards due to the nature of their job. By using, the ergonomics solutions listed above, EMS staff can avoid injury and be physically and mentally prepared.

(Rev. 12/2023)