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Posted

Yeah, seatbelts are a given. Unless you're working a code, kind of hard to do CPR when you're belted into the CPR chair.

As for helmets, jeez why not make everyone in their cars wear them? I think it's going a bit too far personally.

  • Like 2
Posted

If you notice the crash test dummies have full movable safety harnesses yet did you see the head in a low speed crash smack the cabinet. It honestly is not a bad ideal to have them on for those in the patient compartment.

As to CPR you should not be in motion while CPR is in progress so should not be a problem.

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Posted

Regarding CPR, I firmly believe then unless you get a ROSC you shouldn't be transporting a VSA, unless there are exceptional circumstances.

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Posted (edited)

If you notice the crash test dummies have full movable safety harnesses yet did you see the head in a low speed crash smack the cabinet. It honestly is not a bad ideal to have them on for those in the patient compartment.

As to CPR you should not be in motion while CPR is in progress so should not be a problem.

Sure, we'll make helmets legal too for everyone in their cars.

As for your idea on CPR ... I guess you've never had someone you've gotten ROSC on who yet again coded after transport was initiated. Are you going to stop the ambulance in the middle of nowhere to bang on some guy's chest for a while? Perhaps it's lack of resources, because I can't see you being serious ...

And as for this thread, seems to be a revival of something from February 2006 ...

Edited by Siffaliss
  • Like 3
Posted

If you notice the crash test dummies have full movable safety harnesses yet did you see the head in a low speed crash smack the cabinet. It honestly is not a bad ideal to have them on for those in the patient compartment.

As to CPR you should not be in motion while CPR is in progress so should not be a problem.

If I recall correctly, those weren't restrain harnesses, but just apparatus to position the dummies within the mock-up.

Nadine Levick's group is heavily against those tethered harnesses by the way. And heavily in favour of helmets in the back as a stop gap until Ambulances are designed to remove head strike hazard. There's a picture she has somewhere that illustrates this issue quite well for me. I'll see if I can find it but it essentially points out that we don't find it weird when flight crews wear their helmets, or construction crews theirs. Sure it'll seem odd at first, but any time you create a new normal, there will be a period of adjustment. Besides, it's about going home safe at shift change, not looking like Rabbit or that blond who doesn't know how to button her top. Now I'm not super keen on the idea of wearing a helmet in the back, but until we get trucks with a forward facing attendant seat with no head strike hazards, I'm willing to wear one.

It's time to ditch the squad bench folks.

  • Like 2
Posted

+1 for docharris. EMS in general is far behind most other industries in terms of provider safety. There has to be some sort of low profile helmet out there that has the capability of protecting paramedics in a collision while still allowing use of a stethoscope. EMS professionals are already getting used to wearing helmets with face protection at MVC's and construction scenes, etc.

Here in Newfoundland, there is nothing of the sort for providers working for community based and privately owned services. Hospital based services are a different story of course. Even as a student in Ontario, there was a proper helmet marked 'Observer' for me to use. For goodness sakes, stairchairs still aren't required equipment here on the rock. We're also using used ambulances up to 10 years old or up to 500,000 kms; so rest assured there are more sharp edges in the patient compartment then there are adequately padded surfaces.

I'm no engineer, but I fail to see how it can be so hard to design a safe patient compartment. What do we really need the squad bench for anyway? All that's underneath mine is a prybar, axe, small toolset, rope, jackstand, traffic triangles, bedpan and poorly located sharps container. Really only a couple cubic feet worth of gear that is hardly ever used. This could all easily be relocated to allow for a single attendant seat or sliding chair on rails, possibly even with an extendable 5 point harness that allows the paramedic to reach for gear from the cabinets. Cabinets could easily all have latching mechanisms, instead of the standard sliding door type that are only held closed by friction. Air bags can be deployed from a multitude of places, padding can be much thicker and more absorbent. Handsets can be located in a position where they can be accessed from places other than just the rear facing attendant chair. Sharp edges can be completely eliminated. Stretchers can be mounted much more securely than they are with 'antler and hook'. Stretchers designed so that shoulder straps come through the mattress at the point of the patients shoulders and not from the top of the headrest. Grabrails can be brightly coloured and well padded, and all protruding objects recessed into the wall but still accessible.

Just some ideas, and my two cents.

Posted

Flight crews nearly universally wear helmets, and aircraft head strike envelopes are MUCH better designed than the back of an amblulance.

Helo flight crews yes, fixed wing no. Helo crews also wear nomex suits with minimal skin exposed (no rolling of sleeves)...how far do we wish to go?

Posted (edited)

RickBob, please clarify if you are referring to helmets as part of outerwear protective gear, say, for use where stuff might fall on you, or as also mentioned here, in moving ambulances as additional protection to the crew, like seat belt usage, and air bags. Thanks.

For when we in the FDNY EMS Command are involved in an extrication or disentanglement of a patient from a vehicle, working at a multiple casualty incident, or just for visually identifying oneself at a large area event like working the New York City Marathon, the orange plastic fire helmet is not only encouraged, but mandated by our operations guide, to be worn, along with the associated "turnout" coat, pants, and blood borne pathogen resistant boots, as assigned each department member.

FDNY EMS Command has nothing, as far as I am aware, for any type helmet usage, or any type of helmet, for use while the ambulance is in motion, either in the cab or the patient treatment areas of the vehicles.

I will state that, while operating at an MCI, I have been known for not taking off the helmet when driving from the scene to the ER, or back again. When I was asked about that, I stated that there was nothing, either way, in the Ops guide, on that topic.

Edited by Richard B the EMT
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