Ambulance Crashes: Increasing Clinician, Patient and Public Safety
Guidance on Seat Belt Use, Lights and Sirens and Fatigue

Too often, EMS clinicians, patients and others are injured or killed in ambulance-involved crashes. Crash Responder Safety Week is an opportunity to focus on safety practices around seat belts and restraints, lights and sirens use and fatigue mitigation to protect responders and the public.

Ambulance Crash Data
Per U.S. data collected between 2012 and 2018, there were 173 ground ambulance crashes with 199 fatalities. Additionally, National Safety Council (NSC) 2023 data shows:
• 27 ambulance-involved crash deaths
• 16 occupant of non-emergency vehicle deaths
• 7 ambulance passenger deaths
• 4 emergency vehicle operator deaths
The Safe System Approach provides an effective way to address and mitigate the risks inherent in transportation through multiple layers of protection, which will both prevent crashes from happening in the first place and minimize the harm caused to those involved when crashes do occur. EMS agencies can apply the pillars of a safe system: safer people, safer vehicles, safer speeds, safer roadways and post-crash care to road safety for clinicians and patients.

Lights and Sirens Increase Crash Risk
A 2019 study highlights the potential increase in crash risk when ambulances operate with lights and sirens. When an ambulance responded to an emergency call without using lights and sirens, the crash rate is 4.6 per 100,000 responses. That rate increased to 5.5 with lights and sirens.
According to a 2022 joint statement, emergency medical dispatch (EMD) protocols have been successfully used to prioritize the calls that justify a lights and siren response.

Traffic Signal Preemption
Preemption can help emergency responders address roadway risks by reducing cross-traffic at intersections and allowing ambulances to travel safely at lower speeds. Access resources from the Federal Highway Administration (FHWA) like the Traffic Signal Timing Manual, Chapter 9. To learn more about roadway safety, visit www.EMS.gov.