More Questions

[medman123]

"No matter how fast you drive the ambulance to a call, it will never be fast enough; until you pass a police cruiser, at which point it will be entirely too fast. Exception: When you are responding to an "officer down" call, then it is physically impossible to be traveling fast enough!" ……………What’s this mean, aren’t you aloud to drive fast when you have lights and sirens on????? Can they give you a ticket while you are in your rig? I am new so bare with me. Thanks for all your help!!!!

 

[Medic's Wife]

lol...funny and also true. I don't know exactly how it works, and it may vary from state to state or service to service, but I think I remember hubby telling me somthing about not going more than 10mph over the speed limit when responding to a call. I was pretty surprised when I heard it, I had always assumed they were free to go as fast as they safely could.

 

[akflightmedic]

Since you are new, I will take the time to reiterate what I have said many times and have shared in many classrooms over the years.

This is very valuable knowledge so here goes....SPEED KILLS!

Just because we are EMS workers in big boxes with lights does not make us indestructible supermen unaffected by the laws of physics.

One of my big pet peeves are people who feel the need to speed and also feel they do not need to buckle up because they are responding and do not have the time. You have to take care of yourself FIRST, or you are no good to anyone.

I have worked with many partners over the years and been witness to many bad driving habits, however this particular persona was most prevalent in the younger, inexperienced workers. For some reason, they felt they could drive however they wanted, fast as they wanted and everyone should get the hell out of THEIR way because they were responding to an emergency.

This is the wrong mindset for several reasons.

1. It is not you emergency. Drive with due regard and arrive safely so you are able to help if you can with their emergency.

2. If you speed and get in an accident, you now need an ambulance for the original call (not to mention the waste of time for this person), an ambulance for you and your partner possibly, AND an ambulance for whoever you hit.
Does your area have this many resources and is this really the best way to test this?

3. If you drive fast, your adrenaline is pumping and you are now in a very hectic mindset. When you arrive at the call (provided you made it safely) and get out of the truck, you are now operating in a fast mode. This is not the best way to approach an emergency scene. You will get tunnelvisioned and miss details, details that may be dangerous to you.

This is why you need to drive calmly, keep a rational state of mind and approach the scene with caution. No one wants an EMS worker spilling out of an ambulance, heart racing, respirations increased and tunnel visioned all because they drove too fast and already had a few missed accidents on the way to this particular call. You must stay clear headed and focused.

The NATIONAL standard is 10 miles over posted speed limits except for school zones and residential areas. Exceeding these are just plain stupid and yes if you are one who regularly does this, I just called you stupid. It will catch up to you one day and it may not be you who is hurt (not physically anyways); but when you have to wake up every day and know that you critically injured someone or took a life of someone because you were speeding uneccesarily so, the emotional pain will destroy you.

Ask yourself, how many of our emergencies we respond to are actual emergencies? It is all about Risk vs Gain. Big risk for big gain, little risk for little gain. Yes, there are those calls where it is an emergency, however it is not your emergency. We need you to arrive safely so that you may do your job you trained to do.

Another thing to watch out for is maybe not getting in accidents, but causing accidents. I have seen ambulances whizz through traffic too fast and cause other vehicles to collide. Was it worth it to them for you to cause that?

Yes, a cop can pull you over and ticket you in an ambulance for excessive speed. It happened in my last service. The officer didnt interupt the response, however he did follow the unit to the scene and once the patient was squared away, he took care of business.

There have been numerous studies done that show lights and sirens in general do NOT increase response time in a significant manner. At most you save a minute in urban areas yet increase the risk to you and others 10fold.

We are no longer in the days where we are nothing more than drivers and speed was the only thing that would help a patient. We are now trained, some of us are even educated in the art of medicine. We have the knowledge, skills, tools, and assessment abilities to take care of our patients. The first step in utilizing all of these things is arriving in one piece at their bedside.

 

[medman123]

Thats good to know, it will come in handy when I start to work, Thank you for your help!

 

[VentMedic]

Great post akflightmedic!

The van and box ambulances aren't designed for speed anyway.

We haven't ran like the devil chasing us (and shouldn't anyway) since the hearst ambulances with their big engines and road hugging chassis.

I remember listening to the stories of how the big Miami ambulance companies sent a fleet of 50 Cadillac ambulances to the 1972 Eastern Airline crash in the Florida Everglades. 60 miles of empty road...no helicopter could have beat them back then.

May those days rest in peace with the Cadillac Hearst ambulance.

 

[MMiz]

Our ambulances top out around 80 MPH, but they rarely go that fast (especially now that we have a monitoring system that prints out a report on a weekly basis).

I sincerely believe that there are exceptions to every rule, and believe that in EMS we need to help ourselves, our colleagues, and the kids. If I hear a call for a ped. choking you better believe I'll be hearing the loud squeal of the rig's driver-check system as I get there fast and take the corners a bit too quick

 

[akflightmedic]

Our ambulances top out around 80 MPH, but they rarely go that fast (especially now that we have a monitoring system that prints out a report on a weekly basis).

I sincerely believe that there are exceptions to every rule, and believe that in EMS we need to help ourselves, our colleagues, and the kids. If I hear a call for a ped. choking you better believe I'll be hearing the loud squeal of the rig's driver-check system as I get there fast and take the corners a bit too quick

While your thoughts are noble, I respectfully disagree. I do not disagree about the rule bending in general, only disagree when it compromises safety.

As for the choking comment, I have never actually made it to a choking call where I made a difference. I have made a difference when I happened to be in a store and in a restaraunt off duty when people were choking, but as far as responding from the station with an average of 6-8 minutes response time...forget about it.

Having said all of that, and I can only speak from my personal experience, I have never responded in an ambulance and arrived while the person was still actively choking. The majority of choking calls are new parents with their infants who do not realize that babies choke and they do it often. Their baby turns purple and they freak out, call 911 and when you arrive there is a pink baby, smiling and drooling.

I am just trying to present scenarios from all angles so one can make an informed decision about how they will react or respond in the future. I realize one man's comments are not going to change the world but if I am able to get one person to stop and reconsider their ways, then maybe one uneccessary death or injury may be prevented.

A really great link to check out with regards to ambulance crashes is the ambulance crash log on emsnetwork.org.

It has all the reported crashes throughtout the years. Go read it and see what the contributing factors were. Read about the age of drivers, speed, training and who was at fault for the accident. More interesting, is find out what they were responding to...what call necessitated their action and now look at the results.

It offers a whole new perspective, especially for those who think we are impervious to harm due to our elevated status of "Savior of All".

 

[MMiz]

Again, I think it's all about perspective and the situation. My experience working EMS was working suburban streets from 7:30P-7:30A on the weekends. I'd have no reservation about going 80 MPH down a four lane road with no other cars on the road. As a conservative driver I never did it, and never felt the need, but depending on the situation, I'd absolutely do it if warranted.

While I never arrived on an active choking patient who was truly choking, my BLS partner did arrive on a call one day while doing an ALS ride along. The person was choking on their Sunday morning muffin, and no amount of thrusts would dislodge the thing. Magill forceps did the trick, the patient was tubed, taken to the hospital, and had a full recovery.

I also knew a guy that week that had a similar thing occur, was proud to make another save with with the forceps, and then got called a few weeks later to take the patient home from the hospital to an extended care facility... she turned out to be a vegetable.

Our ambulances have a speed monitoring device, and start clicking at around 67 MPH. At around 75 MPH there is a high pitched tone. I have only made the thing click on the freeway (with a 65 MPH limit, 75 MPH average car speed), and have never caused the high pitched alarm.

Driving an ambulance isn't radically different than driving in general. You need more time and room to stop and turn, and have to always be aware of the patient and partner in back. The big difference I find is that the lights and sirens are generally counter-productive, and actually slow down the response time. When driving L/S I try to anticipate the actions of the drivers in front of me, and then assume they'll do the complete opposite.

Enough rambling for me. As long as you're aware of your environment, limitations, and that speed+ambulance=bad, then you'll do fine. I argue, and continue to believe, that there are always exceptions to every rule.

 

[Stevo]

interesting that we are in such a time related business, where the general public expects a quick response.

yet 95% of what we do is a taxi ride, and like a fav PA said to us (as we shoveled yet another over packaged patient into his e.r.) "The patient lived, despite ems's best efforts!"

too bad ambulances don't have some indicating device for that 5% eh?

Man: Here's one-
Cart-master: Ninepence.
Old Man: (feebly) I'm not dead!
Cart-master: (suprised) What?
Man: Nothing! Here's your ninepence....
Old Man: I'm not dead!
Cart-master: 'Ere! 'E says 'e's not dead!
Man: Yes he is.
Old Man: I'm not!
Cart-master: 'E isn't?
Man: Well... he will be soon-- he's very ill...
Old Man: I'm getting better!
Man: No you're not, you'll be stone dead in a moment.
Cart-master: I can't take 'im like that! It's against regulations!
Old Man: I don't want to go on the cart....
Man: Oh, don't be such a baby.
Cart-master: I can't take 'im....
Old Man: I feel fine!
Man: Well, do us a favor...
Cart-master: I can't!
Man: Can you hang around a couple of minutes? He won't be long...
Cart-master: No, gotta get to Robinson's, they lost nine today.
Man: Well, when's your next round?
Cart-master: Thursday.
Old Man: I think I'll go for a walk....
Man: You're not fooling anyone, you know--
(to Cart-master) Look, isn't there something you can do...?

(they both look around)

Old Man: I feel happy! I feel happy!

(the Cart-master deals the old man a swift blow to the head with his wooden
spoon. The old man goes limp.)

Man: (throwing the old man onto the cart) Ah. thanks very much.
Cart-master: Not at all. See you on Thursday!
Man: Right! All right....

~S~

 

[Medic's Wife]

LMAO @ the Monty Python ref :lol:

 

[Tincanfireman]

Without reposting all the excellent points made thus far, I'd like to add the perspective of experience. With no disrespect to anyone, it is generally understood that folks in their teens and twenties are statistically more likely to get into MVC's than those in their 30's and 40's. This is while driving their personal vehicles in normal conditions. Now, add an oversize vehicle, raise the center of gravity a couple of feet, and inject some adrenaline, not to mention higher speeds, crossing intersections against traffic, and distractions caused by activities in the back, etc. The difference between getting to your destination in one piece and potentially not getting there at all lies in experience and a greater ability to weigh risk vs. benefit in older (read more experienced) vehicle operators. For this reason, I believe the biggest benefit we can provide to our passengers/patients/partners is to simply let off on the accelerator a little bit. The time savings of running at greatly extra-legal speeds vs running at a more moderate pace is probably minimal when you weigh in the increased chances of being involved in an MVC while operating at the higher speed. I would submit that in most urban/suburban environments the time savings can be measured in a minute or two at most. I will admit that truly rural roads can be an exception, but that's not in the equation for most of us. I will also agree that there are some excellent teenaged drivers and some perfectly horrible and unsafe older drivers, but in general the point applies. I'm not age-biased, just pro-experience. Just some food for discussion and my personal .02 -_-

 

[VentMedic]

Good posts.

How soon we forget Mike Montecalvo. I don't know if he is still speaking around the country for safe ambulance driving but he is definitely worth listening too. Google paramedics and vehicular manslaughter or homicide...or subscribe to JEMS newletter...

http://www.emsmagazine.com/publication/article.jsp?id=1696&pubId=1

 

[Stevo]

I'm not age-biased, just pro-experience. Just some food for discussion and my personal .02

well that works both ways Tincan, the younger crowd gets all pissed off when i leave the turn signal on for the whole run....

~S~