Wilton Emergency, Inc

1
Wilton Emergency, Inc

• Roadside Incident Safety
• Presented by Matt Stefanacci
• EMT-Paramedic / Safety Officer
• Wilton EMS

2
Topics to cover

• Statistics of emergency responders struck by
  vehicles.
• Hazards to be aware of
• Safety equipment advice
• Advice information specific to management
• Local policy (Wilton EMS specific)

3
Target Audiences

• EMS Agencies
• Fire Departments
• Police Agencies
• Any person that responds to an emergency on a
  roadside

4
Roadside Incident Stories from the Headlines
Rick Seiner, a longtime Citizens Memorial
Healthcare employee and a member of the CMH
ambulance crew, died Friday evening, Sept. 2,
while working a motor vehicle accident.
According to the Missouri Highway Patrol, Seiner
was on Mo. 13, one mile south of Humansville,
when he attempted to cross the roadway and was
hit by a car.
9/6/2005 Courtesy www.Firehouse.com
5
Dont let this happen to your agency
This was a MVC on a 55 MPH road 1 firefighter
was killed, 1 was permanently disabled
Courtesy NIOSH 1999
6
Do you want to be caught in this mess?
7
The Facts...

• Every year, the number of emergency responders
  that are struck on Americas roadways is on the
  rise.
• In a 2002 study by the Detroit times, over 6,500
  ambulances were involved in collisions with other
  vehicles.
• EMS has the highest fatality rate amongst
  Americas First Responders 9.6 per 100,000.
• Comparatively, fire fighters are 4.5 per 100,000
  and police are 6.3 per 100,000.
• On the average, 10 serious injuries occur a day
  in which an ambulance is involved, or 3,650
  serious injuries per year.
• - Study courtesy of Brian J. Maguire the
  Detroit Times 2002

8
The Facts...

• According to the NIOSH, over 175 Emergency
  responders were struck on Americas roadways in
  2003. Of these, 95 were at the scene of motor
  vehicle collisions.
• Of these 175 emergency responders, 120 were
  firefighters.
• Of these 120 firefighters, 5 were killed. 93
  were permanently or seriously injured.
• 82 of firefighters hit on scenes by cars are no
  longer active.
• So, if EMS has over double the amount of
  fatalities per 100,000, then our statistics
  should be doubled.
• There are no accurate statistics for EMS
  providers other than what the NFPA has
  established (some personnel entered in the study
  were Paramedics). There is a joint study (NFPA,
  NIOSH OSHA) due out in the near future that
  will reflect the true dangers of EMS

9
The Facts

• Headlights are set for 160 feet on low and 350
  feet on high.
• Typical reaction time for braking is 1.5 seconds.
• Add 100 time for alcohol or drug influence.
• Add poor road conditions (snow, ice, rain, etc)
  and the stopping distances increase by 50.
• Add 25 stopping distance for UNLADEN trucks
• Add 50 stopping distance for LADEN trucks
• All statistics compliments of National
  Transportation Safety Board DOT, 2002

10
The Physics
Reaction Distance Braking Distance Stopping Distance
20 MPH 44 feet 25 feet 69 feet
30 MPH 66 feet 57 feet 123 feet
40 MPH 88 feet 101 feet 189 feet
50 MPH 110 feet 158 feet 268 feet
60 MPH 132 feet 227 feet 359 feet
70 MPH 154 feet 310 feet 464 feet
80 MPH 176 feet 404 feet 580 feet
NTSB 2002
11
The Reality

• A car traveling at 40 MPH will hit you
• A car traveling 60 MPH with high-beams on will
  hit you...
• You have the greatest chance of being struck
  between the hours of 9 PM 3 AM, by a male
  between 21 28 who is under the influence of
  alcohol

12
Roadside Safety

• Exercise

13
Roadside Emergencies Hazards

• On the next slide, you will have 1.5 seconds to
  find the 3 emergency personnel in the picture
• The posted speed limit is 40 MPH
• The responders are about 120 feet from you in
  this picture
• Can you avoid them?
• Can you see them?

14
The Physics
Reaction Distance Braking Distance Stopping Distance
20 MPH 44 feet 25 feet 69 feet
30 MPH 66 feet 57 feet 123 feet
40 MPH 88 feet 101 feet 189 feet
50 MPH 110 feet 158 feet 268 feet
60 MPH 132 feet 227 feet 359 feet
70 MPH 154 feet 310 feet 464 feet
80 MPH 176 feet 404 feet 580 feet
NTSB 2002
15
Find the emergency responders
16
Did you see them?Or did you hit them?
3
1
2
17
Roadside Emergencies

• Hazards to be aware of

18
Four Topics that contribute to an Unsafe Roadside
Incident

• Insufficient Visibility
• The Other Vehicle
• Unsafe Distance between the public and you
• Rogue Events

19
Ever have One of those days?
20
Roadside Emergencies Hazards

• 1) Insufficient visibility
• Poor lighting conditions
• Poor weather conditions (rain, snow, fog, etc)
• Too many emergency warning lights!!!
• Not enough traffic diversion devices (i.e. road
  flares, triangles, lighted arrow sticks, etc)
• Insufficient or non-existent reflective gear
  (vests, turnout gear, etc).
• Obstacles (i.e. parked vehicles, trees, etc)

21
Stories from the Headlines

• An Essex County Sheriffs Deputy conducting a
  traffic stop on the Adirondack Northway last
  night was killed after he was struck by a
  tractor-trailer.
• 31 year-old Eric Loiselle of Minerva had stopped
  a car for speeding three miles north of exit 30
  in the Town of Moriah. While Loiselle was
  interviewing the driver, a tractor-trailer driven
  by 36 year-old Jacek Bujalski of Quebec, veered
  onto the side of the road and struck the deputys
  cruiser, which hit Loiselle and the car that he
  had stopped.
• NYSP Troop B is still investigating what caused
  Bujalski to swerve onto the shoulder. Right now
  the investigation looks as though its driver
  inattention and that could result in fatigue.
• Loiselle leaves behind a wife and a two year-old
  son.

Courtesy of WNBZ News August 22, 2005
22
Roadside Emergencies Hazards

• 2) Watch out for the other vehicle
• Vehicles that are swerving or acting erratic
• Vehicles that are traveling at a high velocity
  (this is ANY speed over 30 MPH)
• Vehicles that are in YOUR lane

23
This is what the other vehicle looks like
24
Roadside Emergencies Hazards

• 3) Insufficient distance between you and the
  driving public.
• Not shutting down or diverting traffic from the
  incident scene.
• Move Over Laws These laws make it illegal for
  vehicles to be driven within a specific distance
  to an emergency scene
• New York States Law S.04155, also known as the
  Ambrose-Searles move over act . More to come
  in the next few slides
• Hazard 1 Insufficient visibility! If the
  oncoming driver cant see you, then the cant
  prevent hitting you!

As seen on Interstate in Indiana
25
Roadside Emergencies Hazards Whats wrong with
this picture?
26
Roadside Emergencies Hazards Whats wrong with
this picture?

• How many people are watching traffic?
• Truck is not properly positioned.
• Look where the middle of the road lines are
• No traffic diversion devices
• So, this is a real call with a local fire
  department
• Is this your department?

27
The Skinny on the Ambrose-Searles move over act

• Is a two-part law
• Part 1 Educational Component (9/1/05)
• FOR EXERCISING DUE CARE TO AVOID COLLIDING WITH
  A PARKED, STOPPED OR STANDING AUTHORIZED
  EMERGENCY VEHICLE PURSUANT TO SECTION ELEVEN
  HUNDRED FORTY-FOUR-A OF THIS CHAPTER.
• Part 2 Enforcement Component (1/1/06)
• First Conviction 250-400 /or 30 days in jail.
• Second Conviction 600-750 /or up to 180 days
  in jail.
• Third Conviction 750-1,000 /or 180 days.
• All fines are within a 3 year time frame!

28
The Skinny on the Ambrose-Searles move over act

• Basically, this law can only be implemented once
  a collision has occurred!
• Other states have a more aggressive Move Over
  Law(s).

29
Roadside Incident Stories from the Headlines
Two Charlotte firefighters were injured after a
woman hit them with her car outside a business on
University City Boulevard Thursday afternoon.
The accident happened in front of the CVS drug
store located at 10219 Highway 49. Firefighters
had just cleared another emergency call and
stopped by the shopping center for lunch. While
walking into a nearby business, a fire captain
noticed a woman was illegally parked in the fire
lane. When he approached her, she backed up her
car, hitting a firefighter. Then, she drove
forward, striking the fire captain.
9/2/2005 Courtesy www.firehouse.com
30
Is this considered insufficient distance?
31
Roadside Emergencies Hazards

• 4) Rogue events that can be hazardous
• Oncoming vehicle thats operator is ability
  impaired or just not paying attention (a.k.a.
  HUA syndrome)
• Responders running away from a scene due to an
  unexpected or unsafe situation.
• Oncoming vehicles that loose control.
• And one that I believe in BAD LUCK

32
Another Story From the Headlines

• Police officer struck by car
• By WILL DAVID THE JOURNAL NEWS (Original
  publication February 2, 2005)
• A 47-year-old off-duty city police officer was
  hit yesterday morning by a car driven by another
  off-duty officer as he walked across the street
  to the Fourth Precinct on Shonnard Place, police
  said.
• Police Officer Paul Wood, who is a foot patrol
  officer in Getty Square, was listed in stable
  condition at an area hospital yesterday, Lt.
  Maureen Zadorozny said. He suffered leg and head
  injuries, she said.
• The driver, Officer Christopher Coyne, 36, was
  traveling west on Shonnard Place at 739 a.m. in
  a 2002 Nissan Sentra when he was blinded by the
  sun and did not see Wood crossing the street,
  police said.
• "It's an accident," said Zadorozny. No charges
  will be filed against Coyne, she said

Courtesy of www.respondersafety.com 2/2/05
33
Break Time
Take 10 minutesThink about what youve seen so
far
10 minutes
7 minutes
4 minutes
9 minutes
6 minutes
3 minutes
8 minutes
5 minutes
2 minutes
1 minute
34
Roadside Emergencies

• Ideas for Safety on the Roadside

35
Ideas for Emergency Responders

• Dont get complacentFeeling safe will eventually
  kill you.
• Ensure that ALL personnel are wearing a
  reflective traffic vest or other clothing.
  STANDARD TURNOUT GEAR IS GENERALLY
  INSUFFICIENT!!! NIOSH recommends a strong
  yellow-green or orange color.
• All emergency personnel who are outside of a
  vehicle should meet, at a minimum, the ANSI Class
  2 standard. ANSI Class 3 is highly recommended.
• Use road flares to your advantage You can not
  use too many road flares!
• Shut down the lane of traffic next to where you
  are working. An example If you are working an
  incident on the Northway median, then shut down
  the passing lane.

36
Ideas for Emergency Responders(cont)

• Dedicate a Safety Officer to watch oncoming
  traffic and other hazards. This is, of course,
  is on a case by case basis
• Never turn your back to traffic
• Turn OFF white lights while on scene. Remember,
  if you blind an oncoming vehicle, they cant see
  you to avoid you. This includes headlights,
  headlight flashers and white strobes.
• Use lighted arrow sticks to your
  advantage.Consider the oncoming driver confused
  and dumb In need of direction.

37
Why we dont turn our backs to traffic
38
ANSI Safety Vest Class I

• Class 1 garments are for users who have ample
  separation from vehicular traffic that does not
  exceed 25 mph and where the background is not
  complex. Parking service attendants, workers in
  warehouses with equipment traffic, shopping cart
  retrievers, sidewalk maintenance workers, and
  delivery vehicle drivers would wear this class of
  garment.

39
ANSI Safety Vest Class II

• Class 2 garments are intended for users who need
  greater visibility in inclement weather
  conditions and whose activities occur near
  roadways where traffic speeds exceed 25 mph.
  Workers who would wear this class of garment
  include railway workers, school crossing guards,
  parking and toll gate personnel, airport ground
  crews and law enforcement personnel directing
  traffic.

40
Class II safety equipment approximately 120 feet
41
ANSI Safety Vest Class III

• Class 3 garments provide the highest level of
  conspicuity to workers with high task loads in a
  wide range of weather conditions where traffic
  exceeds 50 mph. The standard recommends these
  garments for all roadway construction personnel
  and vehicle operators, utility workers, survey
  crews, emergency responders, railway workers and
  accident site investigators.

42
Class III safety equipment approximately 120
feet
43
Summing it all upVisually

• So, now that youve seen each vest individually,
  lets see what passing cars are seeing
• And missing

44
Heres what a passing car will and wont see
Street Clothes
Class II
Class III
45
Manual on Uniform Traffic Control Devices (MUTCD)

• Under Worker Safety Considerations, the MUTCD
  states
• Worker Safety Apparelall workers exposed to the
  risks of moving roadway traffic or construction
  equipment should wear high-visibility safety
  apparel meeting the requirements of ISEA
  American National Standard for High-Visibility
  Safety Apparel or equivalent revisions, and
  labeled as ANSI 107-1999 standard performance for
  Class 1, 2, or 3 risk exposure. A competent
  person designated by the employer to be
  responsible for the worker safety plan within the
  activity area of the job site should make the
  selection of the appropriate class of garment.

American Traffic Safety Services Association
(1988)
46
HmmmIs this someone you know?
47
A perfect scene

• Does it exists?

48
A Perfect SceneDoes It Exist?

• The definition of a perfect scene is
• A scene in which there is no hazard to any
  responding personnel, including traffic, wires,
  fluids and bystanders. Although this type of
  situation is optimal, it is not reality
• This is what I call the Boy in the Bubble
  theory.

49
A Perfect SceneDoes It Exist?
Since we can not have a Perfect Scene, we
should strive for a Safe SceneDoes everyone
remember this from EMT class????
The definition of a Safe Scene A scene in which
the threat of danger is not eradicated, but
accepted as being present and reasonable measures
for personnel safety is taken.
50
Is this the future of EMS safety?
51
The Scene

• Scene Operations Safety

52
Scene Operations

• All Emergency Vehicles at least 50 to 60 feet
  from incident.
• Road flares or other visual warning creating a
  visual barrier around the scene.
• Position vehicles between a 15 to 30 degree slant
  TOWARDS trafficThis will give the appearance to
  approach traffic that you are pulling into
  traffic Drivers will tend to slow down and
  yield the way
• Also, positioning your vehicle this way will
  divert vehicles away from you in an impact
• Also positioning vehicles in this manner will
  divert the energy during an impact into the
  roadway, not into responders!
• Use apparatus to your advantage Make a barrier
  between passing vehicle and the scene.
• Turn off white and/or blinding lights Remember,
  less is more!

53
Roadside Incident Stories from the Headlines
Fire investigators said the fire engine was
called out to block crews working at an accident
scene for safety purposes. The fire department
has been doing it for about a year. Authorities
said the crash could have been much worse, had
the fire truck not been there.
6/13/04 Courtesy NBC5 Dallas, TX
54
This is a great example of how NOT to place your
vehicle on a roadside scene
55
Safe Area
incident
50 60 feet
56
Scene Operations

• Pattern of portable warning devices should slope
  away from incident, responders vehicles.
• Addition of adding a cross flare pattern to
  visual barrier this provides better distance
  visibility to the already visually appealing
  scene.
• This creates a visual barrier around the
  incident and emergency vehicles.
• Assign at least ONE person to flare maintenance
  and approaching vehicle safety. This is on a
  case by case basis
• Responders should NEVER cross the visual
  barrier unless a DIRE EMERGENCY!
• Road flares should extend 350 feet on high speed
  road ways, and 100 feet on low speed roadways
  (low speed is less than 30 MPH).
• Establish a safe area for responders to seek
  refuge in an emergency. Typically towards the
  shoulder of the road. This SHOULD NOT BE THE
  STAGING AREA!!!!

57
Scene Operations
350 feet
58
3 Lane, High Speed Roadway
Safe Zone
Incident
Flow of Traffic
59
NIOSH recommends
60
Roadside Safety

• Things to remember

61
Things to remember

• The most important person on a roadside incident
  is YOU, the provider.
• Always be aware of your surroundings and
  situationsA roadside incident regardless of type
  is a FLUID EVENT
• A FLUID EVENT means it can shift in ANY direction
  immediately. In other words, you can go from a
  routine call to out-of-control in a matter of
  seconds

62
This is a great example of a Fluid Event
63
Things to Remember
Some things to watch out for during a roadside
incident

• Traffic!!!
• Fluid This includes vehicle fluids, Bodily
  fluids, and Natural fluids (i.e. rain, snow,
  ice, etc)
• Wires that have been compromised
• Arriving emergency vehicles

• The Media Dont hesitate to have them move to
  another area
• Family members of patient(s) - Dont hesitate to
  have them move to another area
• The car itself!

64
Just when you least expect it
65
Roadside Incident Safety

• Ideas for Management

66
Quote for Management

• The most important asset is our people. All the
  machines, tools and equipment can not replace the
  man.
• -Admiral Yashama
• Japanese Imperial Navy
• 1943

67
When someone gets hit, who do you report to?

• Minor Injury
• Report to BEMS (?)
• Self Insurance Investigation

• Serious Injury / Fatality
• Report to BEMS
• Self Insurance Investigation
• OSHA / PESH Investigation
• NIOSH FACE investigation
• (Fatality Assessment Control Evaluation)

68
Paperwork that needs to be filled out

• Employee Injury Form C-2
• Volunteer Ambulance Worker Injury VAW-2
• Employee Death Form C-62
• Volunteer Ambulance Worker Death Form VAW-62
• Volunteer Ambulance Worker Claim for Benefits
  VAW-3
• Self Insurance Investigation
• Agency Self Investigation

69
Ideas for Management before personnel get struck

• Educate personnel about the hazards on roadside
  incidents.
• Develop, implement enforce a SOP for roadside
  incidents.
• Provide safety equipment for personnel i.e.
  Safety vests, turnout gear, etc.
• Be specific when writing policy
• Remember, if you didnt write it, it didnt
  happen!!!

70
What wed all like to say
71
Roadside Incident Safety

• The Standard Operating Guideline (SOG)

72
Roadside Incident Safety SOG
Purpose It is the continued resolve to provide
all personnel with adequate protection and
visibility while operating an all roadside
incidents. This Standard Operating Guideline
(SOG) will replace the previous guidelines
pertaining to roadside safety. Rationale It can
be expected that personnel will be involved with
patient care in and on the side of roadways, some
of which are designated for multiple lane,
high-speed traffic. The biggest problem with
scene safety at any roadside incident is
providers being seen by approaching motorists.
This problem is compounded by darkness, low-light
and/or poor visibility situations.
73
Roadside Incident Safety SOG

• SOG
• All personnel, including observers and interns,
  will conform to the following policies
• Motor Vehicle Collisions / Accident Mandatory
  use of turn-out gear. It is HIGHLY recommended
  that an ANSI Classified safety vest be worn over
  the turn-out gear, but is not mandatory. Each
  Wilton Emergency, Inc vehicle will have a
  sufficient number of ANSI standard 107-1999 Class
  III safety vests for the crew.
• All other Roadside Incidents Mandatory use of
  at least ANSI standard 107-1999 Class II safety
  vest. Turn-out gear (pants and coat) may be
  worn, but a safety vest must be worn on the outer
  most layer. Each Wilton Emergency, Inc vehicle
  will have a sufficient number of ANSI Class III
  safety vests for the crew.
• All safety vests must be returned upon completion
  of the incident, unless cleaning or
  decontamination is needed.

74
Roadside Incident Safety SOG

• Equipment Placement
• All vehicles parked at road-side incidents need
  to have emergency lights activated, excluding
  white or blinding lights (headlight flashers,
  white strobes, etc).
• All vehicles parked at road-side incidents should
  be parked approximately between 15 and 30 degrees
  towards traffic, with front wheels turned into
  passing traffic.
• Portable warning devices should be used on every
  roadside incident (flares, triangle, etc). This
  is at the discretion of the EMS incident
  commander. Portable warning devices should
  extend 350 feet before the incident on high speed
  roads and 100 feet on low speed roads.

75
Roadside Incident Safety SOG

• Any personnel who are not wearing appropriate
  safety devices (intentional or accidental), will
  consider the scene to NOT BE SAFE, and thus, will
  not leave the confines of the EAS vehicle. A
  line officer must be notified immediately. Each
  incidence will be evaluated on a case by case
  basis. Repetitious offenses can lead to written
  warnings, suspension and/or termination of
  affiliation with Wilton Emergency, Inc.

Although this sounds mean, cruel or rude, this
extreme must be achieved to ensure crew and scene
safety
76
Roadside Safety

• Parting Thoughts...

77
Awareness is good, awareness is wise
78
Parting Thoughts

• If they cant see you, then they cant avoid you
• If you dont tell them were to go and how to do
  it, they wont know how to get there and when to
  do it
• Complacency kills
• Avoid using crisis management to solve a
  situation.
• An ounce of prevention is worth a pound of cure
• The only bad accident is the preventable one
• Remember, it doesnt take a police officer to
  shut down a road, just a big, red truck in the
  way...

79
Drunk driver strikes ambulance at scene FDNY EMT
killed
In memoriam to Andre Lehans, EMT FNDY
80
Parting Quote of the Day

• Disorder is born from order...The line between
  disorder and order lies in logistics.
• -SunTzu

81
Incident Roadside Safety

• Resources for this original program
• National Institute for Occupational Health and
  Safety (NIOSH)
• NYS Bureau of EMS
• Unsafe Saviors, Detroit Times 2004
• www.respondersafety.com
• National Safety Transportation Board (NTSB)
• Wilton EMS, Inc.
• Wilton Fire Department
• Maple Avenue Fire Department
• American National Standards Institute (ANSI)
• Occupational Safety and Health Administration
  (OSHA)
• National Fire Protection Association (NFPA)
• Public Employees Health and Safety (PESH)
• NYS Department of Transportation (NYS DOT)
• eBaums World Media www.ebaumsworld.com
• www.warfalcons.com