Abstract
Purpose. There is a paucity of data regarding EMS stretcher-operation-related injuries. This study describes and analyzes characteristics associated with undesirable stretcher operations, with or without resultant injury in a large, urban EMS agency. Methods. In the study agency, all stretcher-related “misadventures” are required to be documented, regardless of whether injury results. All stretcher-related reports between July 1, 2009 and June 30, 2010 were queried in retrospective analysis, avoiding Hawthorne effect in stretcher operations. Results. During the year studied, 129,110 patients were transported. 23 stretcher incidents were reported (0.16 per 1,000 transports). No patient injury occurred. Four EMS providers sustained minor injuries. Among contributing aspects, the most common involved operations surrounding the stretcher-ambulance safety latch, 14/23 (60.9%). From a personnel injury prevention perspective, there exists a significant relationship between combative patients and crew injury related to stretcher operation, Fisher's exact test 0.048. Conclusions. In this large, urban EMS system, the incidence of injury related to stretcher operations in the one-year study period is markedly low, with few personnel injuries and no patient injuries incurred. Safety for EMS personnel and patients could be advanced by educational initiatives that highlight specific events and conditions contributing to stretcher-related adverse events.
Highlights
The majority of patient transportation in the prehospital emergency medical care environment involves the use of mobile stretchers
Despite generally widespread acknowledgement of risk to patient and EMS professional alike, there remains a paucity of data addressing ambulance stretcher associated injury analysis
There were 4 EMS provider injuries, event rate 0.031 per 1,000 transports
Summary
The majority of patient transportation in the prehospital emergency medical care environment involves the use of mobile stretchers. Constraints on the stretcher system are myriad, including weight and size of the patient, ease of use, and durability. With these limitations in mind, finding the balance of performance and safety is an important mission. Wang et al used the United States Food and Drug Administration’s Manufacturer and User Facility Device Experience database to describe adverse events related to the ambulance stretcher. Their dataset captures significant events over a large time period. It is likely that many stretcher events—perhaps some significant—went unreported to the USFDA database
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