# How NOT to drive Code 3.



## LonghornMedic (Sep 29, 2010)

I was going viewing some videos on Youtube and came across this one. I understand NYC is a busy and congested city, but this kind of driving is unreal. I wonder if this agency puts their medics through any kind of EVOC course. If they do, they need some remedial training in a bad way. Make sure to take a look at the scene at time 1:10.

[YOUTUBE]http://www.youtube.com/watch?v=Q1rwzu5HGPQ[/YOUTUBE]


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## rhan101277 (Sep 29, 2010)

If its congested we find another way around.  If its not feasible then we are just in the traffic with everyone else.  If its bumper to bumper then even if we have a critical pt. we won't go lights and siren, we go with the flow of traffic.


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## spike91 (Sep 29, 2010)

Too be honest I've seen much worse. While there were a few intersections they were a bit wreckless with, otherwise it was a relatively safe response. In New York, ambulances are permitted to drive in opposing traffic at or below 20 mph. Was it slightly wreckless? Yes. But otherwise they did it right, they came to a near stop at intersections (minus 2 or three that I counted), they were using their sirens at ALL times (which outside the city is a rarity), and they weren't being jackasses in the passing. The only thing that was a bit off was the way they were driving in the right lanes at the beginning.


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## TransportJockey (Sep 29, 2010)

One of hte things I saw that annoyed me was them trying to l/s that van into traffic at the beginning. Everywhere I've worked, if you're stuck in traffic and can't move without forcing traffic into traffic, you shut your lights down and wait till there's a break you can get out in


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## DrParasite (Sep 29, 2010)

hmmmm, at 1:10, a yellow cab cuts them off..... and that's their fault?  everyone else stops, it's clear, and maybe the cabby blew a stop sign?

they didn't pass on the right, the use the fire lane when it was available, they didn't go the wrong way up a one way street, they didn't blow through every light, they kept their siren on in accordance to state laws, and they appeared to clear intersections before they crossed.  and it's midtown Manhattan (42nd street by Port Authority Bus Terminal if I'm not mistaken) and it's extremely congested, and yellow cabbies are a huge danger to pedestrians and other drivers because they do stupid stuff and drive like retards.

in reality, I've seen FDNY suppression pieces drive more recklessly, and almost run over my feet and other pedestrians who were standing in the street waiting to cross the street.

St Vinnies typically only hires experienced EMTs and Paramedics, usually with 3-5 years experience before HR will even look at you. They do have a training center, and I'm sure they make sure their employees have EVOC.  Why don't you Email St Vinnies EMS and find out?


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## LonghornMedic (Sep 29, 2010)

spike91 said:


> Too be honest I've seen much worse. While there were a few intersections they were a bit wreckless with, otherwise it was a relatively safe response. In New York, ambulances are permitted to drive in opposing traffic at or below 20 mph. Was it slightly wreckless? Yes. But otherwise they did it right, they came to a near stop at intersections (minus 2 or three that I counted), they were using their sirens at ALL times (which outside the city is a rarity), and they weren't being jackasses in the passing. The only thing that was a bit off was the way they were driving in the right lanes at the beginning.



They blew through numerous red lights. There was no communication, i.e. "Trafffic" or "Clear right." That taxi cab was a glaring example of that. There were a couple of other scenes where vehicles were braking hard trying to avoid them because they didn't come to a stop at the red light.(You should be coming to a full stop at all red lights and stop signs. At a four way stop, if everyone is stopped and sees you, I'll slowly roll through.)

They came within a couple feet of pedestrians at high speed on a couple different occasions.

They pushed traffic into intersections at red lights. (Proper Code 3 driving indicates you at least shut your siren off, if not your lights too, until the light turns green when it's that congested)

They passed on the right.(That's a big no, no. Not sure what NY law is, but if you pass on the right and a vehicle decides to yield to the right and hit you, guess who is at fault?)

One of the things that I stress to anyone I precept is that Code 3 driving is without a doubt *THE *most dangerous thing we do. These guys in the video would never last a day in any system I have ever worked for. They an accident waiting to happen. They, and medics like them, are another reason the general public doesn't respect EMS in some areas. If you lived in an area where this kind of Code 3 driving was tolerated, what would your general impression of EMS workers be?


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## jjesusfreak01 (Sep 29, 2010)

Yeah, thats just New York. It would have doubled their response time if they had stayed with traffic on that run.


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## LonghornMedic (Sep 29, 2010)

DrParasite said:


> hmmmm, at 1:10, a yellow cab cuts them off..... and that's their fault?  everyone else stops, it's clear, and maybe the cabby blew a stop sign?



The light was red for the ambulance, which meant the cab had the green. It appears that the cab was moving at regular speed. If the medics had come to a stop and slowly proceeded through, they would have never come that close to hitting the cab. So yes, it was their fault.


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## mct601 (Sep 29, 2010)

They did not properly clear every light - that's very very dangerous and uncalled for. My partners would throw me off the truck if I cleared intersections like that. They were far too aggressive in the congested areas at times (IMO), too. Not everyone hears or sees the ambulance coming, and one oblivious move by another car can prove to  be bad PR for them.


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## Shishkabob (Sep 29, 2010)

Other than them blowing through red lights without stopping and almost getting whacked a couple of times because of it, I don't have much of a problem with it seeing as how in their city it's a different beast.


Much (not all) of the problems with l/s response can be attributed to idiot civilians not knowing how to react when they see l/s and therefor shouldn't have their license in the first place.  Period.


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## LonghornMedic (Sep 29, 2010)

Here is a better example of driving Code 3. I used to work for this agency and proper Code 3 driving is expected of its employees.


[YOUTUBE]http://www.youtube.com/watch?v=kSjgAKm1210[/YOUTUBE]


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## mct601 (Sep 29, 2010)

Linuss said:


> Other than them blowing through red lights without stopping and almost getting whacked a couple of times because of it, I don't have much of a problem with it seeing as how in their city it's a different beast.
> 
> *
> Much (not all) of the problems with l/s response can be attributed to idiot civilians not knowing how to react when they see l/s and therefor shouldn't have their license in the first place*.  Period.



Amen to that brother.  Our DMV books here in MS need to expound on emergency traffic, cause apparently no one learns it getting their license OR from learning from their parents, siblings, elders, experience - whatever. Go RIGHT, not LEFT, not STOP. Or god forbid- TURN ON YOUR HAZARDS AND CONTINUE DRIVING. 

I can't count how many times I come up to an intersection. It will be a two lane with a turn lane on each side. The two straight lanes and the right turning lane will be full, so I come up and ease my way into the left turn lane to go around. Traffic freaks how and now I am several cars deep in EVERY lane. Common sense should tell the traffic that since I am going to their left, they should not go that way.


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## Shishkabob (Sep 29, 2010)

Simple answer to the way people respond to l/s response.


Attach a video camera to all emergency vehicles looking forward.  Have someone dedicated to watching said videos.    If a person fails to react in a proper way, warn them first, then fine them a few hundred dollars or suspend their license for a short period.




If they don't learn after that, they don't need to be driving in the first place as they are obviously a hazard.


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## LonghornMedic (Sep 29, 2010)

Linuss said:


> Simple answer to the way people respond to l/s response.
> 
> 
> Attach a video camera to all emergency vehicles looking forward.  Have someone dedicated to watching said videos.    If a person fails to react in a proper way, warn them first, then fine them a few hundred dollars or suspend their license for a short period.
> ...



In Las Vegas, a couple times a year, Las Vegas Metro would dedicate a bunch of their motor units to following us to calls all day. They wrote a lot of tickets for failure to yield. It was sweet redemption for all those other days when there were no cops around when you needed one.


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## lightsandsirens5 (Sep 29, 2010)

rhan101277 said:


> If its congested we find another way around.  If its not feasible then we are just in the traffic with everyone else.  If its bumper to bumper then even if we have a critical pt. we won't go lights and siren, we go with the flow of traffic.



I have seen much worse as well, at least these guys slowed down at the red lights. I agree they could have been a little more careful, maybe tried to go with the flow of traffic instead of pushing people into the intersection, (the whole laminar vs. turbulent thing. Does that apply in NY?) All that being said, I am in no position to judge them since I have no experience running hot in the city. Out here we might do a 100 mile round trip run and pass 10 vehicles.


Oh yea, and do they not have opticom or preempt systems in big cities?


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## TransportJockey (Sep 29, 2010)

lightsandsirens5 said:


> I have seen much worse as well, at least these guys slowed down at the red lights. I agree they could have been a little more careful, maybe tried to go with the flow of traffic instead of pushing people into the intersection, (the whole laminar vs. turbulent thing. Does that apply in NY?) All that being said, I am in no position to judge them since I have no experience running hot in the city. Out here we might do a 100 mile round trip run and pass 10 vehicles.


I love those kind of transports! Living in Denver did teach me I hate running code in cities


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## DrParasite (Sep 29, 2010)

LonghornMedic said:


> Here is a better example of driving Code 3. I used to work for this agency and proper Code 3 driving is expected of its employees.


don't break your arm patting yourself on the back...

hmm, on your video I counted maybe 10 other cars on the road.  I saw no pedestrians, few cabs, and very little traffic.  Considering I have seen emergency vehicles in Vegas driving on the wrong side of the divided roadways when congestion causes travel to be impossible, I am going to say that your video is shot during ideal conditions, when there is no traffic on the road.  

you can't compare midtown Manhattan during the daytime to a drive on the strip at 4am when there is no one else on the road.


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## JPINFV (Sep 29, 2010)

DrParasite said:


> hmmmm, at 1:10, a yellow cab cuts them off..... and that's their fault?  everyone else stops, it's clear, and maybe the cabby blew a stop sign?


You mean besides the obviously red light that the ambulance has? Does New York have stop signs at intersections controlled by traffic lights?



> in reality, I've seen FDNY suppression pieces drive more recklessly, and almost run over my feet and other pedestrians who were standing in the street waiting to cross the street.


So? Hey, cops beat people all the time for no reason besides contempt of cop, does that mean I get to beat people too?


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## JPINFV (Sep 29, 2010)

jjesusfreak01 said:


> Yeah, thats just New York. It would have doubled their response time if they had stayed with traffic on that run.



How long would it have lengthened the response time if they hit someone or something?


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## Shishkabob (Sep 29, 2010)

If they were going fast enough, not at all


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## LonghornMedic (Sep 29, 2010)

DrParasite said:


> don't break your arm patting yourself on the back...
> 
> hmm, on your video I counted maybe 10 other cars on the road.  I saw no pedestrians, few cabs, and very little traffic.  Considering I have seen emergency vehicles in Vegas driving on the wrong side of the divided roadways when congestion causes travel to be impossible, I am going to say that your video is shot during ideal conditions, when there is no traffic on the road.
> 
> you can't compare midtown Manhattan during the daytime to a drive on the strip at 4am when there is no one else on the road.



We are *allowed to oppose traffic* by agency policy and state law. The way the streets are built with concrete medians, there is little choice. I have driven the strip from Sahara to Flamingo on a Friday night opposing traffic the whole way. When they see you coming at them, they see you sooner than someone who isn't looking in their rear view mirror and move over. But when we do have congestion similar to what is on the NYC video, there is no way our agency would tolerate reckless driving like that. I don't push traffic into intersections. It's dangerous and stupid. I sure as hell don't blow red lights. You criticize the video I posted. But with the light traffic, where it would be easy to blow red lights, the crew still came to complete stops and cleared the intersection before proceeding. How this crew drove at night in light traffic is the same way they would in daylight with heavy traffic. That's how it is taught. It is the same way it's taught here with the agency I work with in Texas. You are more likely to get sued for causing an accident than for malpractice.


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## JPINFV (Sep 29, 2010)

Linuss said:


> Annals of Emergency Medicine, December 1991
> Robert A. De Lorenzo, MD, EMT-P; Mark A. Eilers, MD, FACEP
> 
> Lights and Siren: A Review of Emergency Vehicle Warning Systems
> ...



"To be effective, a siren signal must compete with the masking noise generated by the road, car radios, and ventilation fans and must overcome modern sound insulation techniques. A US Department of Transportation (DOT) report (44, 47) showed that over a siren's effective frequency range, the average signal attenuation (through closed-windowed automobile bodies combined with typical masking noise) *resulted in a maximal siren effective distance of siren penetration of only 8 to 12 m at urban intersections.* Only modest improvement in the situation occurred at suburban intersections and straight-ahead highway conditions. These findings have been corroborated (46,48), and from the data a maximum safe entry speed of 10 mph (15 km/hr) for intersections is recommended (49).* The Department of Transportation report concluded that sirens will never become an effective warning device.*

...



Summary

...

Fourth, several studies clearly demonstrate that the siren is a severely limited warning device, effective only at very short ranges and very low speeds. Differences in siren mode do not appear to be important."

http://www.emergencydispatch.org/articles/warningsystems1.htm

Additionally, in terms of the incident at 1:10, notice the big garbage truck soaking up the siren and blocking the lights on the right side at that intersection.


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## JPINFV (Sep 29, 2010)

DrParasite said:


> Considering I have seen emergency vehicles in Vegas driving on the wrong side of the divided roadways when congestion causes travel to be impossible, I am going to say that your video is shot during ideal conditions, when there is no traffic on the road.



Are we talking about divided road like a road with islands with constant breaks for left hand turns or divided roads like an interstate freeway?


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## firecoins (Sep 29, 2010)

LonghornMedic said:


> I was going viewing some videos on Youtube and came across this one. I understand NYC is a busy and congested city, but this kind of driving is unreal. I wonder if this agency puts their medics through any kind of EVOC course. If they do, they need some remedial training in a bad way. Make sure to take a look at the scene at time 1:10.




I find nothing wrong with this video.  This is how all ambulance, police cars and fire trucks drive in NYC. It is the only way to get through NYC traffic. The crew does not need remedial training. That is how one drives code 3 in NYC.  St Vinnies EMT and medics all had EVOC several times over.  

Traffic regularly gets pushed into intersections in NYC by police, fire and EMS.  It is not specific to this crew.  ANyone who thinks that only that crew does it, needs to come to NYC and take a look.   

The St. Vinnie's truck was driving across 42nd street. It taks 35 to 40 minutes to drive across during midday traffic.  

St. Vincent hospital closed earlier this year. I took my medic class there in 2008.  All EMS personnel had been in EMS for years prior to working there otherwise, they could not have been there.


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## JPINFV (Sep 29, 2010)

firecoins said:


> Traffic regularly gets pushed into intersections in NYC by police, fire and EMS.  It is not specific to this crew.  ANyone who thinks that only that crew does it, needs to come to NYC and take a look.


The only thing that matters is if it's good practice to force cars into intersections against red lights. Whether everyone else is doing it or not is irrelevant.


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## JJR512 (Sep 29, 2010)

LonghornMedic said:


> They blew through numerous red lights. There was no communication, i.e. "Trafffic" or "Clear right." That taxi cab was a glaring example of that.


I agree with this part, to a certain extent. The extent is that the driver isn't always going to have someone in the passenger seat to assist him with traffic spotting. When there _is_ someone there, though, it's more efficient to use the help that's available, of course.



> They pushed traffic into intersections at red lights. (Proper Code 3 driving indicates you at least shut your siren off, if not your lights too, until the light turns green when it's that congested)


I've never liked the concept of turning off lights and sirens. In my opinion, that makes it seem to other drivers like either the call was cancelled, or we were just joyriding. I like to keep the lights on at all times as a reminder that yes, we really are still on an emergency call. If we can't move, and nobody can get out of our way, I don't mind shutting the siren off as a courtesy to other drivers. In my opinion, leaving the lights on and siren off says, "Hey, we're still here, still on an emergency call, we'd like to get through, but we recognize it's currently impossible for you to get out of our way, so we're not going to blare our siren and horn up your *** when it's not going to accomplish anything. But don't forget about us, if you see you have a chance to move safely out of our way, we'd really appreciate you taking that opportunity to clear the way. Thanks a bunch."


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## firecoins (Sep 29, 2010)

JPINFV said:


> The only thing that matters is if it's good practice to force cars into intersections against red lights. Whether everyone else is doing it or not is irrelevant.



1. Its very relevant in NYC.  Its part of the traffic pattern.  The traffic pattern in Manhattan is not like Las Vegas or San Diego or small town USA.  What is good in these locations is not good for NYC and vice versa.

2. Force is a bad word.  These cars do so voluntarily.  

3. Taxi cabs are very expereienced at doing this. They prefer to do it as it speed them up and they make more money.


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## LonghornMedic (Sep 29, 2010)

JJR512 said:


> I agree with this part, to a certain extent. The extent is that the driver isn't always going to have someone in the passenger seat to assist him with traffic spotting. When there _is_ someone there, though, it's more efficient to use the help that's available, of course.
> 
> 
> I've never liked the concept of turning off lights and sirens. In my opinion, that makes it seem to other drivers like either the call was cancelled, or we were just joyriding. I like to keep the lights on at all times as a reminder that yes, we really are still on an emergency call. If we can't move, and nobody can get out of our way, I don't mind shutting the siren off as a courtesy to other drivers. In my opinion, leaving the lights on and siren off says, "Hey, we're still here, still on an emergency call, we'd like to get through, but we recognize it's currently impossible for you to get out of our way, so we're not going to blare our siren and horn up your *** when it's not going to accomplish anything. But don't forget about us, if you see you have a chance to move safely out of our way, we'd really appreciate you taking that opportunity to clear the way. Thanks a bunch."



That is what I do. Some people I have worked with choose to shut everything down. Their logic is that it is still pressuring people to go into the intersection. But my logic is the same as yours. I want them to know I'm still en route to a call and to be aware of me. As soon as the light goes green the siren comes on.


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## LonghornMedic (Sep 29, 2010)

firecoins said:


> 1. Its very relevant in NYC.  Its part of the traffic pattern.  The traffic pattern in Manhattan is not like Las Vegas or San Diego or small town USA.  What is good in these locations is not good for NYC and vice versa.
> 
> *2. Force is a bad word.  These cars do so voluntarily.*
> 
> 3. Taxi cabs are very expereienced at doing this. They prefer to do it as it speed them up and they make more money.



*Force *is the perfect word. If you weren't sitting there, riding up the bumper of the car in front of you, working the siren across all the tones and using the airhorn they wouldn't feel the pressure to get out of your way.

While you condone this, I can guarantee you that not one emergency driving expert in this country would agree with you. And unless state law says you can do all the things you see on this video or you say happens on a daily basis, I feel sorry for the poor :censored::censored::censored::censored::censored::censored::censored: who causes a wreck and has to sit on the witness stand in court trying to convince a jury "that's how we all have done it for years."


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## firecoins (Sep 29, 2010)

LonghornMedic said:


> *Force *is the perfect word. If you weren't sitting there, riding up the bumper of the car in front of you, working the siren across all the tones and using the airhorn they wouldn't feel the pressure to get out of your way.
> 
> While you condone this, I can guarantee you that not one emergency driving expert in this country would agree with you. And unless state law says you can do all the things you see on this video or you say happens on a daily basis, I feel sorry for the poor :censored::censored::censored::censored::censored::censored::censored: who causes a wreck and has to sit on the witness stand in court trying to convince a jury "that's how we all have done it for years."



Okay.  Come to NY and show the NYPD, FDNY and all EMS units how to drive in NYC.  Your the expert. I will make any calls you want.  I have the phone numbers.  What you need set up.


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## JPINFV (Sep 29, 2010)

I didn't realize that basic physics mechanics changed based on geographic location. What would have happened if the Sprinter at the start got t-boned going into the intersection? Do you think that the ambulance crew would share zero responsibility for that accident?


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## spike91 (Sep 29, 2010)

DrParasite said:


> don't break your arm patting yourself on the back...
> 
> hmm, on your video I counted maybe 10 other cars on the road.  I saw no pedestrians, few cabs, and very little traffic.  Considering I have seen emergency vehicles in Vegas driving on the wrong side of the divided roadways when congestion causes travel to be impossible, I am going to say that your video is shot during ideal conditions, when there is no traffic on the road.
> 
> you can't compare midtown Manhattan during the daytime to a drive on the strip at 4am when there is no one else on the road.



+1 for the much needed reality check.


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## aewin90 (Sep 29, 2010)

LonghornMedic said:


> One of the things that I stress to anyone I precept is that Code 3 driving is without a doubt *THE *most dangerous thing we do.


Done properly, Code 3 driving is safer than your commute to work.  Do not race, clear your intersections, pass on the left, and assume that everyone is an idiot and you will be fine.


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## LonghornMedic (Sep 29, 2010)

aewin90 said:


> Done properly, Code 3 driving is safer than your commute to work.  Do not race, clear your intersections, pass on the left, and assume that everyone is an idiot and you will be fine.



In other words, don't do what the people on the video in NYC do.


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## LonghornMedic (Sep 29, 2010)

firecoins said:


> Okay.  Come to NY and show the NYPD, FDNY and all EMS units how to drive in NYC.  Your the expert. I will make any calls you want.  I have the phone numbers.  What you need set up.



You don't get it. Proper and safe emergency driving is universal. Driving Code 3 is no different in NYC than it is in Dallas than it is in L.A. Blowing red lights and all the other stuff talked about on this thread is dangerous no matter where you run calls. I'm happy you "have the phone numbers." Good for you. We'll chalk this up to agree to disagree.


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## Bullets (Sep 29, 2010)

BS, if given the option, NYC yellow cabs, delivery trucks, ect would ignore every single traffic signal in the City. when they get "forced" into an intersection, opposing traffic, if there is any, is going maybe 25 mph, but probably more like 10-15, especially on the short blocks

Passing on the right throught the firelanes at intersections is allowed, encouraged, taught and usually the only viable way to avoid traffic. And the vehicles in front have the option of procceeding through a red light , they are not forced. Its not like we jump out and hold a gun to their heads

While you may not have heard them clear each other, i dont find a problem with this. i only say something if there is a hazard. if its clear i dont say anything

You cant compare central Texas or Mississippi to downtown Manhattan.


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## mct601 (Sep 29, 2010)

Bullets said:


> BS, if given the option, NYC yellow cabs, delivery trucks, ect would ignore every single traffic signal in the City. when they get "forced" into an intersection, opposing traffic, if there is any, is going maybe 25 mph, but probably more like 10-15, especially on the short blocks
> 
> Passing on the right throught the firelanes at intersections is allowed, encouraged, taught and usually the only viable way to avoid traffic. And the vehicles in front have the option of procceeding through a red light , they are not forced. Its not like we jump out and hold a gun to their heads
> 
> ...



You can't, but I'm just saying what the guys have been saying - safe driving is safe driving. Manhattan is not a different country or culture. We are not comparing MS and TX to Australian or Canadian EMS. Although from my understanding you guys up north like to believe it is infact a different country.


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## looker (Sep 29, 2010)

DrParasite said:


> hmmmm, at 1:10, a yellow cab cuts them off..... and that's their fault?  everyone else stops, it's clear, and maybe the cabby blew a stop sign?



They had red light, they had to make sure all other traffic was stopped before entering the intersection. It's clearly at 1:10 they didn't do it and some other time as well. If accident happened they would be found at fault.


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## LonghornMedic (Sep 29, 2010)

This is straight from the New York Dept of Health regarding The Operation Of Emergency Medical Services Vehicles.


NYS — EMS POLICY

Every EMS response vehicle must be driven safely at all times, usually not exceeding the speed limit. Drivers exercising any of the V&T Law privileges must do so cautiously and with due regard for the safety of all others.

Types of Responses -

Non-emergency Operations - anytime an EMS response vehicle is out of the station on an assignment other than an emergency run, shall be considered to be a routine operation. All routine operations will be considered non-emergency and shall be made using headlights only - no light bars, beacons, corner or grill flashers or sirens shall be used. During a non-emergency operation, the ambulance shall be driven in a safe manner and is not authorized to use any emergency vehicle privileges as provided for in the V&T Law.

Emergency Operations - shall be limited to any response to the scene or the hospital where the driver of the emergency vehicle actually perceives, based on instructions received or information available to him or her, the call to be a true emergency. EMD dispatch classifications, indicating a true or potentially true emergency should be used to determine the initial response type. Patient assessments made by a certified care provider, should determine the response type (usually C or U as an emergency) to the hospital. In order for a response to be a true or potentially true emergency, the operator or certified care provider must have an articulable reason to believe that emergency operations may make a difference in patient outcome. During an emergency operation headlights and all emergency lights shall be illuminated and the siren used as necessary.

*Each EMS response vehicle operator must recognize that the emergency vehicle has no absolute right of way, it is qualified and cannot be taken forcefully8.*

*During emergency operations every EMS response vehicle must be operated in such a manner and at such a speed upon approaching an intersection, controlled by a traffic control device so as to permit safe passage through the intersection. Before entering the intersection the operator must reduce the speed of the vehicle to be able to stop the vehicle if necessary to permit such safe passage. They should come to a complete stop if they have a red signal or stop sign*.

Every EMS response vehicle must stop upon encountering a stopped school bus with red lights flashing; any non controlled railroad crossing or railroad crossing at which safety gates and/or warning lights are activated or if requested by a police officer.

EMS response vehicles are discouraged from using escorts or traveling in convoys due to the extreme dangers associated with multiple emergency vehicles operating in close proximity to each other. For the purpose of this policy statement and any developed from it emergency vehicles should maintain a spacing of at least 300 - 400 feet between them in ideal driving conditions and more when visibility is limited or road conditions are less than ideal.10

At emergency scenes the use of emergency warning lights must be governed by the need to protect the safety of all personnel, patients and the public. In some cases the use of emergency lights should be minimized.


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## firecoins (Sep 29, 2010)

LonghornMedic said:


> .
> 
> *Each EMS response vehicle operator must recognize that the emergency vehicle has no absolute right of way, it is qualified and cannot be taken forcefully8.*
> 
> [.



If your video the St Vinnie's crew stopped at a stop light.  They did no force their way trough it. Epic Fail.

Again your internet expert. Come up and demonstrate your super driving abilities for us.


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## looker (Sep 29, 2010)

firecoins said:


> If your video the St Vinnie's crew stopped at a stop light.  They did no force their way trough it. Epic Fail.
> 
> Again your internet expert. Come up and demonstrate your super driving abilities for us.



It clearly says that if you have red light you must stop and make sure the intersection is clear. Watching the video, the crew didn't make full stop at many of red light intersection and if they hit that taxi they would be at fault. If that was my crew, they would be reprimanded for their code 3 driving.


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## firecoins (Sep 29, 2010)

looker said:


> It clearly says that if you have red light you must stop and make sure the intersection is clear. Watching the video, the crew didn't make full stop at many of red light intersection and if they hit that taxi they would be at fault. If that was my crew, they would be reprimanded for their code 3 driving.



Sure many crews make a rolling stops at clear interections.  They only have to look 1 direction at the 1 way streets.  So they should wait an extra 2 seconds to satisfy the EMTs not from NYC watching you tube.  Fantastic. I love it already.  

Come to NYC and reprimand every EMS, firetruck and police car that does that. You will be repremanding the same people several times an emergency run.  Good luck with it.


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## LonghornMedic (Sep 29, 2010)

*During emergency operations every EMS response vehicle must be operated in such a manner and at such a speed upon approaching an intersection, controlled by a traffic control device so as to permit safe passage through the intersection. Before entering the intersection the operator must reduce the speed of the vehicle to be able to stop the vehicle if necessary to permit such safe passage. They should come to a complete stop if they have a red signal or stop sign.
*

I counted 10 clear violations and couple more borderline ones.

*Each EMS response vehicle operator must recognize that the emergency vehicle has no absolute right of way, it is qualified and cannot be taken forcefully.*

At 4:30 through 4:50, they clearly pushed 3 taxis into traffic at a red light.

I still can't understand how anyone here that works in public safety can justify this kind of driving behavior. This isn't a NYC thing. I don't care where you work, that kind of driving isn't acceptable. According to NY state law it isn't acceptable. According to National Highway Traffic Safety Administration's EVOC curriculum it isn't acceptable. Yes, it is our job to get there quickly. That is why the law gives us the privilege to use lights and sirens and to drive faster than everyone else, *within reason*. But if you wreck, how does that help the patient?


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## JPINFV (Sep 29, 2010)

firecoins said:


> Sure many crews make a rolling stops at clear interections.  They only have to look 1 direction at the 1 way streets.  So they should wait an extra 2 seconds to satisfy the EMTs not from NYC watching you tube.  Fantastic. I love it already.



2 seconds also doesn't affect outcomes. Additionally, if 2 seconds mattered, much more time (and money) could be saved by requiring crews to stay inside the ambulance at all times short of food and restroom. No sleeping. No watching TV at the station. Just sitting in the front cab waiting for the next call.


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## 18G (Sep 29, 2010)

I didn't see anything dramatically wrong with their driving other than they should have taken more time to slow at the intersections especially considering how ppl drive in NYC. Coming to a complete stop is near impossible in NYC... you know how many intersections there are and how close together? They would spend more time stopped than moving.  

I've driven in NYC several times and traffic is crazy. You either drive like the rest or you will congest traffic and have 100 cars honking at you and even more middle fingers waving at ya. I know that may not make sense for those who never experienced NYC traffic flow but its true. You have to be an evasive and aggressive (yet safe) driver to navigate NYC in a car yet alone in an emergency vehicle.


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## Bullets (Sep 29, 2010)

I think its interesting that it says they "should" come to a complete stop. our policy says we "must" come to a complete stop


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## 18G (Sep 29, 2010)

Every State's law regarding intersections may be slightly different... again, you can't compare driving in Smalltownville to driving in NYC.


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## looker (Sep 29, 2010)

18G said:


> Every State's law regarding intersections may be slightly different... again, you can't compare driving in Smalltownville to driving in NYC.



In NYC, if taxi got hit or hit someone while clearing the way for the ambulance through red light whos fault would it been?

If ambulance hit that taxi while going through red light whos fault would that been in NYC?


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## JJR512 (Sep 29, 2010)

I think there are always going to be differences between what's done in the field versus what the policy or law says.

Should you come to a complete stop at all stop signs and red lights? Yes. It it absolutely necessary to come to a complete stop, if you can clearly see far down the cross street, and it's quite obvious that either nobody is coming, or any cars there stopped or otherwise yielding to you? *No,* not in my opinion. But this comes with the caveat that you _will_ be held at fault if you're wrong and something bad happens.

I am reminded of when I used to drive around downtown Baltimore, MD, and the surrounding area, working for a hospital-based critical care transport company. My experience prior to that came from commercial BLS driving, i.e., driving for comfort, not speed. Compared to how I saw 911-experienced drivers driving, I maintained a large clearance between me and the vehicle in front of me, and made all turns and lane changes more slowly and cautiously. But this had some odd side effects. Primarily, because I wasn't riding the *** of the car in front of me, blowing my siren and horn up his tailpipe, the drivers in front of me seemed to assume that despite the lights and sirens, I wasn't in any particular real hurry, so they weren't in a real hurry to get out of my way. I guess they thought I was trying to not excessively exceed the speed limit or something, since I was 3-4 car lengths back and matching their speed.

My point with that last paragraph is to illustrate that in emergency driving, you do need to drive with some aggressiveness. I don't think I had enough. There is a fine line between being aggressive enough to get people to safely yield to you, and being too aggressive that people panic and do stupid things and accidents happen. Was that line crossed in the video, regardless of what the law says? Clearly, some of you think it was, and some of you think it wasn't. Personally, I think you can take a few moments and have some constructive criticism about those moments, but overall, I don't think it was bad.


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## sir.shocksalot (Sep 30, 2010)

I think many posters here haven't been in, or lost a friend in an ambulance accident. As Longhorn said, Code-3 driving is by far the most dangerous thing that we do, and the one where you will be held most liable for. Yes you can blow through an intersection, yes you can oppose traffic, yes you can force other vehicles through a red light, but in every case you can be held liable both criminally and civilly for that. If you force someone into traffic as this crew did, and they get hit, they can sue you for damages, and they will win. This has happened at several companies I have worked for. Also keep in mind that if you cause an accident, you are required to stop and render aid; so if you kill someone's 2 year old who is in the back seat of their car, prepare to face the parent and attempt to resuscitate someone that YOU killed.
People will drive emergent however they want to, just keep in mind the danger you are putting everyone in when you drive recklessly.


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## clibb (Sep 30, 2010)

I'm sorry, but who gives a :censored::censored::censored::censored: if they didn't stop at every red light? Can anyone here actually say that they have stopped at EVERY red light when they were going code 3?
Oh and be honest to that question, take your egos out of the picture.


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## adamjh3 (Sep 30, 2010)

clibb said:


> I'm sorry, but who gives a :censored::censored::censored::censored: if they didn't stop at every red light? Can anyone here actually say that they have stopped at EVERY red light when they were going code 3?
> Oh and be honest to that question, take your egos out of the picture.



Yup, I can. 

But I've only driven code outside of CEVO class once, so, y'know, the results might be a little skewed


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## mcdonl (Sep 30, 2010)

I do not work or drive in NYC so I am not going to pass judgement. They arrived at their destination and no one seemed to be hurt in the process.


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## EMS/LEO505 (Sep 30, 2010)

mcdonl said:


> I do not work or drive in NYC so I am not going to pass judgement. They arrived at their destination and no one seemed to be hurt in the process.



Lol any code 3 response you can walk away from is a good response hahaha


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## Outbac1 (Sep 30, 2010)

I was expecting a lot worse when I watched the video. They should have used more caution at some of the red lights but otherwise not bad. They certainly were not "flying" thru traffic.

 When I give instructions to my driving partner I never say "GO" or "NO". as they can be confused. I always say "Clear" or "Stop". It must work, no hits yet.


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## Veneficus (Sep 30, 2010)

Eliminate all code 3 responses and transports.


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## abckidsmom (Sep 30, 2010)

clibb said:


> I'm sorry, but who gives a :censored::censored::censored::censored: if they didn't stop at every red light? Can anyone here actually say that they have stopped at EVERY red light when they were going code 3?
> Oh and be honest to that question, take your egos out of the picture.



Having worked in urban and rural environments, I can say honestly that it is my goal to stop at every red light and stop sign, clear the intersection, making eye contact with any drivers who had the right of way, and then only proceeding when traffic is stopped.  If I didn't stop, it was a mistake, and if I had a vehicle contact during a situation like that, I would accept responsibility with no excuses.

Because this is a painful and extremely time-consuming way to respond, I tend to not transport lights and sirens ever, and I pine for my days in a system with priority dispatching.


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## DrParasite (Sep 30, 2010)

Veneficus said:


> Eliminate all code 3 responses and transports.


and when your baby is not breathing, and it's taking forever for the emergency responders to arrive, and you ask what took them so long to get there, how will you respond when they say "we got caught in traffic, and you didn't want us to use lights or sirens"?


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## looker (Sep 30, 2010)

Veneficus said:


> Eliminate all code 3 responses and transports.



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?


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## Veneficus (Sep 30, 2010)

DrParasite said:


> and when your baby is not breathing, and it's taking forever for the emergency responders to arrive, and you ask what took them so long to get there, how will you respond when they say "we got caught in traffic, and you didn't want us to use lights or sirens"?



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


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## looker (Sep 30, 2010)

Veneficus said:


> 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?


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## Veneficus (Sep 30, 2010)

looker said:


> 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)


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## Veneficus (Sep 30, 2010)

looker said:


> 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.


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## DrParasite (Sep 30, 2010)

Veneficus said:


> 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.


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## Veneficus (Sep 30, 2010)

*i accept your challenge*



DrParasite said:


> 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.



DrParasite said:


> suction if needed,



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



DrParasite said:


> 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.



DrParasite said:


> 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. 



DrParasite said:


> 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.



DrParasite said:


> 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?


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## DrParasite (Sep 30, 2010)

Veneficus said:


> 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.
> 
> ...


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.....


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## DarkStarr (Oct 1, 2010)

thesecretlist.com

......


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## JJR512 (Oct 1, 2010)

Veneficus said:


> (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!


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## Veneficus (Oct 1, 2010)

DrParasite said:


> 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.




DrParasite said:


> 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."


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## lightsandsirens5 (Oct 1, 2010)

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]


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## Shishkabob (Oct 1, 2010)

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.


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## JPINFV (Oct 1, 2010)

^
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.


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## lightsandsirens5 (Oct 1, 2010)

JPINFV said:


> ^
> 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.
> ...



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.


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## abckidsmom (Oct 1, 2010)

JPINFV said:


> ^
> 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.
> ...



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...


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## JPINFV (Oct 1, 2010)

[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.


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## JPINFV (Oct 1, 2010)

lightsandsirens5 said:


> 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.


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## JPINFV (Oct 1, 2010)

abckidsmom said:


> 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."


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## Shishkabob (Oct 1, 2010)

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!


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## abckidsmom (Oct 1, 2010)

JPINFV said:


> 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.


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## JPINFV (Oct 1, 2010)

Linuss said:


> 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.'


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## Shishkabob (Oct 1, 2010)

A couple of months ago, we were sent for an organ transplant, LS.  I was passenger, and watched for my partner who was driving, but I also had my phone out taping just to show my family how crappy people react to ambulances.  I'd upload the video for you guys to see but there's some cussing.


Anyhow, in a couple of the spots, we're coming up on a stoplight with traffic stopped.  Traffic will BLOW THROUGH the red light, even when we're not in their lane,  when we're still a fair bit away, and when there is already an open lane for us to go through.  We pushed no one through any light.




The public has a TON to learn.




(Only LS response I've recorded... I felt like a whacker doing it)


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## JJR512 (Oct 1, 2010)

Veneficus said:


> Why don't we look at the logic?
> 
> Permanant injury/brain death from hypoxia, 6-8 minutes.
> 
> ...



Your entire argument is flawed. It assumes that there's a patient who is in respiratory arrest prior to someone calling 911. That is not always the case. Someone may merely be in respiratory distress of failure when someone decides to call 911, so at that point, the 6-8 minute timer hasn't started yet. The problem might not even be respiratory arrest/failure at all; the patient could be bleeding. There are arterial bleeds that are severe enough to kill someone in _several_ minutes or more, but not so severe that even driving at Mach 1 isn't going to help.

Your argument is flawed because it assumes that Code 3 driving will _never_ get EMS there in time to save a life, therefore there is _absolutely no benefit_ to driving Code 3. If it were as simple, cut-and-dry, black-and-white as that, I'd agree. But it's not, so I remain unconvinced.


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## Indy (Oct 1, 2010)

JPINFV said:


> So? Hey, cops beat people all the time for no reason besides contempt of cop, does that mean I get to beat people too?



WTF are you talking about? I know several police officers and all have been nothing but respectful towards me and others they  have encountered.

I find it unprofessional for you to be saying that. Police, Fire and EMS are all public safety employees, they all are supposed to work together. I suggest you lose the arrogant attitude towards others.


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## JJR512 (Oct 1, 2010)

Indy said:


> WTF are you talking about? I know several police officers and all have been nothing but respectful towards me and others they  have encountered.
> 
> I find it unprofessional for you to be saying that. Police, Fire and EMS are all public safety employees, they all are supposed to work together. I suggest you lose the arrogant attitude towards others.



I doubt JPINFV meant that literally all cops are always beating up everyone they encounter. I suspect that when he said "all the time" he was employing a bit of hyperbole (that's a link in case you don't know what that word means). So exaggerations aside, it is a fact that from time to time in the past, people were beat up by cops who had no real good reason to beat them up. You can't use the fact that it's never happened in your experience as a basis from which to assume that it never happens at all.


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## Indy (Oct 1, 2010)

JJR512 said:


> I doubt JPINFV meant that literally all cops are always beating up everyone they encounter. I suspect that when he said "all the time" he was employing a bit of hyperbole (that's a link in case you don't know what that word means). So exaggerations aside, it is a fact that from time to time in the past, people were beat up by cops who had no real good reason to beat them up. You can't use the fact that it's never happened in your experience as a basis from which to assume that it never happens at all.



I didn't see the humor or exaggeration in it I guess.


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## JPINFV (Oct 1, 2010)

Indy said:


> WTF are you talking about? I know several police officers and all have been nothing but respectful towards me and others they  have encountered.
> 
> I find it unprofessional for you to be saying that. Police, Fire and EMS are all public safety employees, they all are supposed to work together. I suggest you lose the arrogant attitude towards others.



Wow... just... wow. 

1. Since when did "Group X does ____ all the time" mean "All members of group X does ____." The validity of comments like, "College students smoke marijuana all the time," is not mutually exclusive from facts like, "Not all college students smoke marijuana." 

2. It's a way of describing why, "Hey, everyone else does something really bad" doesn't justify any individual from doing something really bad. 

3. Really? You've never heard of "contempt of cop?" Ask your cop buddies about it and I'm sure that they know at least one police officer who does the entire, "You must respect my au-thor-ity" routine. That doesn't mean all do, but that doesn't mean it occurs regularly. Want a good example of contempt of cop? http://www.youtube.com/watch?v=9GgWrV8TcUc

4. I'm arrogant? Have you looked in a mirror recently?


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## Indy (Oct 1, 2010)

"Have you looked in a mirror recently?" 

LOL wow..childish..

I'm glad I'm not your paramedic, you don't seem to have your head together too well. I'd be dealing with your arrogance the whole shift. Thank God I don't have to work with you.


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## Shishkabob (Oct 1, 2010)

*sigh*


Another medic who thinks he's the boss of the truck...






Plus I'm willing to bet JP knows more about medicine than you.  He sure does know more than me.


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## Indy (Oct 1, 2010)

I'm losing it..

I do apologize for be being so damn rude tonight. Not seeing why medicine was brought into this, but anyways..I have been real stupid tonight..

I'm not a Medic yet, I was just saying I'm glad I'm not his paramedic. 

Sorry for being a jackass to everyone..if you were here I'd offer up a few beers..

JPINFV, my apologies for *me* being the arrogant one here..


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## Veneficus (Oct 2, 2010)

JJR512 said:


> Your entire argument is flawed. It assumes that there's a patient who is in respiratory arrest prior to someone calling 911. That is not always the case. Someone may merely be in respiratory distress of failure when someone decides to call 911, so at that point, the 6-8 minute timer hasn't started yet. The problem might not even be respiratory arrest/failure at all; the patient could be bleeding. There are arterial bleeds that are severe enough to kill someone in _several_ minutes or more, but not so severe that even driving at Mach 1 isn't going to help.
> 
> Your argument is flawed because it assumes that Code 3 driving will _never_ get EMS there in time to save a life, therefore there is _absolutely no benefit_ to driving Code 3. If it were as simple, cut-and-dry, black-and-white as that, I'd agree. But it's not, so I remain unconvinced.



condiser the OPALS study as I suggested on how much ALS does for respiratory distress.


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## Veneficus (Oct 2, 2010)

Linuss said:


> A couple of months ago, we were sent for an organ transplant, LS.  I was passenger, and watched for my partner who was driving, but I also had my phone out taping just to show my family how crappy people react to ambulances.  I'd upload the video for you guys to see but there's some cussing.
> 
> 
> Anyhow, in a couple of the spots, we're coming up on a stoplight with traffic stopped.  Traffic will BLOW THROUGH the red light, even when we're not in their lane,  when we're still a fair bit away, and when there is already an open lane for us to go through.  We pushed no one through any light.
> ...



It is a lot smaller task to have responders take responsibility for driving than it is t educate and skill the entire populace. It will never work. 

The idea that people have to move is not written into law moost places. it is simply the perception of emergency providers that the public "has" to do anything.


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## Aidey (Oct 2, 2010)

It isn't the not moving that gets me, it is the slamming on the brakes RIGHT in front of the ambulance, or pulling into our lane, or pulling a U-TURN in front of the ambulance. Not moving isn't going to cause an accident unless the ambulance driver does something stupid. All of the other stuff can and will cause accidents that the ambulance driver can't avoid. 

I have been in two "vehicle contacts" in my career, and they both happened in the same way. We were driving L&S down a straight road without any traffic signals affecting our travel when a car to our right pulled into our lane. On the first one there was only paint damage. On the second one my partner's quick reaction probably saved the life of the kid who pulled in front of us, and saved me from injury. If my partner had swerved any later, or the kid had pulled out a second later we would have slammed into the driver's side door at 35mph (the speed limit BTW). 

In some areas, L&S are going to be useless. There is not enough traffic or traffic signals to significantly affect response times. In areas with high traffic and multiple traffic signals I believe that L&S can reduce response times. The key is figuring out when it is and isn't appropriate to use them. When they are used is going to be different in the middle of NYC than it is going to be in Wyoming.


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## JJR512 (Oct 2, 2010)

Veneficus said:


> condiser the OPALS study as I suggested on how much ALS does for respiratory distress.



What does it say about someone with an arterial bleed? What does it say about someone who calls because he has chest pains, and enters cardiac arrest a minute or two before you arrive?

The point is that your argument is flawed because it assumes we can never get there in time, which is false. When a founding premise for an argument is false, everything built on it is flawed, to say the least.


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## usalsfyre (Oct 2, 2010)

Bleeding control is taught to Boy Scouts. An ambulance is probably not gonna be the deciding factor here.

In 10 years of EMS I can count on my fingers the the number of times I've encountered a true periarrest pt on initial contact, and even then some of them have gone ahead and died prior to being able to intervene. Witnessed arrest while enroute? 3 total. It's andectotal, but study results would pr
obably be similar. 

Speaking of flawed arguments, what's the ratio of patients saved by the small time reduction of a code 3 response, vs the number if people injured and killed by those same code 3 responses? Food for thought.


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## LonghornMedic (Oct 2, 2010)

lightsandsirens5 said:
			
		

> 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.



Why would it be questionable for a command vehicle to respond quickly to a fire? In any area I've lived in, a battalion chief goes Code 3 on every fire. Are they supposed to respond non-code because an engine company Captain is on scene? Didn't appear that he was responding "THAT quickly" to me. He was in an SUV, not an ambulance, engine or truck. While an engine company has a Captain available to run command, it takes one more person out of the equation to fight fire and perform rescues. A battalion chief is also going to have much more experience to handle the command duties at a major event. I can run an EMS MCI, and have, but I would much rather an EMS command unit be there to do it.


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## LonghornMedic (Oct 2, 2010)

usalsfyre said:


> Bleeding control is taught to Boy Scouts. An ambulance is probably not gonna be the deciding factor here.
> 
> In 10 years of EMS I can count on my fingers the the number of times I've encountered a true periarrest pt on initial contact, and even then some of them have gone ahead and died prior to being able to intervene. Witnessed arrest while enroute? 3 total. It's andectotal, but study results would pr
> obably be similar.
> ...



I think a lot of that depends on where you live. In Tyler, there isn't a whole lot of traffic and the coverage is probably pretty good. Now try a city like Los Angeles, Dallas, NYC, Las Vegas, etc. The solution to abolishing Code 3 would be to build and staff more stations to increase non-code responses. How many taxpayers are going to support more government spending just to get rid of lights and sirens? In my opinion, a heavier emphasis on *quality *Code 3 driving training and skills would go along way. Installing a dashcam on all ambulances would also hold crews accountable. Refresher training, other than watching a video every year or two, that would include EVOC trainers going on rides would help too. Most EMS agencies do little EVOC training after you're first hired and most crews are out of sight, out of mind until they get in a wreck.


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## JJR512 (Oct 2, 2010)

usalsfyre said:


> Bleeding control is taught to Boy Scouts. An ambulance is probably not gonna be the deciding factor here.
> 
> In 10 years of EMS I can count on my fingers the the number of times I've encountered a true periarrest pt on initial contact, and even then some of them have gone ahead and died prior to being able to intervene. Witnessed arrest while enroute? 3 total. It's andectotal, but study results would pr
> obably be similar.
> ...



That'd be great if there's a Boy Scout conveniently around every bleeding person. Is that true where you live?

And you've proven my point. My point was that the argument was flawed because it assumes that a Code 3 response _never_ makes a difference, therefore it is _absolutely_ not necessary. You've just said that in your experience, it apparently _has_ made a difference. That's my point. Since it _can_ make a difference, it is false to say it _never_ makes a difference, and any arguments or statements based on that are therefore flawed.

Regarding your food for thought, I can't chew on nothing.

Ultimately, in my opinion, the problem is not with emergency drivers, it's with civilian drivers (by which I mean everyone driving a regular non-emergency vehicle who gets in the way of an emergency vehicle operating in emergency mode). I don't think it's right that emergency services should have to risk patient outcome—even for a small percent of patients—just because some drivers are too stupid to safely get out the way. And I know there are some bad emergency drivers out there, too. All around, more and better education is the best solution to this problem, in my opinion.


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## usalsfyre (Oct 2, 2010)

Double post


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## usalsfyre (Oct 2, 2010)

The point I'm making about bleeding control is, you should be able to coach direct pressure and torniquet use over the phone.

Stop drinking the kool-aid. "Even if it only saves a few" is not how medicine is practiced, and a bogus argument to most of us. A few patients might have irreversible angioedema and die from ACE inhibitors. Does that mean I withhold this medication if it benefits the vast majority of patients with the condition it treats, and the patient may have a worse outcome without it, because "if only one life is saved".

Do I think code 3 driving should be eliminated completely? I don't know. My gut feeling is no, but it needs to be drasticly reduced, and the rediculous overtriage of EMD taken care of. Educating civilian drivers is tilting at windmills. We can't even stop folks from driving drunk, despite obvious negative consequences to them directly. Do you think they give a crap about the guy down the street having an MI? 

Again, is saving one 60 year old because of code 3 response worth running over a 3 year old going to an overtriaged call?


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## JJR512 (Oct 2, 2010)

usalsfyre said:


> The point I'm making about bleeding control is, you should be able to coach direct pressure and torniquet use over the phone.


If a person has been shot in the back, where do they put the tourniquet? How do they apply it if they're alone? It's also kind of hard to apply much direct pressure to your own back. And most people don't carry a tourniquet around with them on a regular basis (and to address the point you're about to make: not everybody wears a belt or shoes with laces, either).



> Stop drinking the kool-aid. "Even if it only saves a few" is not how medicine is practiced, and a bogus argument to most of us. A few patients might have irreversible angioedema and die from ACE inhibitors. Does that mean I withhold this medication if it benefits the vast majority of patients, and the patient may have a worse outcome, because "if only one life is saved".
> 
> Do I think code 3 driving should be eliminated completely? I don't know. My gut feeling is no, but it needs to be drasticly reduced, and the rediculous overtriage of EMD taken care of. Educating civilian drivers is tilting at windmills. We can't even stop folks from driving drunk, despite obvious negative consequences to them directly. Do you think they give a crap about the guy down the street having an MI?


I only said it was a better solution. I did not discuss its practicality. But if you honestly believe that better driver training and education would _not_ be of any benefit whatsoever, go ahead and say so.



> Again, is saving one 60 year old because of code 3 response worth running over a 3 year old going to an overtriaged call?


Well, if one 3-y/o gets run over on the way to every 60-y/o, then no, it's not worth it. Is that the case?

There's a chance I might run over a 3-y/o next time I go out to buy groceries. There's also a chance my family will starve to death if I never go out to buy groceries ever again because I'm scared to take a chance on running over a 3-y/o. Should I let my family starve to death?

I'm not sure what you mean by "overtriage". If the 911 operator gets more information, they might be able to make a better assessment of whether or not an emergency response is needed, and if that happens, perhaps they can reduce the number of non-essential emergency responses. One county near me was experimenting with that recently (I don't know how it's worked out). I think the problem is _undertriaging_, not over-, but perhaps I don't understand how you're using the word.


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## usalsfyre (Oct 2, 2010)

If I suffer exangunating blood loss from a GSW to back there is nothing an ambulance is going to do to help me. If they insist on boardng me there's a very good chance they'll make it worse by screwing around onscene. In addition there's a good portion of trauma centers where the trauma staff is on 15 minute call at night. None of these folks run emergency lights.

I'm guessing your system runs emergency traffic to every call. This is just about the worst way of doing things. Emergency Medical Dispatch (EMD) ask a set of standardized questions and codes the call emergency or non-emergency based on the response. So you can be dispatched to lower priority calls non L&S. The problem with EMD is that there is a MASSIVE amount of overtriage built-in. So you run emergency to a whole lot of stuff that's not time sensitive.

Very little done in EMS is actually time sensitive, just like we very, very few lives. Most situations could stand another 10 minutes for a safer response. I would bet nationally the number of time critical patients with reduced morbidity/mortality is lower than the morbidity/mortality from code 3 accidents. If you don't care about the public, care about the fact that providers are regularly dieing for non-emergency situations.

I will also go on the record and say that I think public education will do bupkis to reduce the emergency vehicle accident rate. For one, I think the problem is mostly internal, and secondly the public is honestly not gonna care unless it's them.


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## Veneficus (Oct 2, 2010)

LonghornMedic said:


> I think a lot of that depends on where you live. In Tyler, there isn't a whole lot of traffic and the coverage is probably pretty good. Now try a city like Los Angeles, Dallas, NYC, Las Vegas, etc. The solution to abolishing Code 3 would be to build and staff more stations to increase non-code responses. How many taxpayers are going to support more government spending just to get rid of lights and sirens?.



I don't think this is the viable solution. I think that lay person CPR/first aid is the most cost effective method. 

When you look at the results from places with a high out of hospital arrest to discharge rate, community CPR is present in every case.

I have only ever taught one first responder class, to school teachers, and it seemed they were quite happy to be able to do something.

In many European countries you must take a CPR class (at your expense) in order to qualify for a driver's license. Driving is not a right, there can be conditions attached.

Part of the problem is it is not economically even possible to increase the amount of responders to cover every block to try and reach a seriously ill person in a few miinutes. It goes back to EMS will have to get serious about prevention/ early recognition. It has been extremely successful for both police and fire. 

In EMS there is lots of talk about prevention, but overall the programs are rather scarce and many are completely ineffective.


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## Chimpie (Oct 2, 2010)

*Let's keep the replies on topic and friendly please.*


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## Veneficus (Oct 2, 2010)

JJR512 said:


> What does it say about someone with an arterial bleed?



Nothing.

How many arterial bleeds have you seen? How many have you saved? Some arteries can bleed for hours if not days if there is not immediate exanguinating hemorrhage. At the same time, without immediate aid, even smaller arteries (like in the testicles) can bleed a person out in minutes.




JJR512 said:


> What does it say about someone who calls because he has chest pains, and enters cardiac arrest a minute or two before you arrive?



I have seen many who arrested just prior and just post arrival. In cardiac arrest the most common complication is arrhythmia, which is helped sometimes by early defibrillation. However, if it comes to an arrest, survival is decided by whether the infarct is transmural and if the fibrous scar can replace the dead tissue prior to a myocardial wall rupture. That is post emergency care. 

For some time now survival to discharge neurologically intact is the measure of a "save." When it coms to arrests, they are few.



JJR512 said:


> The point is that your argument is flawed because it assumes we can never get there in time, which is false. When a founding premise for an argument is false, everything built on it is flawed, to say the least.



It is not false, even in an MI tissue necrosis is measured in roughly 1/2 hour. The pt requires revascularization, either by medical or surgical intervention. Sometimes there is self resolution but it is rare. 

The fact remains there is no evidence at all other than rare anecdote and prejudiced (if not wishful) thinking that demonstrates anyone arrives on time with any level of consistency to effect a better outcome past the ED.

The risk and consequences globally do not compare to the actual instances the few minutes saved actually help. 

It sounds like you are rather new at this, and I would imagine the "hero complex" will be tempered over time, but I hope you don't have to go to a funeral or watch a coworker's life forever destroyed to save a few minutes that in the long run didn't matter at all.

There is absolutely no glory in being a disabled or dead hero when your loved ones pay the price for it. This is not a fantasy world where the injured hero is exalted and taken care of for life. The living ones are physically broken, depressed, often are financially crushed, lose families, and are largely forgotten by the people they "served" with. 

A flag and a wreath doesn't pay for food on the table. Can't replace a lost parent in a child's life. They don't pay for housing or help with college. They do not council loved ones in time of need. They do not help the initial patient either.

Tell me, what career are you planning on after serving time for felony vehicular homicide if you kill somebody in another vehicle?

I seriously doubt you have a realistic view of what you are part of.

Police, Fire, and EMS departments all over the world have been trying to make response safer for at least 2 decades.

Here is a link, as well as a copy of a post by the person who compiled the list:

http://www.emtcity.com/index.php/topic/17318-2009-ambulance-crash-log/


EMS Personnel Injured: 191

EMS Personnel Killed: 5

Patient Injured: 39

Patient Killed: 9

Passenger in Amb injured 3

Passenger in Amb killed: 2

Other Vehicle Injured: 119

Other Vehicle Killed: 20

Pedestrian Injured: 3

Pedestrian Killed: 4


"No there is not a breakdown. I read every accident posted on the emsnetwork's website (http://www.emsnetwor...e-crashes.shtml) and compiled the numbers myself. I can tell you that the death numbers are probably much higher, as many of the injured people were reported critical at the scene (often flown), but there was no follow-up if they died or recovered later, unless you were interested in searching for all of those stories, and knew everyone's name (occassionally you would see a follow up story if multiple people died from the same accident over a 2-3 day period, but you know that many probably died in ICU two weeks later, and the obituary is all that made it to the newspaper). The overall numbers are also low, because this data only represents the crashes that made the news (as you are aware, many do not). I did not categorize by L&S or by who was at fault; my recollection was that it was about 50/50 for L&S versus not, and about 75/25 the other driver's fault versus the medics (other driver did not yield or was drunk more often). When it was the medic's fault it was usually during a critical transport or enroute to a critical call, that the accidents occured, so you can surmize that they were probably driving emotionally and not defensively."


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## JJR512 (Oct 2, 2010)

usalsfyre said:


> If I suffer exangunating blood loss from a GSW to back there is nothing an ambulance is going to do to help me. If they insist on boardng me there's a very good chance they'll make it worse by screwing around onscene. In addition there's a good portion of trauma centers where the trauma staff is on 15 minute call at night. None of these folks run emergency lights.


The GSW to the back was but one example. I don't yet have the experience to state definitively when getting there faster definitely helped improve patient outcome, but I don't need to, because you do. You've already stated that it's made a difference in a very small number of calls. It doesn't matter how small the number is; any small number is >0, and that was my point. It's wrong to say it _never_ makes a difference and is therefore _absolutely_ unnecessary. So that argument is flawed. Period.



> I'm guessing your system runs emergency traffic to every call. This is just about the worst way of doing things. Emergency Medical Dispatch (EMD) ask a set of standardized questions and codes the call emergency or non-emergency based on the response. So you can be dispatched to lower priority calls non L&S. The problem with EMD is that there is a MASSIVE amount of overtriage built-in. So you run emergency to a whole lot of stuff that's not time sensitive.


I'm still new in my current county, still doing ride-alongs. I don't actually know the policy, but I do recall one incident when a Paramedic Unit and Paramedic Engine were dispatched to, if I recall correctly, an unknown medical problem at a convenience store. The ambulance went out emergency, and the engine went out non-emergency. So no, not everything always goes out emergency.

As I said earlier, a neighboring county was experimenting with dispatching units non-emergency if that was determined to be appropriate by the EMD. I was a member of a station in that county just before they started trying that. I don't know how it's been working out for them. Hopefully it's been working out good. You see, just as you don't believe that completely eliminating code 3 responses is probably the best solution, I don't believe that _always_ responding code 3 is necessarily appropriate, either. But I think we all know we've gotten some pretty bad info from the dispatchers; there's plenty of threads here to prove that. So they need to get better training. If they can tell pretty conclusively that an emergency response isn't needed, fine. But if they're not sure, if there's any doubt, then for now, I'd prefer to sticking with the emergency response.


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## JJR512 (Oct 2, 2010)

Veneficus said:


> It sounds like you are rather new at this, and I would imagine the "hero complex" will be tempered over time, but I hope you don't have to go to a funeral or watch a coworker's life forever destroyed to save a few minutes that in the long run didn't matter at all.



I was skimming over your reply to see how many other people had posted while I was writing my previous reply, and this caught my eye. After this, I decided not to read the rest of what you wrote. You lost me here. You don't know me, but you want to accuse me of having a "hero complex"...fine, I won't bother to read the rest of the crap you wrote. You want my attention? Fine, present an intelligent argument that bears in mind what *Chimpie* just wrote.

All I really have to say to you is what I've said in pretty much every post since I jumped in. You took one specific scenario, said that when those exact circumstances are met an emergency response would never help, so therefore an emergency response is absolutely unnecessary. And that's a crap argument, sorry to say it like that but I've grown tired of repeating the nice way I've been saying it so far so I'm going to change it up a bit this time.

Why don't you ask me what my favorite brand of chocolate is. The answer is Hershey. I guess that means everyone's favorite brand of chocolate is Hershey, at least going by the kind of logic you used to conclude emergency responses are absolutely unnecessary.


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## adamjh3 (Oct 2, 2010)

JJR512 said:


> I was skimming over your reply to see how many other people had posted while I was writing my previous reply, and this caught my eye. After this, I decided not to read the rest of what you wrote. You lost me here. You don't know me, but you want to accuse me of having a "hero complex"...fine, I won't bother to read the rest of the crap you wrote. You want my attention? Fine, present an intelligent argument that bears in mind what *Chimpie* just wrote.
> 
> All I really have to say to you is what I've said in pretty much every post since I jumped in. You took one specific scenario, said that when those exact circumstances are met an emergency response would never help, so therefore an emergency response is absolutely unnecessary. And that's a crap argument, sorry to say it like that but I've grown tired of repeating the nice way I've been saying it so far so I'm going to change it up a bit this time.
> 
> Why don't you ask me what my favorite brand of chocolate is. The answer is Hershey. I guess that means everyone's favorite brand of chocolate is Hershey, at least going by the kind of logic you used to conclude emergency responses are absolutely unnecessary.




You provided specific examples in which you thought the circumstances warranted an emergency response. Vene rebutted to those specific examples. How is your argument style an different than his? 

As far as this topic goes, we shouldn't be dispatching six medics code 3 to a stubbed toe or busted lip which seems to be the norm around here, but rather pushing for quality call-taking and proper priority dispatching by EMDs. 

Certainly eliminating L/S responses all together is unrealistic at this point due to public perception of what we do. Changing that view will take years, if it ever happens. And judging from the attitude of many in the field, it may never happen.

I will admit I'm still very new to this field, and I only work BLS, but running code is one of my least favorite things to do. It's difficult enough to drive the ambulance under normal, non-emergency conditions, the stress of running code 3 much greater than I ever thought it would be.


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## LonghornMedic (Oct 2, 2010)

I was thinking through my career of 8 years. Short by most standards. However, in that time, I have worked in EMS systems that averaged over 120,000 calls for service a year. In that time I have seen only 3 Code 3(fire and EMS) deaths. None of which were EMS personnel. The civilian deaths were all found to be the fault of the civilian drivers who failed to yield. The most critical injury was paraplegia to a FF(who was going to a fire and not a medical call) who was not wearing a seatbelt in direct violation of the law and department policy. The only on duty death was a Medic involved in a head on MVA when a truck lost control and entered the ambulance's lane. They were returning to the station when it happened. 

Even the numbers presented earlier still seem low in comparison to the millions of Code 3 responses each year. In my 8 years, I've had one collision. I was returning to post and it wasn't my fault. I've had some close calls running Code 3, but so far(knock on wood) no collisions. 

Interestingly enough, I find that law enforcement agencies have had many more fatal collisions. I think it has to do with smaller vehicles that are harder for the public to see, that can accelerate quicker and go faster. LEO's appear to not wear seatbelts as often as we do for what they describe as "tactical reasons." 

Getting back to EMS. I think many here have very good points. Having a more involved citizenry is a wonderful dream. But reality is they aren't. How many times have you gotten the notes for a cardiac arrest where bystanders are refusing to do CPR(compressions). And do EMD's overtriage? No. They merely do their jobs like we do. They are going off a set of standardized flipcharts that dictate the response. Should it be revamped? I don't know. I do know that they are definitely not perfect. I've been on plenty of non-Code 3 "BLS" responses that were anything but BLS. Luckily all 911 responses get an ALS response. The system is far from perfect, but what system is perfect? What next? Non-code fire department response to house fires? Because it is "only property." Non-code police response? Because most of the time the suspect is already gone. I could go on and on. But if we focus our efforts on good, quality training throughout a career, I think we could cut down on many preventable collisions.


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## Veneficus (Oct 2, 2010)

LonghornMedic said:


> What next? Non-code fire department response to house fires? Because it is "only property." Non-code police response? Because most of the time the suspect is already gone. I could go on and on. But if we focus our efforts on good, quality training throughout a career, I think we could cut down on many preventable collisions.



Because of the nature of the problem, with both law enforcement and the fire service, the threat to life and property increases with time. A fire exponentiates in size by the minute, which increases the potential loss of life. Law enforcement has figured out the hard way that with an active shooter, or somebody who may potentially become violent, more lives are saved by rapid intervention. 

EMS has quite a different circumstance, it is talked about often. EMS deals with individuals. A person having an MI affects that person, possibly the mental or physical health from stress response of a limited family group. With the increased risk of a L/S response, EMS is what is directly escalating the threat to the public. 

The fault of the person when injury or death occurs is really a nonissue. If a firefighter is paralyzed for life, does it really matter whos fault it is? Will his/her benefits be better? Will it keep the family together? Will He go back to the career he wanted and struggled for? 

I am not suggesting there is no reason for a L/S response. Only there are no medical reasons. If there are no medical reasons, it eliminates only EMS from employing it. If you consider that even in large scale disasters, the medical response is often secondary, and in an epidemic or pandemic, (the largest medical emergency) EMS response is moot. It is logistics that solve these incidents, not transport to definitive care. 

I do not support the idea that Police, Fire, and EMS are expendable employees. That a certain level of "acceptable losses" has to be the norm. 

As just food for thought, we know the amount of accidents compared to total L/S response is less than 1%. Let's just estimate high and say that the L/S response makes a difference in 1% of cases. Now compare that to the injury and death in that less than 1% of responses. That equals dozens of deaths and hundreds of injuries, for an almost unappreciably low number. But rather than take it out to the 10x-5 number or greater, why not just call it "0" and be done with it?

Now does it suck if you or a close family member are that <0.00001% ? Sure it does. But the question goes back to how many providers are we going to deem "acceptable losses" in order to make such a small difference?

Not only myself, but the people who argue against L/S response in EMS or its significant reduction, are looking out for providers. From day one you have been taught that your safety is #1. Unfortunately, you are taught safety starts at the scene. That is not true. If you are going to be killed, chances are it will be responding to or from it, according to the numbers.


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## usalsfyre (Oct 2, 2010)

JJR512, we'll agree to disagree. You seem fairly inteligent, so please do one thing for the next few years. Drive with your head and not your b@lls. There's no reason " a little more aggressive" or "push a little harder" on any code three response. Driving beyond your normal limits is asking for trouble.

LonghornMedic, I've been to plenty of calls dispatched as low priority that turned out not to be as well. Which is exactly why I think every patient needs a competent paramedic assesment. But did any of those pts die because the call was undertriaged? I'll bet the number of times that happens pales in comparison to how often you run priority to calls that do not constitute a life threat. I don't blame the dispatchers themselves, they read scripted questions word for word and code the call based on responses. I blame a seriously gutless system that gets the vapors at the thought of anyone possibly trying to blame them for a death that was likely inevitable due to poor lifestyle choices. 

Also, while my current location is Tyler, I started out south of the Potomac in the DC metro area. Lots if people, traffic, stop lights, ect. I don't recall running emergency making that much of a difference. Could just be my colored memories though, it's been 6 years since I was there.


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## JJR512 (Oct 2, 2010)

adamjh3 said:


> You provided specific examples in which you thought the circumstances warranted an emergency response. Vene rebutted to those specific examples. How is your argument style an different than his?


I'm not sure exactly what you're referring to here by argument style. I thought I stipulated that each of my points could almost surely be rebutted by those of you with more experience than my own limited amount. However, since _one_ person has already said that an emergency response _did_ make a difference in at least one occasion, then no amount of point-for-point rebutting is going to change the fact that it is not true that an emergency response is _never_ helpful and therefore _absolutely_ unnecessary. 



> As far as this topic goes, we shouldn't be dispatching six medics code 3 to a stubbed toe or busted lip which seems to be the norm around here, but rather pushing for quality call-taking and proper priority dispatching by EMDs.


In Maryland (at least in the non-rural areas), it's common for multiple units to be dispatched on calls. Here's one example that should make you happy. I was recently riding as an observer on a Paramedic Engine. The Paramedic Unit and Paramedic Engine were both dispatched to a medical call at a convenience store (if I remember correctly, an "unknown" medical call). The ambulance left Code 3 first. The engine went normal. I don't know if that was SOP, the EMD's discretion, or the engine driver's discretion, though.


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## JJR512 (Oct 2, 2010)

usalsfyre said:


> JJR512, we'll agree to disagree. You seem fairly inteligent, so please do one thing for the next few years. Drive with your head and not your b@lls. There's no reason " a little more aggressive" or "push a little harder" on any code three response. Driving beyond your normal limits is asking for trouble.


I'm not likely to be driving the FD ambulances for at least 1.5 years (due to mandatory time as an aide, then lead provider required first), but I appreciate the advice. It's already well-incorporated. I think it was in this thread in which earlier I mentioned I used to drive for a hospital-based critical care transport service, and I was known as a very unaggressive, cautious driver. I don't think it needs to be any more stressful than regular driving. So I happen to have blinky lights and annoying noises coming from the vehicle, so what? Some people will get out of the way. Some won't. It doesn't need to bother you if you don't let it. It's all in the mind. I know I can drive safely if I focus on driving, and not be silently (or not so silently) cussing out all the dumbasses that don't get out of the way.


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## JJR512 (Oct 2, 2010)

One other thing...

When I was working for commercial ambulance companies, I'd frequently get to various hospitals in Baltimore City. From time to time I would see city ambulances arrive Code 3, but the patient _walks_ out of the ambulance and into the ER with the providers. One day I was with a coworker who used to work for the Baltimore City FD, and asked him about that, and he said that their call volume is such that they need to get rid of patients as quickly as possible, because it's extremely likely that the instant they clear, they're getting another call. So the longer they spend transporting even a Priority 3 patient, that's longer that the next patient, who might be worse, has to wait.

Is this a legitimate excuse to drive Code 3 pretty much all the time? No. But it's a sad fact that the conditions exist that practically necessitate it. Baltimore City, I suspect like many urban areas, has had lots of budget problems lately, and has resorted to rolling station shutdowns and overall downsizing, etc., so it's only getting worse.


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## looker (Oct 2, 2010)

JJR512 said:


> One other thing...
> 
> When I was working for commercial ambulance companies, I'd frequently get to various hospitals in Baltimore City. From time to time I would see city ambulances arrive Code 3, but the patient _walks_ out of the ambulance and into the ER with the providers. One day I was with a coworker who used to work for the Baltimore City FD, and asked him about that, and he said that their call volume is such that they need to get rid of patients as quickly as possible, because it's extremely likely that the instant they clear, they're getting another call. So the longer they spend transporting even a Priority 3 patient, that's longer that the next patient, who might be worse, has to wait.
> 
> Is this a legitimate excuse to drive Code 3 pretty much all the time? No. But it's a sad fact that the conditions exist that practically necessitate it. Baltimore City, I suspect like many urban areas, has had lots of budget problems lately, and has resorted to rolling station shutdowns and overall downsizing, etc., so it's only getting worse.



Why are the not utilizing private ems as back up for code 3 respond to 911 calls? There are plenty of private ems that run both bls and als and can handle such calls.


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## JJR512 (Oct 2, 2010)

looker said:


> Why are the not utilizing private ems as back up for code 3 respond to 911 calls? There are plenty of private ems that run both bls and als and can handle such calls.



If they can't afford to pay their own guys, I suspect they can't afford to pay other companies, either.


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## Sandog (Oct 2, 2010)

Below are links to a few articles that seem relevant to this thread. The articles appear to support the argument against L&S. 

http://www.emsworld.com/publication/article.jsp?pubId=1&id=2027

http://www.emergencydispatch.org/articles/ambulancetransporttime1.htm

Below is a small quote from one of the articles.



> *Conclusion*
> 
> We conclude that in the setting in which this study was conducted, the 43.5-second mean time savings with warning L&S does not warrant use of L&S during ambulance transport, except in extremely rare situational or clinical circumstances.


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## looker (Oct 2, 2010)

JJR512 said:


> If they can't afford to pay their own guys, I suspect they can't afford to pay other companies, either.



That type of system need to be reworked. Backup contractors should pay the city for any 911 call they get. The private company makes money when/if they do transport and bill the patient that they transported.


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## CAOX3 (Oct 2, 2010)

Sandog said:


> Below are links to a few articles that seem relevant to this thread. The articles appear to support the argument against L&S.
> 
> http://www.emsworld.com/publication/article.jsp?pubId=1&id=2027
> 
> ...



"The citywide speed limit is 35 mph unless otherwise posted. The city has population of 46,000"


Ok Im of the belief that not many EMS complaints are time sensitive but a city with 46,000 people doesnt really seem like a fair sample study group. I mean some areas have populations over a million and that can balloon to double that during work hours, it can take thirty minutes to go a mile.

What then?

L/S is a neccesary evil in some areas where a citys overburdened infrastructure dosent allow flow of traffic driving.


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## JJR512 (Oct 2, 2010)

looker said:


> That type of system need to be reworked. Backup contractors should pay the city for any 911 call they get. The private company makes money when/if they do transport and bill the patient that they transported.



That is a good idea to have the private company bill the patient, but not one that I feel would work in practice. In Baltimore, taxes pay for the municipal services. People calling 911 and receiving services through municipal agencies do not get billed for those services. But if you happen to be the patient that needed emergency services during a busy time and the city had to get an outside contractor to fill in, are you going to be happy that you're now being billed for a service that you expected to be free, and pay taxes to make it free?

Especially consider the fact that part of the reason why the municipal services in Baltimore are overwhelmed in the first place is due to many people in the lower socio-economic tears abusing the system because they know it's free. They don't have primary care physicians, don't have health insurance, can't afford a taxi, so they call 911. We all know how this works. Good luck getting money from them. They might have Medical Assistance if they're lucky, and maybe the private company can collect from them, but that's taking money from the government's left hand because its right hand is empty. That's not helping the problem, it's just redirecting it.


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## bstone (Oct 3, 2010)

Back to the original topic, I watched the entire video. They needed to make stops at red lights and ensure the peripendicular traffic was clear, but other than that they did fine. They did a lot of rolling stops, which is pretty much par for the course.


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## 46Young (Oct 3, 2010)

LonghornMedic said:


> They blew through numerous red lights. There was no communication, i.e. "Trafffic" or "Clear right." That taxi cab was a glaring example of that. There were a couple of other scenes where vehicles were braking hard trying to avoid them because they didn't come to a stop at the red light.(You should be coming to a full stop at all red lights and stop signs. At a four way stop, if everyone is stopped and sees you, I'll slowly roll through.)
> 
> They came within a couple feet of pedestrians at high speed on a couple different occasions.
> 
> ...



A couple of things: 

If you wait for everyone to stop at each intersection, you'll be waiting a loooooong time to get through intersections there. Whet we always did was enter the intersection, make like we're going to go through, make it like we're going to run into them. In reality we could stop before we enter their path, but we scare them into stopping. Otherwise, cars will keep on passing through, figuring that they can "make it" before the ambulance goes through. Same thing for pedestrians. With people in the city, it's like they dare you to hit them. "They need to wait for me!" "What are they going to do, hit me?" "I'll sue." Everyone is self important, and disrespect for emergency vehicles much worse than I've seen anywhere else. In NY you need to "persuade" the motorists and pedestrians to do what you need them to do.

Wait at an intersection with your sirens and maybe lights cut off? There's a red light and a congested every other block. This is to control speed in the city. We drive the way we do in NYC as a matter of necessity due to the congestion and unwillingness of motorists and pedestrians to yield the right of way.

Due to that congestion and lack of yielding, it's common to go to whatever opening you have. Pasing on the right is common. Because of all the double parked cars and gridlock, it's necessary to weave your way through whatever way you can.

It's a congested, aggressive city, not the suburbs or out in the sticks.


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## 46Young (Oct 3, 2010)

LonghornMedic said:


> *Force *is the perfect word. If you weren't sitting there, riding up the bumper of the car in front of you, working the siren across all the tones and using the airhorn they wouldn't feel the pressure to get out of your way.
> 
> While you condone this, I can guarantee you that not one emergency driving expert in this country would agree with you. And unless state law says you can do all the things you see on this video or you say happens on a daily basis, I feel sorry for the poor :censored::censored::censored::censored::censored::censored::censored: who causes a wreck and has to sit on the witness stand in court trying to convince a jury "that's how we all have done it for years."



We're covered going through an intersection as long as our lights are on and our sirens are running continuously.


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## firecoins (Oct 3, 2010)

The NYPD, FDNY and EMS units in NYC know how to drive safely for NYC.  It might be more aggressive than other cities, suburban areas or rural areas due to the high congestion.  It has to be in order to make it through Manhattan. 

The video in post one is *NOT* an example of wreckless driving as some have claimed here.  It is safe for the NYC driving environment.  The unit never even approached the posted "speed limit"  at any point in the video.  That speed limit is 35 mph.  They did the standard NYC code 3 response. Yes if everyone jumped off the Brooklyn Bridge, the crew would jump too, after it stopped for lunch first.   

A driver an emergency vehicle responing to a call is responsible for the vehicle. Coming to a full stop and than getting into an accident does not shift responsibility to the other driver.


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## JJR512 (Oct 3, 2010)

Just registering my agreement with Post #s 121 and 123.


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## looker (Oct 3, 2010)

firecoins said:


> The NYPD, FDNY and EMS units in NYC know how to drive safely for NYC.  It might be more aggressive than other cities, suburban areas or rural areas due to the high congestion.  It has to be in order to make it through Manhattan.
> 
> The video in post one is *NOT* an example of wreckless driving as some have claimed here.  It is safe for the NYC driving environment.  The unit never even approached the posted "speed limit"  at any point in the video.  That speed limit is 35 mph.  They did the standard NYC code 3 response. Yes if everyone jumped off the Brooklyn Bridge, the crew would jump too, after it stopped for lunch first.
> 
> A driver an emergency vehicle responing to a call is responsible for the vehicle. Coming to a full stop and than getting into an accident does not shift responsibility to the other driver.


An emergency vehicle is *requesting* right of way. Which means an emergency vehicle *must* make sure an intersection is clear before entering it. If an accident is resulted from an emergency vehicle entering an intersection while stop lights tells it to stop it will be found at fault of the accident.


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## LonghornMedic (Oct 3, 2010)

If you guys insist on taking that kind of risk, go ahead. When I first started out, I drove pretty aggressively to make my times. But then I saw some crews get cited by the cops after some accidents. Then the agency cut them loose. I realized that it just wasn't worth it. If the agency needs to meet its time requirements for responses, then they can hire more medics and put more units in the field. I started doing no more than 10 over the speed limit(state law), came to full and complete stops at all red lights and stop signs(state law) and only passed on the left(state law).


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## LonghornMedic (Oct 3, 2010)

I bet these guys thought the way they drove was okay too.

[YOUTUBE]http://www.youtube.com/watch?v=d53NjaNQYJk[/YOUTUBE]


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## firecoins (Oct 3, 2010)

looker said:


> An emergency vehicle is *requesting* right of way. Which means an emergency vehicle *must* make sure an intersection is clear before entering it. If an accident is resulted from an emergency vehicle entering an intersection while stop lights tells it to stop it will be found at fault of the accident.



If you get into an accident while going lights and sirens, its your fault. That is pretty much it.  Any decent lawyer can blame you in court and win. It is deulusional to believe coming to a full stop itself will let you of the hook.   Unless the other person was drunk, had no license or insurance, its your fault.


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## firecoins (Oct 3, 2010)

LonghornMedic said:


> I bet these guys thought the way they drove was okay too.
> 
> [YOUTUBE]http://www.youtube.com/watch?v=d53NjaNQYJk[/YOUTUBE]



*No! No! No!*.  This current video does not demonstrate *NOT *a Manhattan intersection with one way streets, lots of vehicular and pedestrian traffic. You continue to misunderstand what your being told.  It is not in anyway the same situation.  Your current video is a high speed code three response on a multi lane and multi direction intersection. This does not exist in Manhattan where the St Vincents crews responded.


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## Veneficus (Oct 3, 2010)

LonghornMedic said:


> I bet these guys thought the way they drove was okay too.



I wonder if they saved any time responding to the call or transporting the pt. and if they arrived at destination just in time _to save a life?_ 

I'm guessing "no."


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## 46Young (Oct 3, 2010)

lightsandsirens5 said:


> 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.



I don't know how things work around your way, but here, the first due engine officer takes command. That crew can't go inside until the officer passes command. Command can only be transferred once at the company level. So, then the second due's crew is handcuffed until the BC takes command. Most fires are either food on the stove, an appliance fire, or a false alarm. But, when it's the real deal, every second counts.


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## Veneficus (Oct 3, 2010)

46Young said:


> I don't know how things work around your way, but here, the first due engine officer takes command. That crew can't go inside until the officer passes command. Command can only be transferred once at the company level. So, then the second due's crew is handcuffed until the BC takes command. Most fires are either food on the stove, an appliance fire, or a false alarm. But, when it's the real deal, every second counts.



Intending no offense, but that sounds very messed up.

You lose the use of an entire crew because of one officer? 

I have known several places where Captains were more than able to command a box alarm. Not only that, it is the point of having a Captain on an engine instead of a Lt. 

That just sounds like people trying to protect their positions than an actual functional use.

Oh well, different things different places right?


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## 46Young (Oct 3, 2010)

Veneficus said:


> Intending no offense, but that sounds very messed up.
> 
> You lose the use of an entire crew because of one officer?
> 
> ...



They're saffety sallies. Safe to a fault in many instances. They don't want a crew going in w/o their officer. There's really no difference between a Capt and a Lt from a functional standpoint. The position of OIC is the same. They're equally capable of handling command. Luckily, in the majority of areas, the units are stacked. By the time the officer does a lap and the FF's pull the line, the second due is already there, along with the BC.


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## Shishkabob (Oct 3, 2010)

Because firefighters there don't know not to touch burning stuff without being told so?
h34r:


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## LonghornMedic (Oct 3, 2010)

firecoins said:


> *No! No! No!*.  This current video does not demonstrate *NOT *a Manhattan intersection with one way streets, lots of vehicular and pedestrian traffic. You continue to misunderstand what your being told.  It is not in anyway the same situation.  Your current video is a high speed code three response on a multi lane and multi direction intersection. This does not exist in Manhattan where the St Vincents crews responded.



With all due respect, this ambulance was travelling at the same speed going through that intersection as the crew in the NYC video. It looked remarkably similar to the near miss with the cab. Only that the cab missed them by inches instead of getting clobbered.


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## JJR512 (Oct 3, 2010)

I went to Youtube and read the description for that video. So I know what it says, but I have to wonder if that's really an accurate description, because the way the helicopter's camera is tracking the ambulance so closely looks suspiciously similar to the way they pursue stolen vehicles. On the other hand, whoever was driving _did_ slow down some, which vehicle thieves don't typically bother to do, so maybe it is legit.


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## JPINFV (Oct 3, 2010)

Googling "Toronto EMS 874" (without the quote marks limit in the Google search) doesn't bring up anyhting about a hijacking.


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## EMS/LEO505 (Oct 4, 2010)

LonghornMedic said:


> I bet these guys thought the way they drove was okay too.



*sorry if there was audio I couldnt hear do to broken speakers. But it looks like its a police chase, I mean why else would a helicopter and police be following an ambulance?


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## DrParasite (Oct 4, 2010)

EMS/LEO505 said:


> *sorry if there was audio I couldnt hear do to broken speakers. But it looks like its a police chase, I mean why else would a helicopter and police be following an ambulance?


lots of reasons for a cop to follow an ambulance...

  first being the person in the back could be under arrest, second could be it could be an officer in the back, third could be the officer needs to ask the patient questions about the incident (shooting/stabbing/assault) for a police investigation.

as for the helicopter, could just be a nosey reporter


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## firecoins (Oct 4, 2010)

LonghornMedic said:


> With all due respect, this ambulance was travelling at the same speed going through that intersection as the crew in the NYC video. It looked remarkably similar to the near miss with the cab. Only that the cab missed them by inches instead of getting clobbered.



With all due respect, t was not going through intersection in a similar intersection in any capacity.   I can identify where the St. Vinnie's crew was driving because I have been on that street a million times. NO SUCH INTERSECTION EXISTS IN MANHATTAN    Try Again.  The St Vinnies crew also never reaches that speed.  SImply can't do it on 42nd street going crosstown.


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## LonghornMedic (Oct 4, 2010)

EMS/LEO505 said:


> *sorry if there was audio I couldnt hear do to broken speakers. But it looks like its a police chase, I mean why else would a helicopter and police be following an ambulance?



I have had the police follow me with lights and sirens on numerous occasions to the trauma center. It was usually for a suspect or victim who was stabbed or shot. If you were transporting an injured officer you would have a bunch of them escorting and following and that was a pain the rear. Having a bunch of overzealous cops trying to escort and block traffic made a difficult job driving Code 3 to the trauma center even more difficult.


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## Indy (Oct 4, 2010)

LonghornMedic said:


> I have had the police follow me with lights and sirens on numerous occasions to the trauma center. It was usually for a suspect or victim who was stabbed or shot. If you were transporting an injured officer you would have a bunch of them escorting and following and that was a pain the rear. Having a bunch of overzealous cops trying to escort and block traffic made a difficult job driving Code 3 to the trauma center even more difficult.



Not sure how Texans drive, but here in Indy a police escort would be a beautiful thing to have at times driving through the busier areas of the city.


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## JJR512 (Oct 4, 2010)

*FDNY cuts back on sirens, lights for some calls*



> FDNY cuts back on sirens, lights for some calls
> 
> NEW YORK — Fire Commissioner Salvatore J. Cassano announced the start of a Modified Response pilot program in Queens, where firefighters will stop using lights and sirens when responding to certain non-fire and non-life threatening emergencies.
> 
> ...



Complete article at http://www.firerescue1.com/apparatus/articles/888227-FDNY-cuts-back-on-sirens-lights-for-some-calls/


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## DrParasite (Oct 4, 2010)

while I think it's a good idea, just wait till the brass starts complaining (and disciplining drivers)  about extended response times.


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