title: Ergonomic evaluation of the ambulance interior to reduce paramedic discomfort and posture stress.
abstract: OBJECTIVE
  This study aims to evaluate safety and accessibility of an advanced life support (ALS) ambulance interior.
  
  
  BACKGROUND
  The standard ambulance's interior design is unsatisfactory based on perceived discomfort and postures that constrain paramedics and medical staff, resulting in unsafe treatment of patients, mainly when being transported.
  
  
  METHODS
  Two procedures were used to evaluate performance during a wide range of rescue tasks: a survey, based on questionnaires, interviews, and observation of paramedics performing routine tasks; and upper body and back posture analysis, based on postural considerations.
  
  
  RESULTS
  Findings revealed that 74% of the paramedics stated that the location of the paramedic's seat is inefficient while they perform clinical procedures; 94% found the bench uncomfortable; 77% felt that the vertical distance between the bench and the stretcher is too far; and 86% needed to steady themselves when the vehicle was moving. Posture analysis showed that paramedics undergo several nonneutral back postures, including twisted back (>20 degrees) and sitting with back flexion between 20 degrees and 45 degrees.
  
  
  CONCLUSIONS
  Because the interior of the ALS ambulance was found to be unsatisfactory both to paramedics and patients, alternative design issues are proposed.
  
  
  CONCLUSIONS
  The suggested practical layout contains four main modifications: (a) replacing the bench with two adjustable paramedic seats, (b) redesigning the medical cabinet for easy access, (c) adding an adjustable folding seat opposite the two new seats, and (d) adding a swiveling base and lifting apparatus that will accommodate the stretcher and enable better accessibility to patients by the paramedic personnel.
authors: Faculty of Industrial Engineering and Management, Technion - Israel Institute of Technology, Haifa 32000 Israel.
authors: Issachar
authors: I
authors: Gilad
authors: Eyal
authors: E
authors: Byran
mesh_terms: D000328:Adult; D000552:Ambulances; D006804:Ergonomics; D005260:Female; D006801:Humans; D007374:Interior Design and Furnishings; D007407:Interviews as Topic; D007557:Israel; D008297:Male; D019370:Observation; D010146:Pain / Q000517:prevention & control*; D011187:Posture / Q000502:physiology*; D011795:Surveys and Questionnaires