Ambulance crashes are one of many hazards faced by Emergency Medical Services (EMS) personnel. Although no complete national count of ground ambulance crashes exists, the total number of fatal crashes involving ambulances can be ascertained by using the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS). To characterize risk factors for EMS workers involved in ambulance crashes, CDC's National Institute for Occupational Safety and Health (NIOSH) and NHTSA investigated three case reports of ambulance crashes. This report summarizes these investigations, presents surveillance data, and discusses recommendations for prevention measures. NIOSH is identifying and testing alternative measures to reduce injury risk for EMS workers. The findings in this report are subject to at least three limitations. First, FARS records only crashes involving a motor vehicle traveling on a traffic-way customarily open to the public that result in the death of a person (either a vehicle occupant or nonmotorist) within 30 days of the crash. As a result, fatal crashes on private property (e.g., driveways, parking lots, or private roads) are excluded. Second, which ambulance occupants were EMS workers cannot be determined precisely by examining injuries by occupation code. EMS might be provided by local career or volunteer fire departments, private ambulance companies, or volunteer rescue services. Finally, data about nonfatal injuries to volunteer firefighters and EMS workers are not included routinely in occupational injury databases. CDC recommends that EMS employers ensure that EMS workers use patient compartment vehicle occupant restraints whenever possible, ensure that drivers and front-seat passengers of EMS vehicles use the occupant restraints provided, consider equipping ambulances with patient cots that include upper body restraints, and ensure that EMS workers who operate ambulances are qualified and trained appropriately. Ambulance manufacturers should evaluate and develop occupant protection systems designed to increase the crash survivability of EMS workers and patients in ambulance patient compartments and ensure that such systems allow EMS workers mobility to access patients and equipment.
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