Ambulance Hazards Targeted

WASHINGTON -- A major overhaul is planned in the way ambulances are operated, designed and regulated to make them less dangerous to the medics and patients who ride in them, top industry officials say.

Confronting a chronic problem for the first time, the ambulance industry is working on a comprehensive plan to cut down on the number of deaths and injuries that result from the more than 6,500 ambulance crashes every year.

The initiative could result in new standards for how drivers are screened and trained, more reliable ways to protect people and equipment inside the patient compartment and new designs to make the vehicles more crashworthy and less likely to roll over.

All the concerns were outlined in an investigation by The Detroit News earlier this year.

"The problem is that crashes in first response -- in ambulance or police or fire -- are probably more significant than any of us understand," said Larry Wiersch, executive director of Cetronia Ambulance Corps in Allentown, Pa.

Wiersch is a board member of the American Ambulance Association, which is coordinating the efforts of university researchers, government safety officials and the people who make, use and insure ambulances.

The group met last week near Washington to develop short- and long-term goals to improve safety of emergency vehicles.

"There was a clear understanding that everybody would be involved in the developments as they unfolded, that the best way to get the best outcome was having all of the folks from each discipline involved in each step," said Dr. Nadine Levick, a researcher who has conducted crash tests of ambulances and studied their safety.

"It's such a cross-disciplinary situation. What came across is the real recognition of how each area was so important to each other."

The effort came as welcome news to one patient who was involved in an ambulance crash.

Rollin Ager of Ashburn, Va., who was a heart patient in a routine transport to the hospital, suffered a heart attack, a head injury and cracked ribs when the ambulance he was in flipped over several times.

Joseph "Neal" Sherman, the medic who was caring for him in the March 16, 2001, crash, was killed.

Authorities say the driver of the ambulance fell asleep because he'd been up all night and shouldn't have been behind the wheel.

"Certainly I can say the ambulance being safer would be a help," Ager said. "To us, the bigger thing is the driver responsibility, the responsibility of the firm who hires these people, their control of these people and how they dispatch the driver and keep track of drivers' capability."

Wiersch said three working groups are finalizing the goals to reach within a year in technology, vehicle design and the actions of ambulance personnel.

In the meantime, the group wants more reliable data to define the precise dangers ambulances pose to their occupants and other drivers on the road so they can minimize crashes and their consequences.

About 10 serious injuries a day and three dozen deaths a year are reported in ambulance crashes. The industry suspects the real numbers are higher.

Ambulances have proven more dangerous than other vehicles driven on the job.

Emergency medical workers have an occupational fatality rate of 9.6 per 100,000 workers per year in transportation-related incidents, compared with 6.3 for police, 4.5 for fire fighters and 2 for average citizens, according to research by Brian J. Maguire.

He is the associate director of the University of Maryland Baltimore County's Department of Emergency Health Services.

The industry wants to understand everything that transpires in crashes, sudden stops and other incidents that are never reported.

"There needs to be a broader, more intense database that starts to collect not only the fatal injuries ... but how many injuries are out there that aren't required to be reported," Wiersch said.