By Kevin Hughes
The main killer of on-duty firefighters and EMS workers continues to be cardiovascular disease. According to the Centers for Disease Control (CDC), 40% of the deaths in our nation are due to heart attack and stroke, the first and third leading causes of death. The stress of the job and the added challenge of sleep deprivation associated with EMS work place the EMS worker at slightly higher than normal risk for developing cardiovascular disease.
To be a firefighter or EMS worker, you must consider health and fitness. Typically, the first step in becoming an EMS worker requires some sort of physical abilities test in which the candidates must perform a series of very physical tasks that mimic the work performed on the fire or emergency scene. Since this is only the beginning of a physically demanding career in EMS, a proactive approach to health and fitness is important for the EMS worker. The definitions of health and fitness are open to interpretation. Each of us may have our own opinion of the definition of health and fitness. Taking that into account, it is important to define what health and fitness are for the EMS worker, identify the components of each, and understand how health and fitness differ.
Fitness is the state of being fit or, as Webster’s Dictionary states, “good health or physical condition, especially as the result of exercise and proper nutrition.” Fitness, however, becomes a very individualized definition. For the purpose of the EMS worker, one captain from the Sacramento Fire Department defined fitness as “the ability to perform the tasks of daily work without excess fatigue.” As it relates to the EMS worker, imagine you were on a call and had to carry a 200-pound patient down a flight of stairs. To perform this arduous task, one most possess strength, endurance, and mobility. If as an EMS worker you choose not to take care of yourself, this task could cause a great deal of fatigue and it may be hard to continue with the rest of your shift. If you are “fit for the job,” this task would still be challenging, but your recovery would be much faster.
Health is defined as “soundness, especially of body or mind; freedom from disease or abnormality.” In simpler terms, it is absence of illness or disease. Health, while less individualized in its definition, will still be different from person to person. So the question then becomes, Are health and fitness different from each other if fitness is “good health or physical condition”? To answer, let’s take a look at an example of two individuals. The first individual has normal blood pressure (approximately 120/80), has low cholesterol (less than 200 mg/dL), and is free of disease but leads a sedentary lifestyle. According to our definitions, this individual is definitely healthy, but is he fit? The second individual is Lance Armstrong, five time winner of the Tour de France. He has been tested and shown to have the highest recorded work capacity ever, yet he battled cancer for a number of years–making him fit but not healthy.
If health and fitness are then interdependent of each other-if you can have one without the other–it becomes essential to identify the components of each as they relate to the EMS worker. The components are as follows:
- Cardiovascular training–training the heart and lungs through aerobic work or sustained activity. Examples of cardiovascular activity would include walking, jogging, hiking, mountain biking, cross country skiing, basketball, cycling, swimming, and many other activities that will elevate your heart rate for a duration of time.
- Muscular strength–improving the ability to lift heavy objects such as a patient onto a gurney or an extrication tool. Typically, this uses weights and the overload principle to train the muscles.
- Muscular endurance–using the muscles for a long duration of time. An example in EMS work would be holding an extrication tool for a long duration in the same position or walking up stairs. One would use many different methods to improve muscular endurance.
- Flexibility–increasing joint range of motion through a stretching program whether dynamic (using motion) or static (staying in one place). These exercises could include yoga, passive stretching, partner stretching, and other forms of joint manipulation.
- Nutrition-taking in adequate and appropriate nutrients through better food choices.
While contributing to healthy living, these components are focused more on the performance of the EMS worker rather than on overall well-being. The components of health can be labeled as health and wellness, which include the following:
- Nutrition–same as above but also focuses on healthier food choices affecting overall cholesterol, blood pressure, and other heart risk factors.
- Sleep management–important to help manage sleep deprivation. In a sleep deprived state, it becomes increasingly difficult for the EMS worker to make good decisions, which can affect patient care. For example, there are several documented cases in which ambulance drivers have fallen asleep at the wheel and been involved in an accident.
- Stress management–this can help to relieve the stress of the daily job and can include critical incident stress management, relaxation techniques, breathing, yoga, exercise, or any other type of stress relief for the EMS worker.
- Injury prevention education and awareness— this can help to make the EMS worker aware of the most common injury (lower back) and how to prevent it through proper lifting techniques, acquiring assistance to lift, flexibility training programs, and many other avenues of injury reduction programs.
- Preventative medicine–this would include doctor visits, dental exams, and any other medical attention to maintain health before becoming sick and treating the disease or illness.
Both health and fitness are important to the EMS worker. A more healthy and fit individual will be able to perform his job with less fatigue and be able to handle the daily stresses of the job much more effectively than his sedentary counterpart. The EMS worker must realize that fitness may help to serve the customers better by setting a good example.
The reason for practicing healthy lifestyle habits including exercise and diet is to help the EMS worker live longer and happier after retirement. Practicing a healthy lifestyle can reduce injuries and provide for a better quality of life into your older years.
Kevin Hughes is a coach and fitness director for the Sacramento City (CA) Fire Department. He has been managing the In House Health and Fitness Program for the department for two years. He also has been involved with Sierra College Fire Academy as a health and fitness instructor for the cadets. He has a bachelor of science in exercise physiology from the University of California at Davis. For three years of his attendance at UC Davis, he worked as a rehabilitation aide at Woodland Memorial Hospital and Burger Physical Therapy. Kevin also has credentials in Professional Training from the International Fitness Professional Association and also the National Academy of Sports Medicine.
