I-TEAM: EMS union concerned speed bumps hurt patients.
An EMS union in Cleveland was concerned enough about a municipal plan to add more speed bumps to the city streets that they went to the city council to let them know that speed bumps cause harm to patients in pain. They said, while they appreciated the need to slow traffic, slowing cars down was probably best accomplished by law enforcement (pilling people over and issuing tickets) and only as a last resort, by adding speed bumps. The article ended up stating that the EMS union could cite no studies that speed bumps hurt patients.
Studies be damned (and how do you conduct such studies?*) I agree with the union. Speed bumps are uncomfortable to patients. What people outside of EMS do not understand is that ambulances are basically pickup trucks, and the patient and their caregiver are just riding the back of a covered pickup. Every bump in the road is felt by the patient and caregiver. Unless a driver slows down and crawls over a speed bump, the patient feels it. If they are unconscious or getting CPR, they obviously don’t feel it, but if they are alert, and particularly if they have any kind of existing pain such as a broken leg, bad back or bad sores, a speed bump can be excruciating.
One of the first things I tell a new EMT is to drive slowly. There was an old Saturday Night Live ad spoof with a rabbi doing a circumcision in the back of a car (A Royal Deluxe 2) to demonstrate the smoothness of the car’s ride. When the driver hits a bump at the critical moment, there is a wince! I tell people to imagine you are a patient and a rabbi is getting ready to circumcise you. Drive Smoothly!
We pay so much attention to the roads that we will often chose a longer route to the hospital based solely on the anticipated agony the shorter route might produce. I tell the patient’s family, we’re going to take the highway. It’s a little longer, but it’ll be a smoother ride for your loved one.
Years ago, there was construction being done on a bridge that was a main access to one our regular hospitals. The bridge was a nightmare to cross, so much so that we sometimes persuaded people to let us take them to another hospital, or at minimum ordered our partner driving to take a circuitous route.
I apologize to patients more for the bumps in the road and the uncomfortable ride than any pain I might cause them by giving an IV or an intramuscular shot.
I have written before about the back issues I have had from being thrown in the back just straight up in the air and down hard by simple bumps in the road. The bumps sometimes can be so bad on my back that I will do my patient care in the back of the ambulance while sitting on scene, then strap myself in the captain’s chair (the one at the head of the stretcher behind the driver, rather than sitting next to the patient (over the back wheel on the passenger side.)
They need to either invent ambulances with super specialized shocks or get rid of potholes and speed bumps.
Good for the EMS Union for bringing the issue up.
* You can’t deliberately subject someone to possible injury by speed bump. You could do a study with volunteers. Take half on a route without speed bumps and the other half on a route with speed bumps and ask them to rate the level of discomfort they felt on the transport.