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An Overview of Patient Transport Safety

An Overview of Patient Transport Safety

EMT transporting pediatric patient to hospital

During the COVID-19 pandemic, the role of EMS agencies in transporting patients expanded, allowing EMS services to take patients to alternative destinations.1 While it is too early to tell whether these adjustments might have a long-term impact, it’s important that all EMS personnel frequently refresh their knowledge on patient transport safety to help improve outcomes. Developing safe transport skills and knowledge is crucial for workplace safety for EMTs, EMRs, paramedics, and other EMS professionals as well as the safety of our patients.

In addition to preparing for potential disasters, EMS personnel must also be prepared to face daily hazards. For example, incidents of paramedic assault in the United States are rising. According to the  Occupational Health and Safety Administration (OSHA), approximately 75% of workplace assaults reported annually occurred in healthcare and social service settings.2

Other hazards include increased risk of exposure, heat, potential for physical injury, environmental and occupational stressors, and more.

Statistics that demonstrate EMS personnel have a higher risk of injury and assault

Just as it’s important for first responders to brush up on BLS and ALS skills, it’s also important for us to continually review patient transport safety best practices.

Best Practices for Vehicle Operators

A 2011 study in Prehospital Emergency Care found that 45% of fatal injuries for EMS professionals were due to motor vehicle collisions, with an additional 12% of fatalities involving personnel being struck by moving vehicles.3

Additionally, a recent analysis of two decades of data by the National Highway Traffic Safety Administration (NHTSA) showed that ambulances are involved in 10,000 crashes each year.

Improving patient transport safety and the safety of our brothers and sisters in the service starts with the vehicle operator. There are many things agencies can do to help vehicle operators understand their responsibilities and carry them out effectively, including:4

One seemingly obvious and yet often overlooked best practice in patient transport safety is the use of seatbelts. A study by the NHTSA found that “only 16% of EMS practitioners in the patient compartment at the time of a serious collision were wearing seatbelts. The rest (84%) were unrestrained, while 22% of the drivers were not wearing seatbelts.”5

Safe driving to and from emergency incidents can also be improved by increasing the vehicle operator’s situational awareness. Some suggestions include:

Watch: Mastering Situational Awareness

Best Practices for Transporting Patients

The following are best practices that can be put into effect immediately to ensure that patients are safe and secure during transport:

Transporting Violent Patients

Research into how to best work with, prevent harm by, and transport violent patients is still evolving. For too long, violence from patients was an accepted hazard of the job for EMS professionals, but it does not have to be. 

Patients can react violently for a number of reasons, including an uncontrolled psychological response to trauma. To help you handle such situations, here are a few practices that can be applied to discourage or mitigate violent behavior from patients:6


  1. Wirth S, Stark R. Temporary CMS changes provide needed flexibility. EMS1. Apr 1, 2020. https://www.ems1.com/transport/articles/temporary-cms-changes-provide-needed-flexibility-GaDG26aWKluQFPOq/
  2. Occupational Safety and Health Administration. Guidelines for preventing workplace violence for healthcare and social service workers (OSHA, 3148-04R). Washington, DC: OSHA, 2015.
  3. Reichard AA. Fatal and nonfatal injuries among emergency medical technicians and paramedics. Prehospital Emergency Care. Aug 11, 2011. https://www.ncbi.nlm.nih.gov/pubmed/21834620.
  4. Guide for developing an EMS agency safety program. National EMS Safety Council. Oct 11, 2017. http://www.naemt.org/docs/default-source/ems-health-and-safety-documents/nemssc/ems-safety-program-guide-10-11-17.p.
  5. Smith N. A national perspective on ambulance crashes and safety. EMSWorld.com. Sept 2015. https://www.ems.gov/pdf/EMSWorldAmbulanceCrashArticlesSept2015.pdf.
  6. Violence against EMS responders. U.S. Fire Administration. Aug 31, 2017. https://www.usfa.fema.gov/current_events/083117.html.