At the Heart of Things

Why EMS providers need to embrace personal health and fitness


      "It is no secret that, historically, the fire service has placed a great deal of its focus on maintaining apparatus and equipment rather than the uniformed personnel who provide emergency services and use such equipment. Firefighters and EMS responders respond to emergency incidents that require extreme physical exertion and often result in adverse physiological and psychological outcomes. The (Wellness-Fitness) project seeks to demonstrate the value of investing wellness resources for the duration of uniformed personnel's careers in order to maintain fit, healthy and capable firefighters and EMS responders."

   —Fire Service Joint Labor Management Wellness-Fitness Initiative

   The statistics are sobering: According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States, and a major cause of disability. More than 600,000 Americans die of heart disease annually. Sadly, heart disease is also the leading cause of on-duty deaths among emergency responders. It might be prudent for EMS providers to do some serious self-evaluation, risk analysis and lifestyle assessment in order to avoid becoming statistics themselves.

   Measures have been taken nationwide to promote fire-EMS health and wellness, including cardiovascular health. In 1996, the International Association of Fire Chiefs (IAFC) and International Association of Fire Fighters (IAFF) created the Fire Service Joint Labor Management Wellness-Fitness Initiative (WFI) to improve fitness and the overall health of fire-EMS personnel. Management of the WFI program is designed for career fire-rescue agencies and involves mandatory, confidential, nonpunitive participation.

   According to the United States Fire Administration, as of 2007 there were an estimated 1,148,800 firefighters serving nationwide—323,350 with career departments, and more than twice that number, 825,450, with volunteer or combination career/volunteer departments. To address the wellness-fitness issues of volunteer fire-EMS responders, the National Volunteer Fire Council (NVFC) launched the Heart-Healthy Firefighter Program in 2005.

   According to Lillian Ricardo, NVFC health and safety project coordinator, "Volunteer emergency responders have full-time careers and then volunteer their remaining time. Many have families and other things going on in their lives, so time and stress management are big issues. If you're dedicating time to volunteering in your community, you don't always make time to address your physical fitness needs or focus on proper nutrition. A lot of people eat on the run, which can make it difficult to maintain wellness overall. This makes it even more important for volunteer fire and EMS departments to address physical fitness and nutritional needs."

   Phil Caudle is a career firefighter/instructor with Albemarle County Fire Rescue in Virginia. He also serves as a peer fitness counselor and trainer, working with both paid and volunteer colleagues to improve their overall health. His department bought into the Wellness-Fitness Program when it rolled out in 2005. Caudle notes that because career employees are required to take and pass physical exams yearly in order to stay in service, this serves as a strong incentive for maintaining physical fitness and overall good health—but not all volunteer agencies require annual fitness tests.

   "It's a buy-in," Caudle explains. To encourage volunteers to participate in the Wellness-Fitness Program, "We explain that if you want to volunteer for multiple years and you enjoy this kind of work, you have to stay fit enough to remain in service. You have to become an 'occupational athlete,' and maintain fitness at a level that is similar to that of an athlete. If you don't, you're probably not going to have a productive career, let alone a healthy one."

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