Lax Ambulance Rules Put Paramedics, Patients at Risk

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When an ambulance driver using her phone’s GPS got distracted and crashed through a guardrail, rolling off an embankment in north-central Ohio in August 2014, the consequences were dire: A 56-year-old patient was ejected and killed, and an EMS worker was injured.

The emergency medical service worker was not strapped in, and the patient was only partially restrained, a situation that is all too common in ambulances across the nation.

Unlike school buses, ambulances are not regulated by the federal government. While states set minimum standards for how they operate, it’s usually up to local EMS agencies or fire departments to purchase the vehicles and decide whether to require their crew to undergo more stringent education and training.

Some agencies demand that crew members in the back of an ambulance use lap and shoulder restraints for their patients and themselves, but many agencies don’t. In some places, ambulance drivers don’t receive any special training before they get behind the wheel, even though they must speed through traffic under tremendous pressure.

“One agency will make them take a course before they can drive. Another will just say, ‘here are the keys,’ ” said Bruce Cheeseman, Idaho’s EMS operations manager.

Ambulances have been involved in 4,500 crashes a year on average over a 20-year period, a third of which resulted in injuries, according to the National Highway Traffic Safety Administration (NHTSA). About 2,600 people a year were injured and 33 were killed. Some were drivers or ambulance crew members, some were patients and some were pedestrians, bicyclists or occupants of other vehicles.

Safety and EMS experts say ambulances should be safer than cars and more like school buses, given that they’re transporting sick or injured people and workers caring for them. While the number of injuries and fatalities may seem small compared to the number of people transported, the experts say state and local agencies need to do a better job overseeing ambulance safety.

“These are vehicles carrying cargo that’s human and vulnerable and fragile because they’re already injured or experiencing a medical emergency,” said Dia Gainor, executive director of the National Association of State EMS Officials, whose members license ambulance services and personnel. “It’s unconscionable that the public is placed at risk when being put in the back of an ambulance.”

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