At the National Association of EMS Physicians (NAEMSP) annual meeting in New Orleans, James D. Green from the National Institute for Occupational Safety and Health (NIOSH) reported on the institute’s work to improve patient and worker safety in moving ambulances. He reviewed data and results from 10 years of ambulance vehicle safety research and measures to implement those findings into ambulance regulations and manufacture. He also reported on ambulance crash tests that showed why new standards are being developed for occupants and stretcher/cot restraints.
As a result of these studies:
- Newer cot retention systems are now available, replacing the older antler systems.
- Ambulance manufacturers are building better subfloors.
- Better seats are being used in ambulances, and manufacturers are now doing dynamic tests on their seats in order to achieve this standard.
- Lap belts are being replaced and multi-belt systems.
- Portable devices are now being secured by brackets and cabinets (with improved latches) that hold securely when an accident occurs.
- Modular bodies are being improved to hold up better during crashes as a result of front, side and rear crash tests.
- New patient compartment layouts are being adopted by EMS services and ambulance manufacturers as a result of the new Ambulance Patient Compartment Human Factors Design Guidebook published by the Department of Homeland Security.
Green recommended that EMS agencies advocate for seat belt use in the patient compartment, as well as for use of patient shoulder restraints at all times. Providers and agencies can also advocate for the purchase of new cot and cot retention systems that meet the new testing requirements.
EMS agencies are also in a position to encourage policy or regulatory changes at the state level to adopt the NFPA or CAAS ambulance standards. Green said we should also revisit our medical protocols to identify those procedures that can be done in a moving ambulance and those that shouldn’t. The ultimate goal of NIOSH’s work is thoughtful patient compartment designs with worker safety and efficiency in mind.