Seatbelt Policy

[EpiEMS]

Does your agency have a policy that you must wear a seatbelt at all times in the patient compartment of your apparatus?
Should they?

 

[NysEms2117]

Does your agency have a policy that you must wear a seatbelt at all times in the patient compartment of your apparatus?
Should they?

My agency has really "cool" seatbelts. Almost like bungie cords. They exapand with you to a certain extent so if you need to render care in the back you can still move relatively un restricted. Only difficult thing is reaching shoulder level and higher, but that's not all that common in the back. For me anyway

 

[EpiEMS]

My agency has really "cool" seatbelts.

Oh, I've heard about/seen these! These ought to be mandatory (like part of the next KKK standards)!

 

[NysEms2117]

Oh, I've heard about/seen these! These ought to be mandatory (like part of the next KKK standards)!

i really like them, i've heard they do well in crashes? never experienced one **knock on wood**. but Virtually 0 interference with patient care, on my part. Im sure CC-P partner will say different though.

 

[WolfmanHarris]

Oh, I've heard about/seen these! These ought to be mandatory (like part of the next KKK standards)!

If they're the one's I'm thinking of Nadine Levick from the EMS Safety Institute has a position paper based on crash testing against them.

We have sliding side seats that can adjust through 180 degrees and move along the length of the stretcher with three point belts. The expectation by policy is to be belted unless needed for patient care. Since switching to this set-up with a lot of my equipment and laptop in easy reach, I'm belted in the back most of the time. Ironically, during emergent transports when the risk is highest, I'm more likely to be unbelted. That's where a great partner you trust (who doesn't drive like an idiot) is vital. I have two medics in my service that I will NOT have drive an emergent return if I'm in the back unless I have no other choice because they're too heavy on the gas and brake and don't respond to feedback.

In the next couple years they're likely adding active driver feedback systems to our trucks that trigger when acceleration, braking or turning is too aggressive. The original ones trialed by our Driver Training and Safety Officer were rejected when he tested them.

 

[EpiEMS]

Ironically, during emergent transports when the risk is highest, I'm more likely to be unbelted. That's where a great partner you trust (who doesn't drive like an idiot) is vital. I have two medics in my service that I will NOT have drive an emergent return if I'm in the back unless I have no other choice because they're too heavy on the gas and brake and don't respond to feedback.

My main concern on this point - and I agree with you, I'm more likely to be unbelted if the patient is more acute - is that it is just those very times when we're at the most risk, what with the possibility of a car t-boning us at an intersection (or a hard brake to avoid this), regardless of driver skill, hence why we need seatbelts all the time.

 

[NysEms2117]

In the next couple years they're likely adding active driver feedback systems to our trucks that trigger when acceleration, braking or turning is too aggressive. The original ones trialed by our Driver Training and Safety Officer were rejected when he tested them.

EVOC driving classes would then be moot i suppose.

why we need seatbelts all the time.

Maybe not "seatbelts" but some restrains of some kind. I think of the bungie cords where i work as restraints, because "seat belts" have been engrained into my skull as whats in our POV cars ect.

 

[EpiEMS]

EVOC driving classes would then be moot i suppose.

I think EVOC would still have a place - but there would now be real-time feedback for everybody, which would be a helpful reminder.

Maybe not "seatbelts" but some restrains of some kind. I think of the bungie cords where i work as restraints, because "seat belts" have been engrained into my skull as whats in our POV cars ect.

Some sort of restraint, yeah, either way!

 

[WolfmanHarris]

My main concern on this point - and I agree with you, I'm more likely to be unbelted if the patient is more acute - is that it is just those very times when we're at the most risk, what with the possibility of a car t-boning us at an intersection (or a hard brake to avoid this), regardless of driver skill, hence why we need seatbelts all the time.

I'm not disagreeing, it just remains that we have yet to create the perfect mix of vehicle and equipment that allows 100% belting all the time. That's why I find it ironic that I'm more likely to be unbelted when I need it most.

R.e. EVOC, all of our new hires are given EVOC training by our Driver Training Officer over 3 full days. He is a Paramedic and provincially certified driving instructor/examiner for all levels including commercial trucks as well as a consultant for the Ministry of Transport on driver training. He reviews every new hire personally, conducting their driving tests as well as anyone returning from medical leave, light duties etc before they're recleared for the road. You have a collision, even a paint scrape and it goes to him to review and you're getting homework and if necessary brought in for remedial driver training. Before you can drive an RRU there's a separate training, ditto for our support units (though they require a different driver's license with airbag endorsements). He's a fantastic resource that I doubt we'll be able to replace when he retires.

 

[NysEms2117]

I think EVOC would still have a place - but there would now be real-time feedback for everybody, which would be a helpful reminder.



Some sort of restraint, yeah, either way!

wouldn't the sensor stay on if your driving how evoc teaches???


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[Tigger]

Our policy says 100% seatbelt use except when doing so would hinder patient care.

We have gone through three iterations of ambulances to improve safety and what I am slowly realizing is that no layout can really handle a critical patient. So I am trying to design layouts that will allow our people to be belted continuously for 95% of our calls. I am hoping I can also get us Lucas devices so that if the patient arrests during transport we can use that with the vent and remain belted.

 

[WolfmanHarris]

wouldn't the sensor stay on if your driving how evoc teaches???


Sent from my iPhone using Tapatalk

That might have been the problem. I think the sensor they trialled was unreasonably reactive.

 

[WolfmanHarris]

Our policy says 100% seatbelt use except when doing so would hinder patient care.

We have gone through three iterations of ambulances to improve safety and what I am slowly realizing is that no layout can really handle a critical patient. So I am trying to design layouts that will allow our people to be belted continuously for 95% of our calls. I am hoping I can also get us Lucas devices so that if the patient arrests during transport we can use that with the vent and remain belted.

We've had 3 LUCAS 2 and 3 Autopulse on some of our trucks on a trial basis for sometime. Crews seem to like them but with the lack of evidence to support them, our low rates of transport for SCA and our practice of sending minimum of two Ambulances to cardiac arrests, it's been a hard sell to purchase them over other equipment. Not that I'm complaining, we're 100% power cot/power load, tracked stair chairs 100% with powered ones on SRU for bariatrics, EZ-IO, etc...

 

[NysEms2117]

That might have been the problem. I think the sensor they trialled was unreasonably reactive.

I only took EVOC for LE, and if they teach driving even 1/4 the same, those sensors would never go off, because EVOC teaches a game of angles, eye contact, and asserting yourself. Obviously your not going tokyo drift style in any response vehicle LE cars included, but you still need to accelerate and decelerate, sometimes fast if the people in front/side decide they dont see the big rolling box with Christmas lights on it.

 

[EpiEMS]

wouldn't the sensor stay on if your driving how evoc teaches???

Well, it would be on, but it wouldn't necessarily activate. EVOC for EMS is very, very gentle (not like PD ).

I am hoping I can also get us Lucas devices so that if the patient arrests during transport we can use that with the vent and remain belted.

Thinking about it now, the only times I haven't been belted was when we have (yes, I know, it's dumb) transported an arrest or post-ROSC patient...a Lucas (or smarter decisionmaking on my partners' part) would have helped!

 

[DrParasite]

I'll be honest: I can't remember the last time I wore my seatbelt in the back of the ambulance..... not saying it's right, or anyone should follow my example, but if I was doing a long distance transport, or had a patient who I didn't anticipate having to do any interventions on, I would absolutely put it on an be in the captains chair (such as if I was doing an IFT run on a stable patient)

That being said, I would be 100% in favor of a restraint system that actually allowed me to actually treat and monitor the patient, get needed equipment, and move as needed to help my patient.

And from an agency point of view, you absolutely have a policy mandating their use, because it protects the agency from injury claims by providers who don't use them. That is the sad truth, many policies are designed to protect the agency, and are not always written to benefit the employee.

 

[Tigger]

And from an agency point of view, you absolutely have a policy mandating their use, because it protects the agency from injury claims by providers who don't use them. That is the sad truth, many policies are designed to protect the agency, and are not always written to benefit the employee.

It benefits the provider to remind them to wear their damn seatbelt whenever possible.

 

[EpiEMS]

It benefits the provider to remind them to wear there damn seatbelt whenever possible.

Biggest risk for fatalities for us is an MVC, after all!

 

[Kevinf]

Only two of our ambulances have the shoulder/waist harness tether. I wish they all did, as it feels far more comfortable than the bench belts and usually the captains chair belt as well. It's definitely safer as those aforementioned chair and bench belts are poorly designed for the use of actually restraining a body in an accident.

 

[WolfmanHarris]

http://www.objectivesafety.net

Check out the INDEMO module they've put together as a proof of concept.