NHTSA Advances Ground Ambulance Safety by Tracking and Investigating Crashes

The National Highway Traffic Safety Administration’s (NHTSA) mission is to keep everyone safe on America’s roadway - including patients in the ambulance, the crews riding with them and the general public. Toward that goal, NHTSA has carefully examined 20 years of ambulance crash data in efforts to publish the number, type and severity of ambulance crashes in the country and to use that data to improve the safety of the motoring public.

In a recent presentation at the EMS Today conference in Baltimore, MD, staff from the OEMS shared recent ambulance crash data and provided an overview of how NHTSA investigates and gathers data on ambulance crashes.

NHTSA currently collects and reports data on a variety of crash characteristics, such as the number of fatalities and injuries and the use of lights and sirens. Between 1992 and 2011, there was an estimated average of 4,500 motor vehicle traffic crashes involving an ambulance each year. According to law enforcement incident reports, of those crashes, 65 percent resulted in property damage only, 34 percent resulted in one or more injuries, and 1 percent resulted in a fatality. Importantly, these are injuries sustained both inside the ambulance and in another vehicle. Only 25 percent of fatalities from those crashes occurred inside an ambulance.

“NHTSA works to ensure that ambulance crash data is readily available to the public,” said Mirinda Gormley, MSPH, NRP, a public health fellow in NHTSA’s Office of EMS. “Ultimately, this data can be used to better protect EMS personnel and their patients.”

In addition to compiling national statistics, NHTSA also conducts in-depth and on-the-ground investigations of serious ambulance crashes. From 2001 to 2012, NHTSA conducted 32 investigations of ambulance crashes resulting in serious or fatal injuries to ambulance occupants. The National Institute for Occupational Safety and Health (NIOSH) also conducted six investigations and NHTSA analyzed all 38 reports. Valuable findings from those investigations include:


  • Unrestrained ambulance occupants are at greater risk of sustaining severe or fatal injuries in serious crashes
  • EMS providers did not use safety restraints in 80% of investigated crashes
  • In 71% of investigated crashes, patients were not restrained by both a shoulder and lap restraint during transport
  • Patients were ejected from cots in 44% of investigated crashes
  • Patients ejected from the cot are at greater risk of sustaining severe or fatal injuries than those who remain restrained to the cot

The lack of consistent crash data reporting has made it difficult to conduct research in the past, but the OEMS has worked to improve those data collection efforts, including teaming with NHTSA’s Special Crash Investigations (SCI) Program to determine whether an investigation is warranted following ambulance crashes that involve serious injuries or fatalities.

NHTSA continues to support and increase awareness of ground ambulance safety issues with a number of initiatives coordinated by the Office of Emergency Medical Services. Current projects include:



Additional information and analysis about the collection of ambulance crash data will be available during the upcoming EMS Focus Webinar on Tuesday, April 28 at 2PM EST. Click here to register for the webinar.