Ambulance 1 is dispatched to a single-car motor vehicle crash, with injuries.
Ambulance 1 arrives on scene a short time later, and finds a car that has overturned several times, with two patients who are both critically injured, and requests a second ambulance, which also arrives fairly quickly.
Patients are packaged and prepared for transport, and ambulance 1 departs the scene with the injured driver at 14:06:31, heading towards the local trauma center non emergency.
The trauma center is 14 miles away from the scene, and the trip consists mainly of a 4-lane divided road with numerous at-grade crossings with traffic lights. The speed limit is 50 miles per hour.
Traffic is average for a weekday at 2 pm.
Ambulance 1 encounters several traffic lights on the way, but experiences no significant delays.
Ambulance 2 departs the scene with the injured passenger at 14:07:12. Ambulance 2 is traveling emergency to the same local trauma center.
Both ambulances radio their reports to the local trauma center, and are assigned trauma rooms, with teams awaiting their arrival.
Less than 1 mile away from the trauma center, Ambulance 1 yields to the right for Ambulance 2, which is still traveling emergency.
Ambulance 2 arrives at the trauma center at 14:22:53.
Ambulance 1 arrives at the trauma center at 14:23:27, while ambulance 2 personnel are unloading their patient.
Ambulance 1 had a cumulative transport time of roughly 17 minutes.
Ambulance 2 had a cumulative transport time of roughly 16 minutes.
Ambulance 2 saved (at most) 2 minutes by traveling with their lights and sirens activated.
Both patients received excellent care in the back of the differing ambulances.
Using the lights and sirens during transport does have it’s indications and contraindications. But those indications are rare.
Driving with lights and sirens does not get you there appreciably faster, and is more dangerous for the driver, the attendant, the patient, and every other driver on the road.
The danger was witnessed first hand by the driver of Ambulance 2, when he witnessed a rear-end collision that was caused by someone who was attempting to yield to the red lights.
Lights don’t save time, and are over-utilized.
Thank you, Thank You, THANK YOU!
Printing this out and hanging it up at work.
Be safe out there!
The conclusion only applies to the given set of factors as described this particular situation.
If you change some or all of the factors, it changes the both the result (for instance, transport time) and the conclusion (emergency or not).
The time savings come not from driving fast, but from not sitting at traffic lights. In my city, each traffic light sat through adds about 1 minute to the transport time. There are a lot of traffic lights in my city and sitting at each of them is not practical for any patient that is at all acute.
There are also not many four lane roads or divided highways, we mostly have windy old roads that weren’t designed, they just evolved.
None of this is to say that most patients are acute, and there in lies the problem. I see all too many ambulances drive to fast, go through red lights, and then when they get to the hospital place the patient in a wheel chair where they bring the patient to triage. That is the sort of thing that contributes to accidents when there is no credible reason for driving like that.
Of course LAS response is different that LAS transport. There is rarely a valid reason for the latter because in many cases what we do, what we are supposed to do, is ameliorate the emergency. If we have to race to the hospital it’s either because we are poor practitioners OR the patient has a problem that is beyond the scope of our training and practice. Neither is a glowing portrait of EMS.
I have asked my partner to reduce to code one before because of traffic or weather. It isn’t worth getting tossed around in the back while trying to assess an acute patient. Plus, assuming the patient is conscious, it adds a whole lot of stress to their plight to hear sirens, and watch me trying to ‘surf’ in the back. It is all about using good judgment, right?