Patient requesting "shutdown" prior to arrival.

[ArcticKat]

Next time you're with her, key up the mic and have it admitted over the air.

That wouldn't be a HIPPA violation at all?

 

[JPINFV]

Since we're going down this path, California is an "as reasonable" requirement for auditory warning systems.

 

[JPINFV]

That wouldn't be a HIPPA violation at all?

1. It's HIPAA (Yes, America's hat shouldn't know what Canada's Pants requires).

2. Only if otherwise identifying information is also transmitted.

 

[WoodyPN]

Also from Maryland, and when we respond at night when there is less traffic....we aren't going to blast halfway across the city lights and sirens unless we are dispatched as Echo. Other than that, we just use the lights. And they stay on @ the scene, especially when we have to stop in the middle of the street. Unless were dispatched Alpha, then we probably wouldnt but it depends to us where we park and what would make us more visible.

 

[ArcticKat]

1. It's HIPAA (Yes, America's hat shouldn't know what Canada's Pants requires).

Sorry for my typo, at least we keep your bald spot warm.

2. Only if otherwise identifying information is also transmitted.

Such as the original dispatch information for that particular ambulance identifying the age, gender, and location of the individual being recorded? The same information broadcast over the air and scannable by anyone determined enough regardless how secure you think it is?

 

[AlphaButch]

Technically, I DID finish reading Section 546.001

Oh and,
"directing or diverting traffic for public safety purposes"

Diverting traffic away from my ambulance so we can leave when we have to. Ta-da. ^_^

Maybe not within the "spirit of the law", but most defintly within it technically, which is really all that matters in courts anymore.




I smiled and asked her to call the Police if she had an issue.


I would have been less rude had she been less rude.

In Texas, it's been deemed reasonable that the law applies when parking an emergency vehicle to ensure easy egress in the event of an emergency. I'd have to look up the ruling (it involved wal-mart and a fire truck).

I know alot of cities here in Texas have a "no L&S in a residential area after (time)". I've never seen it enforced or even brought up in regards to an emergency.

At every service I've worked at - the decision to use L&S is made by dispatch or by the providers (on scene or enroute) and is determined by the call information. Once upgraded to echo status, it stays that way until someone assesses the scene and determines otherwise. We do find it poor form to use sirens in residential areas at night though, especially since it hasn't shown any difference in response time.

 

[dixie_flatline]

Maryland has this requirement. Well, sort of...



I added the numbers 1 and 2 in brackets to the above quote to address each of those questions as they relate to Maryland.

1. The special privileges afforded to a driver of an emergency vehicle in Maryland, while operating on an emergency call, are afforded only when the vehicle is operated with both audible and visual signals. Md. TRANSPORTATION Code Ann. § 21-106

2. An "audible signal" is specifically defined as a "siren, exhaust whistle, or bell capable of giving an audible signal". Md. TRANSPORTATION Code Ann. § 22-218 Therefore, a horn, including an air horn, is not an audible signal as defined by Maryland law for the purpose of granting emergency driving privileges to the operator of an emergency vehicle.

In my experience, I cannot recall an EVO ever using a siren through a residential area when it wasn't necessary to do so, especially at night. In fact, I would even go so far as to say that in my experience, EVOs I'm familiar with use the siren as minimally as possible, period.

This is true, to an extent. Maryland does require Lights & Sirens to qualify under the statutes that protect us while driving "Emergency" (Priority 1 in Maryland terms, Code 3 elsewhere I guess). If you don't have both L&S going, no proceeding through red lights or anything like that, and you're on much shakier ground in the event something goes wrong (but then again in that case you also have to be able to justify what made the situation a "true emergency" that required running P1 to begin with).

In practice, we run with lights and no sirens fairly regularly for a variety of non-critical patients (call it Priority 2), as well as while transporting patients whose conditions might be aggravated by the sound of the sirens.

However, as a corollary, under no circumstances should sirens be run without lights.

 

[DrParasite]

I know alot of cities here in Texas have a "no L&S in a residential area after (time)".

so which law should you follow, the state law requiring L&S in a residential area, or the city law saying not to?

 

[AlphaButch]

The state law only requires L&S if you are requesting special privilege (similiar to MD's requirements). We go lights only through residential areas unless we are requesting privilege (such as going against a red light), in which case we just hit the siren until we are clear of the intersection and no longer need that privilege.

State law supercedes the city ordinances. Again, I've never seen the city ordinances enforced other than a verbal warning to not spook someone's chickens or wake up the mayor's wife.

 

[firecoins]

Patients don't dictate response or where we park. :rofl:

If I don't need lights and sirens, I won't use them.

If they request no lights, I wonder if they need an ambulance at all.

Its been my experience that the worst patients walk to the ER or don't think they are having an emergency. If they say no lights or sirens, they probably need them.

 

[bstone]

When responding to a call that the PT requests no l/s I will decide if that is appropriate for the type of call. For a "don't feel well" I might agree. For chest pain and SOB then I will light it up. If it's 3am or a residential street with little traffic then I'll keep the lights on but turn the siren off. No sense in waking people up when it's not necessary to be making a very loud noise.

 

[HotelCo]

Completely agree with the last part. And You've never been in the situation that you needed Law and nothing about the call hinted toward that? I couldn't tell you how many times that happens to me. And That Only time I do leave my lights on at the road, is usually on Arrests or at least an actual emergency that fire or Law hasn't made it to yet. Just so they can spot me better.

You said you leave them on if you believe you'll need PD. If you need PD, should you be going in?

If you realize in the middle of the call that you need them, are you going to request them, run out and hit the lights, then go back on scene? If you can't wait the 1.7 seconds longer it'd take for them to find the big ambulance without the lights on, you probably shouldn't be staying on scene, yeah?


Also for everyone else, we're not talking about responding with no lights and sirens. I hear a lot of "patients don't dictate our response." you're right, but I think this is more about shutting them down on their street. How much time are you going to save by having your lights on for a couple hundred feet in a residential area? If I'm having a medical emergency, I wouldn't want all my neighbors coming out to stare at me while I'm being wheeled out to the rig.

 

[Shishkabob]

I keep them on in the street on scene, day or night, for the simple fact that it's easier for others to find the ambulance if I need them to.


Be it police or another ambulance as backup, it's just easier to notice something bright and flashing.

 

[Cup of Joe]

If its a call to a grammar school, where you could park in the parking lot, I could see the school requesting that just to keep from distracting all the kids with the flashing lights. Though an ambulance in the parking would probably get everyone's attention anyway.

 

[LucidResq]

Had a lady call 911 today for hematemesis. She requested early shutdown in part because she was trying very hard to keep her anxiety level down because she felt like she may have an asthma attack. I made this clear to them... and ended up banging my head into the keyboard when I heard the whoo whoos in the background and her starting to freak. Guys, 2 seconds ain't gonna make or break this lady even if she has the Niagra Falls of GI bleeds. Working her up and stressing her out to the point she has an asthma attack will affect her.

I understand if you feel L&S are necessary for responder safety reasons, but beyond that... do right by your patient.

 

[imadriver]

I understand if you feel L&S are necessary for responder safety reasons, but beyond that... do right by your patient.

I agree, there are a lot of good reasons to shut down. And this would differently be one of them.

Although, a few days ago I actually had a request to shut down, and didn't (No Sirens, but Lights). The reason being is cause it was still early in the night, so there was traffic, and this person's driveway happen to be shared with a semi-major four lane road. I shut down as many lights as I could, but my front and back red flashers were still going because I had to park in the left lane of the road directly in traffic. The only time I do leave them on Whether they request it or not at night is when someone may need to spot me for whatever reason.

 

[McGoo]

In West Australia, we only need lights going to claim the exemption from the road rules to go fast, sirens are optional. Our dispatch dictates priority to a call, but if it's not going to save any time getting there, or I'm so tired that I can't think fast enough to drive fast, I won't use them.

As for shutting down early, I turn the lights off maybe a block or two away unless it's an MVA. Most nursing homes don't like the combined heart rate of their residents spiking unless it's absolutely necessary.

 

[exodus]

In West Australia, we only need lights going to claim the exemption from the road rules to go fast, sirens are optional. Our dispatch dictates priority to a call, but if it's not going to save any time getting there, or I'm so tired that I can't think fast enough to drive fast, I won't use them.

As for shutting down early, I turn the lights off maybe a block or two away unless it's an MVA. Most nursing homes don't like the combined heart rate of their residents spiking unless it's absolutely necessary.

If you're that tired you shouldn't be driving at all...

Stay safe.

 

[Missedcue]

It's my belief that we have lights and sirens for our safety as responders. I work in an urban environment and there are times that I have to run with lights and sirens at 3:00AM for BS calls because I don't want to get smashed into by a drunk in an intersection. However I also believe that your level of safety is at your discretion, I will not compromise my safety or the safety of my partner or patient to save someone some embarrassment. At night, I often go with just lights through neighborhoods and just tap my siren around blind curves and major intersections

 

[Missedcue]

Had a lady call 911 today for hematemesis. She requested early shutdown in part because she was trying very hard to keep her anxiety level down because she felt like she may have an asthma attack. I made this clear to them... and ended up banging my head into the keyboard when I heard the whoo whoos in the background and her starting to freak. Guys, 2 seconds ain't gonna make or break this lady even if she has the Niagra Falls of GI bleeds. Working her up and stressing her out to the point she has an asthma attack will affect her.

I understand if you feel L&S are necessary for responder safety reasons, but beyond that... do right by your patient.

I totally agree. Going routine for the last block or 2 will not adversely effect your ability to make it to a patient in a timely manor.