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Emergency Medical Service: Let’s Buckle Up!

If I asked you if your department has a policy requiring all personnel to be properly restrained while the fire apparatus is in motion, I’d venture to say that most of you would say it does. Does your department also have a policy for personnel riding in the patient compartment of ambulances?

If we do have these policies, it seems our personnel aren’t following them.

The National Highway Traffic Safety Administration (NHTSA) has conducted extensive studies on crashes involving ambulances over the past 20 years. The conclusion is quite sobering: over 80% of EMS personnel riding in the patient compartment were not restrained when their ambulance crashed.

Additionally, many patients being transported were injured by occupant-to-occupant contact. That is, their injuries were caused by contact with an unrestrained provider.

If you want further proof, go to the EMS pages of FirefighterNearMiss.com and FirefighterCloseCalls.com. Some posts demonstrate significant ambulance damage, but the providers escaped with relatively minor injuries because they were restrained. There are many more incidents with serious injuries to providers who were unrestrained at the time of a crash.

Does your department have a policy that mandates providers be restrained at all times when the ambulance is in motion? If it becomes necessary for providers to remove their restraints, does the policy state that the ambulance will pull off the road and come to a complete stop while treatment is rendered?

Most arguments will probably come from our own personnel, who may feel that such a policy is impractical and would result in unnecessary delays in transport to the hospital. There are definitely situations in which a provider must be unrestrained to provide treatment, but when do we make their safety a priority?

Ambulance manufacturers are building safer ambulances and offer seating configurations that allow personnel to provide treatment while remaining restrained. Seatbelt monitoring systems are also available, but they’re of no use if they’re ignored or disabled. Some of the equipment we use today also helps to keep providers restrained. For example, one can question the efficacy of automated CPR devices, but one thing is certain—departments that employ them don’t have personnel riding unrestrained, trying to perform compressions in the back of a moving ambulance.

I recall reading an article by Steve Berry in JEMS several years back. He wrote of witnessing a pickup truck being driven at highway speed with teenagers standing in the bed, holding onto a roll bar. He wrote of how dangerous this appeared, but then realized that many of us do essentially the same thing on a regular basis when riding in the back of an ambulance.

This may be an extreme analogy, but the only difference between us and those teenagers is a thin, aluminum covering that may prevent us from being launched out of the vehicle during a crash.

If your department has policies that address personnel restraints in the patient compartment and your members comply, congratulations. If you don’t have a policy, please consider developing one to ensure your personnel have some guidance in keeping themselves safe.

To those of you who are riding in the patient compartment on a regular basis, stay safe and buckle up!


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