Lights and sirens

[tskstorm]

That is why YOU ASK if lights and siren are needed.

If you, the dispatcher, are unsure the nature of the call, like it IS a cat scratch, the the caller will tell you "No".

How many vehicle collisions have occured responding to BS calls?

I am not a dispatcher, I will not ask anyone anything, further more, Civilian call takers take the call and ask questions by a book of series of questions.

Here in NYC we are dispatched to a call with a priority 1-6, and unless it is for a stand by, a potty break, or an EDP we use lights and sirens. It isn't up to the crew to determine if it was dispatched properly and all calls should be responded to appropriately,

How many collisions have occurred because ambulance crews were driving to get food... how can you determine a call is "BS" before you arrive at the scene ?

Please remember when people call 9-1-1 for them it is an emergency whether it is for a hang nail or an amputation its an emergency for them, naturally if they feel its an emergency enough to call 9-1-1 they want/expect lights and sirens, If we asked every caller if they needed lights and siren response who would say no?.... and If they said no would we inform them since they are a low priority in the middle of a weekday during the spring or summer the wait time for an ambulance can exceed 3 hours? There was a 3 hour hold for an injured Police Officer last week but it was only for a hand laceration. If it takes us 3 hours to get to an injured officer, how long would it take us to get to your regular methadone patients, or your regular alcoholics?

[robert gift]

I am not a dispatcher, I will not ask anyone anything, further more, Civilian call takers take the call and ask questions by a book of series of questions.

Here in NYC we are dispatched to a call with a priority 1-6, and unless it is for a stand by, a potty break, or an EDP we use lights and sirens. It isn't up to the crew to determine if it was dispatched properly and all calls should be responded to appropriately,

How many collisions have occurred because ambulance crews were driving to get food... how can you determine a call is "BS" before you arrive at the scene ?

Please remember when people call 9-1-1 for them it is an emergency whether it is for a hang nail or an amputation its an emergency for them, naturally if they feel its an emergency enough to call 9-1-1 they want/expect lights and sirens, If we asked every caller if they needed lights and siren response who would say no?.... and If they said no would we inform them since they are a low priority in the middle of a weekday during the spring or summer the wait time for an ambulance can exceed 3 hours? There was a 3 hour hold for an injured Police Officer last week but it was only for a hand laceration. If it takes us 3 hours to get to an injured officer, how long would it take us to get to your regular methadone patients, or your regular alcoholics?

Correct, crews do not determine response urgency.

Having dispatched myself, YOU ASK...

Not everyone calling 9-1-1 is expecting lights and siren.

If it is a hang-nail, you ask and discern if it is a true emergency.

The mentality that every incident is a life-threatening emergency is what makes people so tired of responding EVs and perhaps makes some reluctant to yield to EVs.

There is a world of difference in a traffic mishap involving an ambulance driving routine compared to

a responding ambulance disrupting traffic, taking right-of-way from others, causing others to unexpectedly stop and get rear-ended, etc.

Why did that police officer not drive himself, or have another officer drive him, to a local ED?

Is it all the BS calls that are causing such delays?

[WelshMedic]

Correct, crews do not determine response urgency.

Having dispatched myself, YOU ASK...

Not everyone calling 9-1-1 is expecting lights and siren.

If it is a hang-nail, you ask and discern if it is a true emergency.

The mentality that every incident is a life-threatening emergency is what makes people so tired of responding EVs and perhaps makes some reluctant to yield to EVs.

There is a world of difference in a traffic mishap involving an ambulance driving routine compared to

a responding ambulance disrupting traffic, taking right-of-way from others, causing others to unexpectedly stop and get rear-ended, etc.

Why did that police officer not drive himself, or have another officer drive him, to a local ED?

Is it all the BS calls that are causing such delays?

So true, and also: most studies point to the fact that the time difference is so slight that it has no effect on mortality and morbidity. Thus making it another EMS myth that needs addressing in order to gain respect from the rest of the medical community.

WM

[2wheelinemt]

Dispatchers have a difficult job in my humble opinion, they don't know what the patients are trying to fully say over the phone.

Some people have a very hard time trying to tell people what is wrong.then add a phone between them and it's even more difficult

Some people don't call it's a third party caller and then it's whole different ball game. In todays world of every one suiting everyone

else the question comes up about running hot a lot.

I this world of having everything right now, the dispatchers have to transfer the information they get from a couple of seconds to a

couple of minutes to the EMT's and then together they need to decide if they should run hot or not. So going to a call here we run

hot responding to a call every time. Then after we evaluate a patient and spend time with that patient and will continue to spend time

with that patient while transporting them we decide not to run hot, no lights or sirens but since you are continuing to be with that

patient and reevaluate then at any given time if they need to they can go lights and sirens at while en route. So no need

to run hot on every call when with what EMT's are taught to always know whats going on with your patient! Knowing that then we don't

need to run lights and siren and even air horns to every call.

[oz_paramedic_chick]

"We are required to respond to any call with lights and sirens ..."

Wow scoobymedic I have never heard of that. Here in QLD we have 3 response codes: 1(time critical), 2(acute non time critical), 3 (non urgent). In my experience I have ever only done one code 3 and it was transferring a discharged pt from hospital to his home. Code 1 is a lights and sirens response where at the least the lights are to be activated (many just use sirens in traffic). Code 1 accounts for things such as chest pain, syncope, RTC/MVA, difficulty breathing, major haemorrhage, ALOC, seizures, etc. Code 2 accounts for things such as post syncope, abdo pain, minor haemorrhage, fractures, inter hospital transfers, etc.

In regards to transferring to hospital we have the choice whether to go code 1 or 2 and it is quite rare for us to go code 1. In regards to interhospital transfers we get dispatched either code 1 or 2 and that is what we transfer as. On rare occasions we go code 1 and if we are code 1 we generally have a Dr and RN on board.

It's quite interesting to see how the different EMS systems around the world work.

[Just Plain Ruff]

Robert, your fixation on english fake calls is bordering on schizophrenia - give it a rest why don't ya!

I rarely use lights and sirens to any call but then again I work nights and our traffic at night is pretty much non-existent so there's not a real need to use them.

But like someone says - it's not our emergency and if the call fits the criteria of Emergency then run hot. if not then don't.

As a emergency driver it is your absolute responsibility to be safe on all calls BS or not.

[robert gift]

Robert, your fixation on english fake calls is bordering on schizophrenia - give it a rest why don't ya!

We are not schizophrenic.

Who said that?

"(many just use sirens in traffic)"

Why would anyone do that?

Using siren will cause drivers to seek the source and they would know it is not you since your lights are not on.

I would use lights and NOT the obnoxious siren.

Edited April 10, 2009 by robert gift

[croaker260]

FACT: Research shows that the average time savings is approx 30 seconds per call in an urban/suburban enviroment. I am not aware of this being studied in a rural enviroment, but believe the benifit would be less than a minute. I would veneture that in 99% of EMS systems the calls that would benifit from that 30 seconds are less than 2%. Not 10%, not 30%, 2%. Even calls that are ALS and "emergent". Even STEMI's.

FACT: MOST EMS RESPONDERS WHO DIE ON DUTY, IN THE LINE OF DUTY, (Excluding those heart condition deaths with in 24 hours of a call) DO SO IN THE RESPONSE OR TRANSPORT PHASE...not on scene. Air Medical, or ground, appropriate use of transport mode and safe driving (or piloting) practices is essential to our (and our patients) survival. As essential as our clinical skills. Note, I didnt say FAST NASCAR STYLE driving skills, I said SAFE DRIVING PRACTICES.

EDUCATED OPINION: If Time is indeed a factor, we can save more time with good scene mamagement skills than we will EVER save driving fast.

EDUCATED OPINION: Most people who are going to "die" (Defined as going into arrest, not stay dead) with in that specific 30 second window of our arrival time that we will allegedly save, are going to "die" anyway, despite our best efforts. Therefore arrving in one peice and being able to work a rescusitation is more clinically important than arriving 30 seconds earlier.

ANECTDOTAL EXPERIANCE: Using traffic pre-emption (i.e. the opticom or other devices) devices both emergently and non emergently, saves more time, provides for SIGNIFICANTLY safer response and transport, and less cardiac stress on the patient than running Lights and Sirens. I work in a system with Opticoms, and I can say we run more calls, and have fewer accidents per call or per mile than the agency I ran with that didnt have opticoms and ran L & S to most everything.

Now, we use an EMD system to determine mode of response. The key to our EMD systems accuracy (and it still makes mistakes) is we use an certified QA process to ensure complaince with the protocols. STrangely, even when there are mistakes (over or under response) these mistakes do not result in bad outcomes.

Now in the field, the medics have the option to either upgrade or downgrade for any reason, but they have to justify it.

Some Common Examples:

Fall Patient that is normally a cold response. But its 110 outside and the patient is on the sidewalk. In our area this can lead to asphalt burns. Call is upgraded by the medic depending on distance. The same is true for a ptaient who falls outside in winter.

Battery victim/shooting/etc where we stage for PD. Typically it makes no sense to run L & S for 3 minutes to stage for 5. Depending on distance, we will run cold to the staging point. If PD secures the scene prior to our arriving at the staging area (rare), then we upgrade. Typically only a small delay (read non clinically significant) in total response time.

Weather: Snow, Ice, poor visibility, we encourage downgrading for safety. And this is in IDAHO where we deal with snow, Ice and fog all the time. Simply put we recognize the risk and while we mitigate it (snow tires, winter driving training, etc), we take a thought out approach to it and try to mitigate it too by downgrading. .

[joesph]

We will often use light and siren in route to the call but usually downgrade enroute or on transport to the hospital. Our purpose is not to drive fast with our heads hanging out the window going woo woo it is to be seen and heard for safety. Once we reach the wreck, sick call or what have you lights are used to mark the scene and be visible in fowl weather or on roads. This is for safety as well as helping other units locate us. From a legal stand point it is inadvisable to run code with a BLS patient if they start circling the drain you can upgrade. Also their is no code 2 and 1/2 its lights and sirens. That being said I must admit we turn our siren off allot who's gonna hear us a deer? Another thing I have found is you roll up on someone and hit the siren you get instant brakes, is that what you really wanted. If your gonna light some one up do it before your tailgating. I must add that we have a very minimal traffic problem and people in areas that do would probably have a different point of view.

[Just Plain Ruff]

We are not schizophrenic.

Who said that?

"(many just use sirens in traffic)"

Why would anyone do that?

Using siren will cause drivers to seek the source and they would know it is not you since your lights are not on.

I would use lights and NOT the obnoxious siren.

Never said you were schizo just the fixation on the fake calls with lights and sirens in England borders on the schizo or obsessive.