National Fire Fighter Near-Miss Reporting System: Riding EMS Units

Many lives have been saved in the back of EMS units during transport to the hospital. These lifesaving actions are accomplished by dedicated providers who often work unrestrained during the ride. As the unit weaves its way to the hospital, the unrestrained provider has the potential of becoming a projectile with little warning. Many providers learn techniques that absorb more than a few of the tests of the laws of physics that occur during transport. But as we read in this week’s featured firefighter near-miss report, some of the laws are not the least bit interested in the provider’s welfare or safety.

” I was assigned with a BLS crew to provide ALS for a patient being transported to [another state]. We were approximately 1 1/2 hours from our destination when a car sideswiped us. This sent us crashing into a car on the shoulder of the road, then over a small embankment, striking a light pole, and ending by crashing head-on into a hillside. I was seated in the patient compartment of the Ambulance in the airway seat directly behind the stretcher. At the time we were struck, I was standing to adjust the oxygen. I was thrown onto the floor of the patient compartment. Our two spare oxygen bottles were mounted to the wall of the walkthrough from the patient compartment to the cab of the truck. I landed directly in this passageway, and when we struck the car on the shoulder this was the exact moment my shoulder, chest, and back struck the oxygen bottles. My head struck the corner of the wall and my back was slammed to the floor against the tracks that were made for the sliding door to separate the patient compartment and the cab. As we went over the embankment, I slid towards the cab. When we crashed into the hillside, I was catapulted into the cab landing on my neck and upper back. Our driver sustained a head injury, and the EMT in the back with me sustained internal injuries. Our patient, thankfully, was basically unharmed other than minor bruising.”

Once the vehicle stops crashing and careening, it is time to assess the personnel damage. It doesn’t take much to come up with a list of potential injuries this reporter may have suffered during his pinball performance. Once you have read the entire report (, consider the following:

  1. Is this incident and the experience of the reporter, solely restricted to the back of an EMS unit?
  2. Are there restraint systems available that can properly restrain an EMS provider and provide the mobility necessary to treat patients in the back of the unit?
  3. If your department provides EMS service or your members assist an EMS service with care and transport, what training is provided to your personnel regarding the hazards of riding in the patient compartment of the EMS unit?
  4. Would you consider this incident a preventable event? Explain your answer.
  5. The reporter describes several construction features of the EMS unit that could be considered contributory to the event. What features would you cite? 

Surviving a ride like this reporter experienced in this featured firefighter near-miss report is nothing short of miraculous. The lessons from this event are as numerous as each impact the reporter suffered. In the end, the emergency service is a high hazard operation, with little predictability as to when the hazard will surface. Acknowledging the hazard is one thing. Reacting when a hazard presents itself is another. Staying one step ahead of the hazard’s adverse impact should be a daily goal.

Submit your EMS unit near miss to today so everyone goes home tomorrow. For more on the benefits of firefighter near-miss reporting, CLICK HERE.

Note: The questions posed by the reviewers are designed to generate discussion and thought in the name of promoting firefighter safety. They are not intended to pass judgment on the actions and performance of individuals in the reports.

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