On driving lights and sirens

Why exactly does the busy "excuse" suck? If we're not in town and there is a dispatch, we have to call mutual aid. This means a 6 minute response time turns into a 12+ minute response time. It makes more sense to SAFELY drive L&S and end up with better call coverage.

That doesn't make sense, ever! I briefly chuckled, interrupting the sleeping people around the pool. Like, talk about stupidity.
 
There's nothing wrong with turning your emergency lights on and then driving flow of traffic. Way I see it is, if I'm coming up to an intersection that I can't see around with no L+S, come to a complete stop at the stop sign, then the cross traffic is going to go, because that's how driving in urban areas works. Being in an ambulance doesn't stop you from being cut off. I'm now sitting at a stop sign. If I at least have my lights on and maybe twiddle the siren as I pull up, I have a much better chance of the cross traffic letting me go. Not to mention that the lights give me much better visibility around intersections, and maybe other drivers near me will be a little more cautious. Lights don't necessarily mean I'm driving like a maniac, and most of the times I get complimented on my driving I'm leaving the lights on and using the siren occasionally. I don't need to slow down as much at intersections where I don't have a stop sign because cross traffic sees me, stops, and I see them stopped. It's smoother and safer.
 
There's nothing wrong with turning your emergency lights on and then driving flow of traffic. Way I see it is, if I'm coming up to an intersection that I can't see around with no L+S, come to a complete stop at the stop sign, then the cross traffic is going to go, because that's how driving in urban areas works. Being in an ambulance doesn't stop you from being cut off. I'm now sitting at a stop sign. If I at least have my lights on and maybe twiddle the siren as I pull up, I have a much better chance of the cross traffic letting me go. Not to mention that the lights give me much better visibility around intersections, and maybe other drivers near me will be a little more cautious. Lights don't necessarily mean I'm driving like a maniac, and most of the times I get complimented on my driving I'm leaving the lights on and using the siren occasionally. I don't need to slow down as much at intersections where I don't have a stop sign because cross traffic sees me, stops, and I see them stopped. It's smoother and safer.

Are you talking about transporting a patient RLS? I still don't see the benefit except in severe circumstances and even then it's questionable.
 
Remind me to stay far away from Massachusetts. Every patient gets transported RLS? That's absurd.

My two favorite sights when I was living in MA was seeing ambulances push lines of cars into an intersection against a red light and seeing ambulances coming up the 93 (I-93) with lights and sirens while being passed by other cars.

Special recognition: Getting into a discussion with one of the owners of the company about the merits of a BLS unit going L/S (he asked why no L/S after I transported without them) while not going to the closest hospital (patient was in pain status post TURP with frank hematuria, but had been seen several times since the procedure was done. Outside of pain, the patient was stable), opting instead to make the 20 minute trek into Boston.

I'm amazed I got out of MA without losing my sanity, as well as other issues.
 
When i worked in NJ, EVERY ambulance I ever saw was going LS TO the patient, and with the patient in the back. Even ankle pain, they would run emergency traffic to the hospital. Ri-dic-u-lous.

That's a matter of local policy. While I will admit that we respond /to/ most calls with RLS (we don't have EMD here, there is no priority of dispatch, and the dispatch information frequently proves incorrect), we very rarely go that way to the hospital.
 
One of the ONLY reasons I can see transporting L&S is to make for a faster trip to the ED on days with heavy traffic. To make the Opticom work, we have to have lights and siren on. (or at least lights). Route 1, near the beach, in the summertime. That's one instance I'm ok with lights on for a transport... otherwise a 20 minute ride to the hospital could become an hour.
 
Now opticom (and other signal preemption devices) is something that I'd like to see a study on in regards to time saved relative to lights and sirens and no traffic. I have no problem with ambulances transporting with opticom on, but no lights/sirens, especially if they have a non-visible light system (e.g. GPS or infrared). Heck, transport and respond all the time with a traffic pre-emption system for all I care.
 
We transport the vast majority of our patients using L&S...and the reason is simple. Given the distances we have to travel to get to the nearest hospital, driving L&S and speeding (75 mph on a 60 mph 2 lane highway with no cross streets or intersections and with all due care and regard) can save us 15 minutes of transport time before we even get to city limits.

Unless it is a truly critical call, we will shut down our L&S as we approach the city, and proceed with a normal transport through town to the hospital.

If we transported non L&S, our average transport time is any where from 60-75 minutes. Driving code like I described can cut that down to 45-50 minutes.
 
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We transport the vast majority of our patients using L&S...and the reason is simple. Given the distances we have to travel to get to the nearest hospital, driving L&S and speeding (75 mph on a 60 mph 2 lane highway with no cross streets or intersections and with all due care and regard) can save us 15 minutes of transport time before we even get to city limits.

Unless it is a truly critical call, we will shut down our L&S as we approach the city, and proceed with a normal transport through town to the hospital.

If we transported non L&S, our average transport time is any where from 60-75 minutes. Driving code like I described can cut that down to 45-50 minutes.

See now this makes a little more sense to me. You're not having to clear intersections which is the most dangerous part of RLS driving.
 
See now this makes a little more sense to me. You're not having to clear intersections which is the most dangerous part of RLS driving.
That's why we do it that way.
 
The dispatchers have set protocols (A Standard manuel of how to deal with any situation) ...All situations are covered with codes. These codes are used for dispatching the trucks/chopper... depending on the 111(911) call - re the condition, amount of patients and their location.

I've never heard of a dispatcher not letting a truck transport to hospital with L & S...Although the patient needs to be a priority 1(life threating condition) or 2 (unstable condition)for them to allow you to do so.

Here is a link to the Dispatch Service for our region..if you care to have a nosey! :)
http://www.wfa.org.nz/comms.htm

Much appreciated
 
We transport the vast majority of our patients using L&S...and the reason is simple. Given the distances we have to travel to get to the nearest hospital, driving L&S and speeding (75 mph on a 60 mph 2 lane highway with no cross streets or intersections and with all due care and regard) can save us 15 minutes of transport time before we even get to city limits.

Unless it is a truly critical call, we will shut down our L&S as we approach the city, and proceed with a normal transport through town to the hospital.

If we transported non L&S, our average transport time is any where from 60-75 minutes. Driving code like I described can cut that down to 45-50 minutes.

So let me get this straight, even if you guys had something like a simple fractured radius you would spend 45-50 minutes driving L&S to hospital, putting your crew, the patient and other drivers on the road at unnecessary risk to save road time? Even if you are doing the speed limit people still drive crazily and are unpredictable around vehicles going L&S
 
No it doesn't, sorry.

A miniscule amount of calls are actually truly time sensitive.

If your citizens are complaining about response times and you are as busy as you say, they can cough up some more money for better coverage. If you live in the sticks that's your choice but you need to recognize you will not get the same 911 service you would in a large urban area.

You are absolutely right. A minuscule number of calls are time sensitive. I don't know which ones and neither do you. So it's my job to be in service as soon as possible because (despite the fact that you clearly do not believe me) there are times when one minute either way will determine whether we are back in service to take a call in town or mutual aid must be called instead.

The citizens are not complaining. I have a service zone plan filed with the state. I'm the one who monitors response times, mutual aid, and the money. So does my general manager and my medical director.
 
You are absolutely right. A minuscule number of calls are time sensitive. I don't know which ones and neither do you. So it's my job to be in service as soon as possible because (despite the fact that you clearly do not believe me) there are times when one minute either way will determine whether we are back in service to take a call in town or mutual aid must be called instead.

The citizens are not complaining. I have a service zone plan filed with the state. I'm the one who monitors response times, mutual aid, and the money. So does my general manager and my medical director.

I'll agree to disagree. As well as plan to never go near your state. While it is your job to provide EMS and compassionate and effective patient care to your district and mutual aid areas if called, it is not your job to endanger yourself, your partner, your patient, or the public by needlessly running RLS to the hospital. Ever heard of "good of the many over good of the one"?
 
I'll agree to disagree. As well as plan to never go near your state. While it is your job to provide EMS and compassionate and effective patient care to your district and mutual aid areas if called, it is not your job to endanger yourself, your partner, your patient, or the public by needlessly running RLS to the hospital. Ever heard of "good of the many over good of the one"?

I'm ok with some disagreement. I will repeat that it is also our policy to drive the speed limit even with L&S (but I'll grant you that probably not all employees do that)
 
So let me get this straight, even if you guys had something like a simple fractured radius you would spend 45-50 minutes driving L&S to hospital, putting your crew, the patient and other drivers on the road at unnecessary risk to save road time? Even if you are doing the speed limit people still drive crazily and are unpredictable around vehicles going L&S

Yes, we would, but you are making several erroneous assumptions in your post.

You're assuming that there are other drivers on the roads we use (most of the time, those highways only see 50-100 cars per DAY). You're also assuming that we pass those vehicles we see without slowing down and doing it in a safe and controlled manner. Finally, you're assuming that we have the ability to treat the patient's pain which we do not. If we could treat a patient's pain, then we would be less inclined to drive the way we do.

I should clarify that since there is so little traffic on these highways, we do not run the siren the entire time. This would unnecessarily increase patient anxiety, so we only use it when other vehicles are within sight.
 
So let me get this straight, even if you guys had something like a simple fractured radius you would spend 45-50 minutes driving L&S to hospital, putting your crew, the patient and other drivers on the road at unnecessary risk to save road time? Even if you are doing the speed limit people still drive crazily and are unpredictable around vehicles going L&S

We do the same thing. Except I am often 120 minutes are more from the trauma center and cardiac/stroke center. That is why lots of things in my area get a ride on the bird. Normally a crushed hand would get run by ground to the er. Out here, with two plus hours to a trauma center, it gets to fly.

Now I know this isn't a MedEvac discussion, but.....

That being said, there are many times I we run Pri-1 with something that is not "time sensitive" in a normal setting. But slap rural time frames on it, and it is a relative time sensitive condition.
 
It sounds like FFEMT is using L/S more for the legal exemption from the speed limit than anything else, which would increase the safety factor. Of course my opinion is, in part, if you're going to speed, just speed.
 
Remind me to stay far away from Massachusetts. Every patient gets transported RLS? That's absurd.

The busy excuse sucks, I run in a high volume, urban system with no 911 backup agency, we are it as far as transport goes. It isn't common but every now and again we will end up with no transport units available and 911 calls pending. If you used "we had to get back in service faster" as your justification for transporting RLS you'd be out of a job pretty quickly.

I run in a system that sounds similar to Rob's. Difference is we go 32 (our term for emergency jobs holding) every day, usually multiple times a day. 32-5 is not uncommon. You also would be job hunting if you used that excuse here.

Why exactly does the busy "excuse" suck? If we're not in town and there is a dispatch, we have to call mutual aid. This means a 6 minute response time turns into a 12+ minute response time. It makes more sense to SAFELY drive L&S and end up with better call coverage.

12 minutes instead of 6 minutes? Who cares? Use the mutual aid, or put more ambulance crews on. The increased risk to life and limb just doesn't justify it. The first time one of your rigs is involved in an accident and someone is hurt or killed, and they were going red to "get back in service quicker", trust me, you and anyone else who approved of this decision will regret it.

There's nothing wrong with turning your emergency lights on and then driving flow of traffic. Way I see it is, if I'm coming up to an intersection that I can't see around with no L+S, come to a complete stop at the stop sign, then the cross traffic is going to go, because that's how driving in urban areas works. Being in an ambulance doesn't stop you from being cut off. I'm now sitting at a stop sign. If I at least have my lights on and maybe twiddle the siren as I pull up, I have a much better chance of the cross traffic letting me go. Not to mention that the lights give me much better visibility around intersections, and maybe other drivers near me will be a little more cautious. Lights don't necessarily mean I'm driving like a maniac, and most of the times I get complimented on my driving I'm leaving the lights on and using the siren occasionally. I don't need to slow down as much at intersections where I don't have a stop sign because cross traffic sees me, stops, and I see them stopped. It's smoother and safer.

You also have a much better chance of being involved in an accident, just for having your lights on, because people react poorly to them. The only justification for transporting red is a critical patient in the back. Ever.


One of the ONLY reasons I can see transporting L&S is to make for a faster trip to the ED on days with heavy traffic. To make the Opticom work, we have to have lights and siren on. (or at least lights). Route 1, near the beach, in the summertime. That's one instance I'm ok with lights on for a transport... otherwise a 20 minute ride to the hospital could become an hour.

The only reason I can see transporting red is for a critical, time sensitive patient.

We transport the vast majority of our patients using L&S...and the reason is simple. Given the distances we have to travel to get to the nearest hospital, driving L&S and speeding (75 mph on a 60 mph 2 lane highway with no cross streets or intersections and with all due care and regard) can save us 15 minutes of transport time before we even get to city limits.


Unless it is a truly critical call, we will shut down our L&S as we approach the city, and proceed with a normal transport through town to the hospital.

If we transported non L&S, our average transport time is any where from 60-75 minutes. Driving code like I described can cut that down to 45-50 minutes.

I just don't see the justification for transporting red unless your patient is critical. 15 minutes? Who cares? That's not going to make a difference in their care. If you are short ambulances to cover jobs during that time, then you need to put more on.

You are absolutely right. A minuscule number of calls are time sensitive. I don't know which ones and neither do you. So it's my job to be in service as soon as possible because (despite the fact that you clearly do not believe me) there are times when one minute either way will determine whether we are back in service to take a call in town or mutual aid must be called instead.

Your argument makes us nothing more than ambulance drivers. "We don't know what's time sensitive, so we just go red with everything." We absolutely know what's time sensitive, and if we don't, we shouldn't be doing this job. That's why we have training and education.

The citizens are not complaining. I have a service zone plan filed with the state. I'm the one who monitors response times, mutual aid, and the money. So does my general manager and my medical director.

Let me tell you, your citizens will be complaining if one of your rigs hits a family and injures or kills someone. And your driver, and your service, will lose. Big time.

Yes, we would, but you are making several erroneous assumptions in your post.

You're assuming that there are other drivers on the roads we use (most of the time, those highways only see 50-100 cars per DAY). You're also assuming that we pass those vehicles we see without slowing down and doing it in a safe and controlled manner. Finally, you're assuming that we have the ability to treat the patient's pain which we do not. If we could treat a patient's pain, then we would be less inclined to drive the way we do.

Why pass them at all if it's not emergent? And they have pain, so lets go faster. Feel all the bumps. That's got to feel good and make their pain better.

And if you don't have the ability to treat their pain, then get the ability. Either intercept a paramedic that can, get your own paramedics with pain management capabilities, or fly them. Turning your lights on increases the risks to your crews and patient, every time.
 
L&S doesn't mean speeding. L&S doesn't mean unsafe.



What makes L&S unsafe are civilian drivers who are uneducated, and refuse to do the right and legal thing.
 
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