FACEValue: EMT killed in ambulance crash

NIOSH’s Fatality Assessment and Control Evaluation Reports
#2001-12
Date of incident: July 13, 2001

A 27-year-old emergency medical technician was killed when the ambulance she was riding in struck an elevated train track support beam. The victim worked for an independent ambu-lance service that had been operating for 45 years. At the time of the incident, the victim was tending to an elderly patient in the back of the ambulance during a non-emergency transport. Although the patient was secured to the cot with leg and hip restraints, the EMT was riding without a seat belt. For reasons that were not determined, the ambulance drifted into the opposite lane of traffic and struck the beam at 26 mph. The driver, also an EMT, had been employed with the company for 14 months and had been an ambulance driver for 10 months. Upon impact, the patient and EMT attending to him both struck the front of the patient compartment. The driver called the ambulance service to report the accident. The victim, patient and driver (who also was riding unrestrained) were transported by ambulance to a nearby hospital, where the EMT was pronounced dead. The driver and patient were admitted into the hospital for several days to treat their injuries.

To prevent future occurrences:

• Employers should ensure emergency service workers use the occupant restraints in the patient compartment whenever possible. An examination of the lap belts on the squad bench by the National Highway Traffic Safety Administration in the aftermath of the crash indicated the belts had not been used. Had they been used, it is unlikely the victim would have struck the front of the compartment upon impact.
• Employers should ensure that drivers and front-seat passengers of emergency service vehicles wear seat belts at all times. Although the ambulance involved in the crash was equipped with a three-point seat belt for the driver and front-seat passenger, the driver was unrestrained. Injuries would have been further reduced had the driver been wearing a seat belt.
• Ambulance manufacturers and emergency services should design occupant protection systems that protect EMT workers while also providing them with the mobility necessary to administer patient care during transport. Tethered harness restraints – such as those used by military air crews – are one possibility. Such systems have not been fully evaluated in ground ambulances, but they may improve the survival rates of workers in patient compartments during an ambulance crash without jeopardizing patient care.