Study Confirms Ambulance Dangers

Author: By Lisa Zagaroli / Detroit News Washington Bureau (Reprinted With Permission)

Reprinted With Permission
Special Thanks To The Detroit News

Ambulance safety

Crashes involving ambulances are the most harmful for people in the patient compartment, according to a study in the Journal of the Emergency Medical Services. The review of 305 fatal crashes from 1988-97 also found that seat belts played a large role in ambulance safety.

  • Unrestrained occupants riding in the back of ambulances accounted for 52 percent of deaths
  • Restrained occupants riding in the back accounted for 20 percent of deaths
  • Unrestrained occupants anywhere in the vehicle were four times as likely to die as those wearing seat belts or other restraints

Source: Journal of the Emergency Medical Services

Related report

"Unsafe Saviors:" This special Detroit News report found that a lack of vehicle performance standards, maintenance and proper safety restraint contributes to the human toll caused by at least 6,500 ambulance crashes a year. Speeding, fatigue, driver error and dispatch blunders often lead to ambulance crashes.

WASHINGTON -- The patient compartments of ambulances are the most dangerous place to be when the emergency vehicles are involved in a crash, a new study shows.

Courtesy of The Washington Post

At least two people died in this Ballston, Va., accident. Victims in the patient compartment accounted for 72 percent of deaths in ambulances.

People riding in the back compartment accounted for 72 percent of deaths in ambulances even though they represented only 40 percent of passengers inside the vehicles when they crashed, according to a report in the current issue of the Journal of the Emergency Medical Services.

The new analysis confirms the findings of a special report earlier this year by The Detroit News. The News found that the patient compartment can be deadly for both patients and medics and that many deaths and injuries that result from the 6,500 ambulance crashes each year are preventable, particularly if people are properly restrained.

"Occupants riding in the back were more than five times more likely to die as compared to escaping unscathed than those riding in the front," said author Les R. Becker, a paramedic.

Becker led a research team at the Pacific Institute for Research and Evaluation in Maryland. The study compared risks of death and injury levels in crashed ambulances.

The News' examination revealed that the rear patient compartments of ambulances aren't subject to crash tests or federal occupant safety standards. The stories also found that while medics cite a lack of mobility to treat patients for failing to secure themselves with seat belts, they often don't wear restraints even when they're not responding to a life-threatening situation.

The JEMS report found that passengers in an ambulance that was on a routine transport were 2.7 times as likely to be killed than one on an emergency run, and nearly 1.7 times more likely to suffer an incapacitating injury in a crash.

The new study, which examined 305 fatal ambulance crashes from 1988-1997, found that people wearing their seat belts had nearly four times less risk of dying than unrestrained occupants, and their risk of suffering an incapacitating injury was nearly 6.5 times lower.

"EMS providers should consider rethinking their individual approaches to prehospital care," wrote Becker, whose study also will be published in an upcoming issue of Accident Analysis and Prevention. "Care that can be initiated on scene without compromising overall patient care is care that might not have to be initiated while unrestrained in the back of a moving ambulance.

"Changes in provider practice that increase the amount of time providers spend wearing a seat belt without compromising patient care will improve provider safety and reduce the toll of death and injury from ambulance crashes," he added.

Courtesy Of The Washington Post

Patient Neil Catherine Crigger, 83, died in this ambulance accident in Morgan County, Ky. Many deaths that result from the 6,500 ambulance crashes each year are preventable.

A Michigan-based manufacturer of ambulances hopes to reconfigure vehicle designs to make it easier for medics to work on patients while keeping themselves safe. "A great way to improve safety is to eliminate people from having to stand up and move around," said John E. Sztykiel, CEO of Spartan Motors Inc. of Charlotte. "If you can stay seated, have your seat belt on, make sure the passenger and the cot is secured, and they're secured, you've gone a long way toward improving safety."

The company builds 200 to 225 ambulance compartments -- or "boxes" -- a year.

The National Highway Traffic Safety Administration is relying on the private sector to take voluntary steps to make ambulances safer. Critics charge ambulances should be subject to crash tests because they have sharp corners and other unforgiving features, and they sometimes completely collapse on impact.

Spartan Motors' Road Rescue subsidiary is exploring ways to better distribute and absorb energy from impact.

"Not only do you want to think about protecting the occupants inside the vehicle, but if we can take that energy when it comes in from the side, instead of it all of a sudden just causing the vehicle to swerve, ... then obviously we are going to have better control in a catastrophic situation," Sztykiel said.

You can reach Lisa Zagaroli at (202) 662-7382 or