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recommended practice
Guidance note 16
September 2014
Emergency response team members run a high risk of getting killed or seriously injured as a result
of vehicle crashes. Emergency Response Vehicles (ERV) have high crash fatality rates per kilometre,
well above those of passenger vehicles, or when compared to similarly-sized vehicles.
The factors that increase the risk of ERV transport operations can be grouped into:
• driver-related risks
• journey-related risks
• vehicle-related risks.
This document is based on OGP Report No. 365, Land transportation safety recommended practice.
It provides further guidance and recommendations on how to reduce and quite possibly eliminate
significant risks associated with the operation of Emergency Response Vehicles.
Contents
1. Drivers 2
2. Seatbelts 2
ERV drivers should attend an accredited defensive driving Consider having front/rear facing seats only. Personnel
course that addresses the challenges of driving ERVs in an in side-facing seating positions, such as squad benches
emergency situation. In some countries, such training is a and CPR (Cardiopulmonary Resuscitation) seats, are
legal requirement. subjected more to serious injury or death, even when
seat-belted, than personnel in frontward or rearward
ERV drivers should not exceed speed limits and should not
seating positions.
use unconventional driving tactics (e.g. driving through
red traffic lights and overtaking on road shoulders). Any If side-facing seating is considered imperative, use four-
exception to this should be managed as such. point seatbelts.
The reasons are three-fold.
3. Vehicle specification and upfitting
• Company-owned or contracted ERV drivers typically
differ significantly from hospital ambulance drivers in This guidance supports guidance note 365 14, 2.8 (Vehicle
terms of training, experience, vehicle familiarity, and specification and upfitting).
route familiarity.
ERVs are typically used infrequently so they are subjected
• Company-owned or contracted ERV operations
to vehicle maintenance procedures that are time-based and
differ from hospital ambulance operations. Medical
not kilometre or engine-hours based.
emergency response plans typically do not require
rushing a first responder from the hospital to the Pay particular to vehicle parts that can seize such as brakes,
accident site. Instead, ERVs are used to transfer wheel bearings, clutch/gear linkages and steering. The
patients who have been stabilized on-site. vehicle(s) should be ‘exercised’ weekly.
• Judicious use of flashing lights and sirens significantly Parts that degrade include fluids (brake, engine oil and
reduces delay, even in the absence of speeding and fuel) and rubber-based parts such as hoses and tyres.
unconventional driving.
ERV tyres should be replaced every four years. Tyre
Overall, in the context of typical ERV operations and in manufacturers do not have a uniform criterion for tyre
the context of a stabilized patient arriving a few minutes lifetime. For most other vehicles, this is not an issue
early at the hospital through speeding and unconventional because they normally wear and are replaced before the
driving, the high risk of an ERV crash outweighs the small maximum lifetime. For special vehicles like ERVs that do
improvement in morbidity. very little actual driving, it is an issue.
2
• have a rotating or pulsing emergency beacon
• have beam spotlights at the rear of the vehicle, to
support casualty stabilization and stretcher handling
behind the vehicle
• have reliable real-time voice communication with the
hospital to which the casualty will be transported
• be designed so that the medical technician is able to
issue instructions to the driver during the transport.
The patient compartment of the ambulance should have:
• climate control
• adequate lighting
• all surfaces padded
• all equipment, cupboards and doors with proper
securement devices
• no sharp or protruding objects
• fixture for IV drip
• water bottle(s) for drinking and hand washing.
The stretcher should be securely fastened to a vehicle
anchor point and preferably have locking wheels. It should
be possible to load the vehicle with the casualty’s head
towards the front, and the medical technician should be
able to sit next to the patient’s head.