Prehospital care providers commonly indicate that they cannot wear seat belts owing to their need to be unrestrained while delivering care to the patient in the back of the ambulance. Each year, providers are injured in situations in which seat belts have been shown to be protective. Are ALS providers able to wear a seat belt and provide care in an ambulance?

The ALS providers were asked to complete a form following calls during which they rode with a patient in the back of an ambulance. They indicated the amount of time which they felt they would have needed to have been unrestrained by seat belts and the reasons. There were no attempts to regulate or quantify seat belt usage. Additional information was gathered from the trip report.

The percentage of the time of each trip during which they felt they needed to be unrestrained was calculated for each trip. The mean was 41%. The mean transport time was 14.7 minutes. Sub-groupings by protocol type, showed that for cardiac arrest patients, providers felt they needed to be unrestrained for 82% of the duration of transport, for patients with “chest pain or cardiac dysrhythmia” 63%, for “shortness of breath” 38%, and for trauma patients 41%. Excluding cardiac arrest patients, the nine patients were assigned by the providers to have the most critical level of case severity required unrestrained time of 72%. Those nine patients with the lowest severity level requires that the provider by unrestrained only 18% of the time. Management of intravenous line and patient assessments most frequently were cited as reasons for needing to be unrestrained.

Perceived need of ALS providers to be unrestrained varied with respect to the type of call, with cardiac arrest patient transports having the greatest need to be unrestrained. However, on the average, providers felt they needed to be unrestrained only 41% of the time; markedly less on some types of call, with cardiac arrest patient transports having the greatest need to be unrestrained. However, on the average, providers felt they needed to be unrestrained only 41% of the time; markedly less on some types of calls. The ALS providers should be able to wear seat belts for at least part of the time, on most ALS calls.