EMS Ambulance Driver Safety Discussion Too Important to Ignore

I’m currently engaged in an interesting discussion with some of my EMS pals via email. The discussion centers around a recent fatal ambulance accident and the public and departmental reaction to the incident. Most of you know that I cover these accidents regularly on the MedicCast with my point of view being that we, as the trained emergency drivers are responsible for the way we transport our patients and ourselves to and from incidents. We should be driving defensively, assuming that every other driver will ignore traffic signals and our lights and sirens.

We routinely overuse lights and sirens simply because we can. That is not a good enough reason. Time and again, we see reviews of response times that say that we don’t safe that much time running “Hot” to an incident or to the hospital. Just a minute or two on average. How often is our patient in a situation when arriving even 5 minutes later at the ER makes a difference in their care?

This goes back to the EMS Culture of Safety discussion that ACEP is currently holding within the industry.  We need to change how we respond and educate in order to create an overall cultural change in how we handle transport of ourselves and patients safely. Check out the MedicCast coverage of EMS Culture of Safety event in Arlington, Virginia last June.

Maryland just released this list of recommendations based on that discussion:

1. Screen ambulance drivers – Jurisdictions and companies should implement initial and periodic driver screening to identify ambulance drivers whose driving records, excessive risk-taking, or medical conditions may make them poor candidates for the responsibility of driving an ambulance.
2. Ensure effective initial ambulance driver training and periodic refresher training – Ambulance-specific driving training should be uniformly required by jurisdictions and available for ambulance drivers in Maryland.
3. Increase use of restraints and safety improvements during ambulance operations – Jurisdictions and companies should set, monitor and enforce policies that require the use of seat belts / restraints for the driver, other EMS personnel in the ambulance and the patient being transported.
4. Reduce the incidence of excessive ambulance speeds and routine use of “lights and sirens” – Jurisdictions and companies should ensure that response and transport policies reinforce the need for safety as the first priority and should tailor practices to the degree of urgency as determined by patient need.
5. Improve monitoring of ambulance safety issues and enforcement of safety practices – Jurisdictions and companies should develop written policies that foster increased ambulance safety, ensure the availability of accurate data needed for effective monitoring of ambulance safety issues, and include formal review of ambulance crashes and near-misses.
6. Create on ongoing statewide forum for ambulance safety issues – The Ambulance Safety Task Force should continue to promote the advancement of ambulance safety throughout Maryland, monitor trends in ambulance crashes, and provide a forum for addressing future ambulance safety issues common to all jurisdictions and counties, including a review of the updated NFPA 1917.