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Lights and Sirens at Night
So it appears the big discussion topics are now appearing on Facebook rather than here, but then I guess its more likely to attract a response than it would here.
Anyway this story cropped up http://www.jems.com/article/vehicle-ops/stealth-mode-use-silent-approa
Thoughts?
In the UK it is mandated that Lights and Sirens be used when responding to all emergencies. You can't have one without the other. It is however the Driver's Discretion, however there would no doubt be an interview under caution with a police officer to explain the decision made if there was an accident.
Its a tricky one....
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Replies to This Discussion
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Permalink Reply by Joe Paczkowski on -
I think that common sense needs to be used. Ignoring the legal issue (i.e. being exempt from the rules of the road, such as stop lights), at 2 am do you really need lights and sirens? If worse comes to worst, just wait a few seconds and the car that isn't yielding is going to be by anyways. A little defensive driving is vastly more important than the status of the siren.
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Permalink Reply by Skip Kirkwood on -
I firmly advocate for the opposite approach - use your warning equipment as required or directed, but drive reasonably and in an "under control" manner.
What's so hard about that?
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Permalink Reply by George Kirubi on -
Thank you Skip Kirkwood, thats a great response ,
Its working in Kenya and the Public Respect here remains wanting.
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Permalink Reply by Neil White on -
I guess it would be interesting to see some studies... but from a public perception point of view, not sure if a defensive response at night would be reward if a patient suffered from a delay (albeit small)
It goes back to the thread on Driver Training. I do remember reading somewhere that in major cities is was easier and more beneficial for everyone involved to ride normal driving, the panic/stupidity of other road users created more stress, uncomfortable travel for patients and yet the saving of time emergent ve non emergent was minuscule
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Permalink Reply by Devin Nemec on -
Neil - Speaking from a strictly urban and anecdotal perspective, using the lights and sirens makes almost no difference in the response time. I still have to clear the intersections of traffic anyway. I've left a hospital lights and sirens for a response, got the patient, then drove back to the same hospital many times. I usually save about 1 minute of a 10 minute response on the way to the patient with the lights on, sometimes less (even takes longer!). In a rural environment, without the traffic and frequent stopping/slowing hazards, I imagine it probably makes almost no difference.
I can say that drivers attempting to comply with the laws when I'm running lights and sirens pull in to intersections through red lights, run busy red lights, slam on breaks and get rear ended, pull their car off the side of the road and into ditches, jerk their vehicle to the right and collide with other cars, ditch motorcycles, and probably more stuff that also happens behind me that I don't see. I've never seen this happen (as frequently) when I'm responding with no lights and sirens. And this is not because of any aggressive driving by me, I drive just like normal. It's people that don't know what to do when there are 3 lanes of traffic 5 cars deep and an ambulance behind it all (i shut down the lights/siren at these until the light turns green to avoid this) that will pull into the intersection to get out of my way.
Another point is even when I do arrive on scene, we still have to exit the ambulance, get the equipment, and then navigate through buildings/elevators/stairs/neighborhoods to even find the patients. The act of actually getting to the patient usually burns up a good 5-8 minutes on average. Saving the 1 minute on the way there only to lose it 5 times over and cause mass confusion on the streets to do it seems like a giant waste.
You know what a good study would be? Normal miles per accident vs L&S miles per accident for an ambulance. Seems like it would be easy to do given the proper data too. That would include all the driving around normal the ambulances do to, since its the exact same as a non lights and siren response.
The public would probably thank us more if we weren't causing them to crash into everything trying to avoid our lights and sirens.
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Permalink Reply by geoff.horning on -
I could discuss this in a semi-intelligent fashion for hours...Devin makes the point that most of us already know and accept although their are thousands who would refuse to believe that going 1 mile at 80 miles per hour results in little difference than going 1 mile at 60 mph. I understand the rule about all or none with regards to warning equipment and I'm fine with it. I always make a decision based on the info given in the dispatch, it's 2 am and I get dispatched to a trauma at a local bar, man laying on ground gets a Code 3 response. Its 2 am and I get dispatched to a 20 y/o with abdominal pain, unless traffic seriously impedes my progress it's getting a Code 1 response. Not that one is more deserving than the other, but the man on the ground may very well be bleeding into the brain, and the 20 y/o isn't likely to have Marfans or a triple A, its more than likely going to be indigestion, flu like symptoms/gastroenteritis, or maybe Gallstones, renal colic, maybe even a hot appendix. Any additional info given enroute might alter my response.
I know that many, especially the risk managers want a standardized response, but in an ever changing environment while dealing with human beings "standardized response" is a pretty vague term. My truck, my patient, my decision and my fault if I'm wrong. As imperfect as I am I use all of my knowledge, and all of my experience and all of my judgement to make a decision and modify it accordingly. I was told at a very early stage in my career to never do anything that I couldn't explain to the judge and a jury of my peers. I remember it on every call. As to the scenario in the article, I'd use code 3 on a busy street and code 1 with all laws followed on the empty street at 2 am. In rural/suburban areas when we know the location and the patient on dispatch, they still get treated like the most important person in the world, but the rules change slightly when I know the history.
Anecdotally: Animals and idiots don't get out of the way of a code 3 response, they get in the way of a code 3 response. Deer, Dogs, Squirrels, drunks...just my experiences, but hitting a deer with your truck makes the response significantly slower, no matter what kind of siren you use.
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Permalink Reply by geoff.horning on
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The NHS is pretty good at propaganda public service announcements, maybe they should do one that says "No lights and sirens? Its not that they don't care, it's that their being safe" with a big background of an ambulance driving with and without lights...Sorry about the propaganda crack, I couldn't resist!
Neil White said:I guess it would be interesting to see some studies... but from a public perception point of view, not sure if a defensive response at night would be reward if a patient suffered from a delay (albeit small)
It goes back to the thread on Driver Training. I do remember reading somewhere that in major cities is was easier and more beneficial for everyone involved to ride normal driving, the panic/stupidity of other road users created more stress, uncomfortable travel for patients and yet the saving of time emergent ve non emergent was minuscule
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Permalink Reply by Rogue Medic on -
The studies showing minimal difference in travel time with lights and sirens were done during the day.
Driving at night, what difference would there be?
If there is an accident and the lights and sirens are not on, the important point is going to be was the driver obey the traffic laws.
If there is an accident and the lights and sirens are on, the important point is going to be was the driver obey the traffic laws.
I am not allowed to drive faster than the speed limit regardless of whether I use lights and sirens.
The only advantage is at traffic lights, which may be switched by a priority light.
The problem is not the avoidance of the use of lights and sirens. The problem is the prevention of the driver from using judgment.
Lights and sirens are not magic, no matter what the law states.
An advantage of lights and sirens includes having the community decide to oppose the placement of an ambulance station near them, so that they are not frequently interrupted by the sirens.
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Permalink Reply by Ben Waller on -
"The only advantage is at traffic lights, which may be switched by a priority light."
There are other advantages. One is in gridlock conditions where there will be little or no forward progress by the emergency vehicle without lights and sirens.
Another is making other motorists aware that the emergency vehicle is on an emergency response, particularly when the vehicle is slowing approaching a roadway accident scene. That reduces the chance of another vehicle striking the rear of the emergency vehicles as it slows.
Still another advantage is during power failures, where both normal and traffic pre-emption intersection controls are not working.
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Permalink Reply by Rogue Medic on
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OK. I should have written that the only advantage is at intersections, rather than at traffic lights.
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Permalink Reply by Ben Waller on
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That's still not completely accurate. It doesn't address the advantage of lights and sirens in situations like divided highway gridlock.
The U.S. highway infrastructure is overloaded with traffic in quite few places, and lights/sirens are beneficial in getting through that traffic, particularly when that traffic is moving at less than the speed limit or not moving at all. That includes roadway accidents on those divided highways with traffic backups upstream from the scene.
Rogue Medic said:OK. I should have written that the only advantage is at intersections, rather than at traffic lights.
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Permalink Reply by Rogue Medic on
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That would only be an indication for intermittent use of the siren, not continuous.
The whole problem with continuous use is that it prevents the driver from using judgment.
When I am in the back, I want my partner to be using judgment, not following some thoughtless rules that discourage judgment; rules that, if enforced, punish the use of judgment.
We have too much of that in EMS.
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