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Distraction is Deadly

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Distraction is Deadly by Greg Friese at Indiana EMS Primary Instructor Conference. May 2014.

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Distraction is Deadly

  1. 1. Distraction is Deadly
  2. 2. Not Urgent Not Important Urgent Not Important Not Urgent Important Urgent Important
  3. 3. Disable Notifications Friend Request Tagged in a Photo Comment on Post Added/Removed New Follower X X X X X
  4. 4. …pilot had made and received multiple personal calls and text messages…while the helicopter was being inspected and prepared for flight, during the flight, on the helipad…making mission-critical decisions about continuing or delaying due to fuel situation, and during the accident flight.
  5. 5. Types of Distraction 1. Manual 2. Visual 3. Cognitive
  6. 6. Manual Distraction
  7. 7. Voice to Text
  8. 8. Visual Distraction
  9. 9. “…ambulance driver … became distracted when he took his eyes off the road while reaching for a company-issued tracking device that fell to the floor.”
  10. 10. Cognitive Distraction
  11. 11. Distraction Type
  12. 12. Texting
  13. 13. ON OFF TASK 1 TASK 2 ON OFF
  14. 14. “This investigation highlighted what is a growing concern across transportation – distraction and the myth of multi-tasking.” NTSB Chairman Deborah A.P. Hersman.
  15. 15. Multi-Tasking Lie Infographic • http://www.nsc.org/safety_road/Distra cted_Driving/Pages/The-Great- Multitasking-Lie.aspx
  16. 16. ON OFF TASK 1 TASK 2 ON OFF
  17. 17. ON OFF TASK 1 TASK 2 ON OFF
  18. 18. Incident Patient Assessment Narrative Signatures Billing Vital Signs Cardiac Monitoring AVPU Pulse RR SpO2 EtCO2 BG GCS Temp Pain
  19. 19. ON OFF TASK 1 TASK 2 TASK 3 ON OFF ON
  20. 20. “When operating heavy machinery, whether it's a personal vehicle or an emergency medical services helicopter, the focus must be on the task at hand: safe transportation.” NTSB Chairman Deborah A.P. Hersman.
  21. 21. New York Times Gauging Your Distraction http://nyti.ms/qgCETw
  22. 22. ON OFF Driving Train TASK 1 TASK 2 TASK 3 ON OFFUsing Phone ON OFFLooking at Paper
  23. 23. ON OFF Driving Squad TASK 1 TASK 2 TASK 3 ON OFFUsing Phone ON OFFLooking at MDT
  24. 24. We Know…
  25. 25. 91%
  26. 26. 5% 9%
  27. 27. 21%
  28. 28. 4x
  29. 29. 0.08
  30. 30. “…Secondary tasks requiring drivers to look away from the road ahead, such as dialing and texting, are significant risk factors for crashes and near crashes, particularly among novice drivers.” New England Journal of Medicine 2013
  31. 31. F.O.S
  32. 32. It’s not you I worry about. It’s the crazy people out there.
  33. 33. “A 20-year-old woman who exchanged a series of text messages then crashed into a bicyclist… convicted of homicide by negligent operation of a vehicle…”
  34. 34. Distraction
  35. 35. Patient Care
  36. 36. Self Partner Community Patient Response Assessment Treatment Transport Risk of Distraction?
  37. 37. “Medical error is... any preventable event that may cause or lead to inappropriate medication use or patient harm” National Coordinating Council for Medication Error and Prevention
  38. 38. “Good person doing what they think is the right thing to do.”
  39. 39. “More commonly, errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them.” To Err Is Human: Building a Safer Healthcare System
  40. 40. Draw up and administer…
  41. 41. Problems With Environmental Factors and Staffing Patterns • Lack of space, crowded and disorganized storage • Poor lighting, excessive noise • High patient acuity • Deficient staffing, excessive workloads
  42. 42. Culture: How we act in workspace
  43. 43. Can I bother you real quick?
  44. 44. Task Interruptions 1. 2. 3. 4. 5. Distraction
  45. 45. “… up to a third of the mistakes were linked to distractions from avoidable interruptions.”
  46. 46. Medication Safety Zone DO NOT DISTURB
  47. 47. Paramedic Doing Math
  48. 48. Close Call Reported 8/1/2013
  49. 49. No Interruption Zone Med Cart?
  50. 50. Checklist
  51. 51. Other read back opportunities
  52. 52. “Checklists and signage can be used as reminders to reduce distractions, and are simple, inexpensive tools for medication safety.”
  53. 53. Daily EMT-P Class Schedule Ride Along Review (device free) Cardiac Lecture (Shared Google Doc notes) **Break** (Ins, Outs, and Inbox) Cardiac Meds (Drug Guide app) Simulation (Code app)
  54. 54. Listen close to what I am about to say... You need to know this… Standby for priority traffic…
  55. 55. I pledge to…
  56. 56. NO PHONE ZONE
  57. 57. DISTRACTION
  58. 58. ANSWER IGNORE
  59. 59. Important? Urgent?
  60. 60. There’s an app…
  61. 61. Unsubscribe g***@centrelearn.com
  62. 62. There’s another app…
  63. 63. Focus Time
  64. 64. Injury Prevention Group Project
  65. 65. Indiana Statutes
  66. 66. Emergency Responder Exemption • WI Distracted Driving Law ??? • MN Distracted Driving Law – https://www.revisor.leg.state.mn.us/statut es/?id=169.475 – “(5) in an authorized emergency vehicle while in the performance of official duties.”
  67. 67. NO PHONE ZONE
  68. 68. Behavior Change Opportunities • Behind the wheel • In the classroom • At the dinner table • In the patient’s home • During transport
  69. 69. “But when we’re caring for their loved ones, they expect our competence, our undivided attention, our concern, our gentleness and our best efforts to keep them comfortable and as free of pain as we can.” People Care, 2nd edition. Thom Dick.
  70. 70. Will you? • Speak up • Change processes • Consider a pledge • Practice focus and refocus • Challenge exemptions

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