'Real world' offers data to enhance safety of ambulance transport of children

May 14, 2000

A four-month study of more than 200 ambulance arrivals at an urban medical center suggests that the potential for injury to children and other occupants should the vehicle crash during transport is "alarmingly prevalent," a Johns Hopkins research team says.

The researchers emphasize that their study did not document any actual injuries or statistically significant injury risk to individual children during emergency transport. "It is known that ambulance transport has a high crash rate per mile traveled," according to lead researcher Nadine Levick, M.D., of the Division of Pediatric Emergency Medicine at the Johns Hopkins Children's Center. "What's important is that we've identified and verified opportunities for prevention of injury that will be useful to vehicle engineers and others."

Levick presented the findings today at the Pediatric Academic Societies & American Academy of Pediatrics 2000 Joint Meeting in Boston.

To document the prevalence of potential injury hazards, researchers observed 213 ambulance arrivals between mid-April and mid-August 1999 involving 219 patients and 672 other occupants, such as medical personnel and patient relatives. The number of occupants per vehicle, including the patient, ranged from three to seven.

Of patients transported on a gurney, 16.2 percent were unrestrained; 25.6 percent of patients were transported unrestrained on the vehicle's bench seat; and, 11.9 percent were transported on the lap of a parent or emergency medical technician. In addition, researchers observed that 13 different types of EMS equipment were unsecured or minimally secured.

Based on these findings, Levick and her research team of physicians and engineers will design and perform crash tests of ambulance vehicles, supported by an Emergency Medical Services for Children (EMSC) Federal Targeted Issues grant. The crash tests will mimic "real world" scenarios, with crash test dummies on board, to determine the optimal methods for ensuring safe transport of pediatric patients.
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Participants in the joint study included the Division of Pediatric Emergency Medicine at Johns Hopkins Children's Center, Baltimore, Md.; Department of Emergency Medicine at Johns Hopkins University, Baltimore, Md.; the Pacific Institute for Research and Evaluation, Landover, Md.; the Thomas Jefferson University School of Medicine, Philadelphia, Pa.; and the Johns Hopkins University School of Hygiene and Public Health.

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Johns Hopkins Medicine

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