Drive Delicately—for Becca`s Sake

Lots of you folks have pickup trucks. Here’s what I’d like you to think about doing:

Stand up in the bed of the truck, give the keys to someone, and tell them to drive around town while you stand in the back. Be sure to ask them to hit high-traffic spots, some country roads, and a bit of interstate. With a little luck it will be raining out, maybe even a little snow.

I want to suspend one law of reality: As you stand in the back of the pickup truck while your partner drives, there will be no wind resistance—none at all. I also acknowledge that this is a crazy as well as illegal—totally nuts! This is a thought experiment only.

Now, what will you hold on to as your partner drives? Well, nothing. Maybe there’s a handle to grab, as with my friend Becca in the picture? (I loved my shifts with Becca, so I would never actually do this to her. She was a top-shelf paramedic.)

One aspect of physics we simply cannot wish away is kinetic energy. This is the energy of motion, and it’s a law that demands compliance. The formula is pretty simple: Kinetic energy equals half of your mass times the square of your velocity: 0.5(mv²). This means even a small increase in speed produces a large increase in kinetic energy.

The faster you have to stop the pickup truck, the faster you need to dissipate that energy so you both come to a stop at the same time. If Becca standing bravely in the back is still traveling forward at 30 mph while the truck is stopped, well, she will be hurt. Not good at all.

Sound Familiar?

You know where I’m going with this, don’t you? Working a patient in the back of an ambulance while standing up, checking equipment, and maybe getting some supplies is very similar to standing in the bed of a truck while your partner drives around.

(Note that you should always remained seated and restrained in the back of the ambulance, and well-designed ambulances permit virtually all needed care to be delivered that way. But let’s face it: The unsafe practice of standing in the back persists, and until it’s obsolete, our drivers have an extra duty to help keep those colleagues safe. Plus, even with everyone in the back restrained, gentle and deliberate operation of the ambulance still reduces accident risk and improves safety.)

If you think holding on to the ceiling grab bar in the ambulance will keep you from hurtling forward, math and physics don’t back you up. Honestly, under gentle braking you can probably hold the grab bar and not fall, but this will lull you into a false sense of empowerment. A sudden braking, and you’ll hear the driver ask, “Are you guys OK back there?” Maybe yes, maybe no. More likely no.

By the way, I bet the surface of your pickup truck’s bed is not as slippery as a typical ambulance floor and has no sort of liquid you’re standing in. No need to go into more detail.

What if you’re sitting on the squad bench? If you’re counting on the friction between your tush and the squad bench to keep you in place, again, the laws of physics will say otherwise. Vinyl seats? Just like a Slip ‘N Slide.

The direction of your force is mostly forward, with hard braking. What’s going to hold the patient on the stretcher? The straps across their legs and waist help hold them down if you take a turn or crest a hill fast. But with forward deceleration, it’s not the friction between them and the stretcher but rather the shoulder straps that will hold them in. Before I realized I needed to change my ways, the shoulder straps in my rig were easy to find: They were mostly tucked behind the stretcher mattress. Admittedly I was bad about using shoulder straps when I started long ago, but I did change my behavior.

What about you? I’ll bet if you glance around the back of your ambulance, you’ll find several sets of seat belts that could be used. Come on, you see them.

Can both you and your patient get hurt in a crash even if everyone is wearing seat belts and straps? Of course. But it will be a lot less likely than if you’re not wearing them. And we haven’t even touched on a t-bone crash. You can run that thought experiment on your own.

Next time, as your partner closes the doors with you in the back, just say to them, “Pickup truck!” to remind them you might be standing as they drive. They should keep it smooth, drive safely, watch the intersections, and not let the kinetic energy get too high. It will also remind you to use the safety equipment that’s right there (like the shoulder straps behind the mattress and your own seat belts).

Dick Blanchet, BS, MBA, worked as a paramedic for Abbott EMS in St. Louis, Mo., and Illinois for more than 22 years and served as an armed federal law enforcement officer for over 11 years. He was also a captain with Atlas Air for 22 years on the Boeing 747 and a lieutenant colonel in the U.S. Air Force with more than 21,000 flight hours over 22 years. Reach him at acls911@aol.com.