I am sure your department has a seat belt use policy. Yet, I sometimes observe EMS professionals not wearing a seat belt in the patient care compartment of the ambulance or the driver compartment. When asked, I have encountered responses that range from indifference to hostility when suggesting we should always wear our seat belts in a moving ambulance. In some organizations not wearing a seat belt was part of the culture.
In a July 2019 EMS1 reader poll only 4% of respondents said “Always” to the question, “How often do you wear a seat belt in the patient care compartment?” A worrisome 29% of respondents said “Never.” Vote in the poll at the end of this article about your seat belt use.
Common complaints are that wearing a seat belt might compromise patient care by not being able to perform tasks like reaching for equipment, using a bag-valve mask, talking on the radio or compressing the patient’s chest.
These are six tips for wearing a seat belt in the patient care compartment as much as possible.
1. Commit
Start by making a personal commitment to use a seat belt on every patient response and transport.
2. Assess and treat on-scene
Maximize assessment and interventions performed before transport starts based on patient condition and protocol. Initiating transport for a patient in cardiac arrest should be exceptionally rare. Follow your local protocols, which in many places direct at least a 20-minute on-scene resuscitation attempt.
3. Optimize patient care compartment
Organize your workspace so the tools and equipment you will most likely need for IV access, oxygen and medication administration, vital sign monitoring and airway management are within reach during transport.
4. Hospital report
Use a smartphone or handheld radio to call in the hospital report, if allowed, so you can talk from any seat belted position.
5. Likely supplies at your side
For additional supplies needed during the transport, I like to keep the first-in bag belted to the seat next to me. I use supplies from there and replenish the bag from the cabinets after the call.
6. Only leave your seat when the vehicle is stopped
If you must leave your seat, try to wait until the vehicle comes to a halt at a stop sign or red light. Tell the driver you are moving and then tell the driver when you are safely restrained in a new seat.
Finally, if your service routinely transports pulseless patients, it is well past time to have a thoughtful conversation with your medical director and service director about the efficacy of manual chest compressions in an ambulance relative to the risk to you and your colleagues.
This article, originally published November 24, 2009, has been updated.
