by Kathryn Robyn & Marie Nordberg
Associate Editors, Emergency Medical Product News
Bicycles and other two-wheeled vehicles are becoming increasingly prevalent in the EMS industry, helping agencies provide quick care in crowded settings like fairs, festivals and sporting events. Maureen Becker, executive director of the International Police Mountain Bike Association (IPMBA), which has a fast-growing EMS division, says that “As of 2002, 52% of EMS agencies in the nation’s largest 200 cities were [reportedly] using bikes.” Additionally, she says, “estimating from IPMBA membership, approximately 300 bike medic teams across the country are being deployed in a variety of circumstances.”
IPMBA, whose annual conference was held May 6-13 this year in Dayton, OH, is the preeminent trainer of both police and EMS cyclists. IPMBA-certified cyclist instructors have trained most, if not all, of this country’s bike medics, as well as the United Kingdom’s famed London Ambulance Service (LAS) bike medics. The growth of the bike medic niche might be reflected by next year’s conference host, East Baton Rouge Parish EMS in Louisiana, the first emergency medical service to host the conference, says Tom Harris, NREMT-P, public service coordinator for the municipal third service.
“It’s predominantly hosted by large police departments,” says Harris. “I’m flattered to be allowed the opportunity to even bid on it, let alone get it.”
The 24-medic bike team in East Baton Rouge Parish EMS, in service since 1995, is an advanced life support team that works the bikes as an extra detail. “We utilize our bike medics for all large special events,” he says. “These vary throughout the year, but I will have a bike team out every week. Louisiana State University typically gets over 100,000 people here for a home football game, so it gets very crowded and we can’t hardly get a vehicle down the streets at all, so we use the bikes for initial first response. They’re meant to stand alone for 10 minutes in a cardiac arrest situation.”
A similar scenario is echoed by the leaders of other bike teams. As metropolitan areas and public events get more crowded, and people’s expectations for emergency response get higher, it makes sense to deploy bikes.
Boston EMS, another third-service municipal agency that had the foresight to invigorate EMS with bicycles some 10 years ago, has 45 medics on its team who share 20 bikes among them. Until recently, the Boston team patrolled day and night, says Deputy Superintendent Neil Blackington. “And, we will do it again if we have the staffing, but right now our unit--like about 90% of the rest of the country--is using its bikes primarily for special events like parades, festivals and unusual concerts. Two of our biggest events are the Boston Pops 4th of July concert and fireworks, which attracts somewhere in the order of 500,000 to 750,000 people to the Esplanade along the Charles River, and the Boston Marathon on Patriot’s Day. About 1.5 million people gather here for that, mostly in the city of Boston, which is where it finishes.”
Bike teams have become more common around the country for these special event standbys, especially in services that consider themselves “very progressive,” as Blackington sees Boston EMS. “We have a lot of alternative response devices for EMS,” he says. “We already had electric cars and golf carts, and we used Segways for a period of time. Bikes were of interest to us as just another tool in the toolbox.”
Training to Ride
Obviously, there’s more to providing EMS from a bicycle than just knowing how to ride one.
“We teach a 32-hour program for EMTs and paramedics that is geared toward using bikes rather than teaching medicine,” says IPMBA-certified instructor Blackington. “Our presumption is, whatever you do once you get off the bike to treat the patient you have gleaned from other training and experience. Our job is really to help people get oriented to professional public-safety biking, which is different from what you learned about bike-riding as a child. Putting that much extra weight onto a bike changes the dynamics of how you handle it. And, we’re doing a different type of cycling most of the time. We aren’t racing around; we’re usually carefully weaving our way through high-density crowds or narrow access points, so we teach a lot of slow-speed skills. The first thing our students learn is that it’s not about racing or about how fast they can get from point A to B. It’s that bikes can maneuver crowds or congested streets better.
“We also teach physical fitness and nutrition. Most places require tryouts, so employees are getting in better shape in order to participate on the team, which creates an upside in having better-conditioned employees. There’s also a maintenance segment in our course that teaches EMTs and paramedics how to handle routine maintenance issues that might occur in the field. Almost everyone carries a spare tire and some emergency tools to keep their bike fine-tuned to their particular fit or to maintain it if something comes loose.”
Blackington says they realize that some departments may not be able to afford a bike for each medic, and that is addressed in the training sessions.
“Some departments just buy a couple of bikes in the mid-range sizes, so we teach students how to make adjustments in seat height and direction and handlebar height, and how to tailor the bike to their particular stature, experience, capability and things like that,” he says.
Where To Next?
As bike use in EMS grows, so, too, has the number of manufacturers that offer emergency lighting systems, bicycle accessories and clothing. Some manufacturers, says Blackington, are even making bullet-resistant vests specifically for bike duty.
Which leads to the question: In these turbulent times, how safe is it to be a medic on a bike?
“I don’t think homeland security circumstances have impacted bikes that much,” says Blackington. “There has always been a training component that deals with EMT and paramedic safety when they’re on a bike. In the last five years or so, we’ve developed a teaching program at the IPMBA conference that deals with putting SWAT officers or special response officers on bikes.”
In EMS providers’ favor is that they can approach a scene relatively unnoticed, allowing medics the opportunity to survey the scene from a distance with relative anonymity, then make a decision about whether it’s appropriate to go the rest of the way. Obviously, the mobility with the bike means they can maneuver out and away from a situation faster than if they were locked into an automobile. They don’t have the glass and steel enclosure that an ambulance provides, but an ambulance doesn’t always provide protection anyway.
“For the most part,” Blackington concludes, “bicycling EMS is a lot of fun. It’s a morale booster for agencies that have bikes and an opportunity to reward good employees.”
This article appeared in the May/June 2006 issue of Emergency Medical Product News. The cover photo and others were taken by Greg Johnson, a former member of the Williamson Medical Center EMS Bike Team in Franklin, Tenn.