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Ambulance Crash-Related Injuries Among Emergency Medical Services Workers in the United States, 1991-2002

Ambulance crashes are one of many hazards faced by Emergency Medical Services (EMS) personnel. Although no complete national count of ground ambulance crashes exists, the total number of fatal crashes involving ambulances can be ascertained by using the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS). To characterize risk factors for EMS workers involved in ambulance crashes, CDC's National Institute for Occupational Safety and Health (NIOSH) and NHTSA investigated three case reports of ambulance crashes. This report summarizes these investigations, presents surveillance data, and discusses recommendations for prevention measures. NIOSH is identifying and testing alternative measures to reduce injury risk for EMS workers.

Case Reports

Case 1. In May 2001, an Emergency Medical Technician (EMT) aged 26 years died when her ambulance was struck head-on by a pick-up truck at 6:30 a.m. The EMT had been riding unrestrained in the patient compartment while attending a patient during a nonemergency transport. During the collision, the EMT struck the front bulkhead of the patient compartment; she died en route to the hospital from blunt force trauma to the head and chest. The patient and pick-up driver also suffered fatal injuries. The ambulance driver had been driving unrestrained and suffered multiple serious injuries, including a fractured leg.

Case 2. In July 2001, an EMT aged 27 years died when her ambulance struck an elevated train-track support column at 12:30 p.m. She had been riding unrestrained in the patient compartment while attending a patient during a nonemergency transport. During the collision, the EMT and the patient both struck the front bulkhead of the patient compartment. Both the driver and patient were hospitalized; the EMT was transported to a hospital, where she was pronounced dead.

Case 3. In March 2002, an EMT aged 22 years who was driving and a paramedic aged 37 years were injured when their ambulance struck an oncoming vehicle head-on and overturned. The paramedic was riding unrestrained on the patient compartment squad bench while attending a patient during a nonemergency transport. A relative of the patient was seated in the rear-facing attendant's seat and was wearing a seatbelt. During the collision, the unrestrained EMT driver sustained minor injuries. The paramedic struck the interior cabinets and shelves of the patient compartment. The EMT and the paramedic were transported to a hospital, where the EMT was treated and released; the paramedic was hospitalized and released 2 days later. The patient's injuries included scalp and shoulder contusions and a shoulder laceration. The patient's relative sustained minor internal injuries.

Injury Severity/ Injury Position Count % within Injury Severity Group % of all Ambulance Occupants
Possible
Front Left 70 41.7%  
Front Right 50 29.8%  
Other Enclosed 34 20.2%  
Other/Unknown 14 8.3%  
Total 168   20.6%
Nonincapacitating
Front Left 81 36.5%  
Front Right 54 24.3%  
Other Enclosed 63 28.4%  
Other/Unknown 24 10.8%  
Total 222   27.2%
Incapacitating
Front Left 43 32.8%  
Front Right 20 15.3%  
Other Enclosed 50 38.2%  
Other/Unknown 18 13.7%  
Total 131   16.0%
Fatal
Front Left 14 17.1%  
Front Right 10 12.2%  
Other Enclosed 48 58.5%  
Other/Unknown 10 12.2%  
Total 82   10.0%
None 201   24.6%
Unkown 12   1.5%

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