3unit2
Junior Member
Posts: 24
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Post by 3unit2 on Nov 18, 2003 8:44:20 GMT -5
AAAHHHHH yes the regional protocols...................................... NO COMMENT!!!!!!!!!
911 WHACKER, you hit the nail right on the head.. You read them and have your interpertation....and I have mine..
bcdispatcher8, I fully agree, one mva is bad enough. We don't need 2 at the same spot, since I may be one of the first 2 or 3 on scene. The first few can't do pt. care, traffic control,scene safety,possiable fire suppresion,and the list goes on.. I want the fire depart. there ASAP and if that means L&S so be it.. As far as the dispatch responce levels go,we have beat on that subject long enough.
canton1, I agree. What is good for the goose, is not necessarily true for the gander. Once again ,it is all in how you read it. I say the glass is half empty,and you say it is half full... Who is right?
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Nick
Full Member
OIF Veteran 2006
Posts: 46
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Post by Nick on Nov 18, 2003 21:14:59 GMT -5
Just as long as there's beer in the glass, I'm good! ;D
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Post by 911wacker on Nov 20, 2003 1:32:25 GMT -5
Regardless of ALS or BLS, shame on any who break policy or protocol. Whether it be ALS or BLS people makes no difference, they should think really hard about what they are doing. Can somebody PLEAZZZZZZZ - tell me why an ambulance or someone who is responding with an ambulance to a fire has to run lights and sirenI don't believe that in the above statement that started this thread I seperated anything except for the odvious. Please don't turn this into one of those Us and Them deals where everyone loses focus on the intended discusion. Here is some info for you: Prehosp Emerg Care. 1998 Apr-Jun;2(2):136-40. Related Articles, Links
EMT knowledge of ambulance traffic laws.
Whiting JD, Dunn K, March JA, Brown LH.
Department of Emergency Medicine, Pitt County Memorial Hospital, East Carolina University School of Medicine, Greenville, NC 27858, USA.
OBJECTIVE: The safe operation of ambulances using warning lights and siren requires both the public and emergency medical technician (EMT) drivers to understand and obey relevant traffic laws. However, EMTs may be unfamiliar with these laws. The purpose of this study was to evaluate EMTs' knowledge of traffic laws related to the operation of ambulances with warning lights and sirens. METHODS: North Carolina EMTs participating in a statewide EMS conference October 6-8, 1995, completed a five-question survey. Knowledge of ambulance speed limits, yielding at intersections, yielding in roadways, and following distances was assessed using a multiple-choice format. Demographic data pertaining to EMT age, years of experience, paid vs volunteer status, driver's education courses, and past accident involvement were also obtained. Proportions were compared using chi-square analysis, alpha = 0.05. RESULTS: Two-hundred ninety-three of 308 (95%) EMTs attending the conference completed questionnaires. The median number of correct responses to the five knowledge questions was 1 (range 0-4). Thirty-three percent of the EMTs knew that other vehicles are required by law to yield while either approaching or being overtaken by an ambulance with warning lights and sirens; 2% knew that due regard for safety is the only requirement of an ambulance approaching a red light at an intersection; 14% knew that the minimum following distance behind an ambulance is one city block; and 28% knew that there is no speed limit on ambulances with warning lights and sirens. Respondents were more likely to score above the median if they had taken one or more emergency driver's education courses or had nine years or more of EMS experience. CONCLUSION: In this sample, EMT knowledge of basic traffic laws pertaining to ambulance operation is poor. Emergency driver's education courses and increased experience appear to be related to increased knowledge scores. Increased training for EMTs about traffic laws may improve the safe operation of ambulances.
PMID: 9709334 [PubMed - indexed for MEDLINE]Some more: Prehospital Disaster Med. 1994 Oct-Dec;9(4):226-9. Related Articles, Links
Patient outcome using medical protocol to limit "lights and siren" transport.
Kupas DF, Dula DJ, Pino BJ.
Department of Emergency Medicine, Geisinger Medical Center, Danville, Pa., 17822, USA.
INTRODUCTION: Emergency medical services vehicle collisions (EMVCs) associated with the use of warning "lights and siren" (L&S) are responsible for injuries and death to emergency medical services (EMS) personnel and patients. This study examines patient outcome when medical protocol directs L&S transport. DESIGN: During four months, all EMS calls initiated as an emergency request for service and culminating in transport to an emergency department (ED) were included. Medical criteria determined emergent (L&S) versus non-emergent transport. Patients with worsened conditions, as reported by EMS providers, were reviewed. SETTING: Countywide suburban/rural EMS system. RESULTS: Ninety-two percent (1,495 of 1,625) of patients were transported nonemergently. Thirteen (1%) of these were reported to have worsened during transport, and none of them suffered any worsened outcome related to the non-L&S transport. CONCLUSION: This medical protocol directing the use of warning L&S during patient transport results in infrequent L&S transport. In this study, no adverse outcomes were found related to non-L&S transports.
PMID: 10155532 [PubMed - indexed for MEDLINE]
Another one - please read: Prehosp Emerg Care. 2001 Jul-Sep;5(3):261-9. Related Articles, Links
Characteristics of fatal ambulance crashes in the United States: an 11-year retrospective analysis.
Kahn CA, Pirrallo RG, Kuhn EM.
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
BACKGROUND: Ambulance crashes have become an increasing source of public concern. Emergency medical services directors have little data to develop ambulance operation and risk management policies. OBJECTIVE: To describe fatal ambulance crash characteristics, identifying those that differentiate emergency and nonemergency use crashes. METHODS: This was a retrospective analysis of all fatal ambulance crashes on U.S. public roadways reported to the Fatality Analysis Reporting System (FARS) database from 1987 to 1997. Main outcome measures were 42 variables describing crash demographics, crash configuration, vehicle description, crash severity, and ambulance operator and vehicle occupant attributes. RESULTS: Three hundred thirty-nine ambulance crashes caused 405 fatalities and 838 injuries. These crashes occurred more often between noon and 6 PM (39%), on improved (99%), straight (86%), dry roads (69%) during clear weather (77%), while going straight (80%), through an intersection (53%), and striking (81%) another vehicle (80%) at an angle (56%). Most crashes (202/339) and fatalities (233/405) occurred during emergency use. These crashes occurred significantly more often at intersections (p < 0.001), at an angle (p < 0.001), with another vehicle (p < 0.001). Most crashes resulted in one fatality, not in the ambulance. Thirty pedestrians and one bicyclist comprised 9% of all fatalities. In the ambulance, most serious and fatal injuries occurred in the rear (OR 2.7 vs front) and to improperly restrained occupants (OR 2.5 vs restrained). Sixteen percent of ambulance operators were cited; 41% had poor driving records. CONCLUSIONS: Most crashes and fatalities occurred during emergency use and at intersections. The greater burden of injury fell upon persons not in the ambulance. Rear compartment occupants were more likely to be injured than those in the front. Crash and injury reduction programs should address improved intersection control, screening to identify high-risk drivers, appropriate restraint use, and design modifications to the rear compartment of the ambulance.
PMID: 11446540 [PubMed - indexed for MEDLINE]
All of you have failed to answer the question posed, Why do you feel it is needed to run lights and sirens to a fire stand bye when there has been no evidence or information regarding a patient needing treatment at the scene?? PLEASE list your reasoning or logic behind your answer. If there is no patient at the scene why should you risk causing an accident to get there and drink coffee or watch while the fire personel put out the fire. The 1 or 2 minutes you may have saved do absolutely no good when you get to the scene and become basicly a spectater............. or what do you call it?
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Post by GVEMS11 on Nov 20, 2003 7:48:55 GMT -5
Relax and drive sensibly. The life you save just might be your own!
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Post by canton1 on Nov 20, 2003 9:34:48 GMT -5
To me most of the time it is and Unknown thing. It is kinda like a Medical patient. You are told all the right answers to make it one thing and then you arrive to find it is completely different. Just the other day, my partner had a call that had no indication that it was a LIFE THREATENING call but, when EMS arrived it was VERY VERY serious. You can only give what you are told so, Shouldnt ever call be treated like a real emergency till someone actually get to the scene to deteremine other wise? ?
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3unit2
Junior Member
Posts: 24
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Post by 3unit2 on Nov 20, 2003 14:11:13 GMT -5
More of ( MY) thoughts on this lights and use or non use of the siren. I have never found on any amb.,fire engine, or POV with "REDS". Where the wireing for said lights and siren were directly connected to and /or controlled the speed of this vech. That is done by the person with the round thing in front of them and the pedals on the floor.. So why are we told that if the lights are on, then the siren "MUST BE ON" ? Why? They work independently of each other!!!!!!! These are EMERGENCY VEHICLES , pt or no pt,fire or no fire. Not a non-emergency transport van and big red POV'S with a few extra lights. Now call it old age or C.R.S. I think it may state law that L&S's must or should be used together. Again Why? When over the years I have seen many State and Local police ,running lights and the siren (only as needed). Shouldn't we all be able to use the same good judgement on there use,as long it is done SAFELY.... I feel if someone has called the 911 system they want and or need our help. Lights always,siren (if you have one,as needed). I also feel for an ambulance, if you are paged out and transport a pt. to a hospital. It shouldn't matter if the pt. is BLS or ALS,(you are giving care to someone). Lights always!!!!!!!!!Granted most people DO NOT pay any attention to flashing lights,no matter what color,but a few do....... And will give you some extra room for you make your trip to where ever, Easier and SAFER for all involved.......
In ending these are some of (MY) many thoughts on this subject and (MY) Story................... I will now go to my bomb shelter, to await the "fallout", I may get on this..
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911Mom
Full Member
Welcome to the real world!
Posts: 60
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Post by 911Mom on Nov 20, 2003 22:30:02 GMT -5
Okay, my turn to dive in and take alittle twist on the subject of lights (red and blue) and sirens. First let me say that in my above post I was venting about a certain thing. I can't, won't, and don't expect anyone anywhere else to understand what, when or who. Believe me I have been to structure fires and I do know the routine , but thanks for all of your willingness to explain it to me. Now for the meat of my post. I would rather have a herd of ambulances coming towards me on a one lane dirt road than having to deal with volunteers responding to some sort of incident on any type of roadway. One case that sticks in my mind is an MVA that occured in my own territory and we were on Rt 220 in the Valley. I have a red light on my car but decided that we were too far out to turn it on and try to make the call. It's raining and visibility stinks. All of a sudden this other blue lighter goes screaming by us, balls to the wall, almost running us off the road (4 Lane). We arrive on scene of this incident (one vehicle patients out of the vehicle in a house), and lo and behold, there is the bluelighter that almost killed us and he was a member of a neighboring department! In my own quiet way I informed him what I thought of his driving and what he could do with his blue light and offered to help put it there. We can go on and on about ambulances and fire trucks, lights and sirens, quote studies forever, but the real danger is when the pagers go off and the key turns in our own vehicles. How many of us brag about making it to a scene in x minutes flat? I'm as guilty as some but not as guilty as others. So I guess the first rules we should pay attention to are the speed rules and remember if people don't pay attention to big things with flashing lights and sirens all over them, they sure aren't going to pay attention to a car with a blue light. I will now get off the soapbox and tuck and roll to avoid the schrapnel.
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Post by canton1 on Nov 21, 2003 0:25:39 GMT -5
Why, Red light and Siren? ? The law says if you are running one you WIL run the other. Not that it is right but that is what it says
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Post by GVEMS11 on Nov 21, 2003 12:40:59 GMT -5
The law does NOT say that if you are running lights, then you MUST also run siren. Police vehicles as well as transporting ambulances are exempt. Also, agreement with the B/S EMS regional protocols is irrelevant -- they are the protocols are need to be followed by those under their governance. Just like a law, if you don't like it, that doesn't mean you don't follow it. Rather, you attempt to get it changed.
PA Vehicle Code Title 75, Chapter 31, Section 5:
ยง3105. Drivers of emergency vehicles. (a) General rule. - The driver of an emergency vehicle, when responding to an emergency call or when in the pursuit of an actual or suspected violator of the law or when responding to but not upon returning from a fire alarm or other emergency call, may exercise the privileges set forth in this section, but subject to the conditions stated in this section. (b) Exercise of special privileges. - The driver of an emergency vehicle may: (1) Park or stand, irrespective of the provisions of this part. (2) Proceed past a red signal indication or stop sign, but only after slowing down as may be necessary for safe operation, except as provided in subsection (d). (3) Exceed the maximum speed limits so long as the driver does not endanger life or property, except as provided in subsection (d). (4) Disregard regulations governing direction of movement, or overtaking vehicles or turning in specified directions. (c) Audible and visual signals required. - The privileges granted in this section to an emergency vehicle shall apply only when the vehicle is making use of an audible signal and visual signals meeting the requirements and standards set forth in regulations adopted by the department, except that an emergency vehicle operated as a police vehicle need not be equipped with or display the visual signals.An ambulance which is transporting a patient may use either the lights or the audible warning system, or both, as determined by the driver of the ambulance.[/u] (d) Ambulances, blood delivery vehicles and human organ delivery vehicles. - The driver of an ambulance, blood delivery vehicle or human organ delivery vehicle shall comply with maximum speed limits, red signal indications and stop signs. After ascertaining that the ambulance, blood delivery vehicle or human organ delivery vehicle will be given the right-of-way, the driver may proceed through a red signal indication or stop sign. (e) Exercise of care. - This section does not relieve the driver of an emergency vehicle from the duty to drive with due regard for the safety of all persons.[/u]
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Post by canton1 on Nov 21, 2003 12:52:43 GMT -5
95----Thank you. I stand corrected. I have never seen the last part of that. Thank you very much for setting that straight.
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Post by 911guy on Nov 22, 2003 8:57:00 GMT -5
To me most of the time it is and Unknown thing. It is kinda like a Medical patient. You are told all the right answers to make it one thing and then you arrive to find it is completely different. <snip> so, Shouldnt ever call be treated like a real emergency till someone actually get to the scene to deteremine other wise? ? I have two problems with this thinking 1) Think about how many calls where there HAS been a "trained responder" on scene and their assessment of the situation was way off! -- Cancel rescue (person still entrapped); Attempt to defibrillate a LIVE patient; Difficulty breathing and a non-rebreather placed on the patient.....and NO oxygen turned on.... I could go on, but you get the idea. Does this mean that there a bunch of idiots out there? Well, that would totally unfair and inaccurate, but we ARE all human. 2) Keeping the above situation in mind, even if we ALWAYS knew with 99.99% accuracy the exact situation, would a hot response make a difference? When the rescue was cancelled and still needed, the rescue actually started to return and then went back. Now, how much longer did it take to get there? What I am trying to say is while it may "feel" like a hot response shows that you "care" (and that is one of the things I have heard time and time again - that ALS doesn't care as much because if they did, they would run lights and sirens), you would first have to show that your hot response truly made a difference. Is every 911 call an emergency? Hell no! But we don't have a "tiered" phone number (If you have a class I emergency, call 911, if its a class II emergency call 912, etc). 911 is a "one-stop-shopping" number. When someone calls 911 to report an erratic driver, should the police run lights and sirens to investigate it? What about barking dogs? Flooded basements? Fallen and can't get up? Does the fact that they called 911 &/or that a paging system was activated automatically make these a life-and-death-drive-fast situation? NO! In the grand scheme theme of things (I didn't say "Look at the big picture" ), if each of you were completely honest with yourselves and thought of each and every incident you responded to----which ones would have turned out exactly the same if you never turned on a light or siren and drove like any other vehicle on the road? I KNOW it would be almost all of them. Is EMD always correct? Is a "structure fire" always a structure fire? NO. Are there unknowns? Always. Even if the unknown situations are true emergencies, does the statistically proven fact that a high percentage of lights and siren reponses KILL people make it worth taking the chance and run hot every time? How would you defend yourself in court if an injury occured while responding to a call that came in as low-priority and you were running hot? That because they called 911 it was an emergency to the person that called? WRONG! There are far too many statistics that prove that MOST 911 calls are NOT life-threatening emergencies. I think we need to redefine our responses as either EMERGENT (immediate/seconds count life or property-threatening), URGENT (needs taken care of quickly) and ROUTINE (needs taken care of eventually). That is essentially what EMD attempts to do. Nothing is 100%. Assuming every call is hot until "proven" otherwise is bad economics. Of course, like sweat pores, these are my opinions...........
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Post by 911wacker on Nov 22, 2003 9:47:13 GMT -5
FINALLY, this thread is making progress towards a decent debate!! But things are still not exactly what I was looking for, the question posed was "responding to a fire STAND-BYE" and to explain the reason, so far all the answers supporting that were basicly "becuase we've always done it that way" or "what if, what if". To those of you who "what if" every situation, here is a little advise for you: Hope for the worst, Pray for the best, Prepare for anything, and use common sense along the way!!! We could sit here and "what if" any given situation forever, but what would a reasonable person do in the same situation? Thats the question you need to ask yourself every time! Would a reasonable person expose themselves to the added risk of responding "code 3" or "hot" to a situation like this one? Besides in the rural setting which Bradford County certianly fits into - you save very little time if any. And for those of you who fit into that catagory of "we've always done it that way" or "insurance reasons", you all need to wake up and smell what you are really shoveling. I know that most people don't want to hear this but, can you honestly tell me that insurance company really wants you to run lights all the time?? I think not and here is why!! Lights and sirens make it like 600% more likely you are involved in an accident, they are your insurance company and ahve to pay out money when this occurs ------- OK YOU DO THE MATH!!!! So then if what you are saying is true your insurance company wants #1 to make less money and #2 to put more people at risk?!?!? I find that hard to believe and yes I dare you to get anything regarding any of this in writing from your insurance company - I bet it won't happen........and better yet the answer you get from a local agent varies because I bet that not many of them really know about the subject and are shooting from the HIP!!! Now, with some of that out of the way- lets look at the response issue as it relates to patient care. This means that for #1 there has to actually be a patient or at least someone is reporting that there is a patient. Then was there a Dispatch Code assigned to this call - if so we have to follow regional policy: Alpha - non-emergency response Bravo- non-emergency response Charlie - can be either emergent or non-emergent at the crews discretion Delta- emergency response Echo- emergency response Now if nobody gave you a response code - then it's kinda like a charlie response anyway. You have to make a decision as too time of day, traffic heavy or not, distance to scene, and does the patient sound life threatening or potentially life threatening. This is where common sense comes inyto play, and as we all know sometimes "common sense ain't to common"!!Now given the question agian, would you still answer the same way??? You are an ambulance responding to a fire stand-bye with no reported patients or entrapment, how will you respond L&S or No L&S??
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3unit2
Junior Member
Posts: 24
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Post by 3unit2 on Nov 22, 2003 14:18:32 GMT -5
You are an ambulance responding to a fire stand-bye with no reported patients or entrapment, how will you respond L&S or No L&S?? L&S.. probably not.... Remember, I feel a siren is a "tool" just like a car horn........ TO BE USED AS NEEDED !!!!!!!!!! Lights only? .. Maybe........ Depending on many factors. Now here is a twist for everone to think about........ We are (the ambulance) paged for a fire stand-by, no reported pt, or entrapment, on first page... Why page us at all? ? We don't have any water,fire hose or pump...You are right, we are going to just sit there and watch. And told (by fire dept) to park somewhere out of the way,and sometimes told wwwwwwaaaaayyyyyyyy out the way.. Page us when and if needed.. A fire engine isn't paged for every ambulance call........
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Flynn
Full Member
Often imitated; Never Duplicated
Posts: 45
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Post by Flynn on Nov 22, 2003 16:06:29 GMT -5
I'll tell you why I want EMS on my fire boxes, MY PERSONNEL. As an IC, I am assigning many people to hazardous duties that could go south almost instantaniously.
As far as parking them "out of the way", my EMS company does this on their own. They are always available on scene (ALS) and I wouldn't hesitate releasing them for an ALS call. My EMS company serves many purposes on our scenes. They establish a rehab area, sometime manning it. THey are great counselors for the homeowners, plus we have used them as another set of "eyes & ears".
I wouldn't trade my EMS company for anything. They know their place and function on our fire boxes and we know our place on MVA's and medical assists to them.
Kinda like a give and take, eh?
Tim
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Post by canton1 on Nov 22, 2003 17:44:32 GMT -5
Yes they are a very important role in the service that we provide. I my area I want them there ASAP, not necessarily Lights and Sirens unless it interferes with Fire Trucks getting there, which it has. Our EMS service does not request to leave (and they should never ask to leave). They have enough manpower to stay and protect the ones that requested them. They come, Treat us, Patients, REHAB (to bad they all dont do rehab), extra eyes. I would hate to see them not be there for us at a moments notice as we are for them if requested to be.
Bye the way---Why would one company that does not like or want to do REHAB whine about someone else doing it.
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