Showing posts with label Motor Vehicle Accidents. Show all posts
Showing posts with label Motor Vehicle Accidents. 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

Wednesday, October 18, 2023

EMS Trauma Assessment - Index of Suspicion & Mechanism of Injury

 

EMS Providers play a crucial role in assessing and managing trauma emergencies. Two important concepts they need to understand are the Index of Suspicion and Mechanism of Injury. These concepts help EMTs make quick and informed decisions about the care of trauma patients.

Index of Suspicion (IOS):

The IOS is an essential element in the assessment of trauma patients. It refers to the level of concern or suspicion an EMS Providers should have regarding potential injuries or conditions.

EMS Providers must maintain a high index of suspicion, especially in trauma situations, because injuries are not always immediately evident. This means considering the possibility of severe injuries even when there are no obvious signs or symptoms.

A high index of suspicion should be maintained for patients involved in high-impact mechanisms of injury, such as car accidents, falls from heights, or severe blows.

EMS Providers should consider the mechanism of injury, the patient's presentation, and the nature of the incident to determine the likelihood of hidden injuries. A high index of suspicion prompts a thorough assessment and treatment.

Mechanism of Injury (MOI):

The MOI is an important aspect of the assessment process for trauma patients. It involves understanding how the injury occurred, the forces involved, and the potential for damage to specific body parts or systems.

EMTs should gather information about the MOI from the scene, bystanders, and the patient whenever possible. Common mechanisms of injury include:

Motor Vehicle Accidents: Speed, type of collision, airbag deployment, seat belt use, intrusion into the vehicle, etc.

Falls: Height of fall, landing surface, position of the body during the fall, and age of the patient.

Assaults: The type of weapon or force used, number of assailants, and locations of injuries.

Penetrating injuries: The object causing the injury, its size, and depth of penetration.

Understanding the MOI helps EMS Providers predict potential injuries. For example, if a patient was involved in a high-speed car crash with significant vehicle damage, the EMT should be highly suspicious of head, neck, and chest injuries even if the patient is alert and without immediate complaints.

Combining the MOI with the patient's presentation and a high index of suspicion guides EMTs in making critical decisions regarding patient care, such as spinal immobilization, oxygen therapy, and the need for rapid transport to a trauma center.

EMS Providers need to maintain a high index of suspicion, especially in trauma cases, and carefully assess the mechanism of injury. These concepts, when used together, allow EMTs to provide timely and appropriate care to trauma patients, even when injuries may not be readily apparent.

Bibliography

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach. 2nd Ed. Hoboken, New Jersey: Pearson Education

Limmer Education (2021) What Does Mechanism Of Injury Tell Us? https://limmereducation.com/article/trauma-assessment-mechanism-of-injury/ Accessed on October 15, 2023

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care. 11th Ed. Hoboken, New Jersey: Pearson Education  

#EMS #IndexofSuspicion #MechanismofInjury #PatientAssessment #TraumaAssessment #MotorVehicleAccidents