TJZ

This I would love to see! All the driver should know is emergent or non for ideal, across the board safety. I have seen risks far too great taken because of this clouded judgment. I have also met MANY in EMS that really should be in Nascar as their heart is not there to heal it is there to go fast. They do not even need a crashing patient to be foolish and reckless. Some I have compared their ego driven driving to the impairment of being totally drunk. It terrifies me from all aspects. As a person on the road, EMT in the back or the patient. I must admit that after my time served in EMS I really don't have as much faith as I should... knowing many of those that will come if I call 911 has changed me, I have lost much faith. I guess you could equate it to working in a restaurant and not ever wanting to eat there again lol

Sometimes I am not as good with words as I would love to be. I was trying to show that there are instances where 95 is safe. They are very few but having the option is a good thing. There are situations where 2mph is not. The trick is knowing the difference and not letting your emotions get the better of you. Picture a rural WI highway, newly repaved, dry with no cross roads, flat with the tree line a quarter mile back from the road. Here with no cars in sight you can push it with a well kept rig having tires that you and mechanic checked that morning. Once I get into town it is entirely different. I never approach any intersection with my foot on the gas, not even on a green light. I always cover the brake. When there are cross roads this speed is not acceptable. You must be able to stop safely without banging your medic head at all times. I could tell stories of stupid people tricks all week (wanna hear some ) Never count on them to yield, never count on them continuing to yield. Do not think they see you, or hear you. Do not think they care about the red light they have, or the green that is for you. That small child does not have a mother nearby. That college student's friend thinks it is funny to push him in the road as you go by emergently. I used my best numbers to make a point of how big the time saving can be but there were only 2 times I was able to do this. As soon as one thing changes it is no longer a viable option to go that fast. Sometimes it is hard to accept that conditions are rarely like that and I have had to deal with the fact that a few minutes I could not make up safely did cost a life. Even if it is true that he may have made it had we delivered him slightly sooner the focus MUST be on arriving safely NO MATTER the nature of the illness or injury. We are not on the road to take risks. Our patients usually have the quota covered on that. Legally, I see where you are coming from. I may have come off as a risk taker, but I assure you I am so much the opposite. My partners learned not to ever tell me to go faster just advise me of patient condition and I will do what I can. I learned to drive with a ceramic, uncovered coffee cup on the dash, if it splashes you are not doing it right. (thanks Mom) On the opposite of this, I have driven lights and sirens to be able to go slowly (5mph) along the lane lines avoiding the bumps of a very rough piece of road so as not to jolt my patient with a bulging, barely leaking AAA.

The answers are yes, I sped in these situations. Yes, we did do a lot of emergent transport over rural highway. (I had no time to post then and have quit since). One of our most frequent callers that very often had train wreck patients was a small rural hospital 45 miles (approx) from the excellent hospital in Madison (there are 3, but UW wins hands down when life is really on the line) We would have to leave from Madison and return to Madison with the patient. Sometimes they would have no blood for a patient and would have us arriving to transport with 3ltr of saline already in and no control over pressure. Yes, I will do 95mph over a straight smooth rural highway with miles of visibility and no traffic. When people can see you coming they are generally very nice and yield very well, or you at least have a chance to compensate. Roads are dry and the pulse ox is dumping, and my medic in the back is telling me about the blue lips... I will speed. I will not endanger lives and know when less than the speed limit is better. Speed is not always the answer but sometimes it is. Most days my medics could handle whatever was thrown at them and I would not have to be so hasty but when it is needed... We were also the only transport in bad weather, when rural crashes love to happen, MedFlight will not launch and we were it. I did not even attempt to make these times in that weather no matter the condition of the patient and that did cost one life... My driving was praised as a smooth glide by anyone that rode with me The REAL need is assessment and sound judgment, crashing is not acceptable transport in any situation. The factors involved in making times this good were all ideal but it always saved time over rural road. I think the L&S are necessary but overused. If your goal is to drive fast get into Nascar. Looking at a post I missed, I also have incredible trust in our mechanic/maintenance guy. He knew what we needed and always had us it tip top condition with a budget to make it happen. Dead ON!! So many factors!!! All must be in place every transport. No two drives are the same.

Emergent transport can make an 75 minute hospital transfer 45 minutes. It may not save much time in urban areas but over rural countryside it is a life saver.

It will be you unless you are lucky enough to die young and leave a pretty corpse. I took pride in doing all I could for each patient and it never was too much trouble to come and get them off the floor at 3am. If it is too much trouble then you are in the wrong job. Never pass up an opportunity to talk to the elderly, they have seen some stuff!!

I did work for a very busy service that had 4 IFT stations, and did 911 for a smaller town nearby. They also had contracts with most of the SNF for emergent transports as well as appointments. It was a nice mix. 911 was far more boring. When we did IFT many were the most acute cases that the small hospitals could not handle. Those were the most challenging calls since many times the little hospital had no clue what they were trying to deal with. It was not uncommon to be dispatched for (actual call) cellulitis and arrive to find a grey patient in acute resp distress, combative then unresponsive after 1mg loraz... the missing piece? leukemia. He died within the hour after we got to the level 1. They are always looking for warm bodies to fill the uniforms...

I would argue that there is training for the EMT that wants to administer pain meds... medic school or higher I think that paramedic is needed to give out narcs. I had one partner that would not relieve head pain... he said that all it did was mask, we "debated" this often I am in favor of medicating all that show need. We did many home to Hospice inpatient transfers and we made it policy to medicate then move. I have only denied one patient. She was claiming 10 of 10 low back pain but was sitting outside on her concrete stoop, had no issue standing to greet us when we arrived, was talkative and walked to the rig. Oh yeah and was wearing a tank top at 2am in Dec in WI. We were right on that one too She was a known seeker that had been to two of the area hospital just that afternoon and evening. She had the words right to get the meds but the actions were way off lol

I have a fun one We were a Basic crew on a merry day of returns when we were dispatched to a local hospital for a transfer to a local nursing home. Patient is to be status post minor stroke, left side weakness, A+Ox3 We arrive to find patient in her hospital bed not moving or answering us. Family present says that she was talking and alert just minutes before. Nurse rushes in and starts pushing us out the door, she is after all, very busy. We can not get any response from patient and ask nurse if she was in fact A+Ox3. Nurse snaps back "A+Ox4!" I say "she is quite non-responsive..." nurse snaps "she is very sleepy, it is a big day for her" Nurse starts strapping our patient onto cot and is literally shoving us out the door repeating that she is just sleepy. Resp are ok and radial pulse is okay so we decide to go and assess in the rig since this nurse is not being helpful at all. How dare a lowly EMT tell her anything about her patient! We get in the rig with paperwork and a non-responsive patient. We decide that if we can't get a pain response we are calling medical control but that we will get on the road. I drive slowly from the hospital as my partner tries to get a pain response and I get med control on the radio. Within one block we get permission to turn around and go back to the ER with our patient discharged from the 8th floor. Patient was having another huge stroke, she is just lucky she was not staying on the floor, I doubt her nurse ever would have noticed... Just to further compound this patient's day lol she responded well to treatment and we were sent to transfer her to the nursing home again late that night. We got 2 blocks from said home and were sent back to the hospital. Nursing home was not willing to accept her so recently after a stroke. We took her back, different floor this time. She got to go out with us twice and never made it to the nursing home, just 8th floor to ER to 5th floor. oooo and I loved my dispatch card from a rookie dispatcher that had us picking up a patient with "ultra metal status" That old guy ROCKED! ultra metal

I wish I had such good advise as the previous posters but this was an epic fail for me... How to keep communication when I, as the basic, am pretty much behind the wheel many days for 12-16 hours straight. Why could I not call, they worried, the calls were short. When I could call I was probably also in the restroom at a hospital... with a new call dispatched and waiting for me to move out. I hope you have better luck!

I found I used them most for ETAs. Learned the hard fast way not to rely on them in a small town trying to find their hospital. I will stick to the highly informative blue H signs I once followed GPS out of a little rural hospital with a ruptured spleen patient bleeding out trying to get to a hospital that could handle it. It led me to a dead end with 20 feet of grass and 2 curbs between me and the highway! I had to backtrack 3 blocks... never again

Excellent points everyone! EMS is right up there with motherhood. Tough job that cannot be beaten. That said I don't think I have posted here since I was hired lol. I got in with a busy service, earned $9.50hr, worked 72-96 ave hours per week and missed my three kids so bad. So much side story here... but it is over now and I am back home with the kids. They are my world and I am better to be here, I will never be able to go back in time to regain this time but... I DO miss it. It almost destroyed my family, but I miss it. My husband couldn't listen to any stories and if he did my awesome was gross to him... but I miss it. It is a second to my family but I swear to you... not by much Yes it is tough, but I loved it. Funny part is that I was never annoyed by the BS calls. We did many returns and elderly care and I was happy to do it so they did not have to ride with the cranky city Fire/EMS and hear about how they are so old they don't deserve an ambulance...

Never say never. I try not to pass on the right but with all of the stupid human tricks I have encountered in my still short EMS career it does happen. If I can see that you are clearly dumb and have clearly pulled over to the wrong side and are clearly holding still, I will go around you on the right but NOT if you are still moving. Just for fun I will throw out there that my FAVORITE stupid human track when noticing an ambulance in the rear view mirror on the 2 lane highway is to lock up the brakes, not pull over, but just panic and lock them up. Ambulances can stop on a dime you know (sarcasm for anyone that may have missed my tone in text ) . I am a bit bitter on the emergent driving today. Lots of snow last shift and long hauls with new vent patients that wrecked in the snow that I am now expected to drive fast in WITHOUT wrecking. Fun times. I must be old because I really am not that excited to go emergent. The kids sure do like it though don't they.

I am in Wisconsin, the rain is cold and I prefer the now. So anyway, since Wisconsin protocol was brought up. It is not much different from those that others have cited for their states. A big no on the scoop stretcher. Those are for elderly on the floor with broken hips (many times a day, they are very handy for that). So, airway and c-spine first, breathing (oxygen just because it never has killed anyone yet), circulation. Full rapid trauma exam while boarding (long board) and deal with anything found as it comes up. Full immobilization no matter how they were when I arrived. I will board you standing up if that is how you are when I get there after a crash. Hell, I will board you even if the first EMT's didn't when they brought you from the scene and I am taking you from small town ER to my town level 1 trauma. I will not punish anyone for not laying there and waiting for me. Sometime people do not think straight when injured.

I am happy to say that I work for a company that does not allow cell phone use while driving and it is preferred that the EMT not driving do the dispatch communication unless directly involved with patient care. We use one word communication with dispatch while on the road and are expected to pull over for further communications if needed. We are allowed to carry our personal phones on vibrate and call them back when we have down time. There are many that follow this wonderfully and will even ask their partner to switch if a call comes in and we have no patient so that they are not driving and can talk. However, we do have some that disregard They generally end up triggering the drive cam eventually and do get reprimanded lol. Cell phone use while driving is just not acceptable and nothing looks more unprofessional to me that someone driving an ambulance with a phone on their ear...shameful.