Light or No Lights?

[Tigger]

No more so than our fellow first responders

Public expectation of assumed risk has been managed by other agencies as as well. Firefighters now know better than to run into every burning building and the police don't get into high speed chases with every driver who attempts to elude. I haven't heard much of a public outcry over those things. If we stopped justifying silly, outdated policies with "it's what the public wants us to do," we would all be doing ourselves a favor. If we want to be considered part of healthcare this absolutely must happen. Even if the argument remains that EMS should remain just an "emergency service," putting ourselves at risk so we can reassure a misguided public who in all likelihood does not care how we deliver service still makes no sense. Many in government/healthcare/emergency services are guilty of pulling the "it's what the public wants card" without actually checking to see, you know, what the public actually wants.

Stop and clear intersections, don't be swerving, only oppose when absolutely necessary, lights and sirens do not mean you have to speed, and more. Assume every other driver is a complete idiot and there will be a car going through that red light at the same time you are if you don't stop and clear first.

I believe proper drivers training, reinforced regularly, and actually enforcing ECOC rules and punishing ambulance drivers that don't abide by them can and will have a significant impact on reducing the danger. On top of knowing when and when not to use this particular tool.

And if you still wish you didn't have to run L&S, maybe it's time to transfer to an IFT only company or health care facility

Or you could just go work for a more progressive agency that, for lack of a better phrase, gets it.

 

[JPINFV]

So because the public expects us to put ourselves into danger, we should?

Sure... however only when the potential benefit outweighs the risks.

 

[JPINFV]

And if you still wish you didn't have to run L&S, maybe it's time to transfer to an IFT only company or health care facility

I wish I didn't have to do rectal exams... I'm still in medicine.

 

[Tigger]

Sure... however only when the potential benefit outweighs the risks.

Which is where the debate comes in...

 

[JPINFV]

Which is where the debate comes in...

Well, yes. However there's a difference between "We take no risks... period" and "we take risks when appropriate." I think the public expects the latter, not the former.

 

[Bullets]

No more so than our fellow first responders

Do your cops run L&S to every call?

Then why should we?

 

[Wheel]

No more so than our fellow first responders

Where I'm from fire and LE don't run emergent to everything. I've beat LE to domestic situations only to stage and wait on them to get there non emergent because we had a policy to run hot to everything. If other agencies can justify not running emergent we should too, because it is a safety issue.

 

[Rialaigh]

So because the public expects us to put ourselves into danger, we should?

Quite frankly, yes. If running hot was so much of a danger issue for EMS than agencies that run hot would have to pay their medics and EMT's more than agencies that don't, The best I can tell agencies that never run hot (IFT) have to pay their EMS more than most 911 agencies despite the fact that the job carries much much less risk. Clearly amount of risk is not an issue for the majority of EMS employees (judging by salaries of EMS systems that carry the highest risk).

Firefighters running into every building and Police chasing every car is apples and oranges.

I am fairly sure firefighters run into basically every building with a person in it that is even remotely viable and many that are not. Police (I would venture) would also run code and chase a car if there was a kidnapped person in it. Thus we run code to every call that is even remotely deemed to be life threatening regardless of the statistics.



EMS is a business, and we will ALWAYS (generally) do what benefits patient perception over what benefits patient outcome.

 

[JPINFV]

Quite frankly, yes. If running hot was so much of a danger issue for EMS than agencies that run hot would have to pay their medics and EMT's more than agencies that don't, The best I can tell agencies that never run hot (IFT) have to pay their EMS more than most 911 agencies despite the fact that the job carries much much less risk. Clearly amount of risk is not an issue for the majority of EMS employees (judging by salaries of EMS systems that carry the highest risk).

The agencies that run lights and sirens often have less demand for EMTs and more supply of applicants than those that don't. Supply v demand is more important than level of risk.

EMS is a business, and we will ALWAYS (generally) do what benefits patient perception over what benefits patient outcome.[/QUOTE]

 

[Mariemt]

The state of Iowa now has us filling out lights and sirens forms every time we use them.

The state believes running hot is a danger to other drivers, not just us.

We fill it out with name, dispatch complaint. Our impression of patient and why they were used. Plus a copy of the run report. When the state comes in and decides to look around, we better have it.

You see it isn't just about us driving safe. Iam considered our best driver. A hot response with traffic is my specialty. I was driving before I was certified. I have SEEN people panic when we got behind them at lights. No worries, I can get around. But they panic and pull out in the intersection, into traffic at a red light.
I have seen people try to give me the right away by pulling into left oncoming traffic.
I have seen one person slam on her brakes and just sit there. . I was half worried she died of fear

It isn't just about us driving safe. Citizens do the craziest things

 

[Rialaigh]

The agencies that run lights and sirens often have less demand for EMTs and more supply of applicants than those that don't. Supply v demand is more important than level of risk.

Point being that the supply of applicants is higher, meaning somewhere in there risking some amount of the reward of working emergencies is completely acceptable to the majority of EMS personnel, if it was acceptable they wouldn't apply for these jobs, they would take the higher paying lower risk jobs.

 

[DesertMedic66]

I guess we have it a little bit wrong in my area. 911 ambulance company has higher pay than the IFTs in my area.

 

[Rialaigh]

I guess we have it a little bit wrong in my area. 911 ambulance company has higher pay than the IFTs in my area.

I think this is the exception rather than the norm, but idk, I know in my area they must pay people much better for IFT than 911 generally

 

[Bullets]

I guess we have it a little bit wrong in my area. 911 ambulance company has higher pay than the IFTs in my area.

Pretty much how it is here, i dont know of any 911 agencies that pays less then the IFTs. Most municipals pay their EMTs $15-$21. The hyvrid agencies run by volunteers are a little less, around $14. IFTs come in around $12.

Exception is CCT, obviously

 

[rob the mexican medic]

I would like to get an idea how EMS runs in different areas and your opinions on Lights/Sirens. What does your department consider as an emergency run vs non-emergency or lights vs no lights?

A little background on this is I work with three different organizations that run three different ways.

A| Volunteer Department - We classify and emergency run as something with significant risk of lift, limb or eminent childbirth. Just because someone dials 9-1-1 does not mean that they will get a response with Lights/Sirens. Lights/Sirens is based on report and whether or not significant risk exists. In fact more than often, lights/sirens do not get used. If BLS, no lights/sirens ever in transport, if ALS up to ALS decision. Additionally some calls never get a light/siren response ie anything with stand-by/staging, mental health or lift assist.

B|Paid EMS Only - We classify an emergency run basically as anything that comes via 911 or direct line with chance of transport. All responses are lights/sirens and all transports are the same. This includes even the most minor of BLS calls and mental health calls.

C| Paid EMS and IFT - All 911 responses get Lights/Sirens. If the call is evaluated to be BLS only on arrival, transport is nonemergent with no lights/sirens. If ALS is on board, lights/sirens are used. No leway on either.


I personally like the volunteer way best. It is the safest option for me and my partner. Also, lights/sirens have shown to only shave off minimal time from response and transport. It distracts other drivers and makes the transport worse for everyone. Many calls we take do not really need and ER let alone an ambulance. I also want to add, that people seem to forget that when utilizing lights/sirens you should still drive with due regard. You should not be going anyway faster or braking any less because you have lights and sirens. They simply help to clear traffic and intersections.

code 1 no lights and sirens - even if it came in 911

code 2 and code 3 lights and sirens

 

[chaz90]

code 1 no lights and sirens - even if it came in 911

code 2 and code 3 lights and sirens

If you're already running hot, what does going from Code 2 to Code 3 do? Make you drive with the lights on brighter or with louder siren volume? In all seriousness, that is great that you respond to some 911 calls Code 1.

 

[JPINFV]

If you're already running hot, what does going from Code 2 to Code 3 do? Make you drive with the lights on brighter or with louder siren volume? In all seriousness, that is great that you respond to some 911 calls Code 1.

 

[chaz90]

I almost said something about turning it up to 11, but I realized that would be silly of me. That would obviously be called Code 11, and they haven't even progressed through Codes 4-10 yet!

 

[Achilles]

Alright since it hasn't been asked, I need to know.
If an EMT uses his siren and no one is around to hear it, does it make a noise?

 

[NomadicMedic]

Alright since it hasn't been asked, I need to know.
If an EMT uses his siren and no one is around to hear it, does it make a noise?

Of course, because the EMT heard it and made a YouTube "cool. I'm responding code 3" video.