Emergency medical technicians perform one of the most critical jobs, but they also face a high degree of risk. In addition to the physical and health dangers that accompany each call, EMTs can easily find themselves in the center of legal disputes. Alarmingly, cases against them are often based on verbal accusations alone.

To ensure that EMTs can remain legally defensible, certain services are now requiring their employees to wear body cameras. These cameras can document interactions with the public and provide a tangible record to be used in court, if necessary. As with every new technology, however, video cameras present challenges when integrating into an EMT’s daily routine.

Body cameras provide EMTs with tangible first-person accounts
Interest in body-worn cameras by other first responder professions has recently surged. According to The Wall Street Journal, body cameras worn by the Rialto, California, police were credited with reducing the number of citizen complaints against police by 88 percent. In the wake of events in Ferguson, Missouri, camera vendors saw a jump in demo requests from law enforcement. Firefighters, who have to consider the technology’s ability to operate under extreme heat, are starting to leverage body and helmet cameras to improve training for new recruits.

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These same kinds of benefits are expected for emergency medical services, where EMTs are increasingly placed in violent and environmentally demanding situations. According to Kent Online, for example, 111 members of the South East Coast Ambulance Service were assaulted between 2012 and 2013. The service hopes to shrink that number and protect EMTs from potentially abusive riders by digitally documenting interactions with patients. Their cameras will be limited to images, however, and hardwired into the ambulances to provide a fixed view of the patient compartment.

By contrast, body cameras keep a more precise record of emergency work by following the EMTs wherever they may go. This first-person account can help clarify situations otherwise in dispute and mitigate additional stress.

For example, Intersurgical EMT-P Dan White recalled a situation where one of his patients brought charges against him for indecent behavior during transportation. According to White’s report, the patient was obese and required extra effort to get her vitals during the quick trip to the hospital. After reviewing each account of the four-minute transport, the charges were dropped, but that didn’t help White’s mental state.

“It was still stressful,” White wrote in an EMS1 article, “and doubtless that stress could have been avoided with a digital recording.”

Body cameras are especially useful when they can improve communications. Footage can be used to reflect on actions taken during a recent call, as well as become examples during future EMT training. Trainees could see how qualified EMTs handled a certain situation, what they did right, and how they can improve their performance. For emergency care, however, White believes that real-time help—EMTs in the ambulance receiving clinical guidance from the receiving physician, for instance—is more useful than reviewing a recording after the fact.

Patient trust might erode with recorded video
While the video may prove the innocence of a paramedic in the field, body cameras involve a substantial financial investment. Purchasing a large quantity of high-tech recorders is an expensive proposition, especially if services intend to require the cameras be worn by all staff. Employees who are not well-versed in using the technology may need supplemental training to operate the cameras.

Other complications arise when capturing video of patient interactions. According to EMS1, integrating cameras into the ambulance may require patient consent to record what transpires, due to HIPPA laws and a reluctance by some to disclose their private medical information. Additional permission may also be required if any of these recordings are meant to be shared for training purposes.

Some EMTs in London—where the integration of cameras in ambulances has been strongly supported—fear that the effect of these cameras will negatively impact patient care. Katy Millar, Deputy Director for London Ambulance Service, believes that body cameras may violate the trust EMTs share with their patients and may not be needed.

“In an emergency situation our ambulance crews can use their radio to connect to the control room and we can contact police,” Millar said to ITV News.

A video record of what transpires can help keep current and future interventions safer for everyone involved. The ramifications of capturing, preserving and distributing a digital record, however, could ultimately detract from the main EMS mission of administering timely medical care. Policy and relational impact should be well understood before any commitments are made to the technology.

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