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Crew and Patient Safety in Ambulances: Results of a Personnel Survey and Experimental Side Impact Crash Test

Published online by Cambridge University Press:  07 May 2013

Marc Fournier*
Affiliation:
Public Assistance Hospitals of Marseille, Marseille, France
Hichem Chenaitia
Affiliation:
Clavary General Hospital, Grasse, France
Catherine Masson
Affiliation:
Northern Marseille Health Centre, Marseille, France
Pierre Michelet
Affiliation:
Public Assistance Hospitals of Marseille, Marseille, France
Michel Behr
Affiliation:
Northern Marseille Health Centre, Marseille, France
Jean-Pierre Auffray
Affiliation:
Public Assistance Hospitals of Marseille, Marseille, France
*
Correspondence: Marc Fournier, MD Public Assistance Hospitals of Marseille 264 rue St Pierre Marseille 13385, France E-mail marc.fournier@ap-hm.fr

Abstract

Introduction

Ambulance drivers often travel under stressful conditions at high speed while using vehicles with poor high-speed maneuverability. The occupant safety of ambulance vehicles has not yet been addressed by the automotive safety paradigm; particularly for the rear patient compartment. This study had two objectives: (1) to assess by survey the French Emergency Medical Services (EMS) to determine the layout of the vehicle most often used and the EMS personnel's behavior during transport; and (2) to conduct a crash test to analyze the injuries which may affect EMS personnel and patients in the rear patient compartment.

Method

Firstly, a survey was distributed to the 50 largest metropolitan French EMS programs. Secondly, a crash test was performed with a Mobile Intensive Care Unit (MICU) in conditions closest to reality.

Results

Forty-nine of the 50 biggest metropolitan French EMS programs responded to the survey. This represents 108 French MICUs. During the last three years, 12 of 49 EMS programs (24%) identified at least one accident with an MICU, and six of these 12 (50%) suffered at least one death in those accidents. A crash test using a typical French EMS MICU showed that after impact of a collision, the ambulance was moved more than five meters with major consequences for all passengers. A study-approved human cadaver placed in the position of a potential patient was partially thrown from the stretcher with a head impact. The accelerometric reaction of the anthropomorphic manikin head was measured at 48G.

Conclusion

The crash test demonstrated a lack of safety for EMS personnel and patients in the rear compartment. It would be preferable if each piece of medical equipment were provided with a quick release system resistant to three-dimensional 10G forces. The kinetic changes undergone by the “patient” substitute on the stretcher would probably have an effect of causing injury pathology. This study highlights the need for more research and development in this area.

FournierM, ChenaitiaH, MassonC, MicheletP, BehrM, AuffrayJP. Crew and Patient Safety in Ambulances: Results of a Personnel Survey and Experimental Side Impact Crash Test. Prehosp Disaster Med. 2013;28(4):1-6.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

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References

1.Elling, R. Dispelling myths on ambulance accidents. JEMS. 1989;14(7):60-64.Google ScholarPubMed
2.De Lorenzo, RA, Eilers, MA. Lights and siren: A review of emergency vehicle warning systems. Ann Emerg Med. 1991;20(12):1331-1335.CrossRefGoogle Scholar
3.Sanddal, ND, Albert, S, Hansen, JD, Kupas, DF. Contributing factors and issues associated with rural ambulance crashes: literature review and annotated bibliography. Prehosp Emerg Care. 2008;12(2):257-267.CrossRefGoogle ScholarPubMed
4.Best, GH, Zivkovic, G, Ryan, GA. Development of an effective ambulance patient restraint. Journal of the Society of Automotive Engineers-Australasia. 1993;53(1):17-21.Google Scholar
5.Levick, NR, Winston, F, Aitken, S, Freemantle, R, Marshall, F, Smith, G. Development and Application of a Dynamic Testing Procedure for Ambulance Pediatric Restraint Systems. Journal of the Society of Automotive Engineering-Australasia. 1998;58(2):45-51.Google Scholar
6.Levick, NR, Swanson, J. Managing risk and reducing crashes: implementing a driver performance-measuring device in ground ambulances. Prehosp Emerg Care. 2005;9(1):108.Google Scholar
7.Becker, LR, Zaloshnja, E, Levick, N, Miller, TR. Relative risk of injury and death in ambulances and other emergency vehicles. Accid Anal Prev. 2003;35(6):941-948.CrossRefGoogle ScholarPubMed
8.Maguire, BJ, Porco, FV. EMS and vehicle safety. Emerg Med Serv. 1997;26(11):39-40.Google ScholarPubMed
9.Winckler, G. Manuel d'anatomie topographique et fonctionnelle. Masson. 1974.Google Scholar
10.Grandall, J. The Presentation of Human Surrogates for Biomechanical Studies [dissertation]. Charlottesville, Virginia USA: University of Virginia; 1994.Google Scholar
11.Richardson, SA, Grzebieta, RH, Zou, R. Development of a side facing seat and seat belt system for the Australian Army Perentie 4x4. International Journal of Crashworthiness. 1999;4(3):239-259.CrossRefGoogle Scholar
12.Miller, RT. Finite element modeling approaches for predicting injury in an experimental model of severe DAI. Paper presented at: 42nd Stapp Car Crash Conference; 1998.CrossRefGoogle Scholar
13.Troseille, X. Development of a F.E.M. of the human head according to a specific test protocol. Presented at: 36th Stapp Car Crash Conference; 1992.Google Scholar