it is easier to copy
The largest problem with ambulance safety isn't the vehicle. It's the operators.
Without getting into the effectiveness of using lights and sirens, it basically boils down to another tradition unimpeded by progress.
There is no reason for a provider to stand in the back of an ambulance. You can't effectely do CPR, you must sit or squat to tube somebody, kneel for an IV start.
Rather than make the ambulances bigger, like we have been doing my whole time in EMS, why no make them smaller? You can get a seat right up against a patient. Relocate your required equipment and be seated in belted in a rear facing seat. (one of the safest way to sit in any vehicle) If everything is in arms reach, including both sides of the patients, there is no need to get up.
Then take into account treatment on scene. No reason to transport an arrest without ROSC. If a paramedic can learn advanced treatments like 12 lead interretation, they certainly can be taught some surgical bleeding control. Add in a fridge with some blood products and you could almost completely bypass an ED to surgery. Of course realizing that the need for surgical trauma care has actually been decreasing over the years. (for many reason too numerous to discuss here) With the rest of treatments currently available for a number of pathologies, this idea of a paniced flight to the ED really should have ended in the 80s.
Now I know there will be some patients where rapid transport is indicated.(stroke for one) But there is no condition that justifies risking the lives responders and the public. The math of killing 2 or more providers to "maybe" decrease a deficet doesn't add up to me.
I realize there are places that only have basic cverage, and the solution to that is simple. People don't want the solution so let them receive all they want in abundance. But even still, there is no justifiable reason to have people at risk unrestrained, performing basic life support measures in a moving ambulance driving in a way that increases a traffic accident by the last numbers I saw by the insurance institute of America was 300%.
The European Union has adopted strict ambulance design,
safety equipment, and procedures that are used and work (for the most part) everyday. They had things like mechanical pt lifts on their vehicles before striker started making cots.
people are needlessly injured and killed because of our arrogance an ignorance. US EMS lacks the desire to be safe, not the ability.
Getting killed doing something that minimally helps, if at all, while behaving in an unsafe manner that can be mitigated today doesn't make you a good person or a hero. It makes you a fool.
h34r:
