"We think it's a pretty significant problem from the information we have and the problem is how can we reduce that, how can we go about this methodically so we can reduce the amount of crashes that are happening out there on a pretty regular basis."
One of the projects already under way, by the National Institute for Occupational Safety & Health, is to scrutinize a few ambulance crashes to determine what went wrong and what might have been done to prevent them.
"We are working to try to better define the risk of ambulance-related crashes of people working in ambulance patient compartments and we are evaluating the use of occupant restraints," said Paul Moore, who works on the fatality assessment evaluation program.
A Detroit News two-day series in January outlined how ambulance occupants were exposed to unnecessary risk because of a lack of safety standards regulating the patient compartment, poor vehicle design and inadequate seat belt systems.
The problems, coupled with poor driver training, poor judgment and fatigue, were contributing factors in some of the 6,500 ambulance crashes each year.
Although the National Highway Traffic Safety Administration is the federal agency that oversees vehicle safety, it has been reluctant to set standards for ambulances and doesn't require them to be crash-tested.
NHTSA officials who attended the ambulance association meeting last week said they hoped to set up an industry meeting early in 2004 to discuss improving emergency vehicle safety.
"I don't know if we're talking mandatory or voluntary standards," Wiersch said.
"It has to be a flexible program. If you make it voluntary and show this can make a difference, it will naturally progress into everyone doing this and saying I need to get on that wagon.'"
While plenty of information is available on crash dynamics and the importance of seat belts, there's a lot to learn about how ambulances respond in crashes, Wiersch said.
"We don't know how our chassis hold up, how crashworthy are they, are there ones that are better than others," Wiersch said.
"We don't know because we've never truly looked at how ambulance vehicles and fire trucks hold up in a crash."
Some of the areas the industry hopes to address in the next year and beyond include:
- Employee Selection -- how to choose candidates who would be good drivers and not prone to aggressive driving or other behavioral or legal problems
- Driver Training, Education and Monitoring -- whether to require trainers to be certified, road tests, more comprehensive classroom training and on-board monitoring devices
- Company Policies -- how to encourage proper seat belt restraint of both patients and medics, speed limit observation and proper equipment storage
- Emergency Dispatch -- how to prioritize calls to make sure drivers aren't rushing to the scene of patients whose lives aren't at serious risk
- Ambulance Selection -- how to evaluate weight limits, center of gravity, design and technology to make sure ambulances are as safe as possible when they crash as well as color schemes, lights and sirens to avoid accidents.
- Ambulance Maintenance -- what is the best schedule for maintenance and whether to give drivers the right to sideline vehicles they think are unsafe.