ABSTRACTS
Relative Risk of Death in the Rear Compartment in Fatal Ambulance CollisionsAuthor: Rebeka Stephen, Cody Olsen, John MacMillan, Stephanie Limmer, Jeffrey E. Rollman, Brian Clemency | | University at Buffalo Jacobs School of Medicine and Biomedical Sciences Associate Authors:
Background: In ambulance collisions, rear compartment occupants have a 2.7 times greater risk of severe injury compared to front compartment occupants. Prior studies of rear compartment fatalities have not distinguished emergency medical services (EMS) clinicians from non-EMS occupants (e.g., patients). The goal of this study was to compare the risk of fatality between EMS and non-EMS rear compartment occupants during fatal ambulance collisions. Methods: The Fatality Analysis Reporting System (FARS) data from 2020-2023 were queried to identify ambulance collisions involving at least one ambulance occupant fatality. Occupants were classified based on the FARS “EMS personnel” identifier (present vs. absent) and seating position (front vs. rear compartment). The relative risk (RR) and 95% confidence interval (CI) of a fatal injury for EMS personnel vs. non-EMS occupants in the rear compartment were determined. Results: Over 4 years, 38 ambulance collisions resulted in at least one ambulance occupant fatality. There were 104 ambulance occupants involved, of whom 66 (64%) were identified as EMS personnel, 55 (53%) were rear compartment occupants, and 41 (39%) died. Among rear compartment occupants, 36 (65%) were not identified as EMS personnel, 22 (61%) of whom died; 19 (35%) were identified as EMS personnel, 4 (21%) of whom died (RR 2.9; 95% CI: 1.3-7.5). Conclusions: In fatal ambulance collisions, non-EMS occupants in the rear compartment were at 2.9 times greater risk of death compared to EMS clinicians in the same compartment. Further research should assess how safety belts, position within the rear compartment, and pre-existing conditions affect fatality risk.
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