James Green, a persuasive engineer with the National Institute for Occupational Safety and Health (NIOSH), wants to make it safer for anyone in the back of an ambulance and is working to reduce the hazards.
Alarmed by statistics revealing the vulnerability of EMTs and patients in crashes, Green spent years building partnerships with ambulance manufacturers to crash-test their products and devise improvements. His work with the public–private team has led him to propose 10 crash safety standards or recommended practices for ambulances and their equipment. The proposals have already triggered some safety reforms within the ambulance manufacturing industry and are under consideration by National Association of State EMS Officials.
“Manufacturers are already stepping up to the plate and taking advantage of the science,” said Dawn Castillo, director of the Division of Safety Research at the Centers for Disease Control and Prevention. “The progress that has been made is remarkable.”
Historically, ambulances have been designed, built and sold without crash certification testing, and most fall under state rather than federal regulatory authority. Although they often travel at high speeds, a lot of their equipment isn’t bolted down, and patients and emergency crew are on cots and seating that don’t meet automotive crash-testing requirements.
Green’s interest in the safety project was spurred in part by Bureau of Labor Statistics data that showed EMS personnel involved in crashes had a fatality rate more than twice the national average for all workers. NIOSH also knew from its own earlier testing that ambulances’ structural integrity was compromised in crashes at 30 miles per hour. Yet, unlike with passenger cars, no national crash safety standards have existed for the ambulances, cots, patient compartment seating or medical equipment mounts.
Green decided to figure out how to make the back compartment of an ambulance stronger. NIOSH began crash-testing to learn what happened when equipment and crash dummies were subjected to rear, side, and front and rollover accident forces. Green, meanwhile, continued to add new players to his team, drawing in more than a dozen commercial interests with a stake in the ambulance industry.
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