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All right, ladies and gentlemen, the topic of this thread is simple (and I couldn't find another one like it after searching, but if there is one and I made a duplicate please let me know): what patients, if any, benefit from a lights and sirens response/transport? We know that under the best conditions we don't routinely save more than a minute of time driving lights and sirens, and that the risk to both us and the patient increases dramatically with lights and sirens response, so what justification do we have for it? Some literature: http://pdm.medicine....es-baptista.pdf (not a very large sample group, they retrospectively looked at 112 transports and compared them) http://www.emsworld....-time-and-lives (cites a study that showed time saved by lights and sirens, while statistically significant, is not likely to be clinically relevant as well as a study done in Pennsylvania that provided a more stringent protocol for lights and sirens use and compared the outcomes of patients) There WAS a study done that showed that response times, when under 4 minutes, resulted in an increase in good outcomes for critically ill patients (can't seem to find it now), however I think we all know that the likelihood of a universal 4 minute response time is pretty low. Now, there ARE patients who do benefit from not dawdling on scene longer than necessary (AMI, CVA within the window of treatment, trauma or disease that requires surgical intervention, etc), and patients whose conditions are so critical that any delays in medical care can be detrimental (cardiac arrest, acute respiratory failure, etc), but aside from those few who benefit from every second saved between the time of onset and the time they receive medical care, are there any patients who benefit from the extra couple of seconds saved getting them to the ER? And is lights and sirens response appropriate for patients who don't fit inside this narrow range of conditions that might benefit from us arriving a couple seconds sooner? I'd really like to hear from the docs and everyone else who's smarter than me (see, everyone), because maybe I'm forgetting some illnesses/injuries that are time sensitive (to the point that seconds or a couple of minutes makes a significant difference), or don't realize how time sensitive a lot of these injuries/illnesses are? What can be done with a couple extra seconds or even minutes for these patients that can make a significant difference in their condition? Thanks, guys.