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

1. Distraction is Deadly

2. Not Urgent
Not Important
Urgent
Not Important
Not Urgent
Important
Urgent
Important

3. Disable Notifications
Friend Request
Tagged in a Photo
Comment on Post
Added/Removed
New Follower
X
X
X
X
X

5. …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.

6. Types of Distraction
1. Manual
2. Visual
3. Cognitive

7. Manual Distraction

9. Voice to Text

10. Visual Distraction

11. “…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.”

12. Cognitive Distraction

16. Distraction Type

17. Texting

18. ON
OFF
TASK 1 TASK 2
ON
OFF

19. “This investigation
highlighted what is a
growing concern across
transportation – distraction
and the myth of
multi-tasking.”
NTSB Chairman Deborah A.P. Hersman.

20. Multi-Tasking Lie Infographic
• http://www.nsc.org/safety_road/Distra
cted_Driving/Pages/The-Great-
Multitasking-Lie.aspx

21. ON
OFF
TASK 1 TASK 2
ON
OFF

22. ON
OFF
TASK 1 TASK 2
ON
OFF

23. Incident
Patient
Assessment
Narrative
Signatures
Billing
Vital Signs
Cardiac Monitoring
AVPU
Pulse
RR
SpO2
EtCO2
BG
GCS
Temp
Pain

24. ON
OFF
TASK 1 TASK 2 TASK 3
ON
OFF
ON

25. “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.

26. New York Times
Gauging Your Distraction
http://nyti.ms/qgCETw

27. ON
OFF
Driving
Train
TASK 1 TASK 2 TASK 3
ON
OFFUsing
Phone
ON
OFFLooking
at Paper

28. ON
OFF
Driving
Squad
TASK 1 TASK 2 TASK 3
ON
OFFUsing
Phone
ON
OFFLooking
at MDT

29. We Know…

30. 91%

31. 5%
9%

32. 21%

33. 4x

34. 0.08

35. “…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

36. F.O.S

38. It’s not you I worry
about. It’s the crazy
people out there.

39. “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…”

44. Distraction

45. Patient Care

46. Self
Partner
Community
Patient
Response Assessment Treatment Transport
Risk of Distraction?

47. “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

48. “Good person doing what
they think is the right
thing to do.”

49. “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

50. Draw up and administer…

51. 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

53. Culture: How we act in workspace

56. Can I bother you
real quick?

57. Task Interruptions
1.
2.
3.
4.
5.
Distraction

58. “… up to a third of the
mistakes were linked
to distractions from
avoidable interruptions.”

59. Medication
Safety
Zone
DO NOT
DISTURB

60. Paramedic
Doing
Math

61. Close Call
Reported 8/1/2013

62. No Interruption Zone
Med
Cart?

65. Checklist

66. Other
read back
opportunities

68. “Checklists and signage can
be used as reminders to
reduce distractions, and
are simple, inexpensive
tools for medication safety.”

69. 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)

70. Listen close to
what I am about
to say...
You need to
know this…
Standby for
priority traffic…

71. I pledge to…

73. NO PHONE
ZONE

74. DISTRACTION

75. ANSWER IGNORE

76. Important?
Urgent?

77. There’s an app…

78. Unsubscribe
g***@centrelearn.com

79. There’s another app…

80. Focus Time

84. Injury Prevention
Group Project

90. Indiana Statutes

91. 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.”

92. NO PHONE
ZONE

93. Behavior Change Opportunities
• Behind the wheel
• In the classroom
• At the dinner table
• In the patient’s home
• During transport

94. “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.

95. Will you?
• Speak up
• Change processes
• Consider a pledge
• Practice focus and refocus
• Challenge exemptions