Safer in the back?

[got_shoes]

http://www.emsresponder.com/print/EMS-Magazine/Safer-In-the-Back/1$11114


I am happy to see that there are some reports coming out about this, maybe as a group of providers, we can get this to become law nation wide. I think everyone can get on this and like it no mater if you are private, 3rd service, or fire.

 

[Veneficus]

ambulance safety is a fantasy

"You've done it! I exclaimed with a scream and a taunt. It's just what I asked for, but it's not what I want"

--Author unknown, not me.

Back in the day when I started there was barely enough room to walk between the bench seat and the cot. With the exceptions of the onboard suction and the radio (no cell phones then) you could reach the patient and every piece of equipment in the truck.

Then when it was time to put in specs for a new one, bigger, more room, more junk in the cabinets, and all kinds of crap was the fad.

Steadily over the last 20 years ambulances have grown in size. I have worked in Type 3s where you could stand to your full 6'4 hight, have providers on both sides of the centered cot with enough room to put a patient on a board on each side. The length increased to the point where the only thing you could reach in the captain's chair was the cell phone charger and the onboard suction.

HIstory has taken us from Hearses and vans to light trucks and I have even seen full size truck chassis. (look at what Miami is using)

Sure we are more comfortable, and we can now put 20 lbs of crap in a 10 lb compartment instead of 10/5 respectively. But we still have a host of unsecured missles hanging off the cot. Everything from the monitor (which weighs a few pounds) to the O2 tank between peoples legs. Instead of drilled and hardened mounting brackets.

We still have a majority of US agencies doing rolling codes. (for what purpose I can only guess at) With standing orders to work pediatric codes even if there is dependant lividity. (anyone who works in peds can tell you kids are ven harder and rarer to get back than an adult once they crash)

Countries around the world have tried to make ambulances safer for years. Everything from a lift for the cot, to a smaller patient compartment so you could sit facing forward or back (safer than sideways) next to the patient and perform any intervention except CPR while belted in a seat.

I can count on one hand the number of times I have seen providers wearing a seatbelt in the back of the ambulance in the US.

The same companies that make ambulances and ambulance equipment in the States make it overseas. They have tested and time proven engineering. They don't even market it in the US because "nobody would buy it."

It is the culture of US EMS that needs to change. We don't need gimmicks like harnesses to strap you in a standing position, which doesn't stop you from getting hit with a monitor anyway, or keep you in a position which reduces lateral forces in a crash.

we don't need 100lb hydraulic cots to load into an ambulance that you still have to carry up 3 flights of stairs. We need 40lb cots with the lift on the ambulance. We need forward/rear facing seats at the patients side, close enough to do everythng except CPR. (which we shouldn't be doing anyway in a moving truck) We need our portable equipment secured in a manner designed and tested to hold it. We need to be able to reach all the equipment we need from our seat without getting up. We need roll cages in the patient compartment, not just a box made from plywood and sheet metal.

Unfortunately it is cheaper to pay out some death benefits and give out a flag and a wreath than it is to pay for safety. Cheaper still to just fire and injured employee and let them fend for themselves or let the government pay their welfare disability. (which a person cannot live on)

All of this is available for sale, today. It has been in use world wide for years. We have willfully and purposefully chosen injury and death over safety, in our protocols, equipment, and driving.

We need to stop making excuses to violate the normal traffic laws and flow. We need to drive at the speed limit. Wait for the green light, etc. We need to mandate not only driving education, but a minimum time in service before a provider is permitted to drive. The new guy should not be driving.

we need to stop believing our own BS.

In the meanwhile, we receive all that we asked for. In abundance.