Ambulance Safety Measures Prove Their Worth

Ambulance Safety Measures Prove Their Worth

By John Erich Jan 31, 2013

It’s been four years since a team of technical experts led by the EMS Safety Foundation set out to distill the safest aspects of ambulances from around the globe and combine them into a single vehicle that could be built and put on the road. It’s been three since those vehicles began rolling out, to much acclaim, in the U.S. (where they were fielded by the Dallas-area service CareFlite) and Oslo, Norway.

It’s time to ask: How have they performed?

“From a safety perspective, better than I expected,” says Jim Swartz, CareFlite’s president and CEO, whose fleet added two dozen Sprinters from Crestline. “We’ve had a couple of crashes, and they’ve protected our people inside. We’re currently preparing to order 10 more—does that tell you how we feel?”


Designing the ambulances brought together experts from diverse but integral disciplines: automotive engineering, clinical EMS and patient transport, operational ergonomics and human factors, epidemiology and ambulance manufacturing. They looked at 179 different vehicle types and configurations, gauging each against technical data and principles of human biomechanics, vehicle dynamics and crashworthiness.

The resulting ambulances were built into OEM vans that had undergone stringent safety and crashworthiness testing and met automotive standards for occupant protection and crash safety performance. They featured original chassis, electronic safety systems such as electronic stability control and antilock brakes, and the full range of air bags, seat belt tensioners and other standard protective measures.

The patient compartment was designed around range-of-reach calculations and operational task analysis, with forward- and rear-facing seats and no squad bench. Portable equipment go-bags reduced the need for cabinetry and thus head-impact hazards. Equipment was secured, sharp edges avoided. The patient-loading height of 27 inches was optimal to minimize the risk of back strain; to the same end, heavy equipment was stored low in exterior compartments.

“It’s not rocket science,” Ronald Rolfsen, an advisor to the Oslo University Hospital ambulance service, told an American audience about these attributes in 2012. “It’s common sense.”

Rolfsen also touted more modest advances like placing lights and siren controls next to the steering wheel (research suggests it’s dangerous to drop your hand or reach too far to the side) and hands-free communications that prevent loose mics in the cabin. Oslo’s even gone so far as to balance the main equipment bags and portable oxygen tanks providers carry into scenes: Each weighs about 6.5 kg, keeping a person carrying them in balance. “Ergonomically,” said Rolfsen, “that’s very good.”

Beyond reducing many of the known threats of the ambulance environment, the rigs that resulted were also cheaper. They maintained good fuel efficiency, and for both services, their overall cost was less than for the previous designs used in purchase price alone, not counting fuel savings.

“And a lot of the feedback I get is, boy, our people like driving them,” adds Swartz. “They’re easier to drive than the boxes, and I think most people really understand their safety aspects. They are, in my mind, probably one of the safest ambulances you can buy, because they meet all the automotive testing standards.”

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1. Levick NR, Fitzgerald C, Swartz J, Lukianov G, Rolfsen R, Cooper A and the Innovation Consortium of the EMS Safety Foundation. Safety and Operational Innovation: Integrating Global Best Practice and Interdisciplinary Technical Expertise into Ambulance Design. Poster presentation, NAEMSP, 2012.

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