December Ambulance Crash Log

[WolfmanHarris]

I would also note that any "scientific study" will be flawed to some extent. One of the issues that Nadine Levick brought up is that ambulance crashes are not reported to any "1" central agency, and often times the police report will not indicate that the vehicle was an "ambulance", it may just say Ford F-350 or Ford Van. Then think about how many minor accidents are never reported, and repaired by the company without an insurance claim (backed into a pole).

Do the parenthesis around "scientific study" represent your disdain for science and academia, or your doubts about the referenced study? As a result of this are you suggesting that we throw the baby out with the bathwater and reject studies due to potential faults (which are usually noted within the study itself) or place them on equal footing with nonscientific studies and online polls? If they should be rejected due to their flaws, then should your arguments based on nothing should probably be rejected as they have even less grounding on facts and less scientific data? Or am I missing something? What about your data makes it more reliable and accurate that than posted by BEorP?

[BEorP]

Beorp: The site I am referencing is a site that lists all ambulance accidents that occur in the US that make the news. If you care to click on any of them, you will see that most are very detailed reports about actual crashes. It is quite possible that the two months that I looked at vary from the norm, as that is how you arrive at an average -- you have a high and a low. Please put a link to your "scientific studies" that prove that all of these "real" ambulance accidents are just myths, and must not have happened because you read a study 2 years ago.

Maybe in posting after a night shift without enough sleep today I was unclear. The site only shows a fraction of the total number of ambulance crashes. Because of this, we cannot draw any real conclusions from it. Even as you stated in your initial post, "Of course, those crashes that are listed are voluntarily emailed to the site, it is not an all-inclusive list."

Here are some things to read to get you started:

Zagaroli L, Taylor A. Ambulance driver fatigue a danger: distractions pose risks to patients, EMTs, traffic. Washington, DC: Detroit News Washington Bureau. 2003;1-8.

Weiss SJ, Ellis R, Ernst AA, Land RF, Garza A. A comparison of rural and urban ambulance crashes. Am J Emerg Med. 2001;19(1):52-56.

Centers for Disease Control and Prevention. Ambulance crashrelated injuries among emergency medical services workersUnited States, 1991-2002. Morbidity and Mortality Weekly Review 2003;52(8):154-156.

Eckstein M. Primum non nocere-first do no harm: An imperative for emergency medical services. Prehosp Emerg Care 2004;8(4):444-446.

Maguire BJ, Hunting KL, Smith GS, Levick NR. Occupational fatalities in emergency medical services: a hidden crisis. Ann Emerg Med. 2002;40(6):625-632.

Proudfoot S. Ambulance crashes: fatality factors for EMS workers. Emerg Med Serv. 2005;34(6):71,73-74.

Custalow C, Gravitz C. Emergency medical vehicle collisions and potential for preventive intervention. Prehosp Emerg Care 2004;8(2):175-184.

Kahn C, Pirrallo R, Kuhn E. Characteristics of fatal ambulance crashes in the United States: an 11-year retrospective analysis. Prehosp Emerg Care 2001;5(3):261-269.

I wish you luck in saving all of us who are still active in EMS. I won't be spending my time in engaging in a discussion with no basis in facts though.

[crotchitymedic1986]

I have no disdain for scientific studies, I relish them. The problem is, when it comes to EMS, there are few scientific studies. Dr levick was the first person to crash test an ambulance. Think about that. You would think someone would have done a scientific study on the crashworthiness of ambulances sometime before the 90s.

[akflightmedic]

Can you please support this statement? To what do you reference?

Pssst, don't ignore me as usual.

[WolfmanHarris]

Actions aren't meeting words there. If you relished science, I'd expect to see more scientific method or basis in your arguments. Perhaps you can explain how you relish them? I'm sure I'm not alone in my confusion on this one.

[crotchitymedic1986]

fair enough B --- I look forward to reading them all, thank you for offering fact instead of opinion.

[akflightmedic]

fair enough B --- I look forward to reading them all, thank you for offering fact instead of opinion.

[emtannie]

Although I am starting to try very hard to avoid crotchity’s threads, as I find them devoid of any scientific basis and the way he presents his thoughts are based more on opinion than fact, I looked at this one because it was getting much attention.. It appears that was my first mistake.

My second (and hopefully last) mistake on this thread is actually feeling like I have to comment on it.

First, to Crotchity:

Once again, you have started a thread with no evidence to support your comments, and then you add to it as other question your intent, changing the focus as you go. Bcause of this I question your intent of your threads – what usually has the potential to evolve into a positive discussion on what changes we could make as EMS providers and what some regions are doing to improve service, ends up in a thread where you refuse to acknowledge most posters, you belittle those who directly ask you for facts and clarification, and rather than trying to lead the thread back to discussion which could improve EMS, you hijack it further.

Your first post:

“Here is a link to a site that maintains an ambulance crash log. December's accidents will pop-up with this link, and you can search all previous months. If I get bored today, I might count up all of 2008's crashes to get an injury and death count. Of course, those crashes that are listed are voluntarily emailed to the site, it is not an all-inclusive list:

http://www.emsnetwork.org/artman2/publish/...-crashes.shtml”

After being asked to clarify your thread, you responded:

“If you extrapolate those numbers out for just those who were injured, to an annual statistic, you would come up with 576 people injured on an annual basis, which on it's face seems low. But if I told you that a piece of equipment that was common to ambulances was going to have a malfunction this year that would result in close to 600 injuries, wouldnt you do something about that piece of equipment ?

These accidents are still the number one killer of our personnel, what does your service do to reduce accidents ?”

And…

“Yes i did break my promise, but it was only at the request of the crotchies who stated they could not go a week without my posts. So to make everyone happy, I am not posting any controversial topics until 2009. You will note that these topics are all warm and fuzzy, and not offensive.”

“These accidents are still the number one killer of our personnel, what does your service do to reduce accidents ?”

Then, you sidetrack the thread with:

“the most critical call you can respond to is a cardiac arrest, and they are already dead.”

Now… let’s look at the posts asking you to clarify:

Reaper said:

“And the point of all of this is?”

“How are statistics preventing it?”

BEorP said:

“crotchity, if your intentions are to do something useful for the profession then I cannot fault you for that. You are kidding yourself and misleading members of this site if you think that the numbers you are citing mean anything.

Please review the literature on this issue, as many of the things that you are making guesses on have been examined in scientific studies.”

Akflightmedic said:

“Care to explain this one? I never viewed an arrest as the most critical...”

“Read any journals or studies regarding cardiac arrests lately??”

Now, to the basis of my post…

Crotchity, you did not provide any factual basis for your comments. You provided no studies, no evidence, no background to your comments. Yet, when people requested it from you (which, as the original poster, you should have been prepared to do) you did not provide any. You waited until someone else took the time which you should have done, and provided a number of studies (thank you BEorP).

You made comments that you could not back up with facts, like:

“These accidents are still the number one killer of our personnel, what does your service do to reduce accidents ?”

“the most critical call you can respond to is a cardiac arrest, and they are already dead.”

Where are the published studies to confirm this and why haven’t YOU posted them?

Instead of providing the thread with constructive dialogue, you present:

“Yes i did break my promise, but it was only at the request of the crotchies who stated they could not go a week without my posts.”

Oh please…. For the most part, we are adults on this site, and your continued reference to your groupies is childish and annoying… I highly doubt that anyone on this site can’t go a week without your posts. I suggest that whoever they are, if they truly are not the voices in your head, that they seek medical attention for their addiction, as it is unhealthy to be that dependent.

And, when specifically asked to clarify (as per akflightmedic, above), you respond with “As usual for AK; too bad.”

I will not do your homework for you. If you are going to start a thread, have the facts to present, and when others ask for clarification and further explanation, I would like to see you back up your comments with facts.

The fact that you continue to NOT present facts, and that you get defensive when asked again and again makes me question your reasons for being on this site.

It appears to me that you would prefer to be the centre of attention through your less than professional attention seeking actions, rather than become a respected member of this site with positive contributions to the forums and the providing of educational material to others.

To date, as I have not seen you provide positive dialogue or anything which furthers my education, I will continue to try very hard to avoid your further posts and threads.

[crotchitymedic1986]

You asked for more thoughts on relishing scientific studies. I think there is some confusion regarding what a scientific study is, especially in regards to data gathering. Many seem to be of the opinion that unless you have studied EVERY case, there can not be a scientific study, which is not true. Most scientific studies use a small sample of data (500-1000 cases) to come to a conclusion. As long as the sampling is done using the same format, you do not have to study every case. For example, if I wanted to determine the average number of fresh egg cartons that contained "cracked eggs", I do not have to look at every egg carton in every grocery store in the United States to determine that probability.

Now as it relates to this current topic. I have in no way stated that my numbers are a scientifc study, but if I continued to tally the numbers from this one site over a year or so, I would say that the numbers would probably be fairly representative of the real world. Remember that this site lists "real accidents" that have occured, it is not a silly poll like mine, that just ask who has had an accident. Since all accidents are not mandated to be reported to a central authority, any study on the subject will be a sampling of "some" crashes, not "all" crashes.

Then there are those on this site that want to discount any theory, that doesnt have a scientific study to back it up. That thought process would be fine, if a scientific study had been performed on every topic imaginable, but that has not happened. Most often, it happens the other way around: Someone says, "I think there is a problem", thens someone says "lets study it, and see if it really is a problem".

I do not need a scientific study to know that we should be doing more to reduce ambulance accidents, since it is still the number one killer in our industry. That fact alone, tells you that we need to do more. Some may say, "accidents are unavoidable, and as long as the death rate is less than "x" we should be happy". I dont subscribe to that theory.

In all of the topics I raise, my hope is that you will just take a minute to ask, "could we do it better in my little corner of the world ?" or "Are we really being the best EMS service that we can be ?". Sometimes I do that by showing the absurd, but most of the time it is based on real EMS issues. I probably will not phrase my questions/polls in a manner that everyone likes, but I am not interested in being the most popular poster here.

[akflightmedic]

I do not need a scientific study to know that we should be doing more to reduce ambulance accidents, since it is still the number one killer in our industry.

If scientific studies have NOT been done due to a lack of awareness of this issue, how do you state or support the above conclusion?