Assessing the performance of various restraints on ambulance patient compartment workers during crash events

Green, J. d.; Yannaccone, John R.; Current, Richard S.; Sicher, Larry; Moore, Peter W.; Whitman, Gary R.

doi:10.1080/13588265.2010.489402

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…The neck injury criterion factor (N ij = 0.47) for the 11-ft drop test in our study is comparable to that observed in the vehicle impact tests (N ij = 0.57) and the ambulance crash test results (N ij = 0.2-0.6) by Green et al (2010), although it is still well below the injury threshold. It should be noted that the N ij for females may be higher since females have a lower tolerance to dynamic loading than do males (Eppinger et al, 2000;National Highway Transportation Safety Administration, 2008).…”

Section: Resultssupporting

confidence: 85%

Assessment of Fall-Arrest Systems for Scissor Lift Operators

et al. 2011

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Objective:The current study is intended to evaluate the stability of a scissor lift and the performance of various fall-arrest harnesses/lanyards during drop/fall-arrest conditions and to quantify the dynamic loading to the head/ neck caused by fall-arrest forces.Background: No data exist that establish the efficacy of fall-arrest systems for use on scissor lifts or the injury potential from the fall incidents using a fallarrest system.Method: The authors developed a multibody dynamic model of the scissor lift and a human lift operator model using ADAMS TM and LifeMOD TM Biomechanics Human Modeler. They evaluated lift stability for four fall-arrest system products and quantified biomechanical impacts on operators during drop/fall arrest, using manikin drop tests. Test conditions were constrained to flat surfaces to isolate the effect of manikin-lanyard interaction.Results: The fully extended scissor lift maintained structural and dynamic stability for all manikin drop test conditions. The maximum arrest forces from the harnesses/lanyards were all within the limits of ANSI Z359.1. The dynamic loading in the lower neck during the fall impact reached a level that is typically observed in automobile crash tests, indicating a potential injury risk for vulnerable participants.Conclusion: Fall-arrest systems may function as an effective mechanism for fall injury protection for operators of scissor lifts. However, operators may be subjected to significant biomechanical loadings on the lower neck during fall impact.Application: Results suggest that scissor lifts retain stability under test conditions approximating human falls from predefined distances but injury could occur to vulnerable body structures.

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Section: Resultssupporting

confidence: 85%

Assessment of Fall-Arrest Systems for Scissor Lift Operators

et al. 2011

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“…NIOSH examined the performance of two-, four-, and five-point restraints, especially the biomechanical and kinematic effects on EMS workers in simulated and actual ambulance patient compartments during crash events. The results indicate that the inclusion of restraint systems that offer mobility have the potential to improve worker safety under many working conditions [ 17 ].…”

Section: Discussion Of Survey Resultsmentioning

confidence: 99%

Ambulance Design Survey 2011

Lee

Kibira

Feeney

et al. 2013

J. RES. NATL. INST. STAN.

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Current ambulance designs are ergonomically inefficient and often times unsafe for practical treatment response to medical emergencies. Thus, the patient compartment of a moving ambulance is a hazardous working environment. As a consequence, emergency medical services (EMS) workers suffer fatalities and injuries that far exceed those of the average work place in the United States. To reduce injury and mortality rates in ambulances, the Department of Homeland Security Science and Technology Directorate has teamed with the National Institute of Standards and Technology, the National Institute for Occupational Safety and Health, and BMT Designers & Planners in a joint project to produce science-based ambulance patient compartment design standards. This project will develop new crash-safety design standards and improved user-design interface guidance for patient compartments that are safer for EMS personnel and patients, and facilitate improved patient care. The project team has been working with practitioners, EMS workers’ organizations, and manufacturers to solicit needs and requirements to address related issues. This paper presents an analysis of practitioners’ concerns, needs, and requirements for improved designs elicited through the web-based survey of ambulance design, held by the National Institute of Standards and Technology. This paper also introduces the survey, analyzes the survey results, and discusses recommendations for future ambulance patient compartments design.

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“…Studies categorized into restraints described EMS personnel's perceptions and use of restraints (42,43), explored various restraint systems for safety and functionality (44,45), and presented a case for including child/infant specific restraint systems (46). The main design challenge for restraints were developing a system that balanced the trade-offs between ensuring that EMS personnel were secured during sudden accelerations/decelerations while enabling them to provide patient care.…”

Section: Restraintsmentioning

confidence: 99%

“…The traditional lap belt, for example, required EMS personnel to be seated with their backs against the seatback; this prohibited the EMS personnel from moving to the edge of the seat to access the patient, retrieving supplies from across the compartment, and performing life-saving procedures that required standing or kneeling. Current research on developing a more functional restraint system recommended to incorporate pelvic retractors to the system, and chest and shoulder tethers for better weight distribution across the hips (44). Although improving seatbelt designs are essential to increasing its usage, other factors such as EMS personnel's attitudes toward restraints and the accessibility of equipment from a seated position also played a significant role.…”

Section: Restraintsmentioning

confidence: 99%

Existing Science on Human Factors and Ergonomics in the Design of Ambulances and EMS Equipment

Du¹,

Boileau²,

Wierts³

et al. 2019

Prehospital Emergency Care

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Background: Emergency medical services (EMS) personnel face a disproportionally high risk for fatality and injury due to the nature of their work; and current ambulance and EMS equipment design standards do not adequately safeguard EMS personnel from sacrificing personal safety for patient care, a known human factors and ergonomic (HFE) design challenge. Despite the desire to include HFE interventions or considerations into a standard, the effectiveness of existing HFE interventions for EMS is unclear. Objective: Therefore, this study aimed to synthesize the peer-reviewed literature on the design features of patient compartments and EMS equipment that affect EMS personnel's performance or well-being. Methods: A scoping review methodology was applied to systematically search and screen for relevant articles, and extract data. Three databases (EmBase, Scopus and PubMed) were searched, and search results were screened for articles that pertained to the performance or well-being of EMS personnel when interacting with the patient compartment or its associated equipment. Results and Discussion: Of the 4125 search results, 48 relevant articles were retained, and then sorted into one of three categories: general design, patient handling, and patient transport. It was concluded that, although research has progressed over the past 15 years, more research, development, and resources are needed. Newer generations of ambulances have not been shown to be safer during collisions and there is a knowledge gap in how occupants and contents of a patient compartment behave during a collision. Crash-tests have been performed with restrained occupants and supplies, however, that scenario is unrealistic in the field. While the existing literature provided initial ideas and innovations for improving the HFE of patient

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Assessing the performance of various restraints on ambulance patient compartment workers during crash events

Cited by 10 publications

References 16 publications

Assessment of Fall-Arrest Systems for Scissor Lift Operators

Assessment of Fall-Arrest Systems for Scissor Lift Operators

Ambulance Design Survey 2011

Existing Science on Human Factors and Ergonomics in the Design of Ambulances and EMS Equipment

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