How to avoid, survive an ambulance collision

Ambulance collisions, which happen with frightening regularity, often result in injury and are occasionally fatal, especially for private vehicle drivers


If you regularly drive an ambulance, here are two questions to ponder.

  1. How much money will a jury award ambulance crash survivors?
  2. How much jail time will I get as the at-fault driver in a fatal ambulance collision?

Seattle agreed to pay $65 million to the family of Brooke Taylor. The settlement will cover ongoing care for Taylor, who suffered a traumatic brain injury in a 2016 collision between a Seattle Fire Department ambulance, running with its lights and sirens, and Taylor's vehicle. The ambulance drove through a red light.

A concrete pumping truck crashed into an ambulance while an EMS crew was pulled over trying to calm a patient, according to officials. (Photo/LEMS)
A concrete pumping truck crashed into an ambulance while an EMS crew was pulled over trying to calm a patient, according to officials. (Photo/LEMS)

The answer to the second question is a little less clear as cases of jail time are relatively rare. A Virginia EMS provider was indicted for involuntary manslaughter and two counts of reckless driving in an ambulance collision that resulted in the death of Rita Davis. The driver of the ambulance, still in training, had the red lights activated, but not the sirens, at the time he drove through an intersection.

Jeffrey Gable, the driver of a non-emergency transport ambulance – presumably a wheelchair van – received six months of prison time for his role in a 2016 crash that killed his passenger and the driver of another vehicle.

In early January, I received a message from Jim Love, a longtime EMS risk and safety manager. Love wrote:

"Recently, I drove through Lorain, Ohio, where in April 1989, paramedic Micheal Montecalvo was involved in a collision that cost another person her life. He was sentenced to 2 to 10 years in prison for aggravated vehicular homicide. He only served seven months of his sentence, but was a convicted felon – never to work in EMS again."

Multi-million dollar settlements and the risk of jail time ought to motivate interest in better understanding how ambulance crashes happen and what you can do to avoid a collision.

Ambulance crashes happen with predictable frequency

EMS1 posts news of ambulance collisions, which happen with such regularity that our news editors aren't able to cover them all. Otherwise our news coverage would be dominated by ambulance crashes. Here are the most noteworthy ambulance collisions from just the first month of 2019:

  • An intoxicated driver of a private vehicle collided with an ambulance in Idaho.
  • Collisions regularly happen in intersections like this one in Michigan that critically injured a paramedic.
  • Wrong way drivers are especially dangerous. An Arkansas ambulance was struck by a vehicle driving the wrong way. One of the injured paramedics is anticipating it will take a year to fully recover. Two Iowa EMS providers were injured after a head-on-collision with a vehicle traveling in the opposite direction.
  • Ambulances operating too fast for conditions were involved in collisions in North Carolina and Kansas, where the ambulance spun and rolled over on an icy roadway.
  • Sometimes, the cause is not known or reported, like an ambulance that went off the road in South Carolina, though it's reasonable to suspect this was caused by either mechanical failure, a sleeping driver or a distracted driver.
  • The patient care compartment of a Kentucky ambulance was dramatically cut in half when it was struck by a concrete pumping truck. The ambulance had pulled over on the side of the road to secure a patient who tried to climb out of the ambulance.

Ambulance collision LODDs in 2018

In 2018, EMS1 reported on 22 EMS provider line of duty deaths. On-duty or after-shift medical emergencies were the leading cause of death. Five fatalities were the result of ambulance collisions. Three fatalities were from a medical helicopter crash in northern Wisconsin. An EMT student was killed in a motorcycle crash en route to EMT school in another vehicle-related fatality.

Avoid and survive an ambulance collision

Ambulances travel millions of miles every year. Whether responding to an emergency, transporting a patient, driving to a posting location or returning to quarters, here are actions for every EMS provider to take to avoid and survive a collision.

1. Trust no one

Other drivers are distracted, drunk, asleep or incompetent until proven otherwise. Drive defensively, anticipating the drivers around you will make the worst possible decisions and will also react erratically and indecisively as you approach them at an intersection or prepare to overtake a vehicle. Never trust another driver to do the right thing. Instead expect them to do the worst thing.

2. Do your job as a driver or passenger

New England Patriots Football Coach Bill Belichick has this expectation of his players: Do your job. Your job as an ambulance driver and passenger includes these fundamentals:

  • Wearing your seatbelt. Always.
  • Operating at speeds safe for road conditions.
  • Never being distracted by a smartphone, a radio, an MDT or food as you drive.
  • Keeping your eyes on the road and mirrors.
  • Assessing hazards and anticipating how you will respond to a dynamic operating environment.

3. The road is a hot zone

Any roadway, especially when stopped on the side of the road, is a hot zone. Minimize your exposure time to all other vehicle traffic. Put as much distance as possible between you and those vehicles. Use other vehicles – fire apparatus and police cruisers – to shield the incident scene from intrusion by other vehicles. Move towards a warm zone with purpose and urgency.  

4. Red lights and sirens are dangerous to life and health

One of the most common attributes of an ambulance collision is the use of red lights and sirens. The risk associated with red lights and siren use – which give an ambulance right of way and permission to operate above the posted speed limit – is well known; at least it should be. Nonetheless, red lights and siren use remains a dangerous sacred cow in EMS that has little impact on patient outcomes.

5. Transport is a treatment

Protocols and clinical decision-making guide patient treatment decisions. Pick the mode of transport, a prehospital patient treatment, most appropriate to the patient's condition. The choices are not limited to either "no transport" or "red lights and sirens transport." Transport modes, include but are not limited to:

  • Patient's own vehicle
  • Ride share
  • BLS non-emergent or emergent
  • ALS non-emergent or emergent
  • Flight

Other than patient lifting, can you think of another treatment that has such a high-risk of injury? If your organization has a mode of transport quality improvement process or project underway to understand and minimize the risk of ambulance collisions, EMS1 wants to hear about it.

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