Gilad Issachar, Byran Eyal
Faculty of Industrial Engineering and Management, Technion - Israel Institute of Technology, Haifa 32000 Israel.
Hum Factors. 2007 Dec;49(6):1019-32. doi: 10.1518/001872007X249884.
This study aims to evaluate safety and accessibility of an advanced life support (ALS) ambulance interior.
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.
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.
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.
Because the interior of the ALS ambulance was found to be unsatisfactory both to paramedics and patients, alternative design issues are proposed.
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.
本研究旨在评估高级生命支持(ALS)救护车内部的安全性和可达性。
基于医护人员感受到的不适以及限制医护人员的姿势,标准救护车的内部设计并不理想,这导致对患者的治疗不安全,主要是在转运过程中。
采用两种程序来评估在广泛救援任务中的性能:一种是基于问卷调查、访谈以及对执行常规任务的医护人员的观察的调查;另一种是基于姿势考虑的上身和背部姿势分析。
研究结果显示,74%的医护人员表示,在进行临床操作时,医护人员座位的位置效率低下;94%的人觉得长凳不舒服;77%的人认为长凳与担架之间的垂直距离太远;86%的人在车辆行驶时需要稳住自己。姿势分析表明,医护人员会经历几种非中立的背部姿势,包括背部扭转(>20度)以及背部弯曲20度至45度的坐姿。
由于发现ALS救护车的内部对医护人员和患者都不理想,因此提出了替代设计问题。
建议的实际布局包含四项主要改进:(a)用两个可调节的医护人员座椅取代长凳;(b)重新设计医疗柜以便于取用物品;(c)在两个新座椅对面增加一个可调节的折叠座椅;(d)增加一个旋转底座和升降装置,该装置将容纳担架并使医护人员能够更好地接近患者。