Fatal Ambulance Accident under Investigation in Utah

[News]

The ambulance was driving on the highway with lights and sirens when it hit a car in an intersection.

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[BillKaneEMT]

I'm pretty cautious going lights and sirens for several reasons. One is my location, Indiana doesn't have a law that people must yield to ambulances/fire trucks, it's considered the right thing to do but there's no actual law. Unfortunately, people in my area are aware of that so I am often cut off or worse going L&S. Worse would be when people ahead are pulling off so I can get by and some jackass cuts in front of me to bypass all the non scumbags. That's happened twice this week. Even if they did make it law here people would probably ignore it as they do most laws so I doubt I'd change my driving tactics. Just speaking for myself I drive as if everyone else is a reckless, drunken piece of excrement with no regard for human life. Drive defensively x 10. That technique has given me 17 years of accident free/ticketless driving.

I am well aware that some accidents are simply unavoidable. I've had a number of close calls, typically due to people who seem drunk and/or extremely inexperienced on the road. That being the case I'm not going to weigh in on this particular accident unless they post the investigation findings somewhere.

Let's be honest here, is an extra 10 mph going to make a life or death difference in your patients outcome? According to our classbooks (which we've already established are not always correct ;-D) the answer is no. If someone has a differing belief based on some study I haven't seen I'd be more than happy to hear about it. Again, this is based on my area where a patient is seldom more that 10 minutes from a hospital. We have so many hospitals around here. Figure a max of 10 miles to a hospital. Slowing down a bit for intersections takes maybe 5mph off my average speed? Short distance runs (which all the 911 calls I've done have been), don't seem like they would be too terribly lengthened by some basic intersection precautions. I know everyone works in different environments, what do you guys think?

edit: I should point out that different services have hugely varying policies regarding L&S. I did a few ridealongs with a certain fire department medic crew which shall remain nameless and I witnessed lights and sirens to the grocery store and to the bank. My service, you better either be responding to a real emergency or taking a critical patient to the hospital if you pop lights and sirens. The only exception is on a BLS rig when you have a patient who is not critical but is in extreme pain. A bite stick is not effective pain management, nor is baby aspirin, so they're ok with you going all out in that situation. It's at the driver's discretion but the driver better be able to justify his decision unless he wants to look for work. That's us though, like I said not everyone around here does things that way.

Edited July 10, 2012 by BillKaneEMT

[Kiwiology]

Lights and sirens are significantly over rated and over used. Sure it's fun to scream through the mean streets of the capital of the Great Nation of Indiana in a huge Ford ambulance with red and white lights flashing, siren screaming, alternating between yelp and hi low while slamming down on the air horn and having a massive fire truck behind us doing the same, it's almost enough to get me hard but lets face it, it's not always in the best interest of the crew, the patient and the public.

There is really little benefit to lights and sirens beyond clearing intersections and I think the average response time saving here between a p1 and a p2 is about two minutes if I remember a presentation by one of the Clinical Standards Officers correctly. Is that two minutes going to save somebodies life? potentially in a very small number of cases but the overwhelming majority of p1 jobs are not emergent life or death but rather a p1 because they are triaged using MPDS which like most things in EMS is based on broad empirical epidemiology and biological or pathological plausibility. It hugely increases risk.

Here in NZ we use lights mostly, the siren to clear intersections or heavy traffic. The Officer in the passenger seat is the "spotter" and is generally the one who is scanning traffic, checking mirrors, checking their side is clear at intersections etc. Going against red lights through a closed intersection is hugely dangerous, look left, right. infront, for pedestrians, creep through slowly and you have to give a good hard blast on the air horn and use the hi low.

I have heard such stupid profane almost blasphemous arguments about lights and sirens like "it saves lives" or "we can get back in service faster if we use them" makes me vomit blood from my eyes, oops that sounds like a p1, hit that little red button down there for me and let me turn this siren know to "RUN" ... Ambulance, City 3 responding ....

Edited July 10, 2012 by Kiwiology

[BillKaneEMT]

I hear ya Kiwi. 1 to 2 minutes max sounds about right. Given the general disregard for lights and sirens by other drivers and pedestrians you'd have to be a maniac to speed through reds with em on, in NW Indiana at least. Hell, during the NATO protest I was trying to get a patient to Rush Hospital in Chicago with lights and sirens and I had a group of protesters link arms and block the street in front of me chanting some random shit. That was kinda scary cuz said patient was not in good shape and I wanted her in the ER under a physician right the hell away. Amusingly as I was calling for CPD assistance about 30 people in full clown outfits showed up and yelled at the lunatics and made em clear the way. That's right. My patient that day was saved by a clown squad. I felt like someone slipped some magic mushrooms into my omelet that morning. Craziest workday ever.

Anyway, the moral is, don't overuse your lights/sirens. In my opinion, unless you believe your patient is unstable enough that they NEED a doctor immediately, L&S is probably unwise. Of course, if you get a call for a patient found in a pool or in full arrest or whatnot you'd obviously want to get there fast. But if you wreck then who are you helping? You're screwing your patient because now YOU need an ambulance, and so does the person you plowed into, and your original patients response time just doubled. I'm not saying to abstain from them entirely, just that they seem to be used rather more often than is necessary. Just my 2 cents.

The secondary moral is: Stay out of Chicago during massive protests cuz protesters are crazy. Except protesters in full on clown outfits. Which is odd.

[Kiwiology]

There was a cardiac arrest case from Portland, Maine back in the 1990s where the guy was given CPR by a bunch of clowns ....

[BushyFromOz]

There was a cardiac arrest case from Portland, Maine back in the 1990s where the guy was given CPR by a bunch of clowns ....

How is it any different now??

[Arctickat]

This disturbs me;

The patient in the ambulance was also treated and released.

"We were told that she received further injuries from the crash, but she has been released from the hospital so those injuries from both crashes must not have been as substantial as we previously thought," Edwards said.

The condition of the patient was obviously such that lights and sirens weren't warranted. If the patient is conscious and the vital signs are normal, there is no need for emergency transport.

[JakeEMTP]

I agree with the above posters. L & S are far too often overused. My partner and I will use them enroute to a call if dispatched emergency traffic. Even that is BS sometimes as "per EMD" is the reason for the elevated response. It is extremely rare that we transport anybody emergency traffic.

[jonas salk]

first thing i noticed while reading the article was that the patient was released the same day. On the surface it sounds like the crew was driving L&S with no real clinical indication for it.

Personally my threshold for a code 4 return is pretty high.

[Kiwiology]

Personally my threshold for a code 4 return is pretty high.

In four years I have seen only four people returned on a priority one

1) an anterior infarct who was crook

2) a young girl post seizure who was very unconscious

3) post cardiac arrest

4) a guy who amputated his atm