Study highlights EMS transport dangers

By Shannon Eliot
EMS1 Editor

LAS VEGAS — Seventy-four percent of EMS worker deaths are transportation-related, according to new research released by the National Association of EMS Physicians. Further, ambulance crashes were shown to be more 27 and 33 percent more fatal than those of their respective police and fire vehicle counterparts.

The report suggests that an increased willingness by first responders to stay seated and wear seat belts, combined with a heightened attentiveness by motorists, could result in a drastic decrease in the number of fatalities.

AP Photo/Colorado State PatrolA study by the NAEMSP shows that ambulance crashes are more likely to result in fatalities than those of fire or police vehicles.

AP Photo/Colorado State Patrol
A study by the NAEMSP shows that ambulance crashes are more likely to result in fatalities than those of fire or police vehicles.

"In an ambulance, the single most important thing one can do to increase survivability or prevent injury is to wear a seatbelt or some type of restraint," said Ron Thackery, senior vice president of safety and risk for American Medical Response.

The risks of death and severe injury for EMS personnel are four to six times higher for unrestrained ambulance occupants than restrained ones. While EMS workers do need to perform critical patient care — such as chest compressions — the majority of procedures can be done in conjunction with a restraint device, according to Thackery.

"If doing chest compressions, it’s going to be difficult anywhere, but 90 percent of typical patient care provided can be done in conjunction with some sort of restraint," Thackery said.

Despite this statistic, Thackery said only 10 percent of EMS workers admit to wearing a seatbelt in the back of a vehicle.

"It is much more common for people to wear seat belts in the front [of the ambulance] than the back," said Thackery. "Seat belt use is monitored in the front and generally affects airbag activity in the case of an accident. One solution may be to simply monitor seatbelt use more efficiently in the back."

Dr. David Slattery, co-author of the NAEMSP study, believes that advances in ambulance equipment are crucial to improve safety in the patient compartment, thereby allowing providers to give care as well as balance and protect themselves in transport.

"Technology is being developed to allow EMS workers to be seated and restrained — for example, automated chest compression devices — which allow the medic to sit down as opposed to standing over a patient performing CPR," Slattery said.

The NAEMSP also reports that failure of an oncoming motorist to yield to an ambulance is the primary cause of crashes when an ambulance is employing its lights and sirens.

"Proper positioning of a vehicle is highly important when responding to a scene," Thackery said. "Most on-scene crashes occur when traffic in the ambulance lane begins to shift to other lanes. To a motorist from afar, the ambulance lane suddenly appears open, so he increases his speed only to ultimately hit the emergency vehicle."

Some states are taking legislative measures to keep their first responders safe.

Following the death of paramedic Michelle Smith in December, the Delaware state senate passed a bill Tuesday carrying her name that would make individuals convicted of causing the reckless death of a paramedic, emergency medical technician, fire marshal, or fire police officer eligible for capital punishment. The legislation, named for the 30-year-old paramedic killed while tending to an accident victim after being struck by a speeding vehicle, would impart any transgressor with a first-degree murder charge.

"Often, people don’t realize the type of issues that EMS workers face," said Slattery. "While the work of EMS personnel can be risky by nature, there is no reason that the risk of occupational death is two and a half times larger for EMS workers compared to other American workers."

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