How NOT to drive Code 3.

[looker]

Interestingly enough, what do you plan to do for my baby that I cannot? Put her on oxygen or a backboard?

Are you really comparing your self to a general joe who got no clue what to do except to call 911?

 

[Veneficus]

So when person is having SOB or CVA you say hold on do not die, we are stuck in traffic and will be there in 30 min?

When you look at the clinical impact the few minutes that are saved makes, or rather lack of it, instead of looking for an emotional response and compare it with the risks involved; there doesn't seem to be much in the way of risk/benefit ratio.

I encourage you to ask your insurance agent to show you the calculated risk as well as damages paid out last year from incidents involing code 3 responses. (I don't have up to date numbers, but I am sure they are worse today than the ones I do have)

In all respects, I would rather wait for a competant, calm provider who can objectively and logically evaluate the situation than an overly emptional one that might get me killed in a MVC on the way to the hospital.

Getting into a MVC during response rather slows the response time too.

(and you would save a bunch of money on your car insurance)

 

[Veneficus]

Are you really comparing your self to a general joe who got no clue what to do except to call 911?

No?

I was asking if an EMT-B has some skill or ability that is going to save the day when they arrive a few seconds early when my kid is not breathing.

 

[DrParasite]

Interestingly enough, what do you plan to do for my baby that I cannot? Put her on oxygen or a backboard?

actually, I would probably ventilate your baby with a BVM and maybe even some oxygen, suction if needed, and rapidly transport to an ER to figure out why the baby wasn't breathing.

I'm sure you keep a suction device lying around, as well as a BVM and oxygen tank just in case. and if you do, then I'm sure your car is set up to properly and safely ventilate the child while in a moving vehicle until you get him to the ER.

or you can just put the baby in the car, and drive really fast, and hope he doesn't suffer too much from lack of oxygen to the brain as you wait and pray the light turns green.

your choice.

 

[Veneficus]

i accept your challenge

actually, I would probably ventilate your baby with a BVM and maybe even some oxygen,.

If we are talking about my kid,I don't need the BVM, mouth to mouth works just fine. Additionally, the oxygen concentration from my rebreathed air will not cause the free radical or lipid peroxidation damage your 100% o2 would. That means she would suffer less harm before you showed up with your 15LPM protocol, which i would refuse the minute you hooked it up anyway since she has no condition it would actually help with.

Also considering the numbers I have seen EMS ventilate at, and the potential harm that causes, I don't think I would really trust it to them either unless they had already done something to instill my confidence in their ability. I am a tough customer, and I am not going to trust my family to a 120, 750, or even 1800 clock hour tech unless I already knew them or they were very calm, knowledgable, and deliberate.

suction if needed,

She can be turned, scooped with a finger, and if desperation calls, suctioned in the reverse manner as ventilation.

and rapidly transport to an ER to figure out why the baby wasn't breathing.

yea, I would probably work on the why not breathing part before you even got there. Lights and siren or not. I am actually rather good at that. As long as there is ventilation, oxygenation, and a heart beat, the tests will wait the few extra minutes your lights and sirens might save, without killing me or my kid in a traffic accident from some over excited ambulance driver panicked because there was a pediatric emergency.

I'm sure you keep a suction device lying around, as well as a BVM and oxygen tank just in case.

Don't need any of that to save a family member or a close friend.

and if you do, then I'm sure your car is set up to properly and safely ventilate the child while in a moving vehicle until you get him to the ER.

If it came to that, I would probably have somebody else drive. So I could take care of my kid. Sorry man, but I can do a much better job of that than most people.

or you can just put the baby in the car, and drive really fast, and hope he doesn't suffer too much from lack of oxygen to the brain as you wait and pray the light turns green.

Wrong again. Passionate, but still wrong. Described above.

And to take it one step farther, if I was concerned there was an airway issue I could not clear manually, before I let my kid stop breathing, I would cut a hole in her throat with a rusty key if that is all i had, and stick a pen in her trachea and breath through that (which is still superior to a supra glottic airway) while I waited for EMS to show up.

Though if I was at home, I do have my own scalpel and a few blades that are unopened, along with a small collection of forceps.

Short of an AED there is nothing on a BLS truck that I would remotely need. Since I am acutely aware of the survivability of pediatric cardiac arrest, I would also thump her several times before you showed up from as close as across the street.

I do try to be at least a little humble, I have been at this game a while, but if you are going to call, what I can improvise is still better than anything you can do.

Save your blazing steed, hero complex for somebody who doesn't know better and actually might believe it.

Any other argument you would like to present?

 

[DrParasite]

Short of an AED there is nothing on a BLS truck that I would remotely need. Since I am acutely aware of the survivability of pediatric cardiac arrest, I would also thump her several times before you showed up from as close as across the street.

I do try to be at least a little humble, I have been at this game a while, but if you are going to call, what I can improvise is still better than anything you can do.

Save your blazing steed, hero complex for somebody who doesn't know better and actually might believe it.

Any other argument you would like to present?

congratulations. You showed me up, with your vastly superior knowledge (4 years of med school done, as well as your time as a medic), and your amazing ability to improvise under a stressful situation, and your overall lack of trust of any EMS provider with less than 2000 hours of training.

I think you would be the exception rather than the rule as to how the general public would or should handle 911 emergencies.

unless you want to advocate John Q public surgically cricing their non-breathing baby with a rusty key since the ambulance is taking so long.....

 

[DarkStarr]

thesecretlist.com

......

 

[JJR512]

(and you would save a bunch of money on your car insurance)

Well we can do that just by switching to Geico.

Insurance problem solved, now we can go back to driving Code 3, yay!

 

[Veneficus]

congratulations. You showed me up, with your vastly superior knowledge (4 years of med school done, as well as your time as a medic), and your amazing ability to improvise under a stressful situation, and your overall lack of trust of any EMS provider with less than 2000 hours of training.

I am supposed to trust people who claim to aspire to professionalism, that claim to be heroic life savers because they can make an emotional plea to keep on doing the same things that have been done sine the 70s despite growing evidence to the contrary? Who constantly remind us how simple the job is so they don't have to go to school any longer? Who don't even understand the risks and benefits involved in their operations?

How inspiring...

What I expect is people who claim to be so capable understand the intricacies of that they profess to be experts at. (or at least worth paying)

I am tired of the excuses.

The very fact that anyone would make an argument that driving lights and sirens and the inherent risks are necessary to "save lives" shows at best, a grossly uninformed person and at worst a person who is more interested in making themselves feel important doing something "cool."

I am going to guess the fact is somewhere closer to the middle.

unless you want to advocate John Q public surgically cricing their non-breathing baby with a rusty key since the ambulance is taking so long.....

Why don't we look at the logic?

Permanant injury/brain death from hypoxia, 6-8 minutes.


The NFPA 1710 standard is based upon a combination of accepted practices and more than 30 years of study, research, testing and validation. Members of the 1710 committee that developed the standard include representatives from various fire agencies and the International Association of City/County Managers (ICMA).

Yet the clinical outcome is not better.

On all EMS calls, the NFPA 1710 standard establishes a turnout time of one minute, and four minutes or less for the arrival of a unit with first responder or higher level capability at an emergency medical incident. This objective should be met 90% of the time.

So if you consider the delay in time of calling, lets say 30 seconds. The dispatcher taking information and dispatchig the responders, 1 minute. 1 minute turnout time, 4 minutes to arrival of the unit. (not to be confused with initiating patient care, which would be impossible unless you had a unit on every block and in every high rise already)

Time to pt contact: >6 minutes 90% of the time

Permanant injury/brain death from hypoxia, 6-8 minutes.

That is 6 minutes to relieve an airway obtruction. 6 minutes to start CPR. 6minutes to control a life threatening bleed.

For the benefit of the doubt, lets say it was an ALS response. By the time you start advanced procedures, like actual IV in and running add another 1 minute. Maybe interrupt CPR to look at the heart monitor?

Fail.

5 years ago I saw a study by the insurance institute of America that concluded there is an increase in the probability of being involved in an MVC by 300%. Last year the number 1 killer of both EMS and Police was traffic related.

If a fire department provides ALS services, the standard recommends arrival of an ALS company within an eight-minute response time to 90% of incidents. This does not preclude the four-minute initial response.

So under the best circumstance you arrive on scene in >6 minutes, but specify an ALS goal of under 8 minutes? Why is that? Because in anyplace other than a suburb, 4 minutes is totally unrealistic.

Permanant injury/brain death from hypoxia, 6-8 minutes.

Fail.

So you are going to risk the lives of crew, a increased response from a second unit in the event of a collision, countless "wake effect" accidents while driving with "due regard to public safety" to make no difference in the outcome of anything that can be helped from a basic CPR course?

How much is acceptable to spend on this "absolutely nothing?"

If you kill somebody on the way to a call in order to make a family "feel better" you got to a potentially permanantly vegatative patient at best when you arrive does it all balance out?

After the permanant disability or death of a responder, how is their family supposed to eek out a living? You see what people get on disability? Even less in most death benefits over the long term.

All that for "nothing?"

As long as you get paid OT for being in the honor guard at the funeral right?

Incorperate that with the findings of the OPALS study.

Logical conclusion: increased risk, no effective difference in outcome.

Let's relook at the things can can be helped.

Transport of CVA? Effective treatment for that measured in hours, not minutes.

Patient in DKA for days? they can wait a few more minutes. If not, nothing that was going to be done anywhere would change the outcome.

Hypoglycemic for hours, if not days? The same.

Anaphylaxis? No airway for 6 minutes best.

FBAO: the same.

Child in cardiac arrest? death.


Whether I trust the medical care or not, there is no responder I don't want to see go home after work. There is no injury or life worth trying to save at best a few minutes, when we have no evidence it helps in any case and the very logic looks flawed.

There are several effective steps to help a person not breathing that can be taught to everyone including children. There is one proven treatment to help in sudden cardiac arrest that can be done by J.Q. Public. It is a CPR class. Easy, cheap, and a pocket mask puts a responder on every block, in every occupied building, 24 hours a day. It is proven to better outcomes.

Much easier than an improvised cric.

It is also much easier to teach/learn CPR than to make up for the consequences of doing something like forcing a vehicle into an intersection that then gets t-boned so you can have enough room to run a red light.

Best of all, the most people have the best chance to go home at the end of the day. Patients, Crew, Bystanders.

It reduces the potential gravity of injuries in the accidents that remain when you reduce "speed" in the equation. (mass x speed)

We really have to get used to the idea that medicine cannot rescue in minutes what people have often done to themselves for years. About the only exception is trauma. While we strive to return people to as close to function as possible. Until we can start regenerating parts, all we can hope for is "close enough."

We cannot justify the loss of life of somebody we care about with the loss of another in the effort to look like we are "helping."

 

[lightsandsirens5]

In response to the op, I think this is a worse example of code driving than the op video. Especially since it appears the driver is running the camera. (Or am I mistaken?) [YOUTUBE]http://www.youtube.com/watch?v=bbrhZfpmp0g&feature=related[/YOUTUBE]

 

[Shishkabob]

LS reutrn to the hospital with a patient is one thing, and the times where it's beneficial are few and far inbetween.


However, you'd be hardpressed at making me think it's a good idea to get rid of LS response TO a patient in certain calls.

If not for horrible info being dispatched to where a stubbed toe is actually a cardiac arrest, than for the fact that on atleast 2 calls during just my internship, that the patient would not have been able to wait for a non-emergent response.




No, see, the bigger problem is the general population who suck butt at driving the moment flashy lights are spotted. THAT is the problem that needs to be fixed.

 

[JPINFV]

^
Given that this appears to be a fire SUV than anything else, which changes dynamics a bit, but the fundlemental strategy is the same.

I actually don't think that video was too bad outside of the first two flashing yellow lights (which I'm going to assume that cross traffic has flashing reds and neither had cross traffic at the light) and what looks to be cutting traffic off at 20 seconds. Even that could be a bad angle to see how close he was.

Good use of the center median area (sometimes just median, sometimes turn lanes).

Good use of opposing lanes of traffic when approaching a red light (minus possible the ducking back at 20 seconds). Driving on the left side, he should be able to see what in the oncoming lanes. Both times he ducked into opposing lanes it was when the only cars were stopped at the red light. In fact, at 8 seconds you can clearly see the driver wait for the last car before the intersection pass, and only then did he duck into opposing lanes. Once he past the cars stopped at the intersection, he went to the median/turning lane or lanes in his traffic. I consider this much safer than forcing cars against a red.

Also, by using opposing lanes when safe (and in this case, both 2 times when opposing traffic was a half block down on the opposite side of a traffic light), he is avoiding forcing cars to merge right by passing safely on the left.

The second intersection looks iffy at first, but upon looking at it it makes sense. 3 way intersection. Opposing traffic has green light for through traffic and a green light for a protected left turn with his lane having a red light. Since it's a T intersection, instead of a left lane there's a painted median for his direction which he uses (so he isn't in oncoming traffic lane). Being in this lane, he has an unobstructed view at the, now empty, left turn lane for oncoming traffic at the intersection, which tells him that he has no traffic really to contend with. Given the speed, it's immaterial that it turns green right before he enters.

No tailgating. No hard or jerky turns. No blasting the horn.

Only bad things (severity varies) that I can see really is maybe slowing down for the two yellows and slowing down for that last intersection. In reality, I think it's a good example of how to use non-lanes (painted medians) when driving emergently. Also, with that second intersection, he goes through the turn lane until it turns into a painted median. However I don't know what's in lanes immediately to his right which makes it hard to judge.

 

[lightsandsirens5]

^
Given that this appears to be a fire SUV than anything else, which changes dynamics a bit, but the fundlemental strategy is the same.

I actually don't think that video was too bad outside of the first two flashing yellow lights (which I'm going to assume that cross traffic has flashing reds and neither had cross traffic at the light) and what looks to be cutting traffic off at 20 seconds. Even that could be a bad angle to see how close he was.

Good use of the center median area (sometimes just median, sometimes turn lanes).

Good use of opposing lanes of traffic when approaching a red light (minus possible the ducking back at 20 seconds). Driving on the left side, he should be able to see what in the oncoming lanes. Both times he ducked into opposing lanes it was when the only cars were stopped at the red light. In fact, at 8 seconds you can clearly see the driver wait for the last car before the intersection pass, and only then did he duck into opposing lanes. Once he past the cars stopped at the intersection, he went to the median/turning lane or lanes in his traffic. I consider this much safer than forcing cars against a red.

Also, by using opposing lanes when safe (and in this case, both 2 times when opposing traffic was a half block down on the opposite side of a traffic light), he is avoiding forcing cars to merge right by passing safely on the left.

The second intersection looks iffy at first, but upon looking at it it makes sense. 3 way intersection. Opposing traffic has green light for through traffic and a green light for a protected left turn with his lane having a red light. Since it's a T intersection, instead of a left lane there's a painted median for his direction which he uses (so he isn't in oncoming traffic lane). Being in this lane, he has an unobstructed view at the, now empty, left turn lane for oncoming traffic at the intersection, which tells him that he has no traffic really to contend with. Given the speed, it's immaterial that it turns green right before he enters.

No tailgating. No hard or jerky turns. No blasting the horn.

Only bad things (severity varies) that I can see really is maybe slowing down for the two yellows and slowing down for that last intersection. In reality, I think it's a good example of how to use non-lanes (painted medians) when driving emergently. Also, with that second intersection, he goes through the turn lane until it turns into a painted median. However I don't know what's in lanes immediately to his right which makes it hard to judge.

True, I was assuming that the cross traffic had flashing reds as well, I guess I would just slow down quite a bit more at those than he did. My two biggest gripes are 1) The one light that changes to green right before he goes through it. It was red up right until he reached the intersection and he clearly had no intention of even slowing down. Maybe he could see both ways and saw that it was clear, but still, you never know. 2) How he just dives into oncoming traffic quite a ways from the intersection. In and of itself, heading into oncoming is not a problem, but he does not even seem to slow the slightest bit. Again, maybe he could see that it was clear, but also again, you never know. Plus, even if the light for the oncoming is red, that means that people are going to be turning right from his left and also left from his right. Ideally, the people turning right should be in the lane farthest to his left (their right). However, with all the traffic backed up in the right lanes, he will not see a person turning left into his path until they are already in his path. Not to mention they will be in the same lane he is in. The intersection that occurs in is the same one that he almost blows the red light in.

So I guess it would be more accurate to say that while he does have some good parts in that video, there are also some things that I would list as unsafe.

I would also question the need for a command vehicle to be on scene THAT quickly for a fire. I understand that command is needed, however, the whole fire service is built around command and an engine officer is fully capable of assuming command at a normal sized structure fire.

 

[abckidsmom]

^
Given that this appears to be a fire SUV than anything else, which changes dynamics a bit, but the fundlemental strategy is the same.

I actually don't think that video was too bad outside of the first two flashing yellow lights (which I'm going to assume that cross traffic has flashing reds and neither had cross traffic at the light) and what looks to be cutting traffic off at 20 seconds. Even that could be a bad angle to see how close he was.

Good use of the center median area (sometimes just median, sometimes turn lanes).

Good use of opposing lanes of traffic when approaching a red light (minus possible the ducking back at 20 seconds). Driving on the left side, he should be able to see what in the oncoming lanes. Both times he ducked into opposing lanes it was when the only cars were stopped at the red light. In fact, at 8 seconds you can clearly see the driver wait for the last car before the intersection pass, and only then did he duck into opposing lanes. Once he past the cars stopped at the intersection, he went to the median/turning lane or lanes in his traffic. I consider this much safer than forcing cars against a red.

Also, by using opposing lanes when safe (and in this case, both 2 times when opposing traffic was a half block down on the opposite side of a traffic light), he is avoiding forcing cars to merge right by passing safely on the left.

The second intersection looks iffy at first, but upon looking at it it makes sense. 3 way intersection. Opposing traffic has green light for through traffic and a green light for a protected left turn with his lane having a red light. Since it's a T intersection, instead of a left lane there's a painted median for his direction which he uses (so he isn't in oncoming traffic lane). Being in this lane, he has an unobstructed view at the, now empty, left turn lane for oncoming traffic at the intersection, which tells him that he has no traffic really to contend with. Given the speed, it's immaterial that it turns green right before he enters.

No tailgating. No hard or jerky turns. No blasting the horn.

Only bad things (severity varies) that I can see really is maybe slowing down for the two yellows and slowing down for that last intersection. In reality, I think it's a good example of how to use non-lanes (painted medians) when driving emergently. Also, with that second intersection, he goes through the turn lane until it turns into a painted median. However I don't know what's in lanes immediately to his right which makes it hard to judge.

I agree. The speed was pretty high, but if it was an SUV, the stopping distance and maneuverability is much lower than a larger vehicle. Not nearly as bad as the first video, and depending on what the actual speed was, I would say that the response was a safe one.

This just demonstrates how dangerous a lights and sirens response is: all the rules were followed and it still looks crazy and reckless! Add to that that the driver's mind was on the structure fire he was missing the beginning of...

 

[JPINFV]

[YOUTUBE]http://www.youtube.com/watch?v=nTeDG6OTMho&feature=player_embedded[/YOUTUBE]

Same unit as the video posted a few moments ago and responding to a bus this time. I think this one is a bit worse than the other one. Definitely should have stopped at a few of the intersections. There's two really interesting points, though. First, at 1:55 he finds a nice way through the intersection instead of sitting there. That's the place, though, where I think he could have stopped and didn't. Of course not seeing what the vehicles immediately to the left was doing is important.

The next interesting tidbit is immediately afterwards and just before going on scene, he gets stuck in traffic. He moves into the far right lane of oncoming traffic. However that lane is blocked upstream by the bus that he is responding to. Given the situation, I think this course of action was safer than hanging out in the number 1 lane of oncoming traffic for that last quarter mile or so.

 

[JPINFV]

2) How he just dives into oncoming traffic quite a ways from the intersection. In and of itself, heading into oncoming is not a problem, but he does not even seem to slow the slightest bit. Again, maybe he could see that it was clear, but also again, you never know.

That's the thing, though. If you're in the number one lane and in the driver's seat, you can clearly see what traffic is like in oncoming lanes. If he was in the number 2 lane and just popped straight through the number 1 lane in his direction and into the number 1 lane of oncoming traffic, then I could see that as being extremely dangerous. Next time you're driving, be it in an ambulance or POV, drive in the number 1 lane and see how much of oncoming traffic you can see. You can see more than you think because normal driving means not really caring what traffic in those lanes are going. As such normally in the number 1 lane you're focused on what's in front of you and what's to your right than forward, right, and left. If you know there's no traffic for a quarter mile and that traffic is stopped at a red light, why slow down? The one big caution I would give with that, though, is if he approached the intersection from oncoming traffic lanes (which he didn't) because then view of him would be blocked from traffic making a left turn into those lanes from the right. However he was back into lanes in his direction before the intersection. The second intersection he was in a painted medium and not oncoming traffic (which, in my opinion, a painted medium be it a dual left turn lane or a no traffic lane is the best place to be for emergency driving. Maximum options, minimum traffic. ).

Plus, even if the light for the oncoming is red, that means that people are going to be turning right from his left and also left from his right. Ideally, the people turning right should be in the lane farthest to his left (their right). However, with all the traffic backed up in the right lanes, he will not see a person turning left into his path until they are already in his path. Not to mention they will be in the same lane he is in. The intersection that occurs in is the same one that he almost blows the red light in.

Actually, go back and look again. It's a T intersection and not a 4-way intersection. From the perspective of a T, he's going from left to right through the top of the T. Traffic going right to left through the top has a green light and traffic turning from right to down has a green light, however there is no one in the turn lane for right to down. Ideally should he have slowed down and stopped? Yes, I agree he should have. I would also agree that it would be unacceptably and recklessly dangerous if it was a 4 way intersection.

I would also question the need for a command vehicle to be on scene THAT quickly for a fire. I understand that command is needed, however, the whole fire service is built around command and an engine officer is fully capable of assuming command at a normal sized structure fire.

It actually looks like a paramedic fly car based on the video I just posted. I also think that the question of "is emergency response needed" and "how to drive emergently" are two different and separate issues and as long as emergency driving is done, analyzing the strategy used should never be connected to whether it the response is valid. No need is every worth driving recklessly.

 

[JPINFV]

This just demonstrates how dangerous a lights and sirens response is: all the rules were followed and it still looks crazy and reckless! Add to that that the driver's mind was on the structure fire he was missing the beginning of...

I think it's a viewpoint issue. It looks dangerous because emergency vehicles use options not open to regular traffic. As such, regular traffic doesn't even normally look at those areas. I'll give an example.

My first EMT job had a traffic light outside of base that would take a good 3-5 minutes to change to allow a turn. In the end, I began to regularly run the light in my POV to get home. Is this dangerous?

Based on that information, yes, which is what most people consider when driving normally. However if I was to add that it was a light industrial area, I worked weekends, got out at night (normally around 9-10pm), and when I did run it I could see a a half mile down the road in each direction to the next intersection and there was never a car on either approach when I did run it. Now is it illegal? Definitely. Dangerous? Absolutely not, it just takes a different approach than saying "red light means I'm going to die if I enter the intersection."

 

[Shishkabob]

And again, many of the issues WITH LS driving stem from civilians, and not from emergency personnel driving. They don't know how to react to us doing what we do. We're relatively predictable. They aren't in the slightest.





Therefor things need to be corrected in the drivers education arena. Heck, I know in some places, once you turn 18 you take a test and get your license, no education needed. That's just screwed up.

Hey, let's put you behind a half ton vehicle able to travel at 100mph just by you taking a single test, WITH other crappy drivers just like you ALSO on the road!

 

[abckidsmom]

I think it's a viewpoint issue. It looks dangerous because emergency vehicles use options not open to regular traffic. As such, regular traffic doesn't even normally look at those areas. I'll give an example.

My first EMT job had a traffic light outside of base that would take a good 3-5 minutes to change to allow a turn. In the end, I began to regularly run the light in my POV to get home. Is this dangerous?

Based on that information, yes, which is what most people consider when driving normally. However if I was to add that it was a light industrial area, I worked weekends, got out at night (normally around 9-10pm), and when I did run it I could see a a half mile down the road in each direction to the next intersection and there was never a car on either approach when I did run it. Now is it illegal? Definitely. Dangerous? Absolutely not, it just takes a different approach than saying "red light means I'm going to die if I enter the intersection."

I get that, I really do. But this guy was in moderate traffic, with several blocked intersections, making very quick lane changes. I guess the FailSafe driving methods made more of an impression on me than I thought, because I just like to see a little more predictability.

I'm just a lot slower through an intersection, willing to sit back and wait the light out instead of moving through a lane of stopped traffic, around an island, and then back into the same line of cars. He saved maybe 2-4 seconds with that move, even though I thought it was clever, so all that maneuvering through traffic really did nothing for the response.

The more vehicles we impact with our response, the more potential for accidents to occur in our wake. When I stopped living and breathing EMS 24/7 back when I had kids, I started making friends with normal people, who think that every single response is a life-or-death emergency, and they get all excited and worried, and sometimes even afraid for the ambulance/emergency vehicle. Seriously. I was amazed to find the levels of anxiety produced in people when they have an emergency vehicle near them in traffic.

All that to say that even though this guy was technically in bounds and the response was for the most part safe, we have to remember that of those people he passed, fully 10% or more will now have 1-2 minutes of anxiety to work out before they're back to their baseline, standard driving skills. And then they'll pass the scene and rubberneck.

The roads are the dangerous part of the job.

 

[JPINFV]

And again, many of the issues WITH LS driving stem from civilians, and not from emergency personnel driving. They don't know how to react to us doing what we do. We're relatively predictable. They aren't in the slightest.

However, we do a lot of things that don't help as well.

Tailgating is something that we do that's terrible. If you're tailgating a car, chances are the only thing that they can see is the grill lights, which aren't exactly the most eye catching lights around.

We overestimate the effectiveness of sirens. Between music at a decent volume (not necessarily ear splitting loud), sound proofing, speed (which causes a functional decrease in reaction time since we're closer by the time they realize we're appproaching), and traffic and building absorbing sound (which is much worse for cross traffic at intersections), we expect to be heard when we actually aren't.

We don't find another way when we should (using other lanes, oncoming traffic, etc.). I will argue that there is definitely a time and a place for passing a car in the number 1 lane on the right, but that decision needs to be made sooner than later.

We don't necessarily use a painted median as much as we should. After all, why drive in the number one lane when you can drive through turn lanes and in areas where cars from either direction shouldn't be?

Yes, there's a lot that the public could do to respond better to our lights and sirens. However there's a lot that we could also do that in the end limits how the actions of other cars affects our responses. In the end, it doesn't matter if a car is wrong for not yielding when we commit the bigger sin of tailgating that car while flipping through every tone on the siren and constantly sounding the siren instead of doing anything else, like driving around him for no better reason than to force him to submit or (as I've seen people argue in other threads) 'teach him a lesson.'