WHAT ABOUT SAFETY OF EMS PERSONNEL IN AMBULANCES?
Our heroes after a crash, medical staff are in danger when responding to calls
I remember like it was yesterday, even though it was years ago, lying flat on my back, more than a little dazed and confused, smack dab in the middle of Church Street in Toronto, not far from The Village’s busy Wellesley intersection. Time seemed to grind to a halt.
Although it was only seconds since I had been flipped off my Yamaha R1 on my way to a business lunch, I had managed to run through an entire compendium of consequences to my sky-ground-sky-ground experience. Well, better call Hilary to let her know I’m not got to make to Cibo’s in time. Jesus, where’s my computer? Man, next week’s Motor Mouth is already in there and I haven’t backed it up. Damn, I don’t think I am going to be able to teach tonight’s Throw Up With Dave high-intensity boxing fitness class. My mind racing, my panic level — and I still hadn’t got around to worrying about any possible injuries yet, adrenalin working its magic — began edging toward DEFCON IV until I heard … the wail of the ambulance.
An ambulance meant I could relax. An ambulance meant help was on its way. They’d probably be able to patch me up like new. At a bare minimum, it meant safe transportation to the doctors who could put whatever bones I had broken back in some sort of alignment.
Now, never mind that emergency medical technician (along with firefighter) is probably the most respected profession in our culture. (In her dating guide, Men: An Owner’s Manual, author Stephanie Brush noted that EMTs and firefighters were perfect, claiming they were the only men with which she could find absolutely no fault.) The wail of an ambulance is the sound of succour, the first sign that you may just make it out of this calamity alive (in my case, it was getting side-swiped by some SUV driver who didn’t find it necessary to look both ways when crossing an intersection).
But who takes care of our saviours? Who protects our protectors? What happens when an ambulance gets in an accident?
I know, I hadn’t thought of it either. As I just mentioned, to virtually everyone who’s been in an accident, a siren is the sound of survival. No one thinks about further catastrophe after the ambulance arrives. But it does happen. Not often, but enough to be a statistic.
According to the American National Highway Traffic Safety Administration (NHTSA), ambulance accidents cause on average 33 deaths per year in the U.S., a pittance compared with the 32,719 who died in roadway accidents in 2013. Closer to home, an Alberta study estimates that emergency vehicles account for about 0.2 per cent of all road accidents in that province. But still, as EMSWorld.com poignantly points out, that involves about 1,500 ambulance crashes a year the occupant — you know, the poor bugger strapped to the gurney — really didn’t need.
In most cases, in fact, the person injured is actually the EMT. While those conscientious emergency medical technicians buckle in more than 95 per cent of their patients, the NHTSA estimates that fewer than one in five of those EMTs is strapped in to their seat, hardly surprising because they are usually busy, well, saving the life of the person strapped onto the aforementioned gurney. In fact, according to EMSWorld, the patient is often in better shape than his rescuers. The magazine detailing one case in Minnesota where most of the information for the accident reconstruction came from the patient, because the two technicians were as dazed and confused as I was when lying in the middle of Church Street.
Part of the reason — and, again, this is something I would have never thought about — is that the improving crashworthiness of ambulances, unlike the enormous research dedicated to automobile safety, is a field of engineering that has only very recently gained any traction. According to Crashtest Technology International magazine (yes, your super-nerdy Motor Mouth has a subscription), only recently has the Society of Automotive Engineers published the development of 10 crash tests that are specific to ambulances. They include EMS worker seating and restraint integrity, and measurement of EMS worker head movement during a crash event, for example.
Surprisingly, according to James Green, an ambulance’s humungous girth contributes to the problem. The lead project officer and safety engineer at the National Institute for Occupational Safety and Health who helped develop the new standards told CTI that “a larger vehicle such as an ambulance is stiffer than a car, so it transmits more energy into the patient compartment.”
Furthermore, the various medical equipment necessary to treat the patient poses its own problem. Green, a former aerospace engineer, explains the reasoning for the test measuring EMS worker head movement is that “the further the head travels, the further away we have to put equipment in order to be safe.” He notes that one of the safety solutions may be to design an helicopter-style safety belt that also allows the EMT room to work.
Another point of contention, says Green, was that pioneering ambulance crash testing (performed here in Canada, by the way) revealed that “during the frontal crash tests, the patient’s cot separated from the floor,” possibly then to strike the EMS workers.
Now that the tests have been developed, the biggest challenge is making them mandatory. There is currently no universal requirement for the crashworthiness of emergency vehicles, as there is for cars.
According to Brian Lacroix, who detailed that terrible 2014 crash in Minnesota for EMSWorld, what makes this all the more problematic is that there are only about 6,000 ambulances sold annually in the United States, a number that is dwarfed by the roughly 17 million or so cars, trucks and other light vehicles sold every year.
“You can imagine how difficult it can be to get the manufacturers to spend a lot of R&D money for 6,000 units per year,” Lacroix says.
No matter. There is no place where the need to feel safe is greater than in an ambulance, and there is no one who should be better protected than the people saving the lives of our loved ones.