Ambulance Trips Put Lives at Risk
Officials: Design, training standards inadequate

By Lisa Zagaroli / Detroit News Washington Bureau
Sunday, January 26, 2003

Poor ambulance design, a lack of safety standards and dangerous driving by rescue workers endanger the lives of the sick and injured and those sent to help them.

Federal regulators and the emergency medical industry have known for decades that a combination of vehicle and behavioral problems leads to unnecessary injury in ambulance crashes. But few steps have been taken to minimize the risks, according to a four-month Detroit News investigation.

In fact, the very vehicle that is supposed to rescue occupants from an automotive crash fails to meet substantive crashworthiness or occupant safety standards, said Dr. Nadine Levick of Harlem Hospital, a leading researcher on ambulance safety. She says ambulance hazards are "predictable and preventable."

By the most conservative estimates, more than 6,500 ambulances crash in the United States each year; at least one crashed in each of Michigan's 83 counties in 2001. Ambulance crashes seriously injure 10 people every day and kill about three dozen a year, many of them motorists in other vehicles.

For example, in Baton Rouge on Nov. 13, 1999, an ambulance being driven at 73 mph in a 45 mph zone crashed into a stolen Lincoln driven by a 21-year-old drunken driver. The ambulance broke apart, ejecting two unbelted occupants, killing a paramedic student and seriously injuring a firefighter.

Individual incidents often highlight a number of failings.

Among the problems:

* Ambulance patient compartments are one of the few passenger environments that aren't subject to crash tests and are exempt from certain safety standards.

* Sharp surfaces and loose equipment can injure occupants who are tossed around the cabin in accidents, and, at times, the whole cabin falls apart on impact.

* Medics often violate speed and safety guidelines, entering intersections without slowing down and failing to wear seat belts. Already sick and injured patients have been hurt by unrestrained medics who fall on them in crashes or because of hastily fastened stretcher restraints.

Government and industry safety officials have recently begun to acknowledge the dangers and are considering changes in the way ambulances are made and used.

"I'm not sure what the countermeasures are. A lot of them are behavioral, a lot of them are crash avoidance," said Dr. Jeffrey Runge, administrator of the National Highway Traffic Safety Administration. "You could have the most crashworthy ambulance known to man, and if people can't ride down the crash in the back because they're unbelted, then it doesn't matter."