Lancaster Emergency Medical Services responds to more than 47,000 requests for service each year, treating patients who have experienced everything from car accidents to cardiac arrest.
EMS providers spend their days — and nights — taking care of others. Many suffer back and other injuries of their own, especially if utilizing improper techniques to move or lift patients.
It is hard work that is often what we picture when we think of the phrase “first responder,” as these providers are among the first to help in an emergency situation.
But when first responders get hurt, who takes care of them?
It is understandable that avoiding injury to themselves is of secondary concern as they race to navigate cluttered spaces or unsafe situations, lifting patients who are larger in size or in awkward positions, such as on the floor or in a bathtub. In addition, many EMS providers may be a bit reluctant to seek their own medical care.
“It’s a difficult job, both physically and mentally,” says Deputy Chief Jerry Schramm, Lancaster EMS Director of Operations. “In general, we’re kind of a stoic bunch. Most of the time, we put our heads down and trudge through it.”
Schramm found a novel approach to injury prevention by connecting with Ann Seaton, MSAT, LAT, ATC, an athletic trainer employed by Penn Medicine Lancaster General Health Physicians Sports Medicine. While similar partnerships are more common in larger cities and other areas of the country, both believe she is the first athletic trainer to work with a public safety agency in Pennsylvania.
With her easygoing, approachable style and healthy sense of humor, Seaton trains EMS providers on how to move and lift patients safely, often riding along on ambulances to observe their form and make real-time suggestions. She also evaluates and treats those who are injured, with the ultimate goal of keeping them out of her office — or any medical office.
“I’ve learned that EMS is a full-body experience,” Seaton recently told a group of new hires. “I’m here to help you do your job more safely. And if you do get hurt, I’m here to help you get better and get back to work.”
In her education sessions, Seaton reviews safe lifting techniques, such as using the leg muscles, which are stronger than the back. She also emphasizes the importance of a healthy lifestyle, including regular strength training, cardio and adequate rest, and taking frequent breaks to stretch and move around while on the job.
Her number one injury prevention tip is one she repeats often: Never be afraid to ask for help.
Keeping first responders on the job
Schramm met Seaton through her “day job” working with student-athletes at a local high school. He invited her to give a presentation on proper moving and lifting during National EMS Week in 2021, which was well-received.
“From all the questions I received at that presentation, it was clear to me that Lancaster EMS could use an athletic trainer,” she says.
Seaton is a fierce advocate for her profession, working hard to dispel the myth that an athletic trainers do little more than hand water bottles to sweaty football players. “Hydration is part of our jobs, yes,” she says, but far from an athletic trainer’s primary responsibility.
After her successful presentation, she approached Schramm with a vision for further collaboration. She officially began working with Lancaster EMS in summer 2022, spending two mornings per week interacting with 155 employees at 11 ambulance stations throughout Lancaster County.
Schramm recognizes the vital importance of injury prevention, and that the stakes are high. While back injuries are by far the most common, his team also experiences shoulder, wrist and ankle injuries.
“Our goal is to prevent those injuries,” he says. “We know that 44 percent of our work injuries are due to improper lifting and moving. And nearly one quarter of EMS providers nationwide experience career-ending back injuries within the first four years of their career.”
While technology enhancements, such as “stair chairs” and motorized stretchers, are making the job easier, poor technique remains the root cause of injuries, he says. Further complicating matters, long-term staff could pass on their own bad habits to the new hires they train.
Seaton hopes to help break that cycle. In addition to providing education, she encourages physical activity with short videos she calls “Stretching with Seaton.” Along with those who are hurt on the job, she works with staff members whose injuries aren’t necessarily work-related, including an EMT who broke a foot in a skateboarding accident.
Riding along on the agency’s fleet of 57 vehicles allows her to see staff members in action and offer feedback. While it is not her primary purpose, when she witnesses difficult situations, such as a combative patient or verbal abuse, she connects those providers with mental-health resources that can help, a personal passion of hers.
It’s becoming increasingly common for people to flag down Seaton for questions or impromptu form critiques as she walks through the station. In September 2022, she treated 10 patients. By March 2023, the monthly total had more than doubled to 27. Encouraged by that success, she hopes to explore the feasibility of starting similar programs at other local public safety agencies.
Schramm believes she is the perfect person for what could have been a difficult job.
“EMS providers are like a family, and for someone new to come in and tell us what we should and shouldn’t be doing is tough,” he says. “Ann is super-intelligent and engaging, as well as very humble. She has a way about her that has really earned the respect of the staff.”
‘Ann shows that she really cares’
Paramedic Ashlea Stoltzfus suffers from intermittent back pain due to the natural alignment of her body, as well as a past on-the-job injury. Earlier this year, she reinjured her back while lifting a stretcher into an ambulance. She knew the proper technique, but unfortunately, in order to complete the lift, she had to sit on the hood of a car that was parked just behind the ambulance.
Stoltzfus tried all of her usual tricks to cope with the resulting lower back pain, but this time, nothing worked. When she was still in pain weeks later, she realized she had to do something. She went to Seaton, who helped her get an appointment at Sports Medicine.
Currently on modified light duty, Stoltzfus follows a treatment plan that includes regular physical therapy sessions, as well as working with Seaton on exercises to improve her core strength. Seaton has also accompanied her on the ambulance, monitoring her form, as well as that of her colleagues, in hopes of preventing future injuries. Thanks to those interventions, Stoltzfus is now nearly pain-free — and grateful to Lancaster EMS and LG Health for supporting her.
“Ann shows that she really cares,” she says. “She even came with me to my first appointment. Now she texts me to check in and see how I’m doing. She’s a huge advocate, not just for me but for all of us.”