They say necessity is the mother of invention. And every change or burst of creativity begins with the identification of a problem and the opportunity to do something to fix it. A conference held in southwestern„Pennsylvania in October 2005 sparked the creation of one of the most talked about ambulance safety initiatives in the state.
Two years later, the fruit of one team_s workƒBaldwin EMS Medic 515ƒwas unveiled at the Pennsylvania EMS Update Conference in April 2007. ˙Medic 515 is the future of emergency medical services in„Pennsylvania,Ó says Pennsylvania Bureau of EMS Director Joseph W. Schmider. ˙The vehicle is loaded with more than 40 additional safety features than the standard ambulance. We will be testing the new equipment to see how we can improve ambulance safety in communities across the commonwealth.Ó„
A 2007 Ford F-450 Life Line Type I ambulance, Medic 515 represents a mosaic of safety innovations that resulted from ˙outside the boxÓ„EMS thinking and ˙inside the boxÓ daily patient care. EMTs and paramedics who work in ambulances every day conceptualized most of the safety modifications. The new designs had to be practical so the crew would embrace and actually use them. Additionally, the design had to be functional so day-to-day„EMS operations wouldn_t suffer.„
The Safety Spark
Baldwin EMS Chief William Plunkett and I were among the providers who attended the„EMS safety conference in 2005. The conference was sponsored by two of the commonwealth_s„EMS officesƒthe Emergency Medical Service Institute and EMMCO West Regional EMS Council.„
After listening to staggering national statistics of needless and, in many cases preventable, EMS injuries and deaths, we left the conference convinced of the overall lack of safety awareness education in EMS and the ambulance design areas that contributed to many injuries and deaths. As a result, we were motivated to evaluate and contribute to the improvement of safety awareness and ambulance design.
With Plunkett_s support, the Baldwin EMS staff embarked on a mission to improve overall ambulance safety in„Pennsylvania. Ambulance design modifications, as well as new training and education modules, became the pillars for the development of the multi-tiered Baldwin EMS Ambulance Safety Awareness Program (ASAP). This program involves continuing education (CE) programs on provider safety and ambulance design training in hopes that all„EMS personnel recognize the need to establish a safer work environment and to encourage a more safety-minded culture.
Along with such safety innovations„as a newly designed ambulance prototype,„ASAP incorporated two„CE programs. ASAP integrates driver safety awareness with DriveCam monitoring devices, enhanced seatbelt and restraint systems, improved audible and visual safety alerts, and an improved patient treatment area design that creates a safer ambulance work environment. Also included is an education program specifically tailored to teach highway traffic safety techniques and review fundamental safety measures to employ when working on a roadway, which should be second nature to all public safety personnel.„
Baldwin EMS began its 18-month initiative to design a new ambulance from bumper to bumper by evaluating existing vehicles in service throughout southwestern„Pennsylvania and identifying areas that could potentially pose a danger to ambulance crews. Findings included such risk areas as:„
- A general lack of padding in the patient compartment interior;
- Seatbelts that weren_t properly anchored or didn_t allow the wearer to provide adequate patient care while belted;
- Equipment that wasn_t easily accessible to the„EMS provider without standing and reaching across patients; and„
- Equipment that wasn_t properly secured or could have become a dangerous projectile in the event of a collision.„„
Baldwin EMS officials recognized the complexity of identifying the potential risks and implementing ambulance design changes to address each risk, so they made a decision to unite a larger group of interested parties to move ASAP forward. The new project team included representatives of the Department of Health_s Bureau of EMS, the Emergency Medical Service Institute (EMSI), Life Line Emergency Vehicle (the vehicle_s manufacturer), Pfund Superior Sales (which facilitated development and delivery of the vehicle) and Baldwin EMS. Life Line also worked directly with a number of specialty vendors that provided components for the new ambulance, which require top-grade materials tailored to the design of the new vehicle.
This partnership approach converged talents, interests and perspectives of the participants with the common goal of designing an ambulance to increase the level of safety available to„EMS providers without disrupting the functionality of providing patient care.
The inclusion of the Department of Health and regional„EMS councils in the development phase was unique and ultimately essential to the overall success of the project. Their involvement, in addition to providing partial funding of the engineering redesign costs, demonstrated resounding support for this safety initiative, says Michael Huff, deputy secretary for Health Planning and Assessment. ˙The Pennsylvania Department of Health was proud to play a part in the design of this state of the art ambulance that will directly impact the safety and efficiency of emergency care in„Pennsylvania,Ó he says.
The Cost of Safety
Unfortunately, safer ambulance designs aren_t a bargain, due to the increased costs associated with engineering and manufacturing modifications. Some EMTs, paramedics and„EMS agency directors have expressed concerns that without supplemental funding, such as that provided for Medic 515, their service won_t be able to purchase a similarly built and equipped ambulance. However, the design team for Medic 515 is hopeful that, as the purchasers of new ambulances demand safer designs, manufacturers will begin to build many of the safety modifications as standard features, making enhanced vehicles more affordable. Even if ambulance manufacturers incorporate only one or two of these safer design modifications, it will be one step closer to providing the safest environment possible for our crews.
Paul Shiring, EMT-P, is shift lieutenant for Baldwin EMS in„Pittsburgh. He has been involved in„EMS for more than 14 years. Contact him at [email protected]