Ops instruction: securing the patient via trolley-cot and harness

A recent court case, not in our region, found the driver of an ambulance guilty of causing death by dangerous driving after they neglected to properly secure a patient to the trolley-cot in their ambulance.

The patient was thrown across the ambulance when the vehicle left the road and subsequently died as a result of head injuries caused by the road traffic incident. The driver of the vehicle was sentenced to 150 hours of unpaid work, banned from driving for 12 months, placed under an 18 month community order, ordered to pay £1,000, and they lost their job.

It is important that you are aware of your responsibilities in securing and transporting persons travelling in the rear saloon. 

It is the Trust’s responsibility to:

• supply equipment that meets and has been tested to Central European Normalisation (CEN) and associated British standards for vehicles and equipment
• to train/familiarise staff in the use of the equipment
• to supply a CEN compliant trolley-cot and harness, approved by the manufacturer, for all ambulances that convey stretcher patients. 

It is your responsibility to:

• ensure your patient is always secured on the trolley-cot via the harness. Clearly, there will be some scenarios where it will not be possible to use all of the straps to secure the patient, but this needs to be risk assessed for each patient, and any interventions required on the journey to the hospital will need to be justified in the event of an injury. If you cannot fully secure the patient, you must document the rationale on your patient record form.
• make sure the harness is not removed from the trolley-cot or the vehicle (it is a criminal offence to do so).

Remember the driver is responsible for the safety of the passengers and the load.

The Trust has released an operational instruction (OI 145) which covers this in more detail, including some guidance on using the restraints (Pegasus MK2), which you can download here. Some ‘safety whilst travelling’ guidance has also been produced, which covers attending the patient, securing other occupants, and securing equipment and luggage. You can view a copy here.

Published 19th February, 2016