New Ambulances an Investment in Safety

Island EMS, a subsidiary company of Nova Scotia-based Medavie EMS, began operating the ground ambulance service in Canada's Prince Edward Island in April 2006. Through a long-term service contract with the PEI government, Island is solely responsible for the delivery of prehospital emergency care and nonemergency transfers for the entire island province. It employs approximately 100 paramedics.

In conjunction with Medavie, Island started working in 2008 on researching a new vehicle design. Leaders consulted with the EMS Safety Foundation to develop a safer ambulance that would provide maximum protection for paramedics, patients and the public. The project involved automobile engineers, ergonomics experts, crash safety engineers, occupancy-protection professionals and conspicuity experts. The team also incorporated work done by IEMS paramedics and management on a multipatient unit they implemented in the spring of 2010.

As the research began, it became clear that one chassis stood out from the rest in reliability, economy and safety: the Mercedes Sprinter, a German-engineered unit equipped with a standard BlueTEC V6 turbo diesel engine that minimizes fuel consumption. The Mercedes also has the longest average maintenance intervals, which makes it very cost-efficient. If that made it appealing, the safety features pushed it over the edge: The vehicle comes equipped with Adaptive ESP (a proprietary electronic stability program), ABS with brake assist, rollover mitigation, and roll movement intervention, all aimed at keeping occupants and members of the public safe. The Sprinter also rates best in class ergonomically.

After months of research and consultation, the team produced a request-for-proposal (RFP) document consisting of 22 sections and more than 68 pages, including required safety testing. The design document was specific in components, equipment and products to be used, with the goal of improving safety engineering and implementing best practices. We allowed the engineers to suggest a layout design reflecting their expert input. We also attended the EMS Safety Foundation's 2010 post-EMS World Expo workshop in Dallas and incorporated feedback from various safety experts there.

The new vehicle design had many key features to allow paramedics to deliver safer care. The first area we focused on was the rear patient compartment--we wanted to arrange it so the paramedic had all their essential and frequently used equipment within arm's reach, so they could remain secured in their seats. A swiveling attendant seat equipped with a shoulder belt was installed instead of a squad bench. The seat swivels 280 degrees and also moves forward and back to allow the paramedic to provide care. The wall console area next to the attendant has a suction unit and an action console that includes lighting, suction, ventilation, intercom and temperature control. There is also a radio.

Above the attendant's head and recessed into the wall are four glove box holders that allow easy access. In front of the seat is a compartment system with the defibrillator secured on top. There is a slide-out writing tray and two compartments that allow for equipment storage below. There is also a kick-open sharps and waste container storage system.

The airway seat allows the attendant to be positioned next to the head of the stretcher, giving them maximum airway control while remaining belted. All seats are ergonomically friendly and fluid-resistant for easy cleaning. The aluminum interior cabinets have a locking mechanism that helps prevent equipment from flying loose in a collision. All exterior equipment is secured with straps and solid doors or walls that can be accessed when the main doors are open. These cabinets include the stair chair, spine boards, portable oxygen and equipment bags used when arriving on scene. There is also a double-locking narcotics storage cabinet that helps secure controlled substances. All areas for entry have grab bars as well as high-visibility yellow padded head-strike zones. The rear lighting is all LED with multilevel lighting ability. The structural integrity of the rear compartment is not reduced in any way.

The front cab area has plenty of storage, with compartments located throughout. The flares, helmets, vest and four sizes of gloves are all located in the cab, which also has an extra set of straps to help secure personal belongings. There are map and clipboard holders, as well as a heads-up display for main controls. The unit is also equipped with an antitheft device.

The lighting, controlled by a Demers multiplex system, reduces the normal ambulance wiring by over 70 lbs. and also allows for easy electrical diagnostics, reducing maintenance costs and out-of-service time. The unit's exterior bears high-conspicuity markings for visibility on the road. When the LED emergency lighting is activated, it makes the unit highly recognizable, providing additional safety on scenes. The rear compartment even has a light bar inside for when the rear doors are open.

The unit also comes equipped with standard features such as outside temperature gauge and running boards with holes in them, allowing snow and slush to drain through. We added features such as a rear-vision camera, rear bumper sensors and the Acetech AVI (auto vehicle informatics) component. This unit also has a rear loading height of less than 19 inches to reduce risk of provider back injury.

By April, Island EMS will have five new type II Mercedes Mirage EX Sprinter ambulances built by Demers. It will be the first service in Canada to implement the Sprinter. Demers won a 2010 Top Innovation Award from EMS World for this model.

Medavie EMS and its group of companies are committed to providing innovative healthcare solutions through caring professionals, while continually working to improve and build on their foundation of safety. Our goal is to keep our healthcare providers, patients and members of the public safe.

Matt Crossman is manager of safety operations for Medavie EMS.