When a motor coach crashed in rural Utah in 2008, it took 36 minutes before it was reported.
There was no cell service in the area. A passing motorist drove to a nearby town to report the wreck, while a truck driver stopped and provided lighting.
The motor coach struck a guardrail and rotated counterclockwise as it veered down the embankment. It then overturned, and struck several rocks in a ditch. As it rolled, the roof separated from the body, causing the majority of the passengers to be ejected, according to a NTSB report.
The first EMS crew arrived about an hour after the wreck. Over the next four hours patients were treated and transported to 13 hospitals in Utah, Arizona, New Mexico and Colorado.
"A tour or charter bus accident, as occurred in Mexican Hat, presents challenges to any rural EMS operation...," NTSB officials noted in their investigative report on the Jan. 6, 2008 crash that claimed nine.
None of the ambulances that responded to the crash were staffed with paramedics. Only BLS care was provided to the injured patients.
Of the 53 passengers, 50 were ejected.
Other NTSB findings include:
- Triage was conducted at the closest hospital -- 75 miles away and a family clinic 40 miles away.
- The nearest trauma center was 230 miles from the crash scene.
- Several seriously injured patients were taken by ambulance to a hospital about 117 miles away. From there, they were flown by airplane to a trauma center in Salt Lake City.
- One victim, who suffered a severe head injury, died after reaching a trauma center -- 12.5 hours after the wreck. Another 16-year-old died before reaching a trauma center.
- Weather grounded two helicopters from Grand Junction and Phoenix. Transfers from local hospitals to trauma centers were done by airplanes.
- Since the crash, three cellular antennas or repeaters have been installed nearby that provide basic 911 notification capability.
While making observations and recommendations, NTSB officials also noted responders and hospitals pulled together to assist the passengers who were returning from a ski trip.
"The NTSB acknowledges the efforts of the on-scene emergency response and the challenges that had to be overcome by the EMS responders. Many aspects of the Mexican Hat EMS response are to be commended. Although its timeliness was affected by travel distances, mutual aid response from surrounding jurisdictions appeared to be well coordinated..."
They also said that while regional crews were well utilized, "the availability of local paramedics with ALS ambulances and trauma centers closer to the accident scene" would have been beneficial.
As a result of their extensive probe, NTSB has requested that the Federal Interagency Committee on EMS (FICEMS) look at two specific issues -- lack of cell service in rural areas and the emergency response.
During a FICEMS meeting in Washington earlier this week, members agreed with a task force to continue work on a plan that can be used by the states to pursue funding for enhancements of wireless communications coverage for emergency notification.
That plan will include a needs assessment, options, resources and funding options as well as potential collaborations.
FICEMS also has been asked to evaluate the EMS response to large-scale transportation-related rural crashes. After the analysis, the committee will develop appropriate guidelines and distribute them to the states.
"The NTSB realizes that the varied nature of state EMS organizations as well as their characteristics differences may dictate that several sets of recommended practices or guidelines be developed for that information be developed in modules that can be customized by state..."
