The hazards of providing care in emergency vehicles: an opportunity for reform.

The risk of occupational death is disproportionately high for emergency medical services (EMS) personnel, largely as a consequence of the high incidence of transportation-related fatalities. The purpose of this narrative review is twofold: to raise awareness in the EMS community by examining the various factors that contribute to vehicular EMS injuries and fatalities and to outline practical strategies for mitigating these risks to EMS professionals. This review describes three main categories of factors that contribute to personnel risk during ambulance transport: the inherent risks of driving/riding in an ambulance, poor ambulance safety standards and design, and increased provider vulnerability to injury while delivering critical patient care in the back of a moving ambulance. Specific educational, technologic, regulatory, and behavioral strategies for mitigating these risks are offered in hopes of improving ambulance safety practices.