How catastrophic is an ambulance crash?

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A Reddit/EMS thread asked, How catastrophic is an ambulance crash?

Like many things…it depends.

This was the answer I posted (with a few edits made for this post):

A few of my thoughts…from reading lots of news accounts about ambulance crashes  and knowing several ambulance crash survivors.

1. Ambulance crashes happen with distressing frequency.
Crashes happen So often that we could probably post 1 or 2 ambulance crash stories per day on EMS1. Most of the crash stories we find we don’t post because the injuries were minor (likely meaning the occupants were wearing seatbelts!), there was no patient on board (so no unbelted medic to get injured in the patient care compartment), and or there was no rollover.

So, sadly, for an ambulance collision to be EMS1 news there usually needs to major injury/fatality, odd collision (like an ambulance vs. bus, ambulance vs. dump truck, rural ambulance struck by a vehicle turning left that it was passing on the left), or some other hook.

2. Characteristics of catastrophic crashes
Significant/catastrophic injuries in an ambulance crash usually have one or more of these characteristics (again from my everyday reading and looking for ambulance crash news):

  • Speed greater than 30-50 mph
  • Fatigued or sleeping driver (ambulance or involved POV)
  • Distracted driver (ambulance or involved POV)
  • Red lights and sirens Swerving
  • Poor driving conditions – snow, rain, or fog – are occasionally a factor, but not that often

3. Emotional and financial injuries
Emotional and financial injuries can be as catastrophic as the physical injuries. Many EMS providers (again from the news I see and regular emails I receive) are uninsured or inadequately insured. The EMS provider, if they survive, are left with medical bills (and possible funeral expenses) they are unable to pay. Requests to publicize GoFundMe efforts for ambulance crash victims and survivors are sent to me every week.

4. Change driver behavior
Driver behavior can change much faster than the ambulance configuration. A safer ambulance, better designed for the realities of patient care and highway operation (include design for minimizing the impacts of crash), is important. But for most EMS providers this is what you can actually control:

  • Slow down
  • Use the lights and sirens as rarely as possible
  • Drive and drive only (No radio, phone or food when you are driving)
  • Never swerve for anything
  • Increase your following distance
  • Perform as much assessment and provide as much care as you can in the patient’s home, driveway or office
  • Wear a seatbelt, all the time. If you can’t do something belted, it should not be done while the ambulance is moving

The crew of the ambulance has a lot more control over preventing catastrophe than the configuration of the box.