Out of concern that ambulances might be targeted for hijack for terrorism purposes, we observed security-related behaviors of a cross-section of ambulance crews and their vehicles in Emergency Department ambulance bays. We sent observers to a convenience sample of trauma and suburban Emergency Department ambulance entrances in several states. We observed 151 total ambulance arrivals. Overall, the average time present was 21.5 min, 23.2% of units were left with the engine running, 26.5% were left open, 90.1% were left unattended, 84.1% were unlocked, and 16.6% had a non-crew visitor in the ambulance bay. Several issues were identified demonstrating potential "attractiveness" to individuals who may wish to disrupt Emergency Medical Services or steal an emergency vehicle. We are concerned that this is the case at the majority of ambulance bays in our country. Emergency services agencies should take steps to train their personnel to secure the ambulance.
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