Emergency lights enroute to ER

[ONEEYEDMIC 68]

On the same topic as some of you have started. One thing that burns me to know end is when I see an ambulance driving to the hospital with the lights on and no siren and obeying the NYS Traffic Law.

Sometimes I know people forget and I have been know to drive around for hours with my rear lights on but you can't forget all the time.

Do some agencies have protocols that say you have to drive to the ER with a stable patient and the lights on?

I have seen it so many times and I just want to pull the ambulance over and see what is going on. Especially if it happens when I am working. Sometimes things do turn bad in the ambulance and they need to "step it up" but for the most part they don't need the lights.

I am not trying to cause a problem just curious of some AMB rules.

[Guest]

Here in northern Vermont some ambulance squads use red lights but no siren when they have a patient on board simply "because it's always been done that way". Perhaps many years ago there was a real reason to do this, but if asked I'm almost certain no one could tell you what that reason may have been.

[IzzyEng4 427]

In New Haven South Central its a priority 1 (hot) or priority 2 (cold) response to the hospital depending on the patient's condition to a hospital. State law mandates that all visual and audio warning devices must be on simultaneously or not used at all.

[Guest]

On the same topic as some of you have started. One thing that burns me to know end is when I see an ambulance driving to the hospital with the lights on and no siren and obeying the NYS Traffic Law.

Sometimes I know people forget and I have been know to drive around for hours with my rear lights on but you can't forget all the time.

Do some agencies have protocols that say you have to drive to the ER with a stable patient and the lights on?

I have seen it so many times and I just want to pull the ambulance over and see what is going on. Especially if it happens when I am working. Sometimes things do turn bad in the ambulance and they need to "step it up" but for the most part they don't need the lights.

I am not trying to cause a problem just curious of some AMB rules.

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Great topic, i'm glad you brought this up. Can't tell you how many times i've transported a patient to the hospital and just as i get within 5 minutes of the hospital another ambulance comes into view with all their lights on, tapping through traffic. Meanwhile, i hear over the radio that they are transporting a patient with post-surgical abdominal pain or general illness. I can recall one time in particular where i actually made a comment to a driver from a VAC about this and he tried to chew me out, i respectfully told him to blow it out his a$$. This goes hand-in-hand with responding lights and sirens to a non-emergent EMS call. Its wrong and unprofessional and, IT DOESN'T SAVE YOU AN OUNCE OF TIME! But, just like everything else its not going to change. I've come to the point where i wounder if i should even bother caring if an ambulance gets out, if they are responding appropriately, if they look professional, etc.

[nycemt728 49]

I have asked around other EMTs in the past, and some leave primaries on as "hazards"; to suggest to motorists that they have a pt on board and that the vehicle may go slower and to be cautious. Whether this is effective, warranted or in some rule book somewhere I don't know.

[OoO 24]

Great topic, i'm glad you brought this up. Can't tell you how many times i've transported a patient to the hospital and just as i get within 5 minutes of the hospital another ambulance comes into view with all their lights on, tapping through traffic. Meanwhile, i hear over the radio that they are transporting a patient with post-surgical abdominal pain or general illness. I can recall one time in particular where i actually made a comment to a driver from a VAC about this and he tried to chew me out, i respectfully told him to blow it out his a$$. This goes hand-in-hand with responding lights and sirens to a non-emergent EMS call. Its wrong and unprofessional and, IT DOESN'T SAVE YOU AN OUNCE OF TIME! But, just like everything else its not going to change. I've come to the point where i wounder if i should even bother caring if an ambulance gets out, if they are responding appropriately, if they look professional, etc.

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I'm not necessarily defending this type of policy, but some VACs might use lights and sirens on a nonemergency calls because they only have one bus and they need to get to and from the hospital as quickly as possible in order to cover their district.

[Guest]

I'm not necessarily defending this type of policy, but some VACs might use lights and sirens on a nonemergency calls because they only have one bus and they need to get to and from the hospital as quickly as possible in order to cover their district.

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Sorry, but thats a line of bull. Completely unacceptable. This is why we have mutual aid and backfill. When someone gets killed as a result maybe a lesson will FINALLY be learned.

Response times are not as important as once thought. It is unfortunate that we place so much emphasis on response times. There is a finite time interval to drive from point A to point B. Using lights and sirens can shave a few seconds off of the response. Driving over the posted speed can shave a few seconds off the response. But both red lights and siren usage and driving over the speed limit SIGNIFICANTLY increases the likelihood of a collision. The time saved is not clinically significant. So, why place employees at risk?

http://www.jems.com/columnists/bledsoe/articles/240570/

Edited May 13, 2007 by 66Alpha1

[ONEEYEDMIC 68]

I can't agree with having lights on so that you can get to the hospital and out of the hospital because you are the only AMB in service. That is why there is Mutual Aid.

I also don't agree to have lights on for Hazzard purposes. I think that when most of the public see's an Ambulance they assume there is a patient on board anyway. I always try and look in the back if I can.

Lights cause problems. All of us that have ever driven and EMERGENCY VEH know that people do not know how to drive when there is a VEH with lights and sirens on either behind them or coming their way. I just think to err on the side of caution and keep them off unless you really, really have too. This is not directed just towareds EMS either.

I also notice that lost of FD's when they are returning to their HQ's have their lights on as well. I was told by someone that by law they had to. Is this true?

I know that the only time that I turn on my lights is if somebody is calling for another car or it is a serious MVA or MEDICAL Condition. Other than that, I just take my time. I would rather arrive alive. Too many careless driving on the road.

[64FFMJK 21]

I have several issues with this as well. There have been several times when I have intercepted with a BLS crew in CT going to sharon hospital and they are driving lights and no siren all the way to the hospital for a PT that was not in a critical PT.

I also was driving an ALS bus with a cardiac PT on the TSP and was pulled over by the NYSP and the trooper said "I don't know if you are alowed on the TSP with an ambulance." I informed him that I had a PT in the back abd was going to Albany for surgery and he replied "why arn't your lights on then?" being it was not a critical PT I explained to the trooper that it is against our SOP's.

I have heard of places that have lights that signify if there is a PT in the bus similare to the cruise lights in the lightbars in CT they are dim steady bulbs but that would just be something else to confuse the drivers out there

[ONEEYEDMIC 68]

Again back in the day I had to TXP a PT from WMC to UPENN Hospital for a liver transplant. The PT was stable and it was a Thurs night I think in the summer. Anyway traffic was backed up on the Garden State and I asked my partner to turn the lights and sirens on so we could get out of the traffic. Well we got pulled over and my partner was really nervous and she asked me what to do. I said that I would talk to the Trooper. He was cool and I told them we had to be at the hospital at a certain time because of the Liver. He said that unless we had a permit to drive with lights and sirens on in NJ that we had to turn them off. In return he told us just to drive fast and said he was going to tell some other troopers what our deal was. That was pretty cool.

That article was great and got me thinking. Most PD's and I think even FD's have a EVOC course. I know that was the best time beating the crap out of cars but you also learn what most cars can do and how to react to certains situations. I know an ambulance is different and I know Fire Trucks are huge but there more and more Fly Cars being used and I think that a formal class should be a requirement for ALL EMERGENCY VEHICLES. Just because you have been driving and AMB, Fire Truck doesn't make you DALE Jr.

[Reliance 29]

Again back in the day I had to TXP a PT from WMC to UPENN Hospital for a liver transplant. The PT was stable and it was a Thurs night I think in the summer. Anyway traffic was backed up on the Garden State and I asked my partner to turn the lights and sirens on so we could get out of the traffic. Well we got pulled over and my partner was really nervous and she asked me what to do. I said that I would talk to the Trooper. He was cool and I told them we had to be at the hospital at a certain time because of the Liver. He said that unless we had a permit to drive with lights and sirens on in NJ that we had to turn them off. In return he told us just to drive fast and said he was going to tell some other troopers what our deal was. That was pretty cool.

That article was great and got me thinking. Most PD's and I think even FD's have a EVOC course. I know that was the best time beating the crap out of cars but you also learn what most cars can do and how to react to certains situations. I know an ambulance is different and I know Fire Trucks are huge but there more and more Fly Cars being used and I think that a formal class should be a requirement for ALL EMERGENCY VEHICLES. Just because you have been driving and AMB, Fire Truck doesn't make you DALE Jr.

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I agree - Up here in Nova Scotia it's either lights and siren Code 1 or no lights and siren code 2.

Also on/off topic I have been in Massachusetts where some fire departments return to the station after a call with lights on and no siren. Question is WHY???

[sr71 1]

in my dept we turn the apparatus lights off when coming back from calls only to turn them on in like less than 300ft from the fd to warn the idiot drivers on the post road that yes we are backing up and go behind us while backing up like a F***ing idiots!! and the ones that do usually get caught at the lights right by the fd so there plate #'s are taken and thte police do act on it

Edited May 13, 2007 by sr71

[Guest alsfirefighter]

There is no such thing as a half response. If you have to drive slow..drive slow who gives a $hit what the other drivers are thinking or what they might do as long as you are aware of it recognize it and avoid their stupid actions. There is no way to justify this as "to let other motorists know there is a patient on board." Last time I checked this wasn't taught at DMV or is it in any of the books. Lights on to me says you are requesting the right of way. Some of these same people are the ones who will insist that if your lights are on your siren has to be on...but apparantly get lost in this instance. Which by the way even that is false..just because your lights are on doesn't mean your siren has to be.

Secondly...traffic, the potential for another call, a partridge in a pear tree are not any defense for using your lights. One call at a time. If your worried about another call, hire staff, put a unit on stand by or figure somethign else out. One call at a time. Sorry ma'am, I know your kid was killed but our ambulance had to hurry to the hospital with that stable patient to get back to the district.

That is one of the great urban myths of EMS..."our insurance says if there is a patient on board our lights have to be on."

Funny enought I had a driver only from an agency, that the head of Putnam EMS was a member of, call him and complain about me when I was working the flycar in Putnam one day. It was a wierd light snow storm in late march and the roads were dusted and he has his lights on and not to mention driving entirely too fast for the road conditions, well for any conditions for that part. Even that patient commented on how fast he was going and he was restrained on the stretcher. I asked him to slow down and turn his lights off and he told me he couldn't. I asked him why and very nastily says "because there is a patient in the back." So when I again asked him to please turn them off due to there is no such priority nor policy to do such he got more nasty and I let it go for reasons not needed to be mentioned here. And I get a complaint to sloper via phone by the head of a county EMS because I asked for the driver not to do it...go figure.

[Guest]

There is no such thing as a half response.  If you have to drive slow..drive slow who gives a $hit what the other drivers are thinking or what they might do as long as you are aware of it recognize it and avoid their stupid actions.  There is no way to justify this as "to let other motorists know there is a patient on board."  Last time I checked this wasn't taught at DMV or is it in any of the books.  Lights on to me says you are requesting the right of way.  Some of these same people are the ones who will insist that if your lights are on your siren has to be on...but apparantly get lost in this instance.  Which by the way even that is false..just because your lights are on doesn't mean your siren has to be.

Secondly...traffic, the potential for another call, a partridge in a pear tree are not any defense for using your lights.  One call at a time.  If your worried about another call, hire staff, put a unit on stand by or figure somethign else out.  One call at a time.  Sorry ma'am, I know your kid was killed but our ambulance had to hurry to the hospital with that stable patient to get back to the district.

That is one of the great urban myths of EMS..."our insurance says if there is a patient on board our lights have to be on."

Funny enought I had a driver only from an agency, that the head of Putnam EMS was a member of, call him and complain about me when I was working the flycar in Putnam one day.  It was a wierd light snow storm in late march and the roads were dusted and he has his lights on and not to mention driving entirely too fast for the road conditions, well for any conditions for that part.  Even that patient commented on how fast he was going and he was restrained on the stretcher.  I asked him to slow down and turn his lights off and he told me he couldn't.  I asked him why and very nastily says "because there is a patient in the back."  So when I again asked him to please turn them off due to there is no such priority nor policy to do such he got more nasty and I let it go for reasons not needed to be mentioned here.  And I get a complaint to sloper via phone by the head of a county EMS because I asked for the driver not to do it...go figure.

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ALS, its funny how nothing has changed since the days you worked in Putnam

[Guest alsfirefighter]

Even worse Alpha its been a couple years now. lol.

Talk about leadership vs management. Or could it be the tail wagging the dog. Needless to say the bus in question was a m/a bus into mahopac from an agency that normally hit 20th tone when I was working there. Nothing like going to school for 2 years...being a fire instructor who heavily teaches EVOC and preaches response and scene safety and responsibility...to be told by someone who can only drive an ambulance. I always wondered if that guy spelled it ecnalubma because that is how he saw it most of the time in the bay...lol.

[ckroll 101]

A couple of things.... Granted I work in a town with 2 traffic lights, but half the time I respond with neither lights nor sirens and respond lights alone unless I'm coming up on someone. Mostly I'm looking to go highway speed and have people yield as appropriate. My experience has been that people will yield to an emergency vehicle with lights on, but tend to do stupid things when challenged by speed, lights and an air horn.

It is rare that seconds or minutes make a difference and the EMS vehicle is fully responsible if an accident occurs while responding as if to an emergency. Maybe there isn't such a thing as half a response, but perhaps there should be.

I recall someone wise telling me that one of the qualities of a paramedic is that they were the only person in the room who wasn't allowed to panic. Paramedics are responsible for controlling the scene and that includes how they drive and how the ambulance drives to the hospital. If one is clear from the time that an assessment is complete what the level of urgency is and communicates clearly what the response should be, then hold the crew and the driver to it.

Some days the crew needs to pick it up and some days they need to slow it down. Be constructive about it, tell them why, treat them like intelligent adults, but let them know what you and the patient need. If the paramedic can't work in the back of the ambulance, then the added speed is a hindrance not a help.

EMS has changed since the addition of ALS. Emergent care can happen at the scene. Transport, save for very special circumstances, ought to be non emergent. For the most part I find volunteer corps responsive if you take the time to explain t to them.

[Oswegowind 17]

Another case where most times the emergency is over once EMS (or properly trained personnel) arrive at the scene. There are very few times it is necessary to respond with a victim/patient to the ER utilizing emergent operation capabilities. If there is a life threatening injury that is out of your control and the need for immediate ER care is necessary than it is justified. I remember volunteering at 2 EMS agencies for some time here is northern Westchester and with the help of some of the EMTBravo members we were able to quell this idea that anytime the ambulance was moving the lights/siren should be on. I hope we actually saved at least 1 life by pushing this issue with the non-progressive senior members that just didn't understand at first!

[WAS967 97]

I have several issues with this as well. There have been several times when I have intercepted with a BLS crew in CT going to sharon hospital and they are driving lights and no siren all the way to the hospital for a PT that was not in a critical PT.

I saw this and had to comment before reading on so I apologize if this was already covered. I assume since you were the one intercepting with the BLS agency that you were the medic or your partner was the medic. Either way, the medic who was caring for the patient in the back of that rig, if they knew of the lights but no siren status should have said something to the driver. While the driver is in control of the vehicle, the highest trained medical person in the back is ultimately responsible for the way in which the pateitn is transported to the hospital. I've told drivers (who routinely drive L&S to the ER with stable patients) to shut the lights down. If they ask why I politely tell them it's not needed. I have only once had a problem with a driver objecting to this, and it was dealt with appropriately after the call.

I tell people, if they are in this just to play with the L&S, they need to find another hobby.

I always wondered if that guy spelled it ecnalubma because that is how he saw it most of the time in the bay...lol.

I am glad I wasn't drinking milk when I read that.

Edited May 16, 2007 by WAS967

[RWC130 594]

Some of these same people are the ones who will insist that if your lights are on your siren has to be on...but apparantly get lost in this instance. Which by the way even that is false..just because your lights are on doesn't mean your siren has to be.

Pursuant to VTL § 1104 ©, all authorized emergency vehicles,

except police vehicles, must be operating a siren and at least one lighted red light for the exemption of the statute to apply.

Vehicle and Traffic Law Sec 1144

Upon the approach of an authorized emergency vehicle ( police, fire, ambulance, etc. ) displaying at least one emergency light and when sounding an audible signal ( siren, air horns ) the driver of every other motor vehicle shall yield the right of way and shall immediately drive to a position parallel to and as close as possible to the right hand edge or curb of the roadway, or to either edge of a one way three or more lanes in width, clear of any intersection and shall stop and remain in such position until the authorized emergency vehicle has passed.

I am not saying you should be transporting anyone lights & siren or just lights, or no lights at all. I honestly don't care. The days of getting a woodie hitting the sirens for me are long gone.

I have read thru numerous case law in the State of New York where motorists have WON lawsuits because the Fire Truck or Ambulance was not in "Emergency Operation" with it's Lights and Siren activated.

Yes, we all use judgement and don't lay on the Federal Q and Air Horns at 4 in the morning but.... Hit someone or someone hits you and you don't have a siren on OH BOY! You better pray EVERY witness says "I heard the siren"

The law is pretty clear "when sounding an audible signal"

So... unless you are a police vehicle and you have the Lights on you

better be making some noise.

Just my TWO cents

[Guest alsfirefighter]

RWC..you are absolutely correct in your statement about V & T Section 1104. It also says "as may be reasonably necessary." If you are using the exemptions stated in 1104 you must have your lights on, siren on as may be reasonably necessary. 3 am no traffic not reasonably necessary. Straight road no traffic control devices...no speeding not necessary.

As an EVOC instructor I would appreciate if you pass along the cases where the apparatus operator/agency lost a case where the accident involved lack of use of siren. Most of the cases I read involved plain negligence of the operator in some other form.

If you hit a vehicle you are at fault no matter what you have on. Vehicle hits you they may be at fault but was probably something controllable by the operator of the EV, like ensuring a vehicle traveling towards them comes to a stop instead of assuming.

[x129K 1,393]

Lights and siren to the ER......

How close to shift change is it?

[ckroll 101]

Don't hit people. Don't put yourself in a position where other people will hit you. Good advice for driving; good advice in general.

[RWC130 594]

NYS VTL 1104

(a) The driver of an authorized emergency vehicle, when involved in an emergency operation, may exercise the privileges set forth in this section, but subject to the condition herein stated.

( The driver of an authorized emergency vehicle may:

1. Stop, stand or park irrespective of the provisions of this title;

2. Proceed past a steady red signal, a flashing red signal or a stop sign, but only after slowing down asmay be necessary for safe operation;

3. Exceed the maximum speed limits so long as he does not endanger life or property;

4. Disregard regulations governing directions of movement or turning in specified directions.

© Except for an authorized emergency vehicle operated as a police vehicle, the exemptions herein granted to an authorized emergency vehicle shall apply only when audible signals are sounded from any said vehicle while in motion by bell, horn siren, electronic device or exhaust whistle as may be reasonably necessary, and whenthe vehicle is equipped with at least one lighted lamp so that from any direction, under normal atmospheric conditions from a distance of five hundred feet from such vehicle, at least one red light will be displayed and visible.

(e) The forgoing provisions shall not relieve the driver of an authorized emergency vehicle from the duty todrive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his reckless disregard for the safety of others.

(f) Not with standing any other law, rule or regulation to the contrary, an ambulance operated in the course of an emergency shall not be prohibited from using any highway, street or roadway; provided, however, that an authority having jurisdiction over any such highway, street or roadway may specifically prohibit travel there on by ambulances if such authority shall deem such travel to be extremely hazardous and would endanger patients being transported thereby

[Guest]

I think that the problem here is not only the (Crew) of the ambulance but is the Departments that either don't set a SOP or have a SOP but loosely follow it. Maybe (a bright idea) at one of their County meetings, Chief Meetings or what ever high level meetings we set a standard for all departments to follow.

Maybe that is to easy?

[ckroll 101]

The idea of a county standard is interesting, but I'm not sure it would be helpful. These tend to get promulgated as SOP's or the silly SOG [ It's a Guideline, not a Procedure, so if a person ignores it they're not actually in violation of anything, like that will keep lawyers at bay..].

V & T is clear on the matter as has been pointed out by a few postings. One may exceed the speed limit or go through controlled intersections against the light.. SO LONG AS IT IS SAFE. The moment an accident occurs, well it wasn't safe and the driver of the emergency vehicle is at fault, no matter who was responsible for the accident, and no matter how many lights or sirens were being used.

People who read V&T as offering protection,in the event of an accident, to drivers of emergency vehicles are completely mistaken. The cop can't write you a ticket for speeding, or creative use of paved surfaces, SO LONG AS IT WAS SAFE. In exchange for that protection, the burden of safety falls completely to the driver of the emergency vehicle.

The moment we turn on lights or sirens, we accept responsibility for all the actions of all the crazy drivers out there, and there are a few of them.

[Guest alsfirefighter]

The SOP/SOG legality issue story (myth) that was floating around about a department getting sued was exactly that a myth. Sometimes it is in a word. Sometimes you need a procedure...and sometimes you need a guideline. To me emergency response is fairly cut and dry and having a "SOP" is warranted.

While 1104 to some of us outlines what is or isn't to be done...its not nearly as detailed as it should be. NFPA 1500 is a much better document, and despite it has be to be followed often is overlooked. It states you must STOP at all traffic lights, stop signs, school buses (which in NY you do being its not an exemption in 1104) and a list of other things. These should be put into a SOP/SOG.

There is way too much lack of understanding, education by the proper persons and misinformation out there in regard to emergency vehicle operations. The only way to counteract that is with good policies.