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Characteristics of Fatal Ambulance Crashes During Emergency and Non-emergency Operation

Published online by Cambridge University Press:  28 June 2012

Ronald G. Pirrallo  and
Robert A. Swor
Ronald G. Pirrallo*
Affiliation:
Society for Academic Emergency Medicine Physio-Control Fellow in Emergency Medical Services, Department of Emergency Medicine, William Beaumont Hospitals, Royal Oaks, Mich.
Robert A. Swor
Affiliation:
Department of Emergency Medicine, William Beaumont Hospitals, Royal Oaks, Mich.
*
Assistant Professor, Medical College of Wisconsin, Department of Emergency Medicine, Box 204, 8700 W. Wisconsin Ave., Milwaukee, WI 53226USA
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Abstract

Objective:

To analyze the characteristics of fatal ambulance crashes to assist emergency medical services (EMS) directors in objectively developing their EMS system's policy governing ambulance operations.

Hypothesis:

No difference exists between the characteristics of fatal ambulance crashes during emergency and nonemergency use.

Design:

Retrospective, cross-sectional, comparative analysis of ambulance crashes resulting in fatalities reported to the Fatal Accident Reporting System (FARS) from 1987 to 1990.

Methods:

Twenty variables, representing characteristics of fatal ambulance crashes, were selected from the National Highway Traffic Administration FARS Codebook and were evaluated using tests of significance for categorical data grouped by emergency use and nonemergency use. Crash variable categories examined included demographics, accident configuration, accident severity, vehicle description, and ambulance operator action.

Results:

During the four-year study period, 109 fatal ambulance crashes occurred producing 126 deaths. Four states, New York, Michigan, California, and North Carolina, accounted for 37.5% of all fatal crashes. Seventy-five fatal crashes (69%) occurred during emergency use (EU) and 34 fatal crashes (31%) occurred during nonemergency use (NEU). The total number of fatal crashes varied in a downward trend (1987:32; 1988:24; 1989:28; 1990:25). The number of fatal EU crashes also varied in a downward trend (1987:28; 1988:16; 1989:19; 1990:12), while the number of fatal NEU crashes increased each year [1987:4; 1988:8; 1989:9; 1990:13](p = .016). Most EU fatal crashes occurred between 1200 h and 1800 h (p = .009). Most NEU fatal crashes occurred during times when light conditions were poor (p = .003). When a violation was charged to the ambulance driver (17 cited), the vehicle was more likely to be in EU (p = .056). No statistically significant differences between EU and NEU were identified by: 1) day of week; 2) season; 3) atmospheric conditions; 4) roadway surface type; 5) roadway surface condition; 6) speed limit; 7) roadway alignment; 8) relationship to junction; 9) manner of collision; 10) year manufactured; 11) vehicle role; 12) vehicle maneuver; 13) manner leaving scene; 14) extent of deformation; 15) violations charged; or 16) number of persons killed in accident.

Conclusion:

Few characteristics differentiate between fatal ambulance crashes during EU and NEU. The difference between EU and NEU were statistically significant in only three out of the 20 variables examined: 1) year occurred; 2) time of day; and 3) light condition. These data provide few objective measures that may be used to develop ambulance operation policies to decrease fatal ambulance crashes.

Keywords

accidentsambulancesemergency medical servicesemergency medical technicianstraffic
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 9 , Issue 2 , June 1994 , pp. 125 - 132
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1994

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References

1. Caroline, NL: Emergency Driving. In: Emergency Medical Treatment, 3rd ed. Boston: Little, Brown and Co. 1991, pp 607–612.Google Scholar
2. De Lorenzo, RA, Eilers, MA: Lights and siren: A review of emergency vehicle warning systems. Ann Emerg Med 1991;20:1331–1335.CrossRefGoogle Scholar
3. Cummins, RO, Ornato, JP, Thies, WH, Pepe, PE: Improving survival from sudden cardiac arrest: The ‘Chain of Survival’ concept: A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation 1991:83:1832–1847.CrossRefGoogle ScholarPubMed
4. Weaver, WD, Hill, D, Fahrenbruch, CE, et al. : Use of the automatic external defibrillator in the management of out- of-hospital cardiac arrest. N Eng J Med 1988:319:661–666.CrossRefGoogle ScholarPubMed
5. Trunkey, DD: Trauma. Scientific American 1983;249:28–35.Google Scholar
6. Clawson, JJ: Emergency Medical Dispatch. In: Kuehl, AE (ed), EMS Medical Director's Handbook. St. Louis: Mosby–Year Book. 1989, pp 59–90.Google Scholar
7. Highway Accident Report: Overturn of Ross Ambulance Service Ambulance, State Route 116, Littleton, New Hampshire, August 22, 1978. Washington, DC: National Transportation Safety Board; May 1979. US Government HSRI42302.Google Scholar
8. Newcomb, FD, Carpenter, K: Emergency vehicle accident involvement 1969–1970. New York: State of New York Department of Motor Vehicles; 1 July 1972. Division of Research and Development HSRI29868.Google Scholar
9. Gad, P: Traffic accidents with personal injury during emergency driving. Danish Medical Bulletin 1971;18:57–61, HSRI17149.Google Scholar
10. Nickles, RW: The call of the sirens. New York: New York State Department of Health; Bureau of Emergency Health Services, January 1973. HSRI28300.Google Scholar
11. Clark, JM: Emergency and high speed driving techniques. Houston: Gulf Publish Co., 1976.Google Scholar
12. Garza, MA: Inside EMS. JEMS 1993;18:24.Google Scholar
13. Saunders, CE, Floersch, D: A study of ambulance collisions in an urban environment (Abstract). Ann Emerg Med 1992;21:643–644.Google Scholar
14. Auerbach, PS, Morris, JA, Phillips, JB, et al. : An analysis of ambulance accidents in Tennessee. JAMA 1987;258:1487–1490.Google Scholar
15. Clawson, JJ: Running “Hot” and the case of Sharron Rose. J Emerg Med Serv 1991;16:11–13.Google ScholarPubMed
16. Shanaberger, CJ: Running hot. JEMS 1987;12:75–76.Google Scholar
17. Wisconsin Statutes Chapter 346: Rules of the road 346.03 (5), Madison, Wisconsin, 1989.Google Scholar
18. University of Michigan Transportation Research Institute: Fatal accident reporting system 1990 data set codebook. University of Michigan, Ann Arbor, Michigan, 1991.Google Scholar
19. National Highway Traffic Safety Administration: Fatal accident reporting system 1990. Washington DC: US Dept of Transportation; 1991.Google Scholar
20. Arnfred, E: Risks involved in emergency ambulance driving. Physicians' Weekly 1975;138:43–46. (Danish translation by Kirsten Alcser, PhD, University of Michigan, Institute for Social Research, Ann Arbor, Michigan) HSRI34691.Google ScholarPubMed
21. Douglas, N, Futoma, G: A report to Governor Grasso on the use of emergency vehicles in Connecticut. Hartford: Connecticut Safety Commission; 1978 HSRI41224.Google Scholar
22. Moffatt, CA, Mitter, EL, Martinez, R: Pelvic fractures crash vehicle indicators. Accid Anal & Prev 1990;22:561–569.CrossRefGoogle ScholarPubMed
23. Cooper, PJ: Differences in accident characteristics among elderly drivers and between elderly and middle-aged drivers. Accid Anal & Prev 1990;22:499–508.Google Scholar
24. National Transportation Safety Board: Special investigation report, emergency fire apparatus. Washington, DC: US Government UMTRI81007, 1991.Google Scholar
25. National Safety Council: Emergency vehicles involved in accidents. Accident Facts, 1990, p 79.Google Scholar
26. Levine, RL, Pepe, PE, Fromm, RE Jr, et al. : Prospective evidence of a circadian rhythm for out-of-hospital cardiac arrests. JAMA, 1992;267:2935–2937.CrossRefGoogle ScholarPubMed
27. Solomon, SS: The safety color. Firehouse 1984;9:106.Google Scholar
28. Green, DA: Emergency vehicle warning systems and identification, Sydney, Australia: University of NSW, Dept of Public Works; HSRI44923, 1978.Google Scholar
29. Leonard, WH: Case studies in risk management. At the fifth annual Paramedic Systems of Wisconsin meeting, Green Lake, Wisconsin, 13 October 1992. AzSTAR Center for Safety & Risk Management.Google Scholar
30. MacLean, BC: Introductory remarks. Canad Serv Med J 1955;11:564–565.Google Scholar
31. American College of Emergency Physicians: Guidelines for emergency medical services systems. Ann Emerg Med 1988;17:742–754.Google Scholar