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Building a safer ambulance through science

Standardizing guidelines for ambulance design and collision testing requirements can save lives

NEW ORLEANS — Building ambulances that appropriately react to a collision remains one of the most important components of keeping EMS providers safe. Jim Green, a researcher with the Division of Safety Research at the National Institute for Occupational Safety and Health, presented on some of the ways his team is working to create a safer ambulance at the 2017 National Association of EMS Physicians annual meeting.

Specifically, he discussed the development of standardized guidelines in conjunction with the Society of Automotive Engineers that correspond to each component of an ambulance and the patient compartment. Green explained that due to the unique build, weight, and internal design of an ambulance, having specific guidelines is critical. And that the best way to confirm if guidelines are effective is to perform a wide variety of crash tests as demonstrated below:

Memorable quotes

Green kept the audience’s attention through his use of videos and memorable quotes, here are some from his presentation to NAEMSP attendees:

“In my travels, I’ve personally met two providers with a broken pelvis from crashes” a concept he demonstrated with the following video:

“Looking at workplace design: How can we get equipment you need most often closer to you?”

“Even with an upper torso restraint, the dummy’s head was eventually decapitated” as seen in the following video:

“Has anyone ever put oxygen cylinders between someone’s legs ... I know of two fatalities from oxygen cylinders hitting someone in the head.”

Key takeaways on ambulance collisions

Green’s presentation did a great job demonstrating the importance of prioritizing ambulance safety and standardized guidelines. Here are my four top takeaways from his presentation.

1. Crashes are frequent

There is an average of 12 ambulance crashes per day in the United States; one-third of crashes result in injury to an individual involved in the crash. Specifically, one-sixth of injuries are reported by the provider driving the ambulance, while just under 30 percent are reported by a passenger in the unit.

2. Seat belts work

Seat belts save lives, both those of the provider and the patient. The more points of contact a seat belt has, the more effective it is at preventing injuries. This is best demonstrated in the video below:

3. Patient care compartment functionality

There is an increased focus on improving the functionality of the patient compartment by moving frequently used equipment, controls and communications closer to an EMS worker’s primary seating location. By doing this, a worker’s need to move around is greatly reduced and they are better able to stay seat belted in the patient care compartment.

4. Standards for ambulance design

The standards created by SAE International are internationally recognized and used by numerous other organizational specifications and standards; however, the use of these standards is not homogenous across the U.S.

Read more about how new ambulance designs promise to improve patient and provider safety in the Paramedic Chief Digital edition. The issue explores efforts to improve ambulance safety, shining a light both on technological advances and ways to improve driver behavior. And here are additional articles on ambulance safety:

Catherine R. Counts, PHD, MHA, is a health services researcher with Seattle Medic One in the Division of Emergency Medicine at the University of Washington School of Medicine. She received both her PhD and MHA from Tulane University School of Public Health and Tropical Medicine.

Dr. Counts has research interests in domestic healthcare policy, quality, patient safety, organizational theory and culture, and pre-hospital emergency medicine. She is a member of the National Association of EMS Physicians and AcademyHealth. In her free time she trains Bruno, her USAR canine.

Connect with her on Twitter, Facebook, or her website, or reach out via email at