Arrive alive

[fakingpatience]

I watch all directions around my rig. Foward, back and sides. I also look in my mirror to see whats going on in the patient compartment. Do I need to adjust driving to allow my partners to do something?

I know some say just to concintrate on whats infront of me but I feel total awarness is key.

As for pulling over because someone is on my back step. Maybe, depends on circumstances. I could care less about Joe Somebody I didn't tell not to. I was more talking about the patient's family. They are the ones sometimes that try following me through things they shouldn't. I don't want them to be patients too.

Its all good though, good comments and posts

I hate it when pt's family try and follow the ambulance, even when we are driving cold. if I go through a yellow light, to avoid a hard stop for my partner in the back, sometimes the family will drive right through the red light. One trick that one of my partners here uses is getting the family to leave first to go to the hospital, while we are getting everything set up in the back, so they have no opportunity to follow us

[uglyEMT]

yup patience thats what I try and have them do too. Go ahead of me that way its one less thing to worry about. Does it work all the time? No but when it does it really helps.

As far as the yellow lights, if I see they are following me and they appear they will run the light and I am running cold I will hit the L&S just to give everyone at the intersection a heads up, while slowing down of course, just to be safe. If I am already code 3 and it happens I try and slow down as much as possible to give everyone a chance. I am pretty good at timing the lights on my normal route, I try and avoid the sudden stops and such as much as possible.

Like I said in a previous post if its not time critical I will shut the lights down and wait for the green vs running the red (if I do have to go through the red I come to a complete stop first). I would rather get there 2 minutes later then not at all.

[Bieber]

All right, I'm going to weigh in on this but if my thoughts are jumbled and and I'm not thinking very clearly, it's because I've got a lot of stuff on my mind right now.

First of all, I'm all for smarter use of lights and sirens. Should we keep them? I think so. But should we run hot to every call? Heeeell no. AMI? Cardiac arrest? Difficulty breathing (tentatively)? Sure, those conditions MIGHT actually have a LITTLE clinical benefit from getting there a little bit sooner. But should we be speeding to get the patients to the hospital or running hot to the hospital with ANY patients? Honestly, no.

Can anyone think of a single medical condition that would benefit to getting to the hospital two minutes sooner? I say two minutes because I think all of the studies I've read on running lights and sirens put two minutes on the high end of possible time saved from running hot. So, is there? First of all, let's ask ourselves, what's the WORST thing that can happen to the patient? Well, the worst thing is that they go into cardiac arrest, and you know what? We can treat that just as good in the back of the ambulance as they can in the ER. What else? Are there any conditions out there that will benefit from an extra two minutes? And if the patient is going to go into cardiac arrest within two minutes if they don't get to the hospital within that time frame, is there any definitive treatment that can be initiated and take effect within two minutes that we can reasonably believe will stave off cardiac arrest? In fact, is there any treatment that can be done only by in-hospital personnel that can be initiated and take effect and reasonably prevent a patient from going into cardiac arrest within, say, ten minutes? How about fifteen? Now when we get to the twenty or thirty minute mark, it becomes a little more reasonable, but that is not the kind of time we can expect to save from running hot unless we were driving seriously dangerously.

Seriously, work it out in your heads. The clock starts ticking, this patient has twenty minutes to live, if you drive regular traffic you can get them to the hospital in in fifteen minutes, and being generous, let's say you can get them there in ten if you drive hot. What definitive treatment can be given in ten minutes? For ANY medical condition? Stroke, well they got to do a CT first to make sure it's not a bleed; AMI, no way they can cath 'em and reach the occlusion in ten minutes; trauma, won't see a surgeon have a guy open in under ten minutes starting from the ER doors; sepsis, antibiotics don't work THAT quick. The WORST thing that can happen to these patients is that they go into cardiac arrest, and we can treat that in the ambulance. However there is, to my knowledge (and if I'm wrong help me out), NO definitive treatment that can be given in the ER that we can't give in the truck that will mean the difference between life and death that can be undertaken in under ten or fifteen minutes. And the studies don't even indicate we can get THAT much time out of running hot, but they sure as hell say we can risk not only the patient's life but OUR lives as well from driving like madmen to the hospital.

[uglyEMT]

All right, I'm going to weigh in on this but if my thoughts are jumbled and and I'm not thinking very clearly, it's because I've got a lot of stuff on my mind right now.

First of all, I'm all for smarter use of lights and sirens. Should we keep them? I think so. But should we run hot to every call? Heeeell no. AMI? Cardiac arrest? Difficulty breathing (tentatively)? Sure, those conditions MIGHT actually have a LITTLE clinical benefit from getting there a little bit sooner. But should we be speeding to get the patients to the hospital or running hot to the hospital with ANY patients? Honestly, no.

Can anyone think of a single medical condition that would benefit to getting to the hospital two minutes sooner? I say two minutes because I think all of the studies I've read on running lights and sirens put two minutes on the high end of possible time saved from running hot. So, is there? First of all, let's ask ourselves, what's the WORST thing that can happen to the patient? Well, the worst thing is that they go into cardiac arrest, and you know what? We can treat that just as good in the back of the ambulance as they can in the ER. What else? Are there any conditions out there that will benefit from an extra two minutes? And if the patient is going to go into cardiac arrest within two minutes if they don't get to the hospital within that time frame, is there any definitive treatment that can be initiated and take effect within two minutes that we can reasonably believe will stave off cardiac arrest? In fact, is there any treatment that can be done only by in-hospital personnel that can be initiated and take effect and reasonably prevent a patient from going into cardiac arrest within, say, ten minutes? How about fifteen? Now when we get to the twenty or thirty minute mark, it becomes a little more reasonable, but that is not the kind of time we can expect to save from running hot unless we were driving seriously dangerously.

Seriously, work it out in your heads. The clock starts ticking, this patient has twenty minutes to live, if you drive regular traffic you can get them to the hospital in in fifteen minutes, and being generous, let's say you can get them there in ten if you drive hot. What definitive treatment can be given in ten minutes? For ANY medical condition? Stroke, well they got to do a CT first to make sure it's not a bleed; AMI, no way they can cath 'em and reach the occlusion in ten minutes; trauma, won't see a surgeon have a guy open in under ten minutes starting from the ER doors; sepsis, antibiotics don't work THAT quick. The WORST thing that can happen to these patients is that they go into cardiac arrest, and we can treat that in the ambulance. However there is, to my knowledge (and if I'm wrong help me out), NO definitive treatment that can be given in the ER that we can't give in the truck that will mean the difference between life and death that can be undertaken in under ten or fifteen minutes. And the studies don't even indicate we can get THAT much time out of running hot, but they sure as hell say we can risk not only the patient's life but OUR lives as well from driving like madmen to the hospital.

Excellent post Bieber! +1 Everything you said is correct. Very well thought response, I wish more folks thought like that. Maybe there would be fewr accidents and deaths.