Let me start off by saying that by no means am I telling you to disregard your department/company’s policies & procedures.  If your policy is to run with lights and sirens to everything, please do.  Don’t lose your license over something so simple and pointless.

Most departments/companies have a “Code 3” policy for response to any 911 call.  What I mean by this is running with lights and sirens.  For the remainder of this article, I am going to refer to this as “running emergent”.  Here in Georgia, we are required to use either both lights and sirens, or none at all.  Some services even allow their crews to decide the response type.  But that is not really what I’m here to talk about today.

Everyone knows that running “emergent” increases the risks of an accident, but does it actually save any time?  A study was done a couple years ago in New York City that showed a NYC taxi can typically get through traffic faster than an FDNY ambulance.  But why is this?  By turning on your lights and sirens, you are literally turning on a GIANT sign saying “hey everyone, stop what you’re doing and look at me”.  Now, this may be the reaction you’re looking for, but not all of us feel the same way (that was a joke, you can laugh).  What this does though, is every person between you and your patient turns into a blockage.  Most of the time they don’t mean to get in your way, but it still happens.  Have you ever wondered why the Secret Service & FBI don’t have their names written down the side of their vehicles???  BECAUSE THEY DON’T WANT THE ATTENTION, THEY WANT TO BLEND IN!!!

Yet, we come through traffic like the freakin Kool-Aid Man on every call!

The company I currently work for has the typical “run emergent to every 911 call policy”, which I can understand from a management perspective.  Until you arrive on scene, you have NO clue what you are walking into.  That “toe pain” call could very well be a Stroke, or an MI, or a psych call.  So from a legal standpoint, it makes sense to respond in this manner.  The problem is that it’s like crying wolf.  The residents of the county we are contracted with CONSTANTLY see our trucks running emergent.  This gives the general population the perception that we do this EVERYWHERE we go.  Now if you’ve worked on an ambulance for more than a day, you know this not to be the case.  But that’s not what they see.  So when they see us YET AGAIN running emergent, they might be less likely to do the best they can to get out of your way.  It’s just human nature.

But as I said before, this response is rarely left to the crew.  Most of the time the transportation method is actually up to them though.  Some crews choose to run emergent for everything, and I’m not here to mock or make fun of anyone for this.  I just want to compare the risks/benefits of this practice.  Does this patient NEED medical procedures RIGHT NOW that you are unable to perform in your truck?  If the answer isn’t a resounding “Yes”, then they probably don’t need to go emergent.  It may sound grim, but unless it’s going to cause more harm, there’s really not a point to increase the risk for yourself, your partner, and the patient for little to no benefit.

I have run MANY calls where family members will follow the crew to the hospital.  Any time I’m transporting a critical patient, my partner or I explain to the family to not try to keep up with the ambulance.  Now most of you know they rarely ever heed this warning, but even if they do they typically arrive at the ER within a minute or two from us.  I’ve even responded emergent to calls with my supervisor driving non-emergent, and they still make it on scene as we are getting the equipment out of the truck.  WE ARE TALKING ABOUT 1-2 MINUTES OF DIFFERENCE HERE!!!  I know we all like to think that we are the most efficient and skilled EMS providers out here, but the sad truth is that we can’t really do that much in that little amount of time.  Now I say this with the assumption that there are already EMS trained personnel on scene, or at least bystanders who are being given instructions via enhanced 911.  In the event that you are in a rural area, and ARE the first responding personnel, then my last statement might not be that accurate, so take that with a grain of salt.

Here is another example of what I’m talking about.  When I moved to Atlanta a few years back, I was amazed that a very predominant EMS service in the area has a policy that they don’t run emergent while transporting a cardiac arrest.  Maybe someone reading this finds this crazy as well.  But if you really think about it, it does make quite a bit of sense.  What exactly can an ER do during a cardiac arrest that we can’t?  Not a whole lot. Now, if ROSC (return of spontaneous circulation) is achieved, the crew upgrades their response and gets to the ER as quickly as possible.  It may sound crazy, but it makes sense.  There is no reason to take a metal box on wheels speeding through the city with 2-3 unrestrained passengers who are moving around and working, for no added benefit.  What happens when you transport a cardiac arrest to the ER anyway? Typically they will work it for a round or two of CPR, but then call it.  This is one of the many reasons I try to remain on scene with cardiac arrests, but that’s a subject for another day.

So long story short, remember when you were taught to drive with

DUE REGARD

That doesn’t mean drive as fast as your ambulance possibly can, and it also doesn’t mean drive 20 under the speed limit.  At the end of the day, we can only help people if we make it on scene.  Don’t get yourself into an MVC, and become just another patient for an EMS service that is probably already understaffed.  And do what’s best for the patient, which at times may be driving non-emergent.