A win for HROs. Employing high-reliability organization characteristics in EMS.

Was I insubordinate, arrogant or disrespectful? You may feel that I was. But in reality, I was educated to a level that could have been validated and should have been respected by command. I was, in fact, practicing a key aspect of HRO. I was stopping an obvious dangerous condition before it could harm or kill emergency responders. My IC colleague knew it from the facts presented and, in fact, joked with me about my "subtle sarcasm" and moved the perimeter to the recommended half-mile distance. Did I win, or did a proactive HRO win? Actually, HRO won and potentially saved 30 lives. I simply presented the hazards of CFC inhalation. A high-reliability organization must not rely on only one source of data when detailed information on a hazard isn't immediately available, or if it isn't very informative during an emergency decision-making process. Read "EMS & High Reliability Organizing: Achieving safety & reliability in the dynamic, high-risk environment and practice its important principles," pp. 60-63. It's really common sense, not rocket science, and may save you, your crews or others in your community.

R.I.P. squad bench. European ambulances designed around the patient, not the vehicle.

You can see and hear more about my journey throughout Germany and England in a special, archived, free Webcast on jems.com. And in future articles, videos and Web presentations, you'll see and learn about the different EMS delivery models I saw, the men and women whom I met and rode with on calls, and, most importantly, their impressive attitude about patient care, customer service and safety. Progressive American and Canadian ambulance manufacturers now agree with safety experts and forward-thinking ambulance operators that the squad bench is dead. These manufacturers now offer innovative seats that are much safer and functional than those coffin-like obstructions that gobbled up so much space in our rigs for the past three decades. Design your next ambulance around the needs and safety of your crews and their patients, and spec a patient compartment that is laid out logiclaly and efficient.