Seatbelt Safety Reminder
There have been several motoring incidents where the manner in which patients have been secured in the ambulances has been brought into question. When considering the issue, wemust consider the potential risks to the patient & crew, the legal requirements and the subsequent consequences that could follow if the patient suffers further harm or fatal injuries whilst in the care of the ambulance service as a result of the mandatory restraints not being used.
Regardless of whether you are working on a DSA, Bariatric, Urgent or PTS/NES ambulance, the requirements with regard to the use of seat belts and the security of persons is the same, as are the possible consequences if the requirements are not fulfilled. If the vehicle you are working in becomes involved in an incident or accident, which causes the vehicle to stop in any manner other than in a normal controlled braking manoeuvre, loose items and incorrectly secured persons may be subjected to increased forces that may propel them in any directions, with the result that serious or fatal injuries are sustained.
If this happens, the DRIVER will primarily be held responsible and will be required to explain to the investigating authority, why they failed to ensure their patient was safely secured before setting off. Should it become apparent that the DRIVER was aware that the patient was not fully and correctly secured at the time the journey was commenced, the defence for the DRIVER significantly reduces and increases the risk of a criminal charge leading to a custodial sentence.
Single Seats: These should always be facing forward when occupied and the person occupying the seat must be wearing the provided seatbelt. We know that on the Mercedes ambulance it takes time to rotate the seat to face forwards, but failing to do so increases the risk of serious personal harm or fatal injuries during a sudden deceleration or involvement in a road traffic incident. The same applies to any patient or passenger travelling in a side facing seat; it must be turned to face forwards and they must be wearing the seatbelt when the vehicle is in motion unless they are medically exempt.
The stretcher: Regardless of which type of ambulance you are working on, the number of straps that must be attached to the stretcher and used on every patient, to meet CEN requirements is EIGHT. That number includes the four straps for shoulders & abdomen plus two each for the upper and lower legs. Every ambulance stretcher has been provided with 8 straps and these must be checked during the MRCs / VDIs to ensure that they are in situ and the buckles function correctly.
If there are problems with the straps / buckles during the MRCs / VDIs then they must be rectified before going out on the road. If a strap or buckle fails while the crew are with a patient, they should carry out a dynamic risk assessment as to whether they should convey or not. They should make an entry in the Patient Care Record / MDT to ensure that the information is embedded in the task. When clear from that patient they should return to base or nearest location to rectify the situation.
The SHOULDER HARNESS is also an integral part of the stretcher and must be employed when securing the patient to the stretcher. If a situation exists whereby the use of the shoulder harness may worsen the patient’s condition, such as traumatic injuries to the shoulders, the clinician and driver must carry out a dynamic risk assessment. If having taken this risk assessment they genuinely believe that to use the shoulder harness would seriously and significantly worsen the patient’s condition, the crew must ensure this information is recorded prior to leaving scene.
The decision not to employ the shoulder harness must not be taken lightly and the crew must be aware that their decision may result in the patient sustaining further harm, even fatal injuries, if the ambulance is subject to sudden rapid deceleration or a roll over. If it can be proven that using the shoulder harness would have prevented further injuries or the death of the patient, the courts will hold the DRIVER responsible for the patient’s outcome.
The one agreed exemption to the use of the shoulder harness is when the patient is being conveyed on the stretcher whilst still secured to the orthopaedic “scoop” stretcher. In this situation, a pair of stretcher straps should be threaded through the side bars of the “scoop” stretcher and secured over the patient before the stretcher side panels are raised into position. By employing the stretcher side straps in this manner it prevents any movement of the “scoop” stretcher along the length of the main stretcher.
When using this method, the crews should ensure that the medics at the receiving hospital are made aware during the handover so that the straps can be released in the correct order while still maintaining the patient securely to the “scoop” stretcher.
Paediatric Harness: The Trust has carried out extensive research with regard to the safe conveyance of paediatrics and has provided Paediatric Harnesses to enable crews to secure our small patients in a safe manner. Allowing parents to convey Babes-In-Arms is unsafe and is no longer an approved method.
Additional information on the law and the correct way to use the stretcher straps will be coming out soon from the Trust safety team.
Remember; allowing ourselves a little bit more time to ensure our patients are safely secured before we set off down the highway, reassures our patients that they are not just another piece of cargo; they will appreciate the attention to detail, consideration, and will find the journey to be more comfortable.
Unison Health & Safety Officer
8 March 2021