Ambulance Accident Research Articles

Analysis of Helicopter Air Ambulance Accidents in the United States From 2010 to 2021

ObjectiveHelicopter air ambulance (HAA) services are essential to air medical transport in the United States. However, HAA accidents, incidents, and fatalities have been a reason for concern for HAA operations. This article analyzes the numbers, proportions, contributing or causal factors, and defining events of HAA accidents in the United States from 2010 to 2021. MethodsThe National Transportation Safety Board final investigation reports, defining events, findings, and summary data were analyzed for 83 HAA accidents in the United States from 2010 to 2021. The 2 proportions test was used to compare the proportions of fatal HAA accidents between 2010-2015 and 2016-2021. ResultsThe data show that 21/47 (45%) of HAA accidents in 2010-2015 and 6/36 (17%) in 2016-2021 were fatal, representing a significant (P < .01) reduction in the proportion of fatal accidents in 2016-2021 from 2010-2015 time period. VFR encounter IMC events accounted for 9/47 (19%) of HAA accidents in 2010-2015 and 1/36 (3%) accident in 2016-2021, representing a significant (P < .05) reduction in VFR encounter IMC accidents. ConclusionThere was a statistically significant decrease in the proportion of fatal HAA accidents from 2010-2015 to 2016-2021, which may be attributable to the changes in the regulatory framework, training protocols, safety awareness initiatives, and technological advancements to address HAA safety.

Transport safety concerning a patient infected with SARS-CoV-2 and emergency service officers in an ambulance accident - a case study.

The manifestation of a new pathogen, the SARS-CoV-2 coronavirus, constitutes a new problem for modern healthcare systems. Developing updated standards for all emergency services working at an accident site during the pandemic has been a continuous challenge. The principal method of preventing the transmission of the SARS-CoV-2 virus is the use of personal protective equipment, such as protective suits, masks and goggles or face shields. The study aims to present the recommended on-site procedures during the coronavirus pandemic based on the description of an accident of an ambulance transporting a patient with confirmed SARS-CoV-2 infection, emphasizing the actions taken by the emergency services sent to the accident site.

Online Newspaper Reports on Ambulance Accidents in Austria, Germany, and Switzerland: Retrospective Cross-sectional Review.

BackgroundAmbulance accidents are an unfortunate indirect result of ambulance emergency calls, which create hazardous environments for personnel, patients, and bystanders. However, in European German-speaking countries, factors contributing to ambulance accidents have not been optimally researched and analyzed.ObjectiveThe objective of this study was to extract, analyze, and compare data from online newspaper articles on ambulance accidents for Austria, Germany, and Switzerland. We hope to highlight future strategies to offset the deficit in research data and official registers for prevention of ambulance and emergency vehicle accidents.MethodsAmbulance accident data were collected from Austrian, German, and Swiss free web-based daily newspapers, as listed in Wikipedia, for the period between January 2014 and January 2019. All included newspapers were searched for articles reporting ambulance accidents using German terms representing “ambulance” and “ambulance accident.” Characteristics of the accidents were compiled and analyzed. Only ground ambulance accidents were covered.ResultsIn Germany, a total of 597 ambulance accidents were recorded, corresponding to 0.719 (95% CI 0.663-0.779) per 100,000 inhabitants; 453 of these accidents left 1170 people injured, corresponding to 1.409 (95% CI 1.330-1.492) per 100,000 inhabitants, and 28 of these accidents caused 31 fatalities, corresponding to 0.037 (95% CI 0.025-0.053) per 100,000 inhabitants. In Austria, a total of 62 ambulance accidents were recorded, corresponding to 0.698 (95% CI 0.535-0.894) per 100,000 inhabitants; 47 of these accidents left 115 people injured, corresponding to 1.294 (95% CI 1.068-1.553) per 100,000 inhabitants, and 6 of these accidents caused 7 fatalities, corresponding to 0.079 (95% CI 0.032-0.162) per 100,000 inhabitants. In Switzerland, a total of 25 ambulance accidents were recorded, corresponding to 0.293 (95% CI 0.189-0.432) per 100,000 inhabitants; 11 of these accidents left 18 people injured, corresponding to 0.211(95% CI 0.113-0.308) per 100,000 inhabitants. There were no fatalities. In each of the three countries, the majority of the accidents involved another car (77%-81%). In Germany and Switzerland, most accidents occurred at an intersection. In Germany, Austria, and Switzerland, 38.7%, 26%, and 4%, respectively, of ambulance accidents occurred at intersections for which the ambulance had a red light (P<.001). In all three countries, most of the casualties were staff and not uncommonly a third party. Most accidents took place on weekdays and during the daytime. Ambulance accidents were evenly distributed across the four seasons. The direction of travel was reported in 28%-37% of the accidents and the patient was in the ambulance approximately 50% of the time in all countries. The cause of the ambulance accidents was reported to be the ambulance itself in 125 (48.1% of accidents where the cause was reported), 22 (42%), and 8 (40%) accidents in Germany, Austria, and Switzerland, respectively (P=.02), and another vehicle in 118 (45.4%), 29 (56%), and 9 (45%) accidents, respectively (P<.001). A total of 292 accidents occurred while blue lights and sirens were used, which caused 3 deaths and 577 injuries.ConclusionsThis study draws attention to much needed auxiliary sources of data that may allow for creation of a contemporary registry of all ambulance accidents in Austria, Germany, and Switzerland. To improve risk management and set European standards, it should be mandatory to collect standardized goal-directed and representative information using various sources (including the wide range presented by the press and social media), which should then be made available for audit, analysis, and research.

An Overview of the Ambulance Safety: Towards the Improvement in ASEAN Countries

&#x0D; &#x0D; &#x0D; Ambulances have been utilized as one of the important vehicles in operating the Emergency Medical Services (EMS) system. As safety is the utmost priority for an EMS crashes involving ambulances would not only delay patient transfers but would also endanger its occupants and other road users. Although the numbers of accidents involving ambulances are considered to be low as compared to other types of vehicles, preventive measures need to be taken in order to eliminate the high risk of accidents occurring as ambulances should be able to provide reliable and safe emergency transport services for the benefit of the public. An overview of ambulance accidents is highlighted in this paper. Based on the literature reviews, four main factors have been identified as the contributor to the causes of the accidents involving ambulances – driver-related factor, vehicle-related factor, task-related factor, and environment-related factor. From the findings, future research should be focused on creating mitigation plans on a structured preventive measure that could be implemented particularly in reducing fatal accidents involving the ambulance in ASEAN countries.&#x0D; &#x0D; &#x0D;

Effects of the institutional structure and legislative framework on ambulance accidents in developing emergency medical services systems

ObjectiveTurkey is a developing country undergoing a system change in the prehospital emergency medical services (EMS). The purpose of this study was to evaluate the effects of the institutional structure and legislative framework on the number of ambulance accidents in Turkey. MethodsDuring the first phase of the study, ambulance accident data was requested and obtained from the Ministry of the Interior. Similarly, data on ambulance numbers were requested and obtained from the Ministry of Health through the Right to Information law. During the second phase of the study, a survey consisting of 112 EMS personnel viewpoints about the effects of the institutional structure and legislative framework on ambulance accidents was conducted using a structured questionnaire. A total of 209 EMS personnel completed the survey. ResultsThe number of ambulance accidents increased by 42.5% over the last five years, whereas the area of coverage increased by 57.3% during the same period. The rate of EMS personnel experiencing ambulance accidents was 69.4%. When age, sex, and profession variables were considered, the varying profiles of the ambulance operators were found to have no significant effect on the number of ambulance accidents following the system change. ConclusionThe rise in the number of ambulance accidents in Turkey was not significant when compared with the increase in the area of responsibility. The present system change was also found to have no effect on the number of accidents. On the other hand, problematic areas in the institutional structure and the legislative framework increased the risk of accidents.

Effects of the Institutional Structure and Legislative Framework on Ambulance Accidents in Developing Emergency Medical Services Systems

Effects of the Institutional Structure and Legislative Framework on Ambulance Accidents in Developing Emergency Medical Services Systems

A Review of Risk Analysis and Helicopter Air Ambulance Accidents

The Federal Aviation Administration announced a final rule in February 2014 that includes a requirement for helicopter air ambulance operators to institute preflight risk analysis programs. This qualitative study examined risk factors that were described in 22 preliminary, factual, and probable cause helicopter air ambulance accident and incident reports that were initiated by the National Transportation Safety Board between January 1, 2011, and December 31, 2013. Insights into the effectiveness of existing preflight risk analysis strategies were gained by comparing these risk factors with the preflight risk analysis guidance that is published by the Federal Aviation Administration in the Flight Standards Information Management System. When appropriate, a deeper understanding of the human factors that may have contributed to occurrences was gained through methodologies that are described in the Human Factors Analysis and Classification System. The results of this study suggest that there are some vulnerabilities in existing preflight risk analysis guidelines that may affect safety in the helicopter air ambulance industry. The likelihood that human factors contributed to most of the helicopter air ambulance accidents and incidents that occurred during the study period was also evidenced. The results of this study suggest that effective risk analysis programs should provide pilots with both preflight and in-flight resources.

Why did the patient die? The relationship between ambulance accidents and death of patients: Forensic medical issues

This article's aim is investigating traumatic consequences of ambulance accident on patients and discussing difficulties to give a decision about the relation between death and accident at these cases. The cases were selected among the forensic medical reports concluded between 1996 and 2005 years. They were documented for age, sex, causes of urgent call, localization and extent of traumatic lesion, properties of events and board decisions. A total of 21 cases were found. 15 cases died on the day of the accident. Skin injuries at head (8 cases) and legs (6 cases) were most common traumatic lesions. Totally 6 deaths were found related with ambulance accident. Death of patient after ambulance accidents may not be associated easily to the accident. Delay due to accident or concomitant contributing medical conditions may also facilitate the death in this type of cases. Reliable medical records were needed for accurate medicolegal evaluation.

Unexpected, periodic and permanent increase in medical inpatient care: Man-made or new disease?

For many years medical admissions to acute hospitals have been increasing at a rate far higher than expected from demographic change. Factors such as emergency re-admission, GP thresholds, breakdown of the family unit and deficiencies in community and social care have been suggested to explain this widening gap. Solutions to the problem have revolved around demand management strategies. While such strategies do result in a relative reduction in demand they are unable to prevent the underlying long-term behaviour. Analysis of daily admissions in Scotland, England and at individual hospitals over the past 25 years shows that the admissions tend to increase in a step-like manner at an interval of three to six years. This causes a typical 10% step-increase in physician work-load and inpatient medical costs and across England adds over 1,200,000 occupied bed days of additional bed demand into the health service within the space of around three months. There are knock-on effects to demand for ambulance services, accident and emergency attendance and GP referral. The step-increase is characterised by a cluster of diagnoses, increases with age and effects women more than men. Such behaviour has similarities to an infectious outbreak and the evidence for this and alternative hypotheses are discussed.

Injuries to emergency medicine residents on ems rotations

Objectives. To study the incidence and nature of injuries sustained by emergency medicine (EM) residents during EMS rotations, and steps taken at EM residency programs to increase resident safety during field activities. Methods. An eight-question survey form was mailed to all 114 U.S. EM residency directors, with a second mailing to nonresponders eight weeks after the initial mailing. Results. A total of 105 surveys were returned (92%). Six surveys were from new programs whose residents have not yet rotated on EMS. These were excluded from further analysis, leaving 99 programs. Of these, 91 (92%) reported no injuries. One EM resident died in a helicopter crash in 1985. Seven other injury events were reported: 1) facial lacerations, rib fractures, and a shoulder injury in an ambulance accident; 2) an open finger fracture (crushed by a backboard); 3) contusions and a concussion when an ambulance was struck by a fire engine; 4) a groin pull sustained while entering a helicopter; 5) bilateral metatarsal fractures in a fall; 6) rib fractures, a pneumothorax, and a concussion in an ambulance accident; and 7) “minor injuries” sustained in a crash while responding to a scene in a program-owned response vehicle. Actions taken at residency programs to reduce the risk of injury include the use of ballistic vests (four programs), requiring helmets on flights (five programs), and changing flight experience from mandatory to optional (two programs). Ten programs (10%) reported using ground scene safety lectures, and nine programs (15% of those offering flights) reported various types of flight safety instruction. Sixty-nine programs (70%) reported no formal field safety training or other active steps to increase resident safety on EMS rotations. Conclusions. Injuries sustained by EM residents during EMS rotations are uncommon but nontrivial, with several serious injuries and one fatality reported. The majority of EM residency programs have no formal safety training programs for EMS rotations.

An Analysis of Ambulance Accidents in Tennessee

In an effort to improve our program for ambulance crash and related injury prevention, we analyzed 102 consecutive ambulance accidents. Incidents reported included those that resulted in human injury or in which property damage exceeded $200. Multiple logistic regression was used to determine the association between circumstances reported at the time of the accidents and the risk of injury. Twenty-nine accidents contributed to a total of 65 injured victims, with one death. The variable most strongly associated with the probability of an injury-accident was use of a passenger restraint device. Darkness and occurrence at an intersection were variables showing increased risk, but were not statistically significant. The interaction of variables did not have a combined influence on the incidence of injury. The mean delay to hospital care after an accident was 9.4 minutes. Based on our data, we conclude that passenger restraints for both ambulance attendants and passengers should be mandatory, and we suggest that traffic signals be strictly heeded at intersections and speed limits in urban settings be obeyed.

An analysis of ambulance accidents in Tennessee

An analysis of ambulance accidents in Tennessee