How not to end your EMS career

My EMS career nearly ended last week. Not once, but three times.

The first time I was treating an agitated patient, whether mental health related or behavioural we couldn’t tell. She required restraint from four police but continued to kick and punch with some force. Sedation had relatively little effect on her with the result that her extrication was a messy affair as she thrashed and fought constantly.

The second time I was treating a young woman who weighed north of 100kg who was suffering from a “seizure” or pseudo seizure. In order to effectively manage her we needed to drag her out of the cramped toilet cubicle she was in and across a small landing. When we finally managed to get her onto our wheelchair, she proceeded to have another “seizure” which destabilised the chair going over a number of steps and gutters.

The third time was the worst. I was transporting a patient on the stretcher to the ambulance, but the stretcher became unstable on uneven ground and toppled completely over. For a moment I fought to prevent it falling as one does instinctively, and when that battle was lost I was thrown into a concrete carpark by the momentum. Against my retrospective better judgement my partner and I then proceeded to hoist the stretcher back to standing position with the patient still attached.

Any one of these three incidents could have ended my EMS career with a back injury. With the possible exception of the last one, none of these are unusual circumstances in ambulance work. We often have to wrestle with patients in the line of duty and physically manoeuvring them into the ambulance is all in a day’s work. Every time we perform actions like this we are exposed to risk.

I can name a dozen friends who have injured themselves in far less dramatic circumstances. Some have had prolonged periods away from work with complications such as chronic pain, the need for surgery and often depression and anxiety. There is very little we can do to modify the environment we work in – it is by definition uncontrolled and sometimes actively harmful to ambulance workers.

Regular readers of my rantings will probably know where I’m going with this thought. If we can’t predict the environment and our ability to modify it is limited, we are left with only one way to minimise injury – we have to improve ourselves. And that means we have to make ourselves stronger. Much stronger.

I can’t prove it, but it is my belief that the only reason I was not injured on these three occasions is that I am physically quite strong. Nothing special by strength athlete standards, but certainly stronger than most people my age and size, and far stronger than I used to be. It was this strength which allowed me to do stupid things like lift up stretchers and feel completely normal the next day. Wrestling with a 100kg+ person is not my normal plan, but it’s what I have to do sometimes.

I have been lucky enough to have had great coaching from Kyle at ACE ( , and I pursue strength as a hobby, but it is not difficult to become plenty strong enough for what we do. More strength equals fewer injuries, easier night shifts, makes you harder to kill and an all-around better person. If you can deadlift and squat your own bodyweight in iron, that is probably strong enough. If you can use double your bodyweight, that is a game-changer.

I’ve run marathons, ridden a lot of bikes, done a bit of rock climbing and parkour, and not one of them prepared me as well for my work as 12 weeks of barbell strength training. I know I sound like a bit of a stuck record on this particular topic, but I’m quite happy to be boring if it means that a few of my colleagues aren’t forced out of the industry with chronic pain and permanent dysfunction. Strength training is the absolute best insurance that a paramedic can buy and frankly I think we’re mad not to do it.

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3 Responses to How not to end your EMS career

  1. One day says:

    Hi James what are your 3 lift totals? I’m Also a strength hobbyist and a big believer in your line of thought as well, cardio is great but how often must we run at work?

  2. Daniel K says:

    Love this post mate! Prehospital doctors in particular need to hit the weights room.

  3. Pingback: Things I’ve learned after a year of lifting at home – Incremental Eudaimonia

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