Get Out of the Way: Ambulance Safety Data Calls For Drivers To Respect Ambulance Right of Way and Rescuers to Buckle Up
Risk of Death for EMS is More than Double that of Other American Workers, 74% of EMS Deaths are Transportation-Related
Las Vegas, Nevada — New research published today in the journal of the National Association of EMS Physicians, Prehospital Emergency Care, finds that 74% of EMS worker deaths are transportation-related, and suggests that these numbers could be reduced if citizens yield to ambulances, and EMS personnel embrace strategies that allow them to remain seated and restrained in the back of the ambulance, among other findings.
“While the work of EMS personnel can be risky by nature, there is no reason that the risk of occupational death is two and half times higher for EMS workers compared to other American workers,” says study co-author David E. Slattery, M.D., FACEP, FAAEM, EMS Medical Director, Las Vegas Fire and Rescue, and Assistant Professor & Research Director, Department of Emergency Medicine, University of Nevada Las Vegas. “Often, people don’t realize the types of safety issues that EMS workers face.”
The article reports that failure of an oncoming motorist to yield to an ambulance is the primary cause of ambulance crashes when an ambulance has its lights and siren on. The risks of death and severe injury for EMS personnel are four- to sixfold higher for unrestrained compared with restrained ambulance occupants. In addition, riding unrestrained in the back of an ambulance poses additional risks to EMS personnel. Often EMS workers have to perform critical patient care while unrestrained, such as while performing chest compressions, airway management, critical procedures and patient control.
“The lack of seat-belt use plays a pivotal role in the hazard of delivering care in the back of a moving ambulance,” says Dr. Slattery. “Technology is being developed to help allow EMS workers to be seated and restrained, for example automated chest compression devices like the AutoPulse, which allows the medic to sit down as opposed to standing over a patient performing CPR.” Automatic ventilators, which provide regular breathing for patients, also free up providers’ hands for personal balance and protection during transport.
Although the immediate goal is to develop strategies for keeping providers seated, restrained and hands-free, other possible solutions include developing better ambulance design and safety standards and implementing Crew resource Management strategies while driving lights and siren.
Ambulance crashes were fatal 27% more often than police crashes and 33% more than fire truck crashes, and, there were 57% more people injured in ambulance crashes as fire truck crashes and 4% more than police crashes.
Nearly killed when his ambulance was in a rollover in a storm, former EMS worker Matt Deicher of Mosinee, Wisconsin knows the importance of being restrained and underscores the need for equipment to be safety-checked, “We were transporting a patient with hip pain who was going into cardiac arrest, and as I was trying to care for him, we moved from cement to asphalt, our tires slid and we flipped.” Matt, who is a quadriplegic because of the crash, believes that it is important that steps are taken to keep his colleagues safe. “People may not realize, how high the risks are for EMS personnel and their patients, and that there are solutions which can be as simple as regular ambulance maintenance, better communication within the ambulance and access to new technologies.”
The National Association of EMS Physicians (NAEMSP) is also focusing on the safety of EMS personnel. According to Dr. Theodore Delbridge, NAEMSP President, “While EMS personnel work diligently to safely treat and transport their patients, we need to work to ensure the safety of EMS personnel. Standards for vehicle design, particularly in the patient compartment, should maximize patient and EMS personnel safety while allowing the necessary care to continue. Similar attention should also be paid to the equipment and supplies that must be readily available so that they are not potential risks but might even improve both patient and personnel safety in a moving ambulance.” NAEMSP is holding a special meeting this fall to focus on ambulance safety and possible solutions.
Las Vegas Fire and Rescue, under the leadership of Fire Chief Greg Gammon, has already started implementing safety measures in their rescues such as deploying the AutoPulse® device and automated ventilators for cardiac arrest patients, strategic positioning of supplies and equipment to be within the reach of seated providers, and increasing provider awareness of the dangers of code-3 driving. Dr. Slattery states that “The common goal of each of these solutions is to remove any obstacle that keeps our EMS providers from remaining seated, restrained, and hands-free as possible in the back of their ambulances.”
• Las Vegas Fire and Rescue—Las Vegas Fire and Rescue provides all fire suppression, prevention and education programs in the city. The department also provides bomb squad, hazardous materials, emergency medical and emergency management services. For more information, please visit http://www.lasvegasnevada.gov/Government/fire.htm.
• NAEMSP—The National Association of EMS Physicians® is an organization of physicians and other professionals partnering to provide leadership and foster excellence in out of hospital emergency medical services. For more information, please visit http://www.naemsp.org