Showing posts with label EMS Operations. Show all posts
Showing posts with label EMS Operations. Show all posts

Monday, July 22, 2024

EMS Safety - Analysis of Ground Ambulance Crash Data


The "Analysis of Ground Ambulance Crash Data From 2012 to 2018" report by the National Highway Traffic Safety Administration (NHTSA) highlights that driver error was involved in 92.6% of fatal U.S. ambulance crashes during this period.

Common errors included improper intersection clearing, running red lights, and driver fatigue. Lights and sirens were active in 40.7% of these crashes, often inappropriately. The crashes resulted in an average of 28.4 fatalities per year, with 40.2% being ambulance occupants. Other contributing factors were speeding, unbelted occupants, and driver impairment or distraction.

“The SCI [the NHTSA’s Special Crash Investigations Unit] reports for 2012 to 2018 showed nearly all crashes (92.6%) involved ambulance operator/driver error,” said the NHTSA report.

“Improper clearing of intersections, traveling against red lights, and operator fatigue were noted as factors in the crashes. Lights and sirens were active in 40.7 percent of the crashes. The expert reviewers noted that lights and sirens were often used in situations that were not recommended according to best-practice guidelines.”

As for the human toll from these errors, “Ambulance-involved fatal crashes remained relatively rare from 2012 to 2018 with a national average of 24.7 fatal crashes per year and 28.4 fatalities per year reported in FARS [the Fatality Analysis Reporting System],” the NHTSA report said.

“Of the individuals killed, 40.2 percent were ambulance occupants (operators/drivers, front seat passengers, and clinicians or patients in the cabin), 52.3 percent were occupants of other vehicles involved in the crash, and 7.5 percent were non-occupants (e.g., pedestrians, bicyclists).”

To put it mildly, these statistics disturb NHTSA EMS Specialist David Bryson. Most of all, “We need to reduce operator error because in 92.6% of the 27 SCI crashes investigated, ambulance operator error was a significant factor,” he told EMS World. “Improper clearing of intersections was a big one.

Ambulances must come to a complete stop at red lights and make sure the way is clear before they proceed. But many of these emergency vehicles did not stop completely before traveling through the intersection.”

Other factors that contributed to these fatal crashes were speeding (14.8%), unbelted occupants (14.8%), driver fatigue (11.1%), impairment caused by alcohol or other drugs (3.7%), driver medical condition (3.7%), and driver distraction (e.g., GPS or cell phone use, 3.7%).

In conclusion, the NHTSA report underscores the critical need for improved safety measures and training for ambulance operators. Reducing driver errors, such as improper intersection clearing and driving against red lights, is essential to decrease the frequency of fatal crashes.

Additionally, addressing factors like speeding, unbelted occupants, driver fatigue, and impairment is vital. Enhanced protocols, adherence to best-practice guidelines, and a commitment to safety can help mitigate the risks and ensure the protection of both emergency responders and the public.

Further Reading:
Graham, L., Thomas, F. D., Finstad, K., Dennert, R., & Southcott, T. (2023). Analysis of Ground Ambulance Crash Data From 2012 to 2018 (Report No. DOT HS 813 480). National Highway Traffic Safety Administration. Accessed August 6, 2024

Thursday, July 18, 2024

EMS Equipment - The Power Paradox


Despite powered advancements in patient movement, the initial ground lift remains a manual task for EMS providers.

The attached JEMS article addresses a critical issue in EMS that despite heavy investments in advanced power stretchers and other power-assisted patient handling devices, the initial task of lifting a patient from the ground remains manual and risky. 

This inconsistency, termed the "power paradox," exposes EMS Providers to significant musculoskeletal injuries, with nearly half of EMS workers experiencing such injuries due to manual patient handling.

While EMS agencies have invested significantly in technologies like power stretchers, power loads, and power stair chairs, they often overlook the necessity of power patient lifts.

The lack of a comprehensive power-assisted patient handling approach leads providers to use makeshift solutions like bedsheets, increasing the risk of injuries to both the patient and the provider. 

Statistics from the National Institute for Occupational Safety and Health (NIOSH) highlight that nearly half of all EMS workers suffer from work-related musculoskeletal injuries, underscoring the need for a complete and integrated approach to patient lifting.

The solution lies in incorporating power patient lifts, which are affordable compared to the costs of potential injuries and liabilities. These lifts can significantly reduce the physical strain on EMS providers and enhance patient safety. 

The article emphasizes that EMS agencies need to prioritize injury prevention by embracing a holistic approach to powered patient handling. 

By doing so, they can protect their personnel, improve patient care, and mitigate liability risks, ensuring the sustainability and effectiveness of EMS operations​.

Journal of Emergency Medical Services 2024 

For more information, access the attached article link.


Sunday, July 14, 2024

EMS Operations - Reimagining the Future With Artificial Intelligence


The article "Reimagining the Future: Artificial Intelligence Implications for Emergency Medical Services" by Michael Wissemann discusses the growing role of artificial intelligence (AI) in healthcare, emphasizing both its potential benefits and challenges, particularly for EMS. 

AI has advanced significantly over the past decade, with applications ranging from radiology to real-time dispatch systems in EMS. 

While AI can improve efficiency and accuracy in various medical tasks, it also poses risks, such as ethical concerns and privacy issues, especially when dealing with sensitive patient information.

In the context of EMS, AI could revolutionize operations by predicting and managing incidents more effectively. For example, AI could optimize the dispatch of emergency units or even assist in triaging mass-casualty events. 

Additionally, AI's integration into vehicles and medical devices could enhance real-time decision-making and patient care. 

However, the article notes that implementing such technologies requires overcoming significant hurdles, including data standardization, ethical considerations, and ensuring patient privacy.

Despite these challenges, the article advocates for embracing AI in EMS to shape its development and application proactively. 

By doing so, EMS providers can ensure that AI advancements align with their needs and improve patient outcomes. Ignoring these advancements, on the other hand, could result in externally imposed changes that may not fully address the unique demands of emergency medical services. 

For the full article, access the JEMS link here.


Friday, June 28, 2024

EMS Operations - Rural Paramedics Making House Calls


In Terlingua, Texas, a new community paramedicine program is helping reduce emergency room visits by having paramedics regularly check on residents with chronic health issues.

This initiative addresses the lack of nearby hospitals and doctors, providing preventative care and support, especially for elderly and reclusive individuals.
Funded by a USDA grant, the program aims to prove its cost-effectiveness by lowering readmissions, despite current challenges with insurance reimbursements for paramedic house calls.
The goal is to sustain these programs through demonstrated economic and health benefits.
A recent NAEMT report listed more than 150 of these kinds of community paramedicine programs across the country yet economic models are challenging.
For more details, visit the article below.

Sunday, November 26, 2023

EMS Operations - Landing Zones


EMS providers play a crucial role in facilitating helicopter operations and setting up landing zones for patient transport.

Here are key points they need to know:

Landing Zone Criteria:

- The landing zone should be a minimum of 100’x100', suitable for both day and night operations.

- Ensure the site is free of obstacles, hazards, and debris.

- Opt for a firm surface and avoid slopes greater than five degrees whenever possible.

- Soft sand or dirt landing sites should be avoided, but can be wet down as a last resort.

Obstruction Assessment:

- Conduct a thorough survey of the landing site to identify overhead power lines, telephone wires, antennas, buildings, or tall trees.

- Attempt to remove or limit any obstructions from the landing location.

- If obstructions cannot be removed, inform the flight crew, and be prepared to find an alternative location if necessary.

Marking the Landing Zone:

- Mark the landing zone using weighted cones or position emergency vehicles at the corners, with headlights facing inward to form an X.

- Clearly visible markings help pilots identify the designated landing area, especially during low-light conditions.

Weather Considerations:

- Inform the flight crew of wind direction and speed, particularly if strong winds exist.

- Weather conditions can impact helicopter operations, and pilots need this information to make informed decisions.

Safety Buffer:

- Ensure all nonessential personnel, bystanders, and vehicles are at least 200 feet away from the landing zone.

- This safety buffer protects individuals from potential hazards associated with helicopter operations.

Personal Protective Equipment (PPE):

Responders operating near the landing zone should wear appropriate PPE, including helmets with chin straps, ear protection, and face shields or other eye protection.

- Be prepared for high wind and noise associated with helicopter take-offs and landings.

Communication:

- Maintain effective communication with the flight crew before, during, and after the landing.

- Be prepared to provide updated information about the landing zone, weather conditions, and any changes in the situation.

- By adhering to these guidelines, EMS providers can contribute to the safe and efficient operation of helicopter transports, ensuring the well-being of both the patient and the emergency response team.

https://www.lifeflight.cc/site_pages/landing_zone.html