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DFRA improves ambulance safety
Herald Staff Writer
Photo by YODIT GIDEY/Herald
Scott Sholes, right, and Dave Abercrombie show a custom-made ambulance at Durango Fire & Rescue’s Station 1 on Thursday. Sholes is DFRA’s chief of emergency medical services, and Abercrombie is the organization’s spokesman. There is a new seat for emergency medical technicians at left. The monitor/defibrillator at the left of Sholes now is secure and can be removed.
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Photo by YODIT GIDEY/Herald
Sholes stands outside the new ambulance that is a model he worked with an ambulance manufacturer to modify. The reconfigured patient compartment now is safer for transporting people during emergencies.
Photo by YODIT GIDEY/Herald
Sholes stands outside the new ambulance that is a model he worked with an ambulance manufacturer to modify. The reconfigured patient compartment now is safer for transporting people during emergencies.
Photo by YODIT GIDEY/Herald
Dave Abercrombie of Durango Fire & Rescue Authority pivots to demonstrate how EMTs can be seat belt-secure and still assist a patient next to them. At right is a seat that can be converted to a child’s seat and removed when necessary to make room for a second patient on the bench.
Recognizing the absurdity of such a situation, Durango Fire & Rescue Authority has been working with an ambulance manufacturer for two years to reconfigure the patient compartment of the vehicles it buys.
As a result, the agency has three ambulances - out of nine - in which everything and everybody riding in the patient compartment is fully battened down.
The patient compartment - the "box" in the jargon of the trade - is where bad things can happen if paramedics and equipment are unrestrained, Scott Sholes, DFRA chief of emergency medical services, said Thursday.
"We've had to devise the features ourselves," Sholes said while showing off one of the new vehicles. "It's embarrassing to say, but the patient compartments of ambulances aren't as safe as a passenger car. There are no specific safety standards for ambulances as there are for motor vehicles."
The cost of the 2009 ambulance was $164,000 - $56,000 for the chassis alone, which is stock Ford, Chevrolet or Dodge equipment. The chassis includes a hydraulic lift at the rear to facilitate movement of patients.
The custom-made ambulances that American Emergency Vehicles of Jefferson, N.C., builds for DFRA can carry as many as four riders and a patient or three riders and two patients in the box - all of them restrained.
A single patient would occupy a gurney in the middle of the compartment; if there are two patients, one would lie on a backboard placed on a bench built against the bulkhead separating the box from the driver's compartment.
All seats are equipped with safety harnesses with 9 inches of "give" that allows medical personnel to attend to patients safely. Three of the four seats are either rear- or forward-facing, and one can be converted into a child's safety seat.
Equipment is stowed in specific locations. A bracket anchors a 24-pound multipurpose monitor and defibrillator which, if unrestrained, could become a cannonball if the ambulance were involved in an accident. Nets prevent other equipment from flying around in an emergency.
A reconfigured ambulance box isn't the only way patients and medical personnel are made safer, Sholes said. Vehicle compartment doors carry reflexive striping and flashing lights; a reflective chevron pattern covers the rear door; a camera allows the ambulance driver to see directly behind the vehicle.
Other emergency agencies have borrowed DFRA ideas to reconfigure their vehicles, Sholes said.
The agency's search for a safer ambulance started in 2006 with a survey of its rank-and-file medical responders, Sholes said. Unrestrained personnel and equipment topped the list. Driver training also was important. Sholes took the information to Troy Allen with Rocky Mountain Emergency Vehicles, from which the agency buys its ambulances, and the two began to design safety features.
Today, DFRA has a pair of 2007 modified ambulances and a 2009 version.
"Everything new is born out of staff experience," Sholes said. "It wouldn't do me any good to incorporate a feature that our emergency medics won't use."
The remainder of the agency's nine-vehicle ambulance fleet will be replaced as time and funding allow, Sholes said. Vehicles are purchased out of the DFRA capital-equipment budget, but there's a good chance the agency can get a state grant available for safety equipment.
The conversion to safer ambulances hasn't occurred overnight, Sholes said. He cited the certain degree of risk to which emergency personnel are inured; the fear that change won't allow them to do their best job; and the cost of new vehicles.
There still is much that can be done to make ambulance boxes safer, Sholes said. One is "integrated" vehicles such as are used in England, Germany and Australia in which chassis and box are one piece. In the United States, a patient compartment is simply attached to a chassis.
"They're way ahead of us," Sholes said. "If I could wave a magic wand, I'd have that type of vehicle with a crumble zone on the front end that absorbs shock instead of propelling it backward."
daler@durangoherald.com
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