Ergonomic evaluation of the ambulance interior to reduce paramedic discomfort and posture stress

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°) and sitting with back flexion between 20° and 45°. Conclusion: Because the interior of the ALS ambulance was found to be unsatisfactory both to paramedics and patients, alternative design issues are proposed. Application: 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.