Improving Outcomes Before EMS Arrives

Background

As a NYCT Structure Maintainer (G), I spent my first year stationed at MOW-W4 Nights. For overtime, I assisted the Masons on concrete pours, clearing excess cement from the oiled plates and track ties in the role of Broom & Pail. Infrastructure repair at this scale demands a dense, multi‑disciplined crew working long hours in a treacherous environment: extreme heat or cold, dim lighting, and an obstacle course of slip, trip, and fall hazards.

I enjoyed the work, but I often thought about how difficult it would be to save a brother or sister if there were a medical emergency. In theory, 911 would be called, EMS dispatched, and once they arrived, FDNY would have to maneuver a backboard more than 300 feet down a tunnel filled with wet concrete before even reaching the victim.

Current Challenge

As a former EMT, I know that rapid medical response is essential to prevent shock. Once shock begins, trauma‑induced hypothermia follows quickly, driving the Trauma Triad of Death:

• Hypothermia (dangerously low core temperature) 
• Coagulopathy (impaired blood clotting)
• Acidosis (cellular failure)

These conditions compound one another, accelerating physiological collapse. In emergency care, preserving body heat is not optional, as it is a critical, lifesaving intervention that directly improves survival and recovery.

Even mild cooling has serious consequences:

• It reduces cardiac output and destabilizes heart rhythm. 
• It accelerates organ failure and worsens acidosis. 
• Patients who arrive hypothermic require more interventions, stay longer, and face higher mortality. 

Proposed Solution

Mylar Thermal Blankets for Critical Life Protection

Mylar thermal blankets — lightweight, compact, and highly reflective — were originally developed by NASA to preserve body heat in extreme environments. They reflect up to 90% of body heat, block wind, and prevent moisture loss, making them highly effective across all MTA NYCT operating conditions. Their usefulness spans both workforce and ridership needs, supporting incident response across trains, tunnels, elevated structures, emergency exits, stations, shops, yards, buses, depots, and office environments.

These blankets are standard in disaster response and search‑and‑rescue because they require no training, no maintenance, and deploy instantly. To use one, remove it from the wrapper, unfold, and cover the individual fully, keeping the face clear so the airway remains unobstructed. These blankets do not generate heat; they retain existing body heat, so one is typically sufficient, with a second used only when the individual is wet or exposed to severe cold.

Integrating mylar thermal blankets into NYCT emergency response protocols ensures early heat preservation at the scene of an incident, an established measure that helps reduce complications during prolonged EMS response times. This support is valuable not only in major trauma, but also in common medical emergencies such as heart attacks, strokes, fractures, or any situation where an individual may become cold, distressed, or physiologically unstable while awaiting EMS.

Specifications & Costs

• Size (unfolded): ~84″ × 52″ 
• Packed size: ~4″ × 4″ × 0.5″ 
• Weight: < 2 oz 
• Material: Reflective mylar film (retains up to 90% of body heat)
• Cost: ~$0.63–$0.75 per unit (bulk pricing)

A review of publicly available MTA procurement records shows no existing contracts or solicitations for mylar or emergency thermal blankets. This indicates that passive warming tools are not currently standardized within NYCT emergency response equipment, presenting a clear opportunity to close a systemwide safety gap.

System Safety Implementation Plan

This proposal recommends that System Safety lead the agency‑wide adoption of mylar thermal blankets as a required emergency‑response tool. It outlines the actions potentially needed to integrate early hypothermia prevention into NYCT’s safety protocols, training programs, and field operations.

• Establish Policy & Standards

• Issue a System Safety Directive requiring mylar thermal blankets in all first aid and emergency‑response kits.
• Update Worker‑Down, Emergency Medical, and trauma‑response SOPs to include immediate passive warming. 
• Incorporate hypothermia prevention into Job Hazard Analyses and Safety Risk Assessments. 

• Coordinate With Operations & Logistics 

• Provide specifications and required quantities to NYCT Logistics for procurement and stocking. 
• Identify stocking points across Track, Structures, Signals, Power, Stations, and RTO.

• Training & Workforce Readiness

• Publish a System Safety Bulletin explaining the importance of early warming. 
• Develop a 5‑minute Toolbox Talk training module for supervisors. 
• Add a short online training module to the Safety curriculum. 
• Integrate mylar thermal blanket use into Worker‑Down and track‑incident drills. 

• Field Deployment Oversight

• Set minimum stock requirements for red bags, trauma kits, work trains, supervisor vehicles, and crew quarters. 
• Add thermal mylar blankets to monthly safety equipment inspections.
• Conduct spot checks during overnight GOs and high‑risk work windows. 

• Reporting & Continuous Improvement

• Add a checkbox to injury and Worker‑Down reports indicating whether a blanket was deployed. 
• Review usage data quarterly to identify gaps or training needs.
• Adjust stocking levels and procedures based on incident findings. 

• Communications & Rollout

• Issue a System Safety notice to all relevant stakeholders.
• Provide posters and quick‑reference cards for crew quarters and supervisor vehicles.
• Deliver a one‑page executive summary to senior leadership. 

• Timeline

• Weeks 1–2: Directive issued; SOP updates drafted; training materials prepared 
• Weeks 3–4: Procurement coordination; stocking plan finalized
• Weeks 5–8: Field distribution; supervisor briefings 
• Weeks 9–12: Training rollout; audits begin 
• Ongoing: Quarterly review and continuous improvement 

Extension to Ridership

Customer Service Booth Emergency Readiness

Rider emergencies often occur before EMS arrives. Falls, collisions, medical distress, and prolonged exposure can rapidly lead to heat loss, especially in winter months or during extended service disruptions. Early passive warming is clinically beneficial for riders just as it is for employees.

Customer Service Booths already function as fixed emergency nodes equipped with AEDs, first‑aid kits, and communication tools. Adding mylar thermal blankets to the existing ER kit provides Station Agents with a simple, non‑clinical means of supporting riders in distress while awaiting EMS.

This enhancement requires:

• Minimal storage space.
• No new equipment footprint.
• Intuitive to use, no additional training burden.
• No expansion of Station Agent responsibilities.
• A simple instruction card (“Call 911 → Notify RCC → Cover with blanket → Await EMS”) ensures clarity and consistency. 
• Integrating mylar thermal blankets into booth‑level ER kits strengthens NYCT’s commitment to customer safety, ADA accessibility, and equitable emergency response across the system. 

Strategic Benefits

For Executive Leadership:

• Strengthens systemwide safety readiness by introducing a proven, low‑cost intervention that enhances early incident care across all operating environments. 
• Improves workforce and ridership outcomes through faster stabilization of individuals experiencing shock, reducing complications and supporting better recovery trajectories. 
• Advances NYCT’s commitment to accessibility and care by integrating a universally deployable tool that requires no training, no maintenance and works across all divisions.
• Enhances operational consistency by standardizing a critical early‑response measure across stations, trains, buses, shops, yards, and field operations. 
• Demonstrates proactive leadership in adopting best practices widely used in disaster response and search‑and‑rescue, positioning NYCT as a national leader in transit‑based emergency care. 
• Supports audit‑ready safety improvements with a measurable, easily implemented enhancement that aligns with existing emergency protocols and requires minimal operational disruption.  

Connection

Your consideration of the Trauma Shock Mitigation Initiative — Mylar Thermal Blankets for Critical Life Protection underscores MTA New York City Transit’s commitment to proactive, evidence‑based safety improvements. By adopting this simple, systemwide enhancement, NYCT strengthens early incident response, improves outcomes for employees and riders, and reinforces a culture of preparedness and care across the entire network.

For inquiries or feedback, please feel free to contact Nicole Weedon, SM‑G, Facilities, at nicole.weedon@nyct.com