Seatbelts in the back

[VentMedic]

In light of all of the ambulance accidents, how many wear seatbelts when in back with the patient and make sure all passengers are in seatbelts?

 

[amberdt03]

i've always make sure the patients and passengers stay buckled down the whole transport, but i can't say the same for myself. only can recall a couple of times i've belted myself in while in the back, but always have when riding up front.

 

[enjoynz]

Wore a belt in the front while responding..not while in the back (I think a large percentage of us are guilty of that one!).
But always made sure all passengers were belted in.

Cheers Enjoynz

 

[Aidey]

All passengers have a seat belt, and the patient has 2-3 seat belts and shoulder straps on while on the gurney. I say 2-3 because occasionally for whatever reason we can't put on the 3rd belt.

I will admit the only time I've put on a seat belt during transport is during the occasional long distance transport. I'm aware of the safety issue here, and I've even broken a rib being thrown, but the current seat belts are a serious interference with patient care.

When seat belted into either the airway seat or the bench seat (we don't have CPR seats) the belt pulls me back against the wall, and I'm short enough I can't reach much, if any of the patient that I need to. I can't apply a 12 lead, listen to lung sounds, or palpate both sides of the patient. The Airway seat is positioned such that I can't even bag a patient while seat belted in, let alone perform an advanced airway procedure.

I've discussed this with people before, and they've mentioned doing all care on scene, but that isn't always in the best interest of the patient. Sometimes it is necessary to reassess the patient en-route, and pulling over every single time you need to do something isn't practical either.

 

[medicdan]

When I am doing a transfer, I sit on the bench while getting my VS (unbelted), then settle down either in the airway seat, or on the bench belted while I talk to the patient, read and fill out paperwork, or get something for the patient. I cant really perform any interventions in the airway seat, so if I am in it, I am comfortable, and dont mind the seatbelt, but I admit wearing the seatbelt on the bench is torturous (I am tall, and it bends my back....)

On emergencies, or anything where I need more then just a set of vitals, I stay unbelted on the bench.

 

[JPINFV]

I didn't use to wear a seat belt at all in the back, but once I started and got used to it I found it works pretty well. In general, I can get a BP on patients when wearing a belt, so the only time I'm not belted is when I need something from the cabinets or am moving between the bench seat and the airway chair.

 

[djmedic913]

I heard they tried a tether system for the attendant in the back. It would retract the attendant to the wall.

I issue I have with wearing a seat belt in the back is I need to treat my patient. Often this intails moving around, moving to the edge of the bench seat so I can reach my patient and start the IV or I just have to get up to reach the med radio (it is behind the Patient) to make my patch.

But, alas, I am still guilty with no excuse because on those mundane, routine calls that do not require much, I'm not belted...

there needs to be a good belting system that is easy to wear and give us the mobility we all would like/need

 

[Hal9000]

Whenever possible

I wear them whenever possible, and it's possible most of the time.

 

[Aidey]

I think a simple waist harness hooked to a D ring in the ceiling with a caribener would be an excellent idea. There could be multiple D rings, so you can have more than one person, or so you can move from one area to another. Even a short (6in to 12in) track would work too.

As much as OSHA, DOT etc and our companies would like us to be sitting and seat belted in 100% of the time, it's not always practical while you are doing patient care.

 

[rmellish]

I rarely wear one in the patient compartment. No good excuses, just a preference on my part.

I can say, however, in our largest type III's there is no possible way for one restrained technician to reach any of the airway equipment, however restraints would allow one technician to reach the Monitor, IV equipment, and drugs. From the airway seat however, most of the airway items are too high up for even those of average height to reach.

 

[medicdan]

There have been some interesting attempts recently both to redesign ambulance interiors for allow for a tech to sit beside a patient and access all important equipment and perform all assessment, as well as seatbelt systems that support this.
http://www.aev.com/scv2/

 

[HotelCo]

Unless I'm getting something from the cabinets, always.

 

[HotelCo]

There have been some interesting attempts recently both to redesign ambulance interiors for allow for a tech to sit beside a patient and access all important equipment and perform all assessment, as well as seatbelt systems that support this.
http://www.aev.com/scv2/

Seems like too many seats. When are you ever going to have/want, that many people in the back of your ambulance?

 

[Aidey]

You're going to need to access different patients from different directions. Yes, there may only be one person in the back with the patient, but they may need to access the patient from 3 different directions during the transport.

For instance, if the patient has an IV in their R arm, I can't give meds and reach the monitor from the same seat, they are just too far apart.

 

[HotelCo]

You're going to need to access different patients from different directions. Yes, there may only be one person in the back with the patient, but they may need to access the patient from 3 different directions during the transport.

For instance, if the patient has an IV in their R arm, I can't give meds and reach the monitor from the same seat, they are just too far apart.

We have a counters on either side of the CPR chair. I usually put the monitor on one of those, if the IV is going in the R arm.

 

[JPINFV]

Yea, but what if the monitor mount isn't on the counter?

As far as seats, CCT transports can have a lot of people on board. It wasn't uncommon to have a 4 person crew (2 basics with one of them driving, RN, and RT) on CCTs. Same thing with specialty care crews.

 

[Aidey]

And what keeps your monitor there? That is a $25,000, 10lb projectile in the event of an accident. Of the 4 different ambulance agencies I've been involved with all but one had a monitor mount of some kind that the monitor attaches too. The agency I work for currently doesn't, but it's always seat belted in. If it's not, and there is an incident and something happens to it, the crew is held personally responsible for the damage costs. Needless to say, everyone keeps them secured.

 

[MSDeltaFlt]

I heard they tried a tether system for the attendant in the back. It would retract the attendant to the wall.

I issue I have with wearing a seat belt in the back is I need to treat my patient. Often this intails moving around, moving to the edge of the bench seat so I can reach my patient and start the IV or I just have to get up to reach the med radio (it is behind the Patient) to make my patch.

But, alas, I am still guilty with no excuse because on those mundane, routine calls that do not require much, I'm not belted...

there needs to be a good belting system that is easy to wear and give us the mobility we all would like/need

Unfortunately you're 'bout not gonna get it me thinks. Mainly because I don't see how one can actively care for a pt and still be strapped in properly. It's either one or the other. The closest thing I've seen regarding restraint is some of what I call "Oh Sh*t" straps on some mini-mods and some vans.

 

[HotelCo]

Yea, but what if the monitor mount isn't on the counter?

As far as seats, CCT transports can have a lot of people on board. It wasn't uncommon to have a 4 person crew (2 basics with one of them driving, RN, and RT) on CCTs. Same thing with specialty care crews.

You have monitor mounts? We just have to seat-belt them to the bench seat when not in use. When we are using it, it goes wherever we need it.

What do these monitor mounts look like? I've never heard of them. Sounds like a great thing.

 

[HotelCo]

I see one person voted that they never make sure their passengers are buckled up. I hope that was a mistake or they are just joking.