# Ambulance Speed Limit?



## CWATT (Jan 24, 2017)

Earlier this year, one of the large Canadian ambulance services declared they are slowing down to 15km/h / 10mph over the limit (max) as a safety precaution.  I thought about it and wondered is the increased time will actually affect patient outcome.  I suspect it won't.  

Anyway, it's the following video that got me thinking about this again.  What are the protocols like on your service?  Thoughts about patient outcome?  Does excessive speed just translate into more risk for patients, the public, and paramedics alike?

Ambulance ride in Brazil:


----------



## StCEMT (Jan 24, 2017)

10 over is my personal and required limit. I have done a little more than that, but that's downhill when I don't have cruise control on and wasn't looking, I don't continue that speed...Usually I just set it on cruise and go when not city street driving. On city streets I usually have to stop at intersections enough we aren't going excessively fast.


----------



## Jim37F (Jan 24, 2017)

When driving Code 2 (non-emergency, no lights or sirens) we are required to follow all normal traffic laws including obeying the posted speed limit. 

Code 3 (lights and sirens) we are authorized up to 10 mph over the posted limit, up to a max of 70 mph, but keep in mind, driving with due regard still trumps all. We're in a heavy urban area so there's really only a few roads where we can get up to and maintain more than that before having to stop and clear intersections and the like.

The freeways are another matter. While I've never actually seen a hard written rule to shut down lights and sirens on the freeway,  that's exactly what we're expected to do. One time we were dispatched to a call while we were on the freeway and I used the lights to pass on the shoulder around otherwise stopped rush hour traffic and dispatch hit us up on the rigs Nextel push-to-talk to ask why we still had our lights on on the freeway...


----------



## StCEMT (Jan 24, 2017)

Jim37F said:


> When driving Code 2 (non-emergency, no lights or sirens) we are required to follow all normal traffic laws including obeying the posted speed limit.
> 
> Code 3 (lights and sirens) we are authorized up to 10 mph over the posted limit, up to a max of 70 mph, but keep in mind, driving with due regard still trumps all. We're in a heavy urban area so there's really only a few roads where we can get up to and maintain more than that before having to stop and clear intersections and the like.
> 
> The freeways are another matter. While I've never actually seen a hard written rule to shut down lights and sirens on the freeway,  that's exactly what we're expected to do. One time we were dispatched to a call while we were on the freeway and I used the lights to pass on the shoulder around otherwise stopped rush hour traffic and dispatch hit us up on the rigs Nextel push-to-talk to ask why we still had our lights on on the freeway...


Why wouldn't you? Or is it because of how heavy LA traffic is? It's rare I have to get on in heavy traffic, so really all lights and sirens do when I get on is "excuse me please" and we stay in the left lane until the last few tenths of a mile.


----------



## Handsome Robb (Jan 24, 2017)

Our written policy is no more than 10mph over the posted speed limit inside cities or high traffic areas and 20mph over in the freeway or highways outside of the cities we serve. School zones we keep our lights on but shut down the siren and follow the posted speed limit. 

I usually shut down on the freeway as the posted speed limit is 70-80mph and our units are governed at 83mph. 

I can count on two fingers where seconds truly matter and one of them can generally be corrected with good pre-arrivals from dispatch (active choking). The other is cardiac arrest and public CPR training can make the difference. 



Sent from my iPhone using Tapatalk


----------



## Jim37F (Jan 24, 2017)

StCEMT said:


> Why wouldn't you? Or is it because of how heavy LA traffic is? It's rare I have to get on in heavy traffic, so really all lights and sirens do when I get on is "excuse me please" and we stay in the left lane until the last few tenths of a mile.


The freeway thing? Yeah I'very heard it's because of our 4 lane+carpool lane freeways (sometimes even bigger!) people would just freak out and get confused if you're running lights and not in the far left lane, plus sirens dont reach out as well to the cars in front of you when you're going 65+, and it's kinda pointless when I'm maxed out at 70 (our AVL system is supposed to send out an email to the manager in charge of drivers training every time you break that limit....discipline mandatory at 80 mph) and everyone else is going faster because they think 65 is the minimum speed limit lol (mixed in with those wonderful drivers who think the actual min of 45 is the max speed....) so yeah, lights and sirens are generally discouraged on the freeway for us. Of course if you're responding to a call on the freeway, or need to get around stopped traffic it's fine, but no specific policy, pretty much just left up to the drivers best judgment.


----------



## StCEMT (Jan 24, 2017)

Jim37F said:


> people would just freak out and get confused


This is new how? 

And why wouldn't you be in the far left lane? Then again, I don't drive on those massive things, so I have no idea what its like. Guess that may very well be easier.


----------



## STXmedic (Jan 24, 2017)

Hell, I usually drive slightly slower than the speed limit when I've got the lights on.


----------



## Jim37F (Jan 24, 2017)

StCEMT said:


> This is new how?
> 
> And why wouldn't you be in the far left lane? Then again, I don't drive on those massive things, so I have no idea what its like. Guess that may very well be easier.


I know right? No ever comes to a dead stop in the lane in front of me, or pulls over to the left when that's where I'm trying to pass, or stops in the intersection of the street I'm trying to turn down or anything like that.....

I said keep to the left because generally speaking we try to keep towards the left lane because people are supposed to (supposed to) pull over to the right,  but with the freeways, unless I'm responding to a call, I generally find myself in the right lanes (at least in the ambulance lol)


----------



## hometownmedic5 (Jan 24, 2017)

Stats show driving faster doesnt improve outcomes, but ambulance involved mva's absolutely do.


----------



## dutemplar (Jan 24, 2017)

StCEMT said:


> This is new how?
> 
> And why wouldn't you be in the far left lane? Then again, I don't drive on those massive things, so I have no idea what its like. Guess that may very well be easier.



Crossing many lanes to take the very next exit or so... or heavy traffic on the left, and taking the right shoulder, etc.    Trying to get around the Baltimore and DC beltways in years past you also had that fun.


----------



## EpiEMS (Jan 24, 2017)

My service, dangerously, has no written policy, even after several high profile accidents. There is also pressure on personnel to respond as rapidly as possible even though our cold response times to the farthest reaches of our area are circa 15 minutes. I have even been directed while riding with the chief of the service to "drive faster" when on a L&S response to a fairly moderate acuity call (which first responder BLS on scene was attending to). I have huge problems with this and I strongly believe that limiting speeds unless truly justified to circa 10 over the posted limit in good conditions maximum (e.g. I was en route to the hospital with a CVA a patient early morning on a weekend, so 75 on a 55 mph posted totally clear highway struck me as not ridiculous, if a bit fast).


----------



## captaindepth (Jan 24, 2017)

Do any of you have a "road safety" system in your ambulances? We had it in Colorado Springs and it would click as your speed increased and make a harsh tone when you went too fast or took corners to hard. In the beginning it was very distracting and I felt myself actually driving less safe in an attempt to not "tone." Once I got used to it, it wasn't so bad (but I sure don't miss it.


----------



## NomadicMedic (Jan 24, 2017)

I think Road Safety and Drive Cam are both good tools to teach better habits, but are morale destroyers if used punitively.

My service also has a "+10mph" rule, but it's rarely followed. Most of the newer EMTs drive like total arseholes. I think they would change their tune if I put them on a board and on the stretcher in the rig and then drove around like they did. Thom **** called it a "ceiling inspection". Every time I work with a new partner it's always "we go cold to the hospital unless I specifically tell you."


----------



## Akulahawk (Jan 25, 2017)

The services I used to work for usually didn't have a set policy regarding L&S speeds. The one major rule we did have was that we must _always_ drive with due regard for the safety of others. I have been well over 100 MPH on a very few handful of occasions where time _was_ a factor and we were very short on that..  but most of the time, I wouldn't have my driver go L&S unless I specifically directed it. One of the services I worked for actively did put new employees on backboards, strapped them on the gurney and then we'd drive around like we were recreating scenes from MJ&S and then we'd do it again the way we were supposed to. We rarely got complaints about the driving while a patient was aboard! 

Oh, and yes, I'm quite good and adept at driving a 9,000 lb, top-heavy ambulance in conditions and at speeds that would otherwise make people cringe. There's a reason why I _don't_ drive like that "little old lady from Pasadena"... Just because I _can_ doesn't mean that I _should_.


----------



## DesertMedic66 (Jan 25, 2017)

School zone with children present is posted speed limit. 

Regular roads is 10 above posted max. 

Freeways posted speed limit. 

All driving is done with due regard.


----------



## EpiEMS (Jan 25, 2017)

DEmedic said:


> I think they would change their tune if I put them on a board and on the stretcher in the rig and then drove around like they did.





Akulahawk said:


> One of the services I worked for actively did put new employees on backboards, strapped them on the gurney and then we'd drive around like we were recreating scenes from MJ&S and then we'd do it again the way we were supposed to.



I absolutely love this idea! I've been thrown around in the back by an....angry, I suppose, ALS partner who really hated "bull" BLS calls...and the first time it happened, I was kind of shell shocked. I think this experience keeps me more on the "slow and steady" side, and I can't imagine a similar albeit safer/intentional experience would teach newer  providers what the patient and provider in the box is feeling.


----------



## Bullets (Jan 25, 2017)

This is a weird question to me....the speed limit for an ambulance is the same as everyone else, ie the legal posted limit


----------



## dutemplar (Jan 25, 2017)

Bullets said:


> This is a weird question to me....the speed limit for an ambulance is the same as everyone else, ie the legal posted limit



That occasionally varies depending on your state.  Technically in PA, fire apparatus and police cars operating emergently are exempt from standard rules other than "due regard."  Police vehicles, given the need to not use lights or sirens sometimes, were further exempt and could be driven emergently without L&S outside of the vehicle code plus were exempt from, for example, cell phone restrictions.  You can go as nuts as you want - until you mess up and then it's your fault.  Ambulances or medic units, not so much.That at least _was_ the state vehicle code when I was there, it may have been updated.


----------



## EpiEMS (Jan 25, 2017)

@dutemplar, this is my understanding as well.

In CT, for example:



> *Sec. 14-283. Rights of emergency vehicles. Obstruction of.* (a) "Emergency vehicle", as used in this section, means any ambulance or emergency medical service organization vehicle responding to an emergency call, any vehicle used by a fire department or by any officer of a fire department while on the way to a fire or while responding to an emergency call but not while returning from a fire or emergency call, or any state or local police vehicle operated by a police officer or inspector of the Department of Motor Vehicles answering an emergency call or in the pursuit of fleeing law violators.
> (b) The operator of any emergency vehicle may (1) park or stand such vehicle, irrespective of the provisions of this chapter, (2) proceed past any red light or stop signal or stop sign, but only after slowing down or stopping to the extent necessary for the safe operation of such vehicle, (3) exceed the posted speed limits or other speed limits imposed by or pursuant to section 14-218a or 14-219 as long as he does not endanger life or property by so doing, and (4) disregard statutes, ordinances or regulations governing direction of movement or turning in specific directions.
> (c) The exemptions herein granted shall apply only when an emergency vehicle is making use of an audible warning signal device, including but not limited to a siren, whistle or bell which meets the requirements of subsection (f) of section 14-80, and visible flashing or revolving lights which meet the requirements of sections 14-96p and 14-96q, and to any state or local police vehicle properly and lawfully making use of an audible warning signal device only.



i.e. if you are an emergency vehicle (police, fire, EMS) en route to a call, you may, among other things, "exceed the posted speed limits" as long as you "*[do] not endanger life or property by doing so*..."

I think one needs a law degree to interpret that one, but, in general, it looks like you can indeed exceed posted limits.

FWIW, NYS seems to have a similar statute, am I right, @NysEms2117?


----------



## NomadicMedic (Jan 25, 2017)

EpiEMS said:


> @dutemplar, this is my understanding as well.
> 
> In CT, for example:
> 
> ...




Due regard. 

A concept that is lost on many.


----------



## NysEms2117 (Jan 25, 2017)

There's a whole endless loop. That's the general concept. I'll do the whole legal thing on lunch 


Sent from my iPhone using Tapatalk


----------



## NysEms2117 (Jan 25, 2017)

Epi was just about head on. NYS statue 1104 a-c, subsection 1-4 on section b states: 
"_(b) The driver of an authorized emergency vehicle may:_


_Stop, stand or park irrespective of the provisions of this title;_

_Proceed past a steady red signal, a flashing red signal or a stop sign, but only after slowing down as may be necessary for safe operations;_

_Exceed the maximum speed limits so long as he does not endanger life or property;_

_Disregard the regulations governing directions of movement or turning in specified directions;"_
HOWEVER, this excludes police vehicles: "_Except for an authorized emergency vehicle operated as a police vehicle, the exemptions herein granted to an authorized emergency vehicle shall apply only when audible signals are sounded from any said vehicle while in motion by bell, horn, siren, electronic device or exhaust whistle as may be reasonably necessary, and when the vehicle is equipped with at least one lighted lamp so that from any direction, under normal atmospheric conditions from a distance of five hundred feet from such vehicle, at least one red light will be displayed and visible."_
These laws are often referred to as V&T laws in most states. ~~~~~~~ this means police can make silent approaches (legally) to a house for a burglary in progress ect. 

@DEmedic I think this quote is what you were trying to hammer home "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" 

There are also legal mandates saying ambulances even L&S *must* stop for school bus', construction zones, as well as police officers discretion (another accident/ telephone pole maintenance ect).
Part 800 in NYS is what an ambulance must carry, and all that fun jazz. As per part 800.21 of NYCRR (codes rules and regulations book for the state), or ALSFR say that they as a company can revise laws (only stricter, not more leniency) such as speed restrictions, and any other zones to slow down.  

Also a thing to remember in most states volunteers have POV lights(stupid imo), however in *most states they are courtesy lights * which are not legally mandated as emergency vehicles.
Sources: NYS DOH  EMS policy 00-13


----------



## phideux (Jan 26, 2017)

On the ambulance we rarely run code to the hospital. We are never far away. Technically our rules say that we can run 10mph over the limit and if our lights are on, so are the sirens, we don't run lights only.


----------



## Giant81 (Jan 27, 2017)

I think it has to come down to common sense and driving with due regard.  If you are in town where speeds can vary anywhere from 15-35mph, 10 over is a sizable % increase in speed.  Not to mention the close proximity of other people, and the significantly higher chance of cross traffic.

If you are on a straight, flat, 2 or 4 lane highway, during the day, with light to no traffic, and a speed limit of 70, 10mph over will probably get you passed.  

Do I think the additional time saved by going faster then that in an urban area with shorter transports can really make a difference? No
Do I think the additional time saved by going faster than that in a rural area with very long transport times on open roads designed for high speeds COULD MAYBE make a difference and maintain safety? Possibly

Both still need to be driven with due regard, and not arriving at all because you rolled in the ditch at 90mph, or you clipped a pedestrian doing 45 down a residential, is the best way to lose more than just your PT or your job.


----------



## CALEMT (Jan 27, 2017)

DesertMedic66 said:


> School zone with children present is posted speed limit.
> 
> Regular roads is whatever the ambulance governs at.
> 
> ...



Fixed it for you.


----------



## DesertMedic66 (Jan 28, 2017)

CALEMT said:


> Fixed it for you.


Until you T-bone a car............


----------



## STXmedic (Jan 28, 2017)

DesertMedic66 said:


> Until you T-bone a car............


Are those shots I hear?...


----------



## exodus (Jan 28, 2017)

DesertMedic66 said:


> Until you T-bone a car............



Wasn't it a rear end collision?


----------



## CALEMT (Jan 28, 2017)

STXmedic said:


> Are those shots I hear?...



More like stab wounds.


----------



## DesertMedic66 (Jan 28, 2017)

exodus said:


> Wasn't it a rear end collision?


That's what his boyfri..... nevermind


----------



## Giant81 (Jan 28, 2017)

The greatest time savings while running hot don't come from the increase in speed.

They come from the ability to request the right of way at intersections.  Parting traffic like the red sea, safely slipping through a red light and moving on instead of sitting in a line of cars picking your nose for 2-3 cycles of the light waiting for your chance to get through.


----------



## NomadicMedic (Jan 28, 2017)

The point is, using lights and sirens dramatically increases the risk of a motor vehicle collision... and in the majority of transports, the minimal time saved isn't clinically significant. 

Bottom line, in most cases it's safer for you, your partner and your patient to sit and pick your nose through a couple of traffic light cycles.


----------



## NysEms2117 (Jan 28, 2017)

I personally feel driving lights and sirens the same way you drive normally is beneficial. Just to make the ride smoother, stop at lights maybe cut a few minutes off( in a safe manner). I will say driving Leo L&S is legit a whole new world


----------



## NomadicMedic (Jan 28, 2017)

Good piece from PW&W

https://www.pwwemslaw.com/news/blog/ems-use-red-lights-and-sirens-dangerous-sacred-cow


----------



## Giant81 (Jan 28, 2017)

DEmedic said:


> Bottom line, in most cases it's safer for you, your partner and your patient to sit and pick your nose through a couple of traffic light cycles.



Oh without a doubt, the vast majority of our transports are non-emergent.


----------



## VentMonkey (Jan 28, 2017)

DEmedic said:


> The point is, using lights and sirens dramatically increases the risk of a motor vehicle collision... and in the majority of transports, the minimal time saved isn't clinically significant.
> 
> Bottom line, in most cases it's safer for you, your partner and your patient to sit and pick your nose through a couple of traffic light cycles.


This. Geezuz this. All of this. I think it's safe to admit an old partner and I tested our theory out way back when I was a tech to see the difference in an area where we knew even in peak LA traffic we wouldn't get an "over".

The timed difference between a code 3 response and not? A whopping 2 minutes. For a low-level BLS-d patient.

And I am so glad we're not expected to go code to the ED where I am now for every friggin' ALS work-up.


----------



## NysEms2117 (Jan 28, 2017)

VentMonkey said:


> This. Geezuz this. All of this. I think it's safe to admit an old partner and I tested our theory out way back when I was a tech to see the difference in an area where we knew even in peak LA traffic we wouldn't get an "over".
> 
> The timed difference between a code 3 response and not? A whopping 2 minutes. For a low-level BLS-d patient.
> 
> And I am so glad we're not expected to go code to the ED where I am now for every friggin' ALS work-up.


do the helicopters have lights and sirens too ?? lol


----------



## STXmedic (Jan 28, 2017)

NysEms2117 said:


> do the helicopters have lights and sirens too ?? lol


I actually had a paramedic student a few months ago ask me why helicopters didn't have lights and sirens...


----------



## NysEms2117 (Jan 28, 2017)

STXmedic said:


> I actually had a paramedic student a few months ago ask me why helicopters didn't have lights and sirens...


please tell me your joking... or please tell me he's not a paramedic now..


----------



## STXmedic (Jan 28, 2017)

NysEms2117 said:


> please tell me your joking... or please tell me he's not a paramedic now..


No and Yes. We do too good of a job teaching them here for him not to be


----------



## DesertMedic66 (Jan 28, 2017)

NysEms2117 said:


> do the helicopters have lights and sirens too ?? lol


Well actually a couple of firefighting helicopters here have sirens on them for clearing away people when filling up their water tanks...


----------



## Aprz (Jan 31, 2017)

We work b/p trucks so I almost never drive. When I was as an EMT, I pretty much just drove with due regard only. I didn't watch my tachometer. If it looked fast, it was probably too fast. Too may close calls? Probably not driving with enough due regard. Our type IIIs didn't go very fast and weren't very good at stopping; I always kept that in mind. I did activate the ABS once nearly rear ending a car. That scared me. I wish people could just use some good judgement.


----------



## cruiseforever (Feb 1, 2017)

DEmedic said:


> I think Road Safety and Drive Cam are both good tools to teach better habits, but are morale destroyers if used punitively.
> 
> I love Road Safety.   When it was first introduced at Allina there was a lot of concern about it being used punitively.  It has not been used that way.  Rating are posted every now and then and I think most people take pride in trying to score high.  The ride in the back sure improved.


----------

