Report on run-off-the-road accident with an ambulance on E18 in Holmestrand on 18 January 2023
Road traffic report 2024/02
The investigation has shown that the ambulance was travelling at too high a speed, especially in light of the prevailing road surface conditions, and that this contributed to the ambulance losing road grip. The safety margins were further reduced due to the winter tyres on the ambulance’s rear wheels not meeting the tread depth requirements. Based on the road surface conditions, the vehicle’s speed as it entered the curve, as well as the analysis of video footage showing the sequence of events in the accident, the NSIA believes that the ambulance experienced aquaplaning and that the driver lost control of the vehicle. The ambulance driver was seriously injured in the accident. Good security of people and equipment in the patient room was crucial to ensure that the extent of the damage did not become more extensive. The investigation has shown that there is a need to strengthen both the training and the follow-up of emergency driving by ambulance in order to increase traffic safety.
On 18 January 2023, an ambulance with a driver, patient and two ambulance workers on board was travelling on the E18 road on its way to Rikshospitalet hospital in Oslo after responding to a call-out. There was slush and water in the roadway, and traffic was moving below the 100 km/h speed limit. Most of the northbound traffic was in the right lane, so the ambulance had the left lane to itself on its way north. From when the ambulance entered the E18 road, it maintained a speed of approximately 140 km/h, increasing as it approached the gentle curve ahead. In the left-hand curve at Helland bridge, the ambulance was travelling at a speed of around 160 km/h when it lost road grip.
The ambulance ended up outside the roadway in a maintenance opening in the central barrier in an area with hazardous elements. The ambulance almost rolled over onto its roof before coming to a halt in its final position, overturned across the central barrier. The driver was seriously injured in the accident. The extent of the driver’s injuries could probably have been reduced if the window airbag had deployed.The fact that the people and equipment in the patient compartment were well secured reduced the extent of injury. The investigation has not found any technical faults in the airbag module, but the location and number of sensors may help explain why it did not receive signals that indicated impact and rollover.
The ambulance driver was young, with limited experience of driving emergency vehicles, and had had a long absence from emergency vehicle driving. The NSIA considers it unfortunate that the driver drove alone under the prevailing road surface conditions, without support or follow-up with respect to choice of speed. Vestfold Hospital also lacked sufficient procedures to check and maintain the condition of tyres on its ambulances. After the accident, the hospital has initiated a number of measures to address safety in connection with emergency vehicle driving.
The investigation has shown that both the organisational and systemic framework relating to emergency vehicle driving must be improved in order to increase safety. Emergency vehicle driving training is not arranged in order to enable students to acquire practical knowledge and experience of the importance of speed choices under different road surface conditions in a given vehicle. The NSIA’s survey has also shown that practices vary with respect to the different health authorities’ safety management and follow-up of road safety in connection with emergency vehicle driving. The health authorities have limited follow-up of driving behaviour and speed in connection with emergency call-outs. The extent to which the health authorities conduct internal training for new emergency vehicle drivers or retrain drivers following long-term absence also varies.
The NSIA submits safety recommendations in five areas following this investigation.
The ambulance overturned across the central barrier. Photo: NSIA
Published 05.03.2024
Safety recommendation
Safety recommendation Road No 2024/02T
The run-off-the-road accident on the E18 road at Helland on 18 January 2023 occurred as a result of the ambulance losing road grip and ending up outside the roadway in a maintenance opening in the central barrier in an area with hazardous elements. The opening was approximately 40 metres long and was one of a total of 39 identical openings on an approx. 52-km long motorway section. The openings lack railings to absorb energy in the event of a collision and pose a risk of vehicles crossing into the opposite lane. The current road design norm N101 states that emergency and maintenance openings in central barrier must be designed so as not to pose a hazard to road users.
The Norwegian Safety Investigation Authority recommends that the Norwegian Public Roads Administration map maintenance openings (that do not have median safety barriers with emergency opening systems) on its class A motorways, and rank them according to risk as a basis for prioritising measures.
Safety recommendation Road No 2024/03T
The run-off-the-road accident on the E18 road at Helland on 18 January 2023 occurred as a result of the ambulance driving at too high a speed, especially in light of the prevailing driving conditions, which meant that the ambulance lost road grip. The investigation has shown that, in practice, an emergency vehicle driver driving a class C1 ambulance on slippery roads will not have received vehicle-specific practical and supervised driving training in slippery conditions or training in driving emergency vehicles with characteristics similar to the vehicle they will drive on a daily basis.
- The Norwegian Safety Investigation Authority recommends that the South-Eastern Norway Regional Health Authority draw up procedures and guidelines for training emergency response drivers to drive the relevant vehicles under different road and driving conditions.
- The Norwegian Safety Investigation Authority recommends that Central Norway Regional Health Authority draw up procedures and guidelines for training emergency response drivers to drive the relevant vehicles under different road and driving conditions.
- The Norwegian Safety Investigation Authority recommends that Western Norway Regional Health Authority draw up procedures and guidelines for training emergency response drivers to drive the relevant vehicles under different road and driving conditions.
- The Norwegian Safety Investigation Authority recommends that Northern Norway Regional Health Authority draw up procedures and guidelines for training emergency drivers to drive a relevant vehicle under different road and driving conditions.
Safety recommendation Road No 2024/04T
The run-off-the-road accident on the E18 road at Helland on 18 January 2023 occurred as a result of the ambulance driving at too high a speed, especially in light of the prevailing driving conditions, which meant that the ambulance lost road grip. The ambulance driver was young, with limited experience of driving emergency vehicles, and had had a long absence from emergency vehicle driving. The NSIA believes that it was unfortunate that the driver drove alone under the prevailing driving conditions, without support or follow-up with respect to the choice of speed in the driving process.
- The Norwegian Safety Investigation Authority recommends that the South-Eastern Norway Regional Health Authority ensure that the ambulance service has procedures and practices in place to ensure that emergency response drivers with limited experience and/or long-term absence receive support and follow-up in connection with emergency vehicle driving and choice of speed under different road and driving conditions.
- The Norwegian Safety Investigation Authority recommends that Central Norway Regional Health Authority ensure that the ambulance service has procedures and practices in place to ensure that emergency response drivers with limited experience and/or long-term absence receive support and follow-up in connection with emergency vehicle driving and choice of speed under different road and driving conditions.
- The Norwegian Safety Investigation Authority recommends that Western Norway Regional Health Authority ensure that the ambulance service has procedures and practices in place to ensure that emergency response drivers with limited experience and/or long-term absence receive support and follow-up in connection with emergency vehicle driving and choice of speed under different road and driving conditions.
- The Norwegian Safety Investigation Authority recommends that Northern Norway Regional Health Authority ensure that the ambulance service has procedures and practices in place to ensure that emergency response drivers with limited experience and/or long-term absence receive support and follow-up in connection with emergency vehicle driving and choice of speed under different road and driving conditions.
Safety recommendation Road No 2024/05T
The run-off-the-road accident on the E18 road at Helland on 18 January 2023 occurred as a result of the ambulance driving at too high a speed, especially in view of the prevailing driving conditions, which meant that the ambulance lost road grip. The safety margins were further reduced due to the winter tyres on the ambulance’s rear wheels not meeting the tread depth requirements. The investigation has shown that Vestfold Hospital lacked sufficient procedures for checking and maintaining the condition of ambulance tyres, and that several other health authorities also lacked such procedures.
- The Norwegian Safety Investigation Authority recommends that the South-Eastern Norway Regional Health Authority ensure that the ambulance service has procedures in place to check and maintain emergency vehicles’ tyres, cf. Regulations of 25 January 1990 No 92 on the use of vehicles.
- The Norwegian Safety Investigation Authority recommends that the Central Norway Regional Health Authority ensure that the ambulance service has procedures in place to check and maintain emergency vehicles’ tyres, cf. Regulations of 25 January 1990 No 92 on the use of vehicles.
- The Norwegian Safety Investigation Authority recommends that the Western Norway Regional Health Authority ensure that the ambulance service has procedures in place to check and maintain emergency vehicles’ tyres, cf. Regulations of 25 January 1990 No 92 on the use of vehicles.
- The Norwegian Safety Investigation Authority recommends that the Northern Norway Regional Health Authority ensure that the ambulance service has procedures in place to check and maintain emergency vehicles’ tyres, cf. Regulations of 25 January 1990 No 92 on the use of vehicles.
Safety recommendation Road No 2024/06T
The run-off-the-road accident on the E18 road at Helland on 18 January 2023 occurred as a result of the ambulance driving at too high a speed, especially in view of the prevailing driving conditions, which meant that the ambulance lost road grip. The Norwegian Safety Investigation Authority’s survey has shown that practice varies when it comes to the health authorities’ safety management of emergency response activities, and that the health authorities have limited follow-up of driving behaviour and speed during emergency call-outs.
- The Norwegian Safety Investigation Authority recommends that the South-Eastern Norway Regional Health Authority establish a standard for safety management and follow-up of road safety in connection with emergency vehicle driving. The standard should include instructions and follow-up of safe driving behaviour and speed during call-outs, as well as how the service’s electronic call-out and management systems can be used for systematic follow-up of road safety in the organisations.
- The Norwegian Safety Investigation Authority recommends that the Central Norway Regional Health Authority establish a standard for safety management and follow-up of road safety in connection with emergency vehicle driving. The standard should include instructions and follow-up of safe driving behaviour and speed during call-outs, as well as how the service’s electronic call-out and management systems can be used for systematic follow-up of road safety in the organisations.
- The Norwegian Safety Investigation Authority recommends that the Western Norway Regional Health Authority establish a standard for safety management and follow-up of road safety in connection with emergency vehicle driving. The standard should include instructions and follow-up of safe driving behaviour and speed during call-outs, as well as how the service’s electronic call-out and management systems can be used for systematic follow-up of road safety in the organisations.
- The Norwegian Safety Investigation Authority recommends that the Northern Norway Regional Health Authority establish a standard for safety management and follow-up of road safety in connection with emergency vehicle driving. The standard should include instructions and follow-up of safe driving behaviour and speed during call-outs, as well as how the service’s electronic call-out and management systems can be used for systematic follow-up of road safety in the organisations.
Facts
| Location | E18, Helland, Holmestrand |
| Occurrence date | 18.01.2023 |
| Accident type | Run-off-the-road accident |
| Road class | European road |
| County | Vestfold og Telemark |
| Vehicle type | Passenger car, Van |
| Type of Transportation | Passenger transport |
| Accident category | Accident with emergency vehicle |