A comparison of rural and urban ambulance crashes

Abstract

Ambulance crashes are a significant safety issue both to the EMTs and to patients transported in the vehicle. Safety issues are dependent on the environment and may be different in rural and urban settings. Ambulance crashes reported to the State EMS bureau during the years of 1993 to 1997 were evaluated. Counties with >250,000 population were considered urban. State population was 2 million urban and 2.8 million rural. Two investigators determined first if the crash was urban or rural. Outcome information was extracted on the degree of injury, citations given, and information on the ambulance and other vehicle condition. In addition, independent variables of weekend versus weekday, day versus night, posted speed, weather, road condition (wet versus dry), intersections, and use of seat belts were extracted. Results were compared using a 2-tailed Chi-square or Fisher's exact with significance at P 54 mph (OR = 0.24, 95% CI = 0.06 to 0.78) and nonrestrained people were less likely to be injured (OR = 0.28, 95% CI = 0.06 to 1.25). For injured persons there was no difference in independent variables in the urban versus rural settings. Although the rate of ambulance injuries was greater in the urban environment, the severity of the injuries was worse in the rural environments where crashes occurred at higher posted speeds. In the rural setting nonrestrained passengers were more likely to be injured. Copyright © 2001 by W.B. Saunders Company.