Prototype ‘Safety Concept' Ambulances – Are They Actually Safe?

Objectives: To evaluate the potential safety performance and occupant protection of prototype ‘safety concept' ambulances based on accepted crashworthiness principles.

Methods: An engineering study, based on validated engineering methodology. Study vehicles were selected as self described ‘safety concept' ambulances, 2002-2007. Expected safety performance was analyzed by a multidisciplinary engineering and EMS team. Information on vehicle design and construction was identified, and evaluated via application of basic engineering principles of crashworthiness and available crashworthiness testing data.

Results: Of 5 vehicles identified, none appeared to be subjected to dynamic crashworthiness testing to demonstrate safety performance. Application of fundamental technical principles of crashworthiness and vehicle safety demonstrated these vehicles were not optimized for occupant protection. Dangerous features included: interior design hazards (seat design/orientation, head strike zones), poor layout (TV screens behind head) anchorages for restraints systems and equipment items not subjected to any 25 G pulse, side facing occupants with 4-5 point harnessing and no demonstrated patient compartment structural crashworthiness.

Conclusion: Ambulance design is an automotive safety engineering issue, a technical field of expertise outside of EMS medical practice. Based on established automotive safety principles there are major deficiencies in these ambulance's safety design. However, marketing of these vehicles is disseminated in EMS publications as a ‘safety' best practice model. The resource expenditure on development of these alleged ‘safety concept' vehicles, outside of accepted automotive safety expertise is unacceptable. There is need for EMS providers to collaborate with automotive crashworthiness experts to be aware of and apply existing principles to address vehicle safety.