[SS80]

What I meant was the cost of a vehicle shoots up as the features like ESP are added. When the purchase price of a winger goes up due to feature addition, the ambulance owners will just increase their cost per km rates, thereby many patients would avoid a winger with esp (costly vehicle) and choose an Omni instead for lower prices. As it might save them 1000 or 2000 during that trip. I have paid 5000 for Tempo Traveller for an 18km trip during covid times, and Omni was available for just 2000. Not everyone would prefer or afford a bigger ambulance, isn't it?

Most people will always prefer the cheaper ambulance unless it's too time critical.

[Mumbaiker]

This is disastrous. Feel really sad for the toll booth employee who went out to remove the red barricade and was caught between the ambulance and the wall.
I wish the driver had slowed down before the toll booth, I am sure he would be knowing where the toll booth is.

[Sran]

Originally Posted by A777R

I met an EMT in the US and their ambulances are top notch (they are issued bullet proof vests as well) where I would feel safe if I ever have the misfortune of riding in one.

Yet another useless comparison with USA. We get it, we still aren't the brightest of the lot but hey at the very least people here aren't stealing shampoos from bottles and women can have choices. At the very least we don't have to pay for fire brigades, it's totally free as opposed to usa where if you don't, the city isn't obliged to come and extinguish the fire.

Ambulances there are top notch because they charge top dollars.

https://cchealth.org/ems/ambulance-rates.php

https://www.usatoday.com/story/money...sts/334338001/


How much does an average ambulance ride cost here and there? There are no free rides there but here every city has free ambulance service. Look at EMT salary there, internet is filled with horror stories about how they have to work 2 jobs to make ends meet. Uninsured or low insured people there do not even dream of asking for ambulance due to the charges associated, people take taxis in emergencies, here its free by respective state governments or pay a nominal rate of Rs 200-400.

https://www.cnbc.com/amp/2020/07/10/...ed-states.html
71% of ambulance providers don't take the patient's insurance. That same study found that 79% of patients who took a ground ambulance could be on the hook for an average fee of $450 after their insurance paid out. These surprise bills can be a huge problem, especially when nearly four in 10 Americans would have to borrow money to cover an unexpected $1,000 emergency.

People without insurance pay more out of pocket.

Nonetheless, there is certainly a huge need of safe vehicles but drivers will remain the same. Only and only one thing will make them improve and that is regulations. The new MV act by GoI was fantastic in this regard but petty politics by states ruined the one semblance of a mature law. We need lengthy studies and then make laws unlike whims banning 10 year old cars or no HCV in capital area(looking at you Delhi). I tried to find emergency vehicle accident data of India in the MoRTH accident data 2020 and 2019 but couldn't, it seems GoI still hasn't done any study on this. https://morth.nic.in/road-accident-in-india

Japan Data: Rules and regulation for ambulance operations differ across countries and regions, however, little is known about ambulance crashes outside of the United States. Japan is unique in several aspects, for example, routine use of lights and sirens during response and transport regardless of the urgency of the case and low speed limits for ambulances. The aim of this study was to describe the incidence and characteristics of ambulance crashes in Japan. Methods: We retrospectively analyzed data from the Institute for Traffic Accident Research and Data Analysis (ITARDA) that includes all traffic crashes resulting in injury or death in Japan. The study included all ambulance crashes from 2009 to 2018. We compared crashes that occurred during emergency operations with lights and sirens (i.e., when responding to a call or transporting a patient) to those that occurred during non-emergency operations without lights or sirens. We also used data on total number of ambulance dispatches from the Japanese Fire and Disaster Management Agency to calculate ambulance crash risk. Results: During the 10-year period, we identified a total of 486 ambulance crashes out of 59,208,761 ambulance dispatches (0.82 in every 100,000 dispatches or one crash for every 121,829 dispatches). https://www.researchgate.net/publica...nce_Crash_Data

Ambulance Accidents in Austria, Germany, and Switzerland 2014-19:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8663702/

Results
In Germany, a total of 597 ambulance accidents were recorded, per 100,000 inhabitants; 453 of these accidents left 1170 people injured, corresponding to 1.409 per 100,000 inhabitants, and 28 of these accidents caused 31 fatalities per 100,000 inhabitants. In Austria, a total of 62 ambulance accidents were recorded, corresponding to 0.698 per 100,000 inhabitants; 47 of these accidents left 115 people injured, corresponding to 1.294 per 100,000 inhabitants. In Switzerland, a total of 25 ambulance accidents were recorded, corresponding to 0.293 per 100,000 inhabitants; 11 of these accidents left 18 people injured. There were no fatalities. In each of the three countries, the majority of the accidents involved another car (77%-81%). In Germany and Switzerland, most accidents occurred at an intersection. In Germany, Austria, and Switzerland, 38.7%, 26%, and 4%, respectively, of ambulance accidents occurred at intersections for which the ambulance had a red light (P<.001). In all three countries, most of the casualties were staff and not uncommonly a third party. Most accidents took place on weekdays and during the daytime. Ambulance accidents were evenly distributed across the four seasons. The cause of the ambulance accidents was reported to be the ambulance itself in 125 (48.1% of accidents where the cause was reported), 22 (42%), and 8 (40%) accidents in Germany, Austria, and Switzerland, respectively (P=.02), and another vehicle in 118 (45.4%), 29 (56%), and 9 (45%) accidents, respectively (P<.001). A total of 292 accidents occurred while blue lights and sirens were used, which caused 3 deaths and 577 injuries.

For each accident with an ambulance, on average two people were injured, except in Switzerland reporting a lower rate of 0.72 injured per accident. In all three countries, most of the casualties were staff and, not uncommonly, a third party. In Austria and Germany, ambulance accidents caused the death of a third party, patient, and staff in over 50%, 30%, and 13% of cases, respectively. Two children succumbed in these accidents in Germany. According to our data, the fatal ambulance accident incidence per 100,000 inhabitants was 0.034 for Germany, 0.068 for Austria, and zero for Switzerland.

The majority (77%-81%) of the accidents involved another car. In Germany, most accidents occurred at an intersection, junction, or simply on a stretch of road in the city (street). In Austria, accidents most commonly occurred on the street, on a regional road, or at an intersection. For Switzerland, the highest accident incidence was on the street, followed by intersections and highways.

Despite modernization of ambulances, more than 30 years later, these statistics remain very similar. This could also be because minor accidents with ambulances were not reported in the newspapers accessed for this study. Additionally, ambulance design and safety measures for passengers have perhaps not been sufficiently adapted for high-speed driving.

Furthermore, we were unable to compare the ambulance accident data collected from this media-based review with the information collected by local, regional, or national institutions in these countries. Such information is not freely available and special permission would be necessary to access and analyze such data. In this light, we could not calculate the incidence of ambulance accidents per total number of ambulance callouts, since the information is not easily obtainable from the relevant institutions.

USA data from a decade back: https://www.arnolditkin.com/blog/mot...idents-in-the/

Ambulance Accidents in the U.S.
The National Highway Traffic Safety Administration (NHTSA) released a report in April 2014 that provided an overview of the number of ambulance accidents in the United States. The agency studied the number of ambulance accidents over a 20 year period from 1992-2011. North-Western National also conducted a recent study of 466 ambulance accidents.

There are an estimated 6,500 accidents involving ambulances each year.
35% of crashes resulted in injury or fatality to at least 1 occupant of a vehicle involved.
When injuries occur, there are, on average, three unique injuries per accident.
On average, 29 fatal ambulance accidents produce 33 fatalities each year.
On average, 2,600 people are injured in 1,500 ambulance accidents each year.
Of those killed in an ambulance accident, 63% were occupants of a passenger vehicle, 21% were passengers in the ambulance, 4% were the ambulance drivers, and 12% were non-occupants.
Nearly 60% of ambulance accidents occur during the course of emergency use.
Emergency medical personnel are at a higher risk of crashing when compared to other first responders.

[A777R]

Originally Posted by Sran

Yet another useless comparison with USA. We get it, we still aren't the brightest of the lot but hey at the very least people here aren't stealing shampoos from bottles and women can have choices. At the very least we don't have to pay for fire brigades, it's totally free as opposed to usa where if you don't, the city isn't obliged to come and extinguish the fire.

Well with all due respect, this is not about USA vs India. You may hate or love USA, but India can learn from every other country's good implementation of technology. My simple argument is that if an average job is expected to pay 7-8 Lakhs OTR for a simple hatchback because the government will not compromise on their safety, then emergency vehicles should have at least the same standards if not better. Cost will always be an issue for any sort of medical care, but if you have ill-equipped vehicles with untrained drivers, accidents are bound to happen. Ambulance rides even if they are expensive, are still a small part of the overall medical expenditure in case of a serious issue, so the implementation of safety features cannot be left just cause it will increase the ambulance bill by 20%.

And it's not only the ambulance safety features, I would argue that the most basic insurance plans should cover ambulance rides more comprehensively, which should remove some cost issues. Also, as India has woefully inadequate number of ambulances, in the near future someone (either private players or the government itself) will try to address it, so it's better that at least the new ambulances are well equipped through regulation.

[fiat_tarun]

There is a very high probability that the Ambulance would not have lost control if it was fitted with ESP. This is a typical loss of control accident where the vehicle has oversteered and gone into a spin.

In this case, ESP would have cut power and braked the left front wheel preventing the vehicle from spinning out or at least reducing the speed of impact.

ABS is already mandatory for ambulances and ESP might come in soon. From April 2023, all buses with more than 22 seats have to compulsorily have ESP. This can be extended to ambulances as well.

[DhinaStark94]

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I can see a lot of people saying it is the drivers fault or it is a combination of all factors in this situation. But what I say is, we only started to talk about these stuff because of such a grave incident. This is where lack of all research and policy comes into the picture. Speed kills, it is plain and simple. And with VIP escorts or an ambulance, it is the other factors such as traffic, other vehicles giving way etc. What happens when a cow or some other obstacle randomly jumps into the way? Will we only blame the cow owner or the government and responsible authority?

Take VIP escorts for example. Sometimes these escort vehicles feel like they're actually escorting GOD himself and that gives them the right to go at insane speeds in narrow traffic areas. What gives them the right to issue speeding ticket and fines to a common man but then get do the same act on duty?! It is this mentality that needs to be changed in India. Is solely blaming the government not only for this situation but for many like this helpful?

For example: a long distance radio alerting the toll plaza to clear traffic well in time, or to communicate with highway patrols or police vehicles in the vicinity or make at least ABS standard and compensate by reduction in tax or GST. Such rules and regulations that are the responsibility of the government authorities are lacking. So, when a driver goes fast to save a life, it all depends on several external and internal factors which may not be ideal on every day. But rules and regulations imposed in a manner that also doesn't impact the role of an ambulance can reduce these factors in a huge way.

[IamNikhil]

What's needed is specialised vehicles and veteran drivers for Ambulances. Have seen rickety Omni's also being converted/repurposed for use as Ambulances. Govt needs to implement strict regulations on these things.

[locusjag]

It's not as if emergency response vehicles (police cars, ambulances, fire engines etc.) don't get into accidents at all.

During the pandemic's lockdowns, near Pondicherry, we've seen footage of a Bolero ramming an Omni ambulance head-on, on the accidents thread.

And this isn't something that happens in India only. You can scour YouTube and find ample CCTV footage showing cop cars getting T-boned when they run red lights with their emergency lights on. I've seen footage of an American fire engine rolling over in a tight turn. Heck, I remember a cop car running over a pedestrian in the US, sometime in the last 5 years...

Here are several different recent Western examples of ambulances that got into accidents. These all have occurred within the last 2 years:

https://www.youtube.com/watch?v=zAL_B0gjIi8

https://www.youtube.com/watch?v=WB5XPnZgiOE

https://www.youtube.com/watch?v=BnSkQvcsCc8

https://www.youtube.com/watch?v=bZWakXWCDM4

https://www.youtube.com/watch?v=hUVULTmWoUQ

It's like this - the way of the Samurai is death. In other words, he who wields the sword is highly likely to die by it. Driving emergency vehicles is inherently risky.

[Kosfactor]

Originally Posted by Ragul

It was poor training for ambulance driver combined with over-speeding on a rainy wet road. The Ambulance driver needs to be booked for negligence. He is guilty - Period!

Looking at the video, I think he stepped on the brakes after seeing the cow sleeping in the toll booth. The rain made sure the rest of the things happened.

I do not think an Ambulance driver will have any intent to kill someone whose life depends on him - assumed to be innocent until proven guilty.

[McLaren Rulez]

The whole system looks crazy - toll booth employees risking their lives to pull barricades out of the way of a speeding ambulance - imagine if one of them tripped and fell during that moment.

If the road system can't be designed to support such speeds, ambulance drivers should not be hitting such speeds. What's the point if the risk of killing others on the road or the paramedics exceeds the potential benefits of saving one patient?

[Gummybear]

In this particular video, accident was most likely to happen, even if somehow ambulance didn't loose balance due to hydroplaning, the cow, in middle of road, was tough to avoid by ambulance at those speed.

Even if tarmac is smooth; stray animals, wrong side drivers, people crossing roads wherever they like, changing lanes with no signal or late signal, no lane driving, unwarranted barricading, trucks and slow vehicles in fast lane, etc. there are too many unknown factors on our roads for high speed driving.

Building good roads are just one part, but without bringing change in mindset of people, good roads will be a knife in monkey's hand.

[PaddleShifter]

I have traveled in Ambulances daily for two years during early part of my work. For two more years in total, I have traveled in ambulances on quite a few occasions.

I have observed that the Ambulance drivers are over worked, under paid, some even run personal errands for their seniors and what not. Contractual jobs (outsourced contractual jobs not direct contract) where a driver is paid less than 5 figure salary as of 2015, makes the job very uninteresting and life quite frustrating on a few days. I am not generalizing it for all but just saying what I have observed here in North Indian establishments in both rural and urban areas.

The problem with an ambulance is that there are not sufficient numbers out there and in some states like Haryana, the solid Government support for delivery means that drivers are always running around picking up ladies in labour, some of whom get referred to bigger govt. hospitals of the district, further adding to the pressure on drivers to take them to a far location and come back soon for the next pick up.

I have seen with my own eyes, some very heavily intoxicated drivers doing their duties. Reasons for use could be one of many listed above. In my personal opinion, the first thing that needs to be addressed is the lack of sufficient driver, their pay must be raised to some acceptable levels, followed by strict control over alcohol use by doing random checks. More ambulances should be added to the hospital fleet as well.

[navinkamath4657]

Hello BHPians,

I beg to differ from all the above reasonings and explanations.
The first thing that should change in India as a whole with regards to this particular incident is the Whole Healthcare Setup. Imagine a patient having to travel nearly 200 us KMs to get a brain surgery done.
We already have reached a point where nearly all necessities and most luxuries are available at tier 2 and 3 cities but the cream Dela cream of health care is concentrated only in the metro and few tier 1 cities
Coupled with that the ignorance of common man to seek medical advice at the earliest leads to all this hurried up situations which puts the ambulance the driver the relatives and all associated people at unduly stress.
We have a looonngg way to go in improving our basic right to health before we have ESPs ABS and Airbags in our ambulances
The day we have specialized Healthcare at each and every town we will no more see such ambulances been driven at such high speeds in the rain to save a life and at times at expenses of so many more.

Drive safe

[driver52001]

Medical service providers buy the cheapest van models they can afford to run as ambulances. Bare bones. And they modify it according to God knows what safety yardstick. I am yet to come across an ambulance whose tyre tread is not bald. Usually my eyes drift towards tyres of vehicles to check what make or age they could be, just a thing of pastime. 9 out of 10 every ambulance tyre is worn out. See how the van in the toll plaza accident skidded on a thin film of water.

[RaviCar]

In this video it look likes the driver was well out of control when entering the lane.

Respecting vehicles ability and self ability goes a long way. If the driver was trying to lessen 5 min by driving at speeds which were uncontrollable on wet surface, I believe it's his fault. ( I presume it's this vehicle he drives daily). You can't be penny wise and pound foolish.

Even if this was a 5 star vehicle, I don't see if it could save the injury/life to the toll gate operators probably save the Occupants though.

Toll gates are widely mismanaged. And commuters are routinely harassed by make shift barricades and routes. Even if you know the toll there could be surprises. If a toll is down due to any technical fault they should just let the vehicle pass, instead they make the vehicle turn or go back and have witnessed multiple small accidents due to this. Why was a plastic barricade placed there? Why can't the get a secure and robust system while they mint money much higher than the Stipulated amounts in their contracts?

Most mistakes are not done from one side but a culmination of a lot of factors, all we can do is place ourselves in a safe space, especially when you are behind wheels.