**Abstract**

Patients deserve high-quality, evidence-based care delivered from the moment they call for help to the moment they are safely delivered to the hospital. Often patient safety is not viewed as a fun or exciting topic by prehospital clinicians, but it need not be a burden. A culture of safety in emergency medical services can enhance patient outcomes and improve the overall safety in a community. The design and structure of the ambulance are the first layer of protection for patients. Couple that with ambulance operations topics, such as speed and light and siren use and that covers a large swath of the patient safety engineered into the system. There are patient-focused topics such as medication safety protocols, structured handoffs, and competency assessments of high-risk procedures that all serve to increase patient safety. Lastly, an emergency medical services clinician-oriented topic that also heavily impacts our patients is fatigue mitigation. Actively addressing fatigue and employing fatigue mitigation strategies can be used to enhance the safety of patients and will likely enhance the experience of prehospital clinicians in the organization.

**Keywords:** emergency medical services, EMS, patient safety, medication safety, lights and sirens, EMS vehicle operations, paramedics, fatigue, transfer of care, SBAR, DMIST
