Industry insiders concerned by lack of EMS driving standards
(KMSP) - When people call 911 for an ambulance, most people aren't thinking about the driver's training or what the state is doing to make sure the ride to the hospital is safe.
But some who work in EMS came to the Fox 9 Investigators to say there is a big problem and it needs attention.
In Minnesota, the safety requirements for driving an ambulance aren’t nearly as strict as for a trucker who’s hauling a semitrailer of beer.
Marina Challeen, 24, was an EMT who wanted to become a doctor.
She was killed last October when the ambulance she was riding in smashed into a stalled truck alongside a metro freeway.
“I’m just sad that after losing my daughter to learn of this,” said Dan Challeen, Marina’s father, after learning what the Fox 9 Investigators found.
“If she were here now and able to speak, she would say ‘Come on people, get with it, and do something about this,’” said Linda, Marina’s stepmother.
On average, an ambulance crash happens every seven days in Minnesota, and about 22 percent of them involve someone getting hurt.
One of the worst crashes happened in northern Minnesota in 2005 when an ambulance, on a non-emergency transport, rear-ended a garbage truck, killing the patient and the driver of the ambulance.
The State Patrol determined excessive speed and inattention were factors.
PARAMEDIC SPEAKS OUT
An experienced Twin Cities paramedic, who asked that his identity be disguised, said more needs to be done.
“I think the dangers are much worse than they used to be,” he said.
According to him, the driving skills of some of the young "newbies" entering the EMS work force are down-right scary.
“It’s nerve-wracking when you’re in the back, especially if you’re getting thrown around because they have to hit the brakes because they’re not sure of something,” he said.
Most ambulance crashes happen at intersections where, the insider said, some new hires still blow through red lights at high speeds.
“They get tunnel vision on the fact that they’ve got emergency lights, everybody gets out of their way and they just hit the gas and go,” the paramedic said.
GROWING SAFETY CONCERN
A Fox 9 investigation finds the state board responsible for regulating ambulance operations has taken little initiative to address what many in the industry call a growing safety concern.
“Nationwide we have a shortage of paramedics, every service is doing what they can to hire, and they’re younger and they have less experience,” said Mike Trullinger from Hennepin Emergency Medical Services.
Many are in their late teens, early 20s and right out of paramedic school; some have only a couple of years’ experience driving a car.
Yet, they’re given responsibility to take control of an ambulance based on training which can vary widely from one company to the next.
Dave McGowan is a safety consultant and used to be in charge of a large metro ambulance service.
“We have a very big problem, but unfortunately it’s under reported,” he said. “Certainly we’re not decreasing crashes and if anything, the trend line is still continuing to go up.”
The Emergency Medical Services Regulatory Board oversees ambulance services in Minnesota. Under current state law, a driver doesn’t need a special license to drive an ambulance. New drivers must attend an eight-hour safety class which includes actual driving.
But it’s up to individual ambulance services to decide how extensive behind-the-wheel training should be.
“We feel here at HCMC, we’re ahead of the curve,” Trullinger said.
New hires at HCMC spend a day going through all kinds of maneuvers at the Minnesota Highway Safety Center in St. Cloud. They repeat the exercise every three years.
Some smaller ambulance services told Fox 9 their training involves driving around some cones in a parking lot.
“Too many people are getting hurt and they need to have that type of standard out there to help guide our training,” the paramedic said.
DRIVING STANDARDS TOUGHER FOR TRUCKERS
Commercial truck drivers have more safety regulations than anyone driving an ambulance.
First of all, they have to pass a test to get a commercial license. They’re also limited to driving 11 hours a day to guard against fatigue and a 10-hour rest period between shifts is mandatory.
“At the end of the day you could be pretty exhausted,” the paramedic said.
EMS crews can work anywhere from 8 to 12 to 16 hours or longer.
"You just feel yourself sitting at a stoplight and all of a sudden you dose off,” he said.
There's currently no state or federal requirement that limits their hours or a mandated set rest period.
“I was concerned about her getting enough rest; she was constantly telling me how tired she was,” Linda said.
The crash that killed Marina Challeen is still under investigation.
Fox 9 doesn’t know if her colleague, who was driving the ambulance back from a call, was tired or what else might have caused her to run into the semi-truck.
“Are we monitoring drivers, making sure they’re driving safely?” McGowan asked.
Some companies have voluntarily installed systems that warn drivers when their actions are dangerous, but the state’s EMS Board does not require them. And unlike the trucking and aviation industries, there’s no directive for random drug or alcohol testing of people who work in EMS.
"It could be that each individual service may adopt that, but, no, not from a government level," McGowan added.
A Fox 9 review of disciplinary actions by the EMS Board shows since 2014, at least four individuals had their licenses yanked for drug use.
One EMT tested positive for meth after a co-worker noticed her “pupils were dilated while she was on duty.” Three paramedics were caught stealing pain meds.
LESSONS FROM THE AVIATION INDUSTRY
Dick Blanchet writes about ambulance safety and said the industry could learn a lot from aviation, where every crash is carefully reviewed and the lessons learned are incorporated into training for the whole industry.
“I have a unique perspective; I was both an airline pilot for 22 years, as well as being a paramedic for 22 years,” he said.
Minnesota’s EMS Board doesn’t require the reporting of ambulance crashes and doesn’t have a system to review what’s causing them.
“If you don’t have the data to identify 'is there a problem,' then it’s hard to put a solution onto a problem,” Blanchet said.
Fox 9 does not know if discrepancies in training, or if fatigue or drugs and alcohol played any role in the ambulance crash that killed Marina Challeen.
But her family hopes the tragedy will bring change.
“If there’s anything that can be done to prevent this from happening, improve the chances of these drivers to come home at the end of their shift safely, then those things should be done,” said Linda. “It seems like a no-brainer to me.”
The State EMS Regulatory Board declined Fox 9’s request for an interview. They did tell Fox 9 they’re looking into one of the issues highlighted in the Fox 9 investigation: the problem of fatigue among EMS workers.