Editor's Note: For more on Matt Deicher's story, discussed below, visit From Provider to Patient.

New research published today in the journal of the National Association of EMS Physicians, Prehospital Emergency Care, finds that 74% of EMS worker deaths are transportation-related, and suggests that these numbers could be reduced if citizens yield to ambulances, and EMS personnel embrace strategies that allow them to remain seated and restrained in the back of the ambulance, among other findings.

"While the work of EMS personnel can be risky by nature, there is no reason that the risk of occupational death is two and half times higher for EMS workers compared to other American workers," says study co-author David E. Slattery, M.D., FACEP, FAAEM, EMS Medical Director, Las Vegas Fire and Rescue, and Assistant Professor & Research Director, Department of Emergency Medicine, University of Nevada Las Vegas. "Often, people don't realize the types of safety issues that EMS workers face."

The article reports that failure of an oncoming motorist to yield to an ambulance is the primary cause of ambulance crashes when an ambulance has its lights and siren on. The risks of death andsevere injuryfor EMS personnel are four- to sixfold higher for unrestrained compared with restrained ambulance occupants. In addition, riding unrestrained in the back of an ambulance poses additional risks to EMS personnel. Often EMS workers have to perform critical patient care while unrestrained, such as while performing chest compressions, airway management, critical procedures and patient control.

"The lack of seat-belt use plays a pivotal role in the hazard of delivering care in the back of a moving ambulance," says Dr. Slattery. "Technology is being developed to help allow EMS workers to be seated and restrained, for example automated chest compression devices like the AutoPulse, which allows the medic to sit down as opposed to standing over a patient performing CPR." Automatic ventilators, which provide regular breathing for patients, also free up providers' hands for personal balance and protection during transport.

Although the immediate goal is to develop strategies for keeping providers seated, restrained and hands-free, other possible solutions include developing better ambulance design and safety standards and implementing Crew resource Management strategies while driving lights and siren.