Driving the Amb. Help.

[CountryEMT-bGurl]

Please NO debating on this topic!! As that seems to follow me.

Okay, since we all agree that I did not get proper education on driving the ambulance; can I get some advice??

I definitely want to keep myself and my crew safe, as well as my patient and others driving safe. So please I need advice in case I don't get proper advice.

 

[akflightmedic]

There are online CEVO and EVOC programs. Treat yourself to one if you are this concerned.

No you wont get the practical portion but you will have the basic knowledge.

Then, when on duty..practice practice practice.

Ask your employer if they will set up something for you, argue that it is cheap training and it reduces their liability. Cheaper for them no as opposed to later.

In your off duty time, see if any friends have big trucks you can practice with and use your mirrors only...either cover your rear view mirror and black out the rear window or do your best not to use it at all. And then drive around a safe place using only your side mirrors.

Rent a UHaul for a day...drive around town (buy the insurance).

Once you are comfy in non emergency mode, the emergency part is easy IF you use good judgment. There is no need to be driving at excessive speeds or weaving in and out of traffic, on medians or curbs. Drive normal, slightly above posted speed limit when safe to do so, allow traffic time to react...do not get on their rear ends and then get upset when they do not move within a nanosecond.

Start braking long before you need to...what you say? Exactly...when approaching intersections, look at the lights, are they going to change soon, have they been green for as long as you could see them? That means it is going to change soon, so start slowing down by letting off accelerator first, then hover over the brake pedal.

If light is red, again let off accelerator, start coasting, then apply brake. Stop completely at the red light. Look both directions twice, then proceed.

Always remember, this is NOT YOUR EMERGENCY. There is no need to create another one or make one your own.

I will think of more later but this should get ya started and others will chime in...

 

[JPINFV]

Ambulances have a wider turning radius than a car (I'm not sure what you're driving experience is). If you have the option to cut hard or flair out on a turn, flair out.

Any forces that you feel from turning, accelerating, or breaking up front is magnified 100 times in the back.

Nothing is so emergent that you should be flooring the ambulance or running up to an intersection to slam on the breaks. If there's break lights ahead or a stoplight/sign, start slowing earlier than later. Similarly, know where the holes are around you and what the cars 3-4 cars ahead are doing. You're stopping distince is much greater in an ambulance. So if something happens, have a plan to know where you can place that ambulance in a pinch. On a handful of times, I've had to place an ambulance on the hard shoulder when traffic suddently stopped. Of course once on the hard shoulder, you have a longer stopping distance. Use said distance if it's there.

Lights and sirens are a legal demand for the right of way. Physics, on the other hand, don't care who was legally right. Similarly, there's generally a clause in the legalese on the exceptions about "due regard." As such, while you might have the legal right of way and physics doesn't care who has the right of way, a judge will almost always find the driver at fault. Finally, any advantage of driving with L/S is immediately negated in an accident.


When coming to a stop, right before you stop let go of the break for a second and then slowly apply it. This allows you to release the momentum so that you don't rock backwards.

 

[natrab]

Typically your employer should be providing you with an EVOC training (Emegency Vehicle Operations Certification/Course) upon employment. They are usually required to by their insurance company.

If they didn't for some reason, I recommend seeking your own training. There is didactic training from CEVO ( http://www.coachingsystems.com/product.php?productid=16163&cat=249&page=1 ), though it may be difficult to find actual hands on training.

If you're working somewhere, tell them that you would like additional driving training. If you want a fun option, talk to your local police stations/state troopers as they often do some serious EVOC training (I did the Salinas PD driving course once and it was a blast). When I googled Missouri and EVOC I got numerous recommendations to do the Missouri State Highway Patrol EVOC program. I couldn't find anything on their site describing it, but you could give them a call.

Hope that helps!

 

[CountryEMT-bGurl]

I am use to driving a big F-350 truck, and horse trailer. I can't remember how long the horse trailer is, but about a 6 horse slant. (if your familiar with horse trailers)
I can back the horse trailer up with just using my side mirrors in between a 12ft narrow space.

 

[firetender]

Half the battle is learning to maneuver the mass you're in within the space available. I think that's the most intimidating aspect for newbies. You've got that licked, so now, just take your time and drive like you were the attendant in the back working on your Brother.

 

[EMSLaw]

Are you driving a box ambulance or a van?

 

[CountryEMT-bGurl]

Both a Van, and a box ambulance. I drove both on my first day, and the VAN by far was the easiest. But I still didn't feel to uncomfortable driving the box amb. The only thing that got me was entering on the Interstate I couldn't just look behind my shoulder when merging into traffic. And I couldn't see them all the way in my side mirrors. Any advice on that?

 

[JPINFV]

The ambulance (both box and van style) should have blind spot mirrors either blow the main side mirror or attached.

 

[CountryEMT-bGurl]

Ya they were under. But i guess i just wasn't use to using them. I'll have to practice a little more with them!!!

 

[Sasha]

Check and adjust your mirrors BEFORE you're driving down the highway...

 

[JPINFV]

Ya they were under. But i guess i just wasn't use to using them. I'll have to practice a little more with them!!!

Yep. Just incorperate it into your mirror rotation when you look to that side.

Check and adjust your mirrors BEFORE you're driving down the highway...

...but, "Hey, could you roll down your window and push the mirror up a tad bit? A little bit more... a touch more.. grrr, sigh... that wasn't a touch" is so much more fun! (electric mirrors, for the win).

 

[zmedic]

My rules for emergent driving:

1: Expect people to be idiots. Yes they are stopped at a red light and you have a green but expect them to pull out in front of you, expect people to slam on the brakes rather than pull over, expect pedestrians to run across the street even though they clearly hear you. And therefore give yourself time to react.

2. Watch how your more experienced partner driver L & S (though they may have some bad habits)

3. Don't try to take any curbs higher than a coke can. And you should be going super slow (like 5mph) when you take a curb.

4. Change your siren frequency as you are approaching intersections. The change makes people pay attention and also helps them locate you.

5. You should almost never pass anyone on the right. They are supposed to pull over to the right for you. If someone just stops in the left lane I would stop behind them and lay on the siren until they moved. This helps educate them, and also you would be at fault if you tried to pass them on the right and they suddenly tried to pull right as they are supposed to. They could say "I heard a siren and pulled right."

6. Watch out for cops, they do some crazy things to "help" you. I had a call where a state trooper kept running ahead, blocking the intersection, then speeding past me to block the next intersection. Nice of him but we had never been trained on how to do that, what to expect the cop to do (like when he passed me on the right, cut in front of me to block the intersection from my left). It just made me nervous.

7. Educate the family before you leave. Make sure they know where you are going and how to get there. You may have to remind them "I might be going through red lights, please don't follow me. Just drive normally and meet me at the hospital." You may have to stop and remind them if they are on your butt. And worst case get the cops involved. Its not worth ignoring to save 2 minutes and have them wreck on the way or hit you.

8. Don't throw your partner around in the back, they will get you.

9. Limit the amount you are doing while driving lights and sirens. Your partner might be able to handle both radios, change the siren, while listening to the FM station and eating a pizza, but you can't.

10. Watch out for fire trucks. They are often headed to the same scene from a 90 degree angle and weigh a lot more than you do. So you better be the one to stop.

11. Don't yell at people over the PA to get out of the way. We all want to do it but it looks bad.

12. Keep the speed under control. My rig could go 90 mph, but it wasn't a good idea.

13. Know where the heck you are going. Otherwise you are going lights and sirens fast the wrong way and it always looks bad when an emergent ambulance has to flip a 180.

14. Don't assume that your lights are enough to protect you on scene. Someone going 90mph on the highway will see you, but they might not stop, so park downstream of the firetruck if they are on scene. They'll also protect you as you load. (more of a parking tip)

I'm sure I'll think of more later.

 

[zmedic]

Oh yeah, the big one:

15: Going through red lights. You should treat it like a stop sign. Come to a complete stop , visually confirm that each lane has stopped and slowly proceed through the intersection. If you cannot clear the whole intersection, slowly advance to what you have cleared (so if the cars on your left have stopped but the cars from your right are still going pull up in front of the stopped cars and wait for the right to clear. This will prevent those on the left from becoming frustrated and going, and will help the cars on the right see you. Be wary of the last lane (ie third lane away from you if there are 3 on each side). If drivers are stopped in the first two lanes drivers in the third lane may not see you and will just drive through the intersection. Approach with extreme caution when there is a lane at the intersection that does not physically have a car stopped in it.

16. Use your partner. Yes you should look yourself both ways before going through an intersection, but their warning can give you the extra two seconds you need to stop. Have simple words for communication. "Traffic" or "clear," not "oh, yeah, I think I see a pretty big, uh, red truck coming from your 3 o'clock." Better to say "traffic right."

17. Driving head on into traffic. Really this should only be used near the intersection where there are a bunch of cars stopped in front of you at a red light. You duck one lane over to the left, going slowly (like 10 mph), and are prepared to move as far right as possible if someone shows up in front of you. This should only be done with extreme caution.

18. Heavy traffic. Consider just turning the lights off until you get into the intersection/start moving again. If you sit behind people at a red light with the siren and lights on they will panic, and often bust through the red to get out of the way. Maybe this is called for in rare situations (baby not breathing, cpr in progress etc) but the people in front of you don't have lights and those who have the green aren't expecting it. Better to just shut down and wait.

19. Find an empty parking lot (without light poles) and learn what your rig can do. Don't flip it over but you should try to get an idea of how long it takes to stop it at various speeds (10mph, 30mph, 40, I wouldn't go much faster than that).

20. Remember you are driving a big billboard with the company name on it. If you do something stupid, cut someone off etc they tend to remember and you'll hear about it later.

21. Stay left, especially when going L &S. People are supposed to go right, and you have too many blind spots to be jumping left and right. Good habit to get in when driving non emergent. If you get a call while you are just driving around you can light it up and go, bust left around people etc. If you are in the right lane it now you have to move over to really get going (see point #5), and that sucks in traffic.

22. Advanced moves. If traffic is super tight and there is a divider to the left you can put the right two wheels up on the sidewalk and usually get around people on the right. This is dangerous, assumes there are no light poles, mailboxes, pedestrains etc. Also considering rule #5 not my favorite move, but worth keeping in the back of your mind. You can also try to "split the red sea," drive between the two lanes of traffic. If you go slow those on your left will move left, those on your right will go right. There is usually enough room to get through if you are driving a van, though watch out in a box. Again, advanced moves to be used once you've been driving emergent for awhile and at your own risk.

23. Make sure you transmit over the radio that you are going emergent. I used to work in a big county with a lot of departments. Sometimes when on a county call I'd have to drive emergent through this city we covered. I always told that city I was coming through emergent, where I was started and where I was going. So "Longmont Fire, Pridemark 3, we're emergent through your district en route to Lynos, via Hover." That keeps the cops happy, cuz they get upset when people are going L & S for no reason (ie they didn't hear a call come through) and it lets others who are responding to their own calls (like FD) know that there is someone else to watch out for while they are diving code.

24. Warn your partner who is in back before you doing something crazy. "Railroad tracks" when you are coming up to them. "Hard stop!" when someone cuts you off and you are going to have to slam on the breaks. "bump" It gives them that extra second or two to grab onto something, or not stick the IV. Similarly they might want to tell you that they are going to do an IV so you know to be extra careful until they get it.

25. If you ambulance isn't an off road rig, don't take it off road. I know you want to get to the "man hit by train" by driving along the tracks but it sucks when I have to dig it out. Sigh.

Hope that helps.

 

[Tincanfireman]

Nothing is so emergent that you should be flooring the ambulance or running up to an intersection to slam on the breaks. If there's break lights ahead or a stoplight/sign, start slowing earlier than later. Similarly, know where the holes are around you and what the cars 3-4 cars ahead are doing. You're stopping distince is much greater in an ambulance. So if something happens, have a plan to know where you can place that ambulance in a pinch. On a handful of times, I've had to place an ambulance on the hard shoulder when traffic suddently stopped. Of course once on the hard shoulder, you have a longer stopping distance. Use said distance if it's there.

Drive like you're on ice, meaning nice and easy on the starts and stops.

Fast isn't smooth, but smooth is fast.

Don't worry about your speed at first, it will come with experience and confidence.

Drive like a fool all you want, but remember, life's a circle and the one you toss around the back on this call will most likely be driving the next call.

You don't know as much as you think you do, and you're not as good as you think you are. (Nothing personal, just a good philosophy)

Murphy is always riding shotgun...

 

[JPINFV]

5. You should almost never pass anyone on the right. They are supposed to pull over to the right for you. If someone just stops in the left lane I would stop behind them and lay on the siren until they moved. This helps educate them, and also you would be at fault if you tried to pass them on the right and they suddenly tried to pull right as they are supposed to. They could say "I heard a siren and pulled right."

If you have enough time to sit behind a car "educating" them, then you have enough time to transport non-emergently.

10. Watch out for fire trucks. They are often headed to the same scene from a 90 degree angle and weigh a lot more than you do. So you better be the one to stop.

Watch out fire fire trucks since they don't even stop for their own.

[YOUTUBE]http://www.youtube.com/watch?v=G3uoVOOlT2s[/YOUTUBE]

23. Make sure you transmit over the radio that you are going emergent. I used to work in a big county with a lot of departments. Sometimes when on a county call I'd have to drive emergent through this city we covered. I always told that city I was coming through emergent, where I was started and where I was going. So "Longmont Fire, Pridemark 3, we're emergent through your district en route to Lynos, via Hover." That keeps the cops happy, cuz they get upset when people are going L & S for no reason (ie they didn't hear a call come through) and it lets others who are responding to their own calls (like FD) know that there is someone else to watch out for while they are diving code.

I really wouldn't worry about this is you are in anything outside of BFE. BFE might care. However, I'm willing to bet that absolutely none of the cities I've worked in cared, especially when I worked in Southern California. Furthermore, heave help any police officer that would even think about pulling me over if I'm transporting or responding lights and sirens. Official complaints and prime time news coverage would put an end to that stupidity quickly. I guarentee you that the leading story that night would be, "Podunk Town police putting lives at risk by holding up ambulance in route to a medical emergency."

 

[zmedic]

The issue isn't being pulled over as much as them calling your supervisor and saying "ambulance #12 was running code in our town, we think it was just to get home quicker etc." As well as just improving relations with them (if they don't like you, you will pay. They will call EMS in for every nasty drunk etc)

It also covers you a bit in terms of liability, if you are running L & S and didn't tell dispatch or the county or whomever it makes it look like it wasn't an "offical" code return, it was just you trying to get somewhere quicker.

 

[zmedic]

Murphy is always riding shotgun...

"Murphy was an optimist"

and "and optimist believes we live in the best of all possible worlds, and a pessimist fears that this is true."

 

[Tincanfireman]

Watch out fire fire trucks since they don't even stop for their own.

Equal time for EMS, my brother...lol

http://www.youtube.com/watch?v=tENsLVH8UFE

 

[JPINFV]

Tell your dispatch? Sure. Tell local 911/fire/police/towtruck/etc dispatch for the heck of it? Hell no. First, I've never had a radio connecting me to fire or police dispatch. Second, half the time in So. Cal. I'm crossing into 2-3 cities during a transport. If something changes during a transport and I upgrade, how many cities do you want me to notify? Your time is better spent watching the road than finding the right channel on the radio and yacking that you're coming through. If they want to call your supervisor to make sure it's a legit run, then so be it. Try to pull me over just to check if I have a patient on board and the police chief is getting a complaint letter that will be forwarded to the local media, state police oversight, and EMS oversight (county/regional/state as appropriate). Afterall, I don't go pulling over police cars to make sure that they are on legit runs.