Ambulance Speed Limit?

[CWATT]

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]

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]

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]

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]

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]

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]

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]

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

 

[Jim37F]

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]

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

 

[dutemplar]

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]

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]

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]

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]

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]

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]

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.

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]

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]

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]

@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?