Analysis of Ground Ambulance Crash Data From 2012 to 2018

Graham, Lindsey A.; Thomas, Dennis; Finstad, Kraig A.; Dennert, Rachel; Southcott, Tyler · 2023 · ROSA P / United States. Department of Transportation. National Highway Traffic Safety Administration

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Summary

This study, conducted by the National Highway Traffic Safety Administration (NHTSA), analyzes ground ambulance crash data from 2012 to 2018 to identify contributing factors and prioritize safety countermeasures. The research was motivated by the fact that ground ambulance crashes are the leading cause of on-the-job death for emergency medical services (EMS) personnel. Building on a previous 1992–2011 study, this analysis aimed to update findings in light of emerging technologies, improved vehicle designs, and changes in the driving environment. The researchers queried four national databases: the Fatality Analysis Reporting System (FARS) for fatal crashes, the National Automotive Sampling System General Estimates System (NASS GES) and the Crash Report Sampling System (CRSS) for property-damage-only and injury crashes, and NHTSA’s Special Crash Investigation (SCI) reports for detailed case studies. The study team reviewed 27 SCI reports involving ground ambulances, with subject matter experts coding each report to identify critical findings, fault, and contributing factors. Data from FARS, NASS GES, and CRSS were analyzed to determine crash frequencies, occupant positions, and the status of emergency lights and sirens. Results from FARS indicated that ambulance-involved fatal crashes remained relatively rare, averaging 24.7 crashes and 28.4 fatalities annually. Of those killed, 52.3% were occupants of other vehicles, 40.2% were ambulance occupants, and 7.5% were non-occupants. Approximately 45.7% of fatal crashes occurred during emergency use, with 28% involving active lights and sirens (2013–2018). Analysis of injury crashes showed that 36.2% involved active lights and sirens, and 24.4% of injuries occurred to ambulance occupants in those instances. The SCI review revealed that 92.6% of crashes involved ambulance operator error, including improper intersection clearing, running red lights, and fatigue. A critical finding was the lack of restraint use: only 8.8% of clinicians in the patient compartment were properly restrained, and no front-seat passengers were restrained. While 95.7% of patients were restrained in some manner, only 17.4% used both lateral belts and shoulder harnesses; 44% of patients were ejected from cots, none of whom had shoulder harnesses. The study concludes that priority countermeasures to improve ambulance safety include strengthening organizational safety policies, reducing operator error through specialized training, fostering a safety culture, and adopting new vehicle safety designs. The authors emphasize that existing countermeasures, such as emergency vehicle operator courses and updated patient compartment standards, require organizational commitment and continuous monitoring to ensure best practices are followed. Implementing these measures is essential to reducing injuries and fatalities among EMS personnel and patients.

Key finding

Nearly all (92.6%) of the 27 Special Crash Investigation ambulance crashes involved operator error, and a key finding was the widespread lack of proper restraint use by both clinicians and patients.

Methodology

dataset

Provenance

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Topics

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• incidence prevalence
• naturalistic crash near crash
• demographic disparities
• comparative international

Information type

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• Empirical Findings: crash risk outcomes, observational prevalence
• Methodological Resource: dataset resource