Lights Vs. No Lights To The ED

[Guest]

Why do some crews drive with Lights on to the hospital with BLS patients?

Is it Corp./FD "Law"

Do they not know how to shut them off?

Did they leave food on the stove?

Do they think it's cool?

Just wondering

[Guest WolfEMT]

Common sense...if it's a bad call or serious to the point where you may have to haul butt to the ER, then we leave the lights on. If it's not too serious, then we shut them off.

Oh, btw...based on your line of questioning, you wouldn't happen to be a guy by the name of "superwhacker," would you?

[tbendick 27]

This is a topic that does bother me. I see this over and over people going to lights and sirens to the ER and then walking a PT into the ER with something very minor.

This should be something that the crew thinks about. I very rarely go lights and sirens to the ER. I also watch the speed and keep it nice and slow either way. I see people put the lights and sirens on and drive a little too fast. Remember if the person is in bad shape the crew needs to do some work in the back and can only do this if you drive safely.

Also last thing. For those minor calls that are for the most part a transport with little or no care need on the way to the ER. "Please Put your seat belt on in the back"

[Guest NYTruckie]

It blows my mine that the crews will make family members that ride with the patient wear a seatbelt, but they don't put one on. I understand that a serior calls that you really can't because you have to much to do. But on a minor call I think you can reach to take a BP if you are wearing a seatbelt. You can't do any good if you get hurt.

Also I believe that if you have the lights on in New York you MUST "act in due reguard for all other drivers" So if you have an accident with the lights on it's your fault. But if you have the same accident without your lights on it MIGHT not be your fault. (been a while since I looked at VNT law)

[Guest DADAY]

Speaking from my own experince. No matter what the PT status I used to go lights to the ER from where i was. The reason being that we were at least 10-13 mins away from the closest facdility. And most times further then that. Not going crazy just getting through traffic.

[tbendick 27]

Speaking from my own experince. No matter what the PT status I used to go lights to the ER from where i was. The reason being that we were at least 10-13 mins away from the closest facdility. And most times further then that. Not going crazy just getting through traffic.

With the laws and lawsuits today and the danger that we face. NYS EMS states all depts need to have this issue as a SOP on how they should handle this. I know FDNY EMS rules are patients that are C,U and some P's can go lights and sirens all Stable patients go with no lights or sirens.

Also don't leave your lights on and drive around when not in emergency mode.

[Guest WolfEMT]

I also watch the speed and keep it nice and slow either way.

It's too bad that not too many people follow this general common sense rule. Believe it or not, the safest speed to drive with a working code in the back is 20-25 mph.

[Guest]

Usally the senior Medial Provider can state wether or not Lights or sirens are needed. BLS calls should be no lights or sirens.

Where can I look up these laws?

[Guest NYTruckie]

Hard Copy:

Vehicle and Traffic Law

How can I get a copy of the NYS Vehicle and Traffic Law?

The Vehicle and Traffic Law is available as a book from the DMV for $1.50 per copy. Send your request to the Certified Document Center, NYSDMV, Empire State Plaza, Albany, NY 12228. Pay with a check or money order payable to "Commissioner of Motor Vehicles".

The NYS Assembly and NYS Senate web sites have some sections of the Vehicle and Traffic Law on-line.

http://www.nysgtsc.state.ny.us/emer-vt.htm#top

§ 1144. Operation of vehicles on approach of authorized emergency vehicles.

(a) Upon the immediate approach of an authorized emergency vehicle equipped with at least one lighted lamp exhibiting red light visible under normal atmospheric conditions from a distance of five hundred feet to the front of such vehicle other than a police vehicle or bicycle when operated as an authorized emergency vehicle, and when audible signals are sounded from any said vehicle by siren, exhaust whistle, bell, air-horn or electronic equivalent; the driver of every other 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 roadway 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, unless otherwise directed by a police officer.

( This section shall not operate to relieve the driver of an authorized emergency vehicle from the duty to drive with reasonable care for all persons using the highway.

Back to Section List

Hope this it what you were looking for

[x635 4,066]

Another aspect to this issue is that why do some agencies drive the flycar Code 3 to the hospital, and some even tailgate the bus doing it? That has to be one of the most ridiculous, unsafe, negligent acts ever. Many times, the person driving isn't even trained to drive Code 3!!

Also, what is the purpose of leaving the lights flashing in the ER bay???

IMO, It's much harder to assess and work on a patient going Code 3, and it puts everybody in that bus at a much greater risk.

There are departments in the WC that transport EDP's Code 3, and I mean a fast and furious Code 3...what is the point????

BTW, even with a routine (if there is really such a thing) code going on in the back, if it's being worked ALS by a competent provider, chances are there's not much more the ED can do anyways.

[Plectron 1]

I ALWAYS drive down Rt 9 to PMH with the rear lights on at the least. The pt may be stable or potental, but that road sucks. I couldnt tell you how many times i've almose been run off the road, or almost witnessed a head-on because some moron decided I was driving too slow in the ambulance and tried to cross the double-yellow to go around.

[tbendick 27]

Seth,

Brought up a good point.. 2nd Units going to the ER wether it's a Engine company, 2nd ambulance or flycar. Sould not respond with lights and sierns to the ER.

NYC came out with a rule a few years ago. "No patient = no lights and sirens"

Still see people doing this. As well there was a fatal MVA that was involved with a 2nd ambulance following the ambulance with the patient to the ER.

[LCFD994 8]

I cant tell you how many times I have triaged a patient BLS to an agency and gone back into service to only have them pass me going lights and sirens to the hospital. It is crazy but I think some services and agencies have a rule stating as long as a patient is in the ambulance they have to use lights and sirens. Trust me I dont agree with this at all.

In my opinion 9 out of 10 calls whether they are ALS or BLS in the back of the Ambulance do not require lights and sirens to the hospital, no matter how far away you are. I think it does add to the risk of an accident and injury to not only other people but also to the crew, let alone the fact that I think the accelerator pedal is attached to the siren. Which in turn tosses the crew around in the back.

[TRUCK6018 50]

It is crazy but I think some services and agencies have a rule stating as long as a patient is in the ambulance they have to use lights and sirens. Trust me I dont agree with this at all.

I too have heard of agencies doing this for "insurance reasons". I don't think it will hold up well if you're transporting Mrs. Jones with lights and sirens for a hang nail with lights and sirens and you happen to hit a car load of nuns.

[Pudge3311 5]

Ill use lights on the Bronx River Parkway because it is way to narrow to drive a box on. Its a nice easy drive right down the middle line, and people still try and run me off the road to pass me. Other than that, 99 percent of my rides to the hospital are nice and easy without lights.

[LCFD994 8]

You would think Truck that the insurance company would prefer that you " never" used lights and sirens, but we all know that is impossible...

and I hate it when those nuns get in the way.....lol

[CG206 29]

When I'm driving the rig, I will always ask the highest medical provider in the back how he/she wants the ride to the ER to be...usually location, type of medical condition/injury, weather, and traffic play a very important role in this determination.

[mikeinet 37]

I have an issue with people responding to "everything and anything" with lights/sirens. If you are in a rig, you have a pt with you that absolutly stable (lets say general illness + a little vomiting) - then why the heak do you need lights / sirens? Lights/Sirens are supposed to be used in an "EMERGENCY RESPONSE" - not a "the rig is in motion" response.

If you ride EVERYWHERE with lights/sirens, then people become used to it, don't notice it as much... and just think "oh, there goes xxxVAC again... playing with the lights and sirens trying to be cool and get through traffic" and not something like "oh S*IT something bad is going on, get out of the way!"

my $0.02.

[Guest NYTruckie]

I too have triaged a patient BLS and the ambulance goes to the ER with the lights and siren. I have also been in that back of BLS ambulances and asked the driver to shut off the lights and they will not, "We have to use the lights". I have seen the Fly car coming to the E/R with lights, then when I come out of the E/R the Fly Car is shut off and all the lights are still on. Just some of the tonage of things I don't understand. I think that all EMS/Fire and personal should have to take an EVOC class prior to being cleared to drive.

My $0.02

[JBE 328]

Speaking from my own experince. No matter what the PT status I used to go lights to the ER from where i was. The reason being that we were at least 10-13 mins away from the closest facdility. And most times further then that. Not going crazy just getting through traffic.

I draw on my experience and concur with this line of thought. Tap the siren when needed, but when you're hauling someone from the @$$ end of Lake Carmel out near Kentwood Estates, it's a hike. Unless that patient is critical or unstable, lights only. Although, if anyone from back then is on this board and remembers, I wasn't the greatest at driving the bus.

[roeems87 0]

Most rides to the hospital where I am tend to be no lights. Even if it is an ALS call, many medics will know the patient is stable and there is no need to haul "rear end" to get to the hospital three minutes quicker. Like Pudge said, I'll use them on the parkways. In addition to that, when we're looking for a quick turnaround (another call to follow) or the patient is in a lot of pain (still BLS) I would use lights to get there a little bit quicker. Otherwise, no reason to rush or to alert people around you that anything is the matter.

[PVFD113 6]

Okay--you can agree or disagree with this one. Those of you who drive Route 6--almost anywhere(or 202)-but especially through Mohegan on weekends and at rush hour--a 10-15 minute ride from "The Village" can take a half hour. I am not condoning the Haul A$% transport--I believe is was Dadday that mentioned it earlier--lights--blip the siren occasionally. The patient may be stable but mot many patients likes riding in the back at all never mind for that long and may make other symptoms appear. This also keeps the rig tied up longer before being able to return to service.

[WAS967 97]

But does saving 10-15 minutes justify the L&S siren use/risks? I personally don't think so. You have 3 rigs in Mohegan. If one is out on a call, then you have two others to use. Can't staff the other two? Still doesn't justify the L&S use in my mind. Even if a second call is holding. You aren't in service until the pateitn is offloaded at the ER and report is given. It's not fair to the patient you asre currently careing for to risk his life in effort to get to another call.

patient is in a lot of pain (still BLS)

Not for nothing, if a patient is in that much pain, maybe they shouldn't be BLS. I know it doesn't apply to many Paramedics, but in both ALS district I work in we are Hospital based. As such we are OBLIGATED to treat a patient's pain if they so desire. Got a patient in 10/10 pain from a kidney stone? It shouldn't be BLS. We carry Morphine for a reason. Medics just seem too freaking lazy to use it.

[Guest NYTruckie]

WAS Types:

"Not for nothing, if a patient is in that much pain, maybe they shouldn't be BLS. I know it doesn't apply to many Paramedics, but in both ALS district I work in we are Hospital based. As such we are OBLIGATED to treat a patient's pain if they so desire. Got a patient in 10/10 pain from a kidney stone? It shouldn't be BLS. We carry Morphine for a reason. Medics just seem too freaking lazy to use it."

Not for Nothing thats a lot of paperwork for pain that I can't feel

[WAS967 97]

Not for Nothing thats a lot of paperwork for pain that I can't feel

If I were the one in pain, I'd make sure you felt it. Seriously tho, it's not that much paperwork. And added line or two, a doctor signature isn't my idea of a lot of paper work. People just don't want to walk thier fat asses down to the pharmacy for restock.

[Pudge3311 5]

Was967,

I definatly agree, medics are lazy about restocking. Maybe they should go back to being EMTs for a little while, having to ride in all of the calls they routinely triage down, and thinking about whether they could have gone ALS.

[Guest NYTruckie]

Walk [-X I take the elevator, but really it wears you down "begging" for meds from some doctors, that you don't call because you don't have the fight in you that day.

[Guest NYTruckie]

Was967,

I definatly agree, medics are lazy about restocking.  Maybe they should go back to being EMTs for a little while, having to ride in all of the calls they routinely triage down, and thinking about whether they could have gone ALS.

Pudge3311 Restocking supplies and/or Meds and Restocking Narcotics are not the same. Which are you talking about?

[calhobs 110]

Not sure if pain is a protcal to call ALS, never heard of that one.But if your holding back meds or narcs to a Pt that needs it because of paper work there is a bigger problem then going lights and sirens to the ER. If your not going to use them whats the sense of being a medic you do no good showing up to my call. lets all remeber lets just go out there and do the right thing.

[Guest alsfirefighter]

Good point WAS. There is no inbetween and you should take it one call at a time. We are responsible for public safety that includes the rebound accidents of other cars you can cause by unnecessary use of L/S as well as the what the heck exactly is he doing and what does he want me to do.

Pain management is now in the forefront of medicine. Noone should withhold easing a patients pain because of restocking issues you have with your system. Most medics learn quickly who is in agonizing pain and who is just chronic pain management drug abusers. Irrregardless of what the medical control perspective is, there is no fight, I paint a picture if they deny me, I professionally explain to the patient that I attempted to get them something for the pain through my medical control physician and he felt that I shouldn't give it at this time. Any issues I have with a med control and there are those out there we all know who are a pain with getting narc orders I bring it up to my med director and urge other medics in my system to do the same. A good med director will look at the case and hopefully attempt to bring some change.