Driver training

[EMTBUNGO]

I like the drive to get there alive statement. You want to obviously go home to your families after shift and you dont want to compound the problem by having an accident of your own or causing an accident. Due regard is huge!! and in the state of Ohio, you are required to run sirens with lights, of course your not going to do it at 3 in the morning with no traffic, but it is the law here in Ohio.

[Lone Star]

I like the drive to get there alive statement. You want to obviously go home to your families after shift and you dont want to compound the problem by having an accident of your own or causing an accident. Due regard is huge!! and in the state of Ohio, you are required to run sirens with lights, of course your not going to do it at 3 in the morning with no traffic, but it is the law here in Ohio.

The rescuer that needs to be rescued is of no use to those that made the original call....

[Richard B the EMT]

The rescuer that needs to be rescued is of no use to those that made the original call....

Correct!

You involve your ambulance in a crash, you're out of service. So is the ambulance, or ambulances, that respond to your incident. Then add the one assigned to your original call.

So, that is a minimum of 3 ambulances not available, due to your incident.

[CBEMT]

A crew running L&S for a Fractured Tib-Fib? FAIL

I would say 95% of the time, that would be a stable injury, and the "Need for the Speed" is replaced by the need of the "Ride that's a Glide".

That remaining 5%? Suspected arterial bleed and/or suspected nerve damage MIGHT be requiring the L&S.

I emphasize "MIGHT".

Come on, Richard. I agree with the sentiment, but are you telling me FDNY BLS trucks sit in Manhatten traffic with tib-fib fractures?

[Richard B the EMT]

I do, and I have. When there are 200 vehicles in a section of roadway designed for 150, where are they going to go to get out of your way, without someone attempting to violate the law of physics that states

Two objects cannot occupy the same space at the same time.

[kohlerrf]

I like the drive to get there alive statement. You want to obviously go home to your families after shift and you dont want to compound the problem by having an accident of your own or causing an accident. Due regard is huge!! and in the state of Ohio, you are required to run sirens with lights, of course your not going to do it at 3 in the morning with no traffic, but it is the law here in Ohio.

I realize that the various states "require" you t0 run lights and sirens. However I also know that more specifically in most states the law states you are required to have your emergency lights on at all times while responding to an emergency and only requires you to have your siren or "audible warning signal" when you are in violation of local traffic ordinance. in other words, if you are traveling at or below the posted speed limit although you must have your lights on you are "not" required to have a siren running. In addition if it were the case that you have to use your lights AND sirens while responding, you would be required to have your siren on while backing your truck into the driveway of at the address of the call until you put your vehicle in park? The law is very specific and this is the point of my post. ALL of us, me included, have been trained "by the senior guy" lights and sirens go together. I have found they don't. More importantly it has been proven factually in many many studies both on a closed coarse and the open road that regardless of you experience the driver will drive at a faster rate of speed if a siren is in use regardless of the type of call they are responding to. I would be interested in specifically seeing your ordinance regarding the use of an audible warning signal while responding to an emergency. The law is very specific and we on the other hand don't take time to read it putting ourselves and others at risk. After reading the specific law I think you might be pleasantly surprised!

[kohlerrf]

Kohlerrf, I'm not sure I understand your point. Are you suggesting that we no longer run hot when called for?

Frankly, Yes. If it were a perfect world I don't think we should have lights and sirens on an ambulance!

People often ask me what can a PARAMEDIC do that an EMT cant? my reply is " In a "non traumatic case" Paramedics can do everything the Emergency Room will do to you in the first 20 minutes of your visit. For example if you need the ambulance to take you to the hospital because you have a cold and a fever, what would the ER do in the first 20 min. Nothing but maybe take your temperature and a history, we can do that. On the other hand if you are in cardiac arrest or acute pulmonary edema, what would the ER do in the first 20 min.....Bla Bla Bla Bla....yes we can do all that too right here in your living room!" I never use lights or sirens in route to the hospital with 3 exceptions, Trauma, CVA and PAMI. I think the use of lights are still necessary because all municipalities do not allow Paramedics to operate at the same level and the training varies widely. In adtion there needs to be some pre-hospital soultiions developed for the 3 sitiuations I mentionsed but barring that since we can do everything the ER will do I firmly believe the use of lights and sirens should be the exception rather than the rule.

Lastly I will submit, with the current systems I can recognize that there might be a benefit to the patient for you to use your lights and sirens to enter on coming "SLOW MOVING" traffic cautiously at a slow rate of speed to avoid senseless grid lock that would other wise unusually delay your response.

Remember the easiest fastest and safest way the reduce response time is to add more ambulances to a given area and NOT TO SPEED THEM UP!

Come on, Richard. I agree with the sentiment, but are you telling me FDNY BLS trucks sit in Manhatten traffic with tib-fib fractures?

There is NEVER the "Need for Speed" reducing response time yes! but never the need for speed. Either speed kills them and stopping kill you!

Good example of a basic 'evasive maneuver'. Have I used it? Yes. Do I reccomend it for every call? NO.

I've never understood the need to run 'hot' to every call. It not only creates an 'insensitivity' to the lights and siren, but it also puts the general public (and the responding crews) at unnecessary risk.

In MI (the only state I can quote with authority), there IS a requirement that if you're running lights you MUST operate the siren. Aside from that, there is nothing in that state's Motor Vehicle Code that REQUIRES the use of lights and siren when the vehicle is in motion to a call or from a call to the hospital. I've even seen a crew get ticketed for running lights and siren to the hospital for a possible broken tib/fib.

I don't care if you ARE a 'newb' or not....there's an appropriate time and place for lights and siren, and that doesn't include EVERY call.

When running lights and sirens...you must be even MORE careful than you are normally. (I love how people will say something like, "I'm the most careful/responsible driver I know!).

Just because you have lights and siren operating, you DON'T have the 'right' to blow through stop lights/stop signs, you're not automatically granted the right of way and you do NOT have the 'right' to exceed the speed limits by 20 mph or more! Even with lights and siren activated, you MUST drive according to the weather conditions, traffic and with 'due regard' for the general public. You cause an accident in an emergency vehicle that's running 'hot'...you're AUTOMATICALLY 'at fault'!

Im curious? Does your VTL state that your siren must be "CONSISTENTLY SOUNDING" the entire time your vehicle is in motion while your emergency lights are on?

[JPINFV]

You know, I've heard of laws compelling the use of lights and sirens, but have never seen one. I'd love to see that statute spelled out that compels EMS providers to use lights and sirens when responding to an emergency call.

[kohlerrf]

You know, I've heard of laws compelling the use of lights and sirens, but have never seen one. I'd love to see that statute spelled out that compels EMS providers to use lights and sirens when responding to an emergency call.

I have heard of those same laws, I have read in our own SOP here that we are required to use lights on every emergency response, but I think that may be an insurance issue frankly. Come to think of it I dont know of any state or federal VTL that requires the use of Emergency lights during an emergency response as long as the vehicle is operating within the applicable local ordinance such as the posted speed limit. I do recall though, that New York State does require you to display "visual and audible warning signals while operating in discordance with the applicable traffic ordinance". You bring up an interesting point, because my service does not allow us to exceed the posted speed limit at any time, so it must be an insurance thing that we have to keep the lights on, but no where have I ever seen that the siren must be consistently sounding during a response.

Every day I learn how much more I don't know!

Edited December 14, 2009 by kohlerrf

[JPINFV]

Another thing to think about is that there's a difference between an emergency response and an emergency call. It's possible to respond non-emergently (no L/S) to an emergency call (patient going to the emergency room).