Ambulance Safety and Crashes.

Introduction: Ambulance crashes have garnered increasing attention over the last several years. Several high-profile incidents have involved serious injuries and deaths to both EMS workers and civilians. The injuries, as well as the resulting liability concerns, have elevated the discussion of ambulance crashes to an urgent level. This chapter explores the scope of the problem, describes risk reduction initiatives, and makes recommendations for ways that EMS medical directors, administrators, and field personnel can help mitigate this serious problem. Ambulance crashes have long been known to be a serious problem for EMS, but the scope of the problem has not been well understood. Over just the past few years Maguire found that ambulance crashes cause 59% of all EMS occupational fatalities,1 the rate of transportation-related occupational injuries for EMS personnel is more than 30 times higher than the national average,2,3 and crashes involving ambulances produce twice as many casualties as the national average. 4 Kahn et al. studied the characteristics of fatal ambulance crashes in the United States involving 89 ambulance occupant fatalities and 592 nonfatal ambulance occupant injuries during one 11-year period. Their findings included that most crashes and fatalities occur during emergency use and that most of the fatal and serious injuries among ambulance occupants occurred in the patient compartment.5