Retrospective analysis of risk factors associated with road ambulance crashes and injuries in Victoria, Australia

Introduction: Paramedics in developed countries are more likely to be killed while driving for work compared to the national average for all occupations. Most previous research has examined risk factors associated with road ambulance crashes in the United States where the types of emergency vehicles, medical personnel, and operating conditions may not be generalizable to other countries. Methods: This study examined risk factors associated with road ambulance crashes and injuries occurring between May 2017 and December 2023 using data from a single state-wide ambulance service in Victoria, Australia. Results: Factors associated with crash and injury crash risk were examined using multivariable logistic regression analyses. Of the 2,524 crashes with a reported outcome, two resulted in serious injuries, 2.6% resulted in personal injury, 2.7% required a vehicle to be towed, and 94.6% resulted in vehicle/property damage. The most common crash type across all levels of severity involved a collision with another vehicle. Metropolitan location, intersections, inexperienced paramedics and first responders (ambulance community officers) were associated with increased odds of a crash. Responding with warning lights and sirens, and traveling with a patient on board were both associated with reduced odds of a crash. Factors associated with increased odds of injury crash included traveling on public streets or roads, traveling on freeways or highways, involvement of at least one other vehicle, intersections, and single responder ambulances. Future research should aim to reduce missing data to improve the validity and generalizability of these findings. Conclusions: This is the first study to examine crash and injury crash risk factors associated with road ambulance crashes in Australian paramedics. Practical applications: The findings identify environment, trip, paramedic and vehicle related factors associated with ambulance crashes and injuries that can be used to support interventions for the areas and individuals at greatest risk.