In Winter Park, Employee Safety Comes First

     According to a 2003 article in the CDC's Morbidity and Mortality Weekly Report, ambulance crashes killed 27 emergency medical professionals between 1991 and 2000. Of those killed, seven were unrestrained at the time of the crash.

     That's a sobering statistic for people who work unrestrained in ambulance patient compartments a good deal of the time. Although the Winter Park (FL) Fire Department has never experienced an employee fatality in that manner, it decided to be proactive and look at how to keep its employees safe at work. After two years of research, the department recently debuted two redesigned ambulances, complete with five-point safety harnesses that keep paramedics restrained while providing care.

     "We looked at our restraint policies for all of our apparatus and found there was no way we could hold our people accountable for meeting the requirements for being restrained while they were treating patients," says Winter Park's Fire Chief, Jim White. "It was physically impossible for them to do their job in the back of the units and be restrained properly. So, when we went to replace the units, we began working with several manufacturers and determined it might be possible to redesign them--to look at the way the compartment was laid out and come up with a way to bring the work space to the paramedics where they sit on the squad bench."

     A lot of systems have been developed and installed, including safety harnesses, says White, but their research and experience showed that they were seldom used because the paramedics still had to reach for a lot of their equipment. That's when EMS Supervisor Lt. Andrew Isaacs was given the task of coming up with a new design.

     "I began to realize that the back of every ambulance is the same," he says. "You have your bench, a place for one stretcher and one seat. So, I sat down on the bench and tried to figure out how it could be arranged so the paramedics don't have to get up."

     When bids went out to various manufacturers, Medtec Ambulance Corp. of Goshen, Indiana, came back with the lowest bid, says White.

     "This was a very innovative redesign," says Medtec's Jim Philips. "Using Isaacs' recommendations, we redesigned everything to be within arm's reach, including the critical areas of the patient: access to the head and chest for airway control; access to the arms for IVs; drug storage; radio and oxygen equipment; suction; intercom; glove dispensers; and electrical switches and controls, and we placed them in such a fashion that they would be crashworthy. Then, in conjunction with some external vendors, we developed a completely new seat design and harness. We looked at the aviation industry and NASCAR racing, and noted how they secure people in very dynamic situations. We also had to make it affordable. An aviation seat that would have met the design to a T cost $26,000, so that wasn't a viable option."

     Because management had been upfront with their employees from the outset about the need to improve the safety of their workplace, acceptance of the newly designed vehicles, including the harness, was not a problem, says White.

     "Once the paramedics saw that the changes were easy to use and would make them safer, they were very accepting," he says.

     Isaacs agrees. "The paramedics are doing everything they can to wear the harnesses on calls," he says. "If a situation arises where they can't wear it, we're usually able to make minor adjustments to equipment locations so they don't have to take the harness off. A representative from NIOSH said ours is the best he's seen of any of the devices he's tested in the NIOSH study. Some people are coming here from NIOSH to look at our ambulances, and we're hoping it might create some change in the federal ambulance guidelines."

     For more information, visit Winter Park online at www.wpfd.org.