Few areas of EMS are more important than vehicle safety. Many of you spend hours every day behind the wheel or in the back of a rig, treating and transporting, making your communities safer and better places to live. Your safety in that ambulance is a top concern for all of us. For vehicle designers and manufacturers, this means incorporating the latest and best features designed to protect their occupants. And for EMS providers, that means operating these vehicles with the proper training, equipment and attitude. In this special three-part supplement, we examine this equation in more depth. Last month, we looked at how agencies can create a "culture of vehicle safety." This month, we review what's new in terms of safety features in the back of the ambulance.
Ambulance safety has always been a hard area to get our hands around in a scientific way. Data are imprecise as to how many accidents occur, how many providers, patients and others are hurt and killed, and just how those deaths and injuries happen.
But that hasn't stopped efforts to make the ambulance environment safer. Even without optimal data, recent years have seen such commonsense improvements as securing equipment so it doesn't become airborne and placing netting to keep personnel from striking the bulkhead in frontal collisions (this, you'll remember, killed the young providers discussed in the first installment of this series).
Across the industry, efforts in this vein continue-perhaps more than ever.
"For a long while, it didn't seem like much happened (in regards to ambulance safety)," says Paul Moore, a safety engineer with the National Institute for Occupational Safety and Health's Division of Safety Research, who's been involved in both crash investigations and safety research for that federal agency. "But now I think we're on the verge of seeing some changes. There are indications that people are rethinking what happens in the back of an ambulance and what's needed to better support EMS providers."
"There have been huge strides forward," concurs top ambulance-crash researcher Nadine Levick, MD, whose new organization, Objective Safety, is dedicated to EMS vehicle safety awareness and improvement. "If you compare what's happened in the area of safety over the last, say, 3-4 years to what happened in the 15 years before that, it's huge."
This article will look at some of what's current and potentially coming in the area of ambulance safety.
Beyond The Belt
Some EMS providers have already worked to design enhanced-safety vehicles. The central aspect of their approach is facilitating patient access for providers who are seated and restrained. Some have experimented with arranging the interior so that necessities like drugs, oxygen, suction and radios can be within personnel's reach without standing. They have included harness restraints, rather than lap belts. Others have offered safeguards like collision-avoidance warning systems, external caution lights and "black box" computer systems to enforce safe-driving parameters.
These approaches are too new and limited to say if they've been successful, but there's no question that restraints are a major part of any safety equation. In a recent survey conducted by this magazine, roughly three-quarters of respondents said their current restraint systems were impractical or inhibited their doing their jobs.
This view isn't new, and neither are efforts to build a better belt. As far back as the early 1990s, firefighters in Phoenix developed a retractable harness that allowed movement, but would snap wearers back into place and hold them secure in an accident. But their idea has yet to be broadly embraced.