Guest blog post from the National Institute for Occupational Safety and Health.
May 22, 2017 — Ambulance crashes are a major safety concern for workers and patients. The National Highway Traffic Safety Administration reviewed data from 45 special crash investigations from 2001-2015, and found that 84% of EMS workers were not wearing a seat belt in the patient compartment.1 For EMS workers, wearing a seat belt can be at odds with doing their jobs properly: they need the mobility to reach the patient at all times, collect needed supplies, adjust lighting and temperature, and communicate with their driver and the hospital. Early NIOSH research focused on advanced harness-like systems similar to those used in military helicopters, which allow workers to be safely restrained but fully mobile. This initial work showed promise, and some early adopters purchased the systems for their ambulances.
Realizing there were more opportunities to improve worker and patient safety, NIOSH formed a diverse team of more than 30 industry partners that included ambulance builders, cot and seat suppliers, and other parts of government to tackle a range of safety concerns. The research was co-funded by the Department of Homeland Security’s Science and Technology Directorate (DHS S&T) and resulted in the publication of 10 new crash test methods that address everything from seating to storage cabinets in the patient compartment.
NIOSH crash tested ambulances in front, side and rear impacts and measured loading in each vehicle to better understand an ambulance’s ability to withstand the impact it would experience during an actual crash event. In fact, the same crash test methods that are used to test the safety of the cars we drive were used to test the safety of the ambulance. Data collected from crash testing allowed engineers to better understand how the structure reacted during a crash event, and to recreate the conditions in a lab setting to test and design safer seating, cots, equipment mounts, and the body structure itself.
The new ambulance crash test methods published by the Society of Automotive Engineers (SAE) are:
- SAE J2917: Crash pulse from frontal impact
- SAE J3026: EMS worker seating and restraint integrity
- SAE J3027: Patient cot, floor mount, and restraint system
- SAE J3043: Ambulance equipment mount devices and systems
- SAE J3044: Crash pulse from rear impact
- SAE J2956: Crash pulse from side impact
- SAE J3057: Modular body (or box style) integrity
- SAE J3058: Storage compartment integrity
- SAE J3059: Measurement of EMS worker head movement during a crash event
- SAE J3102: Floor integrity test to hold patient cot
The above mentioned test methods provide builders with the guidance and criteria they need to design, test, and manufacture an ambulance. All these test methods are focused on improving structural integrity and crash survivability. Cost-sharing with industry partners allowed the team to design and test new crashworthy seats, cots, and equipment mounts and develop test methods concurrently. Many crash-tested products are now available for purchase.
The next step is to encourage the adoption of the 10 SAE (Society of Automotive Engineers) test methods in national consensus standards published by the National Fire Protection Association (NFPA) and the Commission for the Accreditation of Ambulance Services (CAAS). Currently, NFPA and CAAS each reference the first six SAE published test methods listed above.
Unlike automobiles, which are built according to national safety standards published by the federal government, the safety of ambulances is the responsibility of each individual state. Some states now purchase ambulances that meet either the NFPA or CAAS national standard, but much work remains before we will see new and safer ambulance designs in every state and territory.
A new video series, Improving EMS Worker Safety Through Ambulance Design and Testing, covers more information about the test methods and what to consider when building or purchasing an ambulance.
Let us know if you have purchased an ambulance or components designed to any of the new crash test methods.
Jim Green, is a project officer and safety engineer in the NIOSH Division of Safety Research
Sydney Webb, PhD, is a health communications specialist in the NIOSH Division of Safety Research
Smith N (2015). A national perspective on ambulance crashes and safety. EMSWorld.com, https://www.ems.gov/pdf/EMSWorldAmbulanceCrashArticlesSept2015.pdf (pdf, 10 pages, 2.6 MB)