Physician-Staffed Emergency Vehicle Crash: A Case Report

Abstract

Physician-staffed vehicles are widely operated in many countries. There is a paucity of literature regarding physician-staffed emergency vehicle accidents. On an evening in January 2016, at the request of the fire department, a physician-staffed vehicle was dispatched with two physicians, a nurse, and a driver from the base hospital to the scene of a patient with cardiopulmonary arrest. The vehicle ran with the alerting siren and warning lights. On its way, the vehicle struck a car and the mission was canceled. The patient was transported to another hospital by the ambulance staff only. No passengers were injured. One physician and a nurse examined the driver of the struck car and transported the driver to the base hospital by additional ambulance units. Because there were no manuals or guidelines, the staff responses were not systematic. After the repair of the crashed vehicle and preparation of operation manuals for two months, the physician-staffed vehicle returned to service, and it has worked without any accident since then. The physician-staffed vehicle is of benefit to critical victims and it rarely crashes. When the vehicle is involved in an accident, it results in multiple victims as well as additional emergency demands. Warning lights and sirens in the dark at a four-point crossroads might increase the risk of crashing. Information influx from the emergency scenes might distract the physicians' attention and put stress on the driver, leading to dangerous high-speed emergency driving. Educational training and manuals in each hospital and a nationwide framework regarding safety operations and accidents are needed.

Keywords: health services administration; occupational accidents; occupational injuries; prehospital emergency care; traffic accident.

Figure 1. Physician-staffed vehicle (A), view from the seat of the chief physician (B), and medical equipment within the vehicle (C)

(A) This vehicle is based on the Nissan Murano® and has been modified as an emergency vehicle. It is equipped with warning lights in front and on the roof. A siren and loudspeaker are attached to the front of the vehicle. Occupants can alert nearby vehicles via the loudspeaker. (B) The chief physician assists the driver by alerting nearby vehicles using the microphone (white arrow). (C) The vehicle carries medical equipment and medications to perform medical interventions, including administration of medication, surgical airway management, tube thoracotomy, resuscitative thoracotomy, pericardiocentesis, manual defibrillation, and percutaneous pacing. The vehicle also carries a portable ultrasound device (black arrow) for emergency ultrasound examination on scene.

Figure 2. Diagram of the accident

The physician-staffed vehicle (gray box) paused at the entrance of the crossroads signaling stop. When the vehicle proceeded straight to the crossroads, it struck a car (black box).

Figure 3. Damaged vehicle

The bumpers were damaged. There was no damage to the wheels and cabin.