Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Does use of Lights and Sirens save lives?

AmboLights
 

A recent Fire Chief Magazine and the current JEMS have some articles on the use of lights and sirens and the effect on patient outcomes. Doug Wolfberg, one of the EMS lawyers who might be trying to defend your choice on use of lights and sirens, states –
 

Few cows are more sacred in fire service based EMS than the ones that flash, wail and yelp. The use of emergency lights and sirens is an inseparable part of everyday EMS life.[1]

 

and –
 

Yet when we look at the actual evidence, a few things become apparent about RLS use. First, it’s proven to be dangerous. Second, it’s not proven to be beneficial.[2]

 

In another article, several of the top medical directors in the country state –
 

Unlike fire emergencies, which can grow exponentially and spread quickly, only a small subset of medical emergencies is truly time sensitive. Most don’t dramatically worsen in the course of a very few minutes, and they don’t spread from person to person.[3]

 

In rare cases, such as those where we are not able to control bleeding, or breathing, and the hospital is close enough that the patient won’t be dead by the time we get there, does use of lights and sirens save lives? In those rare cases? Sometimes.

Wouldn’t it be better to improve the quality of the people treating these patients, rather than increase the speed of transport?

When is the last time you transported a patient to the emergency department for something that needed to be done immediately to save the life of the patient?

Why not do that before transport?

Was it out of your scope of practice, did you not know what was going on, did you not feel comfortable performing the skill, could you not make up your mind about what to do, . . .?

Can’t place an endotraceal tube successfully? Use an LMA (Laryngeal Mask Airway), King Airway, BVM (Bag Valve Mask or resuscitator bag), stimulate the patient to breathe for himself, . . .

Can’t place an IV successfully? The IV is not a life line, but you can place an IO (IntraOssesous) line, apply direct pressure to bleeding, lay the patient flat (Trendelenberg does not improve things for the patient, although it might make you feel like you are doing something good), consider IM (IntraMuscular) or IN (IntraNasal) administration of medication, . . .

But it is an emergency!
 

We used to drive cardiac arrests to the hospital quickly, because we thought that was better.

We were wrong. If we do not resuscitate people prior to arrival at the hospital, they will probably stay dead. Driving fast just increases the odds that we will be as dead as the patient.

There has never been any good evidence to support driving fast.

We need to develop a better understanding of the treatment we provide. We need to provide better assessments (and continue to assess). We need to provide appropriate treatment on scene prior to transport. We need to rush less.
 

Do you believe in frequent lights and sirens transport?

Here is a dare for you.

Keep track of the times you transport with lights and sirens (these should be sentinel events) and document the actual life saving treatment provided in the emergency department in the first 10 minutes.

Keep track of this for a month, or a year.

Do you have anything?

Was it really something that saved the patient’s life?

If you do come up with something, does it amount to more than 1% of lights and sirens transports?

If we have almost always beenwrong about what is going on, should we be endangering everyone on the road to cover for our ignorance?

Footnotes:

[1] Why running lights and sirens is dangerous
Fire Chief
June 5, 2016
By Douglas M. Wolfberg, Esq.
Article

[2] Pro Bono: EMS Use of Red Lights and Siren Offers High Risk, Little Reward
JEMS
Wed, Feb 1, 2017
Doug Wolfberg
Article

[3] The Case Against EMS Red Lights and Siren Responses
JEMS
Wed, Feb 1, 2017
S. Marshal Isaacs, MD, FACEP, FAEMS , Carla Cash, MD , Osama Antar, MD , Raymond L. Fowler, MD, FACEP, DABEMS
Article

.

Do People Yield to Ambulances? Sometimes

 

This is not just a problem in the US. This is in Perth, Australia, where they drive on the left side of the road, so the directions are the opposite of driving in places where driving is on the right side of the road, such as the US and most of Europe.

The problems are the same as for ambulances in other countries.

This is a 2 minutes and 17 second news story that can also work as an excellent public service announcement.
 

[youtube]273ZGyDR0TY[/youtube]
 

Ambulances will get in the way of our driving. Get over it.
 

The people who refuse to yield to ambulances do not seem to be much different from those who want everyone to merge early when the number of traffic lanes decreases. Apparently, this is because they are afraid someone will get ahead of them or they just don’t know how to merge.

Sometimes people will get ahead of you. You will also pick the slowest checkout line to get into when shopping. Get over it.

A late merge, or zipper merge, will get everybody through faster.

We should not let the lowest common denominators determine how we drive.

Merging is all about taking turns and being mature behind the wheel.
 

[youtube]vLVMW8KnfBE[/youtube]
 

[youtube]ZcPby71TNC0[/youtube]
 


 

Click on images to make them larger.

MUTCD = Manual on Uniform Traffic Control Devices or Early Merge.
vphpl = traffic volumes in Vehicles Per Hour Per Lane.

 

 


 

 

Figures 9 through 11 present an overview of how the late merge compared to the MUTCD treatment for the 3-to-1-lane closure scenario. It is clear in Figure 9 that the late merge had a significant impact on throughput at both free flow speeds, with a 120 to 130 vphpl increase over the MUTCD.

Figure 10 shows that the late merge is superior at various percentages of heavy vehicles. However, the difference between the two types of traffic control decreased as the percentage of heavy vehicles increased.

In Figure 11, throughput is higher at all volume levels for the late merge and rather consistent as compared to the MUTCD treatment.[1]

 

Footnotes:

[1] Evaluation of the Late Merge Work Zone Traffic Control Strategy
AG Beacher, MD Fontaine, NJ Garber
2004 – trid.trb.org
Virginia Department Of Transportation
Free Full Text Download in PDF format from Virginia DOT

.

The Less-Than-Brilliant Defend NOT Wearing a Seat Belt

Someone dying in an ambulance crash is not good news, but a couple of people who seem to think that reality is whatever they want it to be has decided to use this death to justify spreading their belief that seatbelts kill. No matter how hard they believe this, they will still be safer wearing seat belts. Their belief does not change reality.

Troopers said Amsbaugh was partially ejected and was not wearing his seat belt.[1]

That is in the main article. The problem is in the comments.

But first, something that these magical thinkers are probably unaware of – facts.

Of the 25,351 passenger vehicle occupant fatalities in 2008, restraint use was unknown for 1,844 (7%). Of the 23,507 passenger vehicle occupant fatalities for which restraint use was known, 12,865 (55%) were unrestrained.[2]

55% of fatalities were not wearing seat belts.

In June 2005, safety belt use in the U.S. reached 82 percent, the highest level yet recorded and a statistically significant increase over the 80 percent use rate from a year prior. This result is from the National Occupant Protection Use Survey (NOPUS), which provides the only probability-based observed data on safety belt use in the United States.[3]

Over 80% of vehicle occupants wear seat belts (82%).

Over half of vehicle occupants killed in crashes are not wearing seat belts (55% of the 93% of fatalities where we know if they were wearing seat belts + some portion of the unknown 7%).

For everyone who dies from the very large group of people wearing seat belts, at least one dies from the very small group of people not wearing seat belts.

If we do not wear seat belts, we are dramatically increasing our chances of dying in a motor vehicle crash.

Here are the less-than-brilliant comments –

thaddey
well also gotta think of all the accidents were he may hve seen ppl dead cause they had a belt on!! second if he was in the back helping a pt, its kinda hard to help and be straped in!! third, why pin point it happened RIP BRO!! ps im in health care and i will NOT wear a seatbelt!!
[1]

Erica
. . . my father was thrown from a garbage truck and the police said if he would have wore his seatbelt he probably wouldnt be here. also we lost another member of the mount union fire department in an automobile accident and he wore his seatbelt and still passed away so before you go saying he should have buckled up you should realize this could have happened with or without a seatbelt. thank you.
[1]

She knows of a case, where she is sure that the seat belt killed the person. Due to her writing skills, we know that this case is well documented.

What about the other occupant of the ambulance?

From an article with more details –

Deborah Mease, 55, was driving the ambulance and suffered minor injuries, state police said. She apparently was wearing a seat belt; Amsbaugh was not.[4]

Dead vs. minor injuries.

Not ejected vs. partially ejected.

This is such a difficult choice.

I could be hit by anyone running a red light, or crossing the double yellow line, or . . . .

Do I want to be wearing a seat belt if I am in a crash?

Negatives of seat belt use – extremely small chance of becoming trapped in a vehicle that has a very small chance of catching fire. The chances of both happening together is ridiculous.

Positives of wearing a seat belt – less likely to be thrown around, or out of the vehicle and much less likely to be killed or injured.

Is this really such a difficult choice?

Would Ethan Amsbaugh be alive to day if he had worn a seat belt. We can’t be sure, but he probably would still be alive.

We respond to emergencies, but we are not immune to emergencies.

Footnotes:

[1] Local EMT killed in crash
Posted: Jun 02, 2012 5:21 PM EDT
Updated: Jun 02, 2012 5:21 PM EDT
By Kyle Gamble
abc27 WHTM
Article

[2] Traffic Safety Facts – 2008 Data
NHTSA (National Highway Transportation Safety Administration)
Occupant Protection
Fact sheet

[3] Safety Belt Use in 2005 ─ Overall Results
NHTSA
Donna Glassbrenner, Ph.D.
Research note

The survey data is collected by sending trained observers to probabilistically sampled roadways, who observe vehicles between the hours of 8 a.m. and 6 p.m. Observations are made either while standing at the roadside or, in the case of expressways, while riding in a vehicle in traffic. Observers do not stop vehicles or interview occupants, so that the NOPUS captures the untainted behavior of motorists. The 2005 NOPUS data were collected between June 6 and June 25, while the 2004 data were collected between June 7 and July 11, 2004, excluding the period July 2 – 5.

[4] 22-year-old ambulance worker dies in crash
June 3, 2012
By Ryan Brown
The Altoona Mirror
Article

.

Motorcycles and Splitting Lanes

Motorcycle lane splitting has been a controversial and confusing subject for years, so the California Office of Traffic Safety decided to find out about the public perception of lane splitting.

Is lane splitting legal for motorcyclists in California?

The frequencies of responses is shown in Table 7, with 52.9% of all vehicle drivers stating “yes”, that lane splitting for motorcycles on freeways is legal, while 36.7% did not think it to be legal, 9.8% of all respondents did not know.[1]

The key to legal lane splitting for motorcycle riders is doing so in a safe and prudent manner, being cognizant of overall traffic speeds, speed differences, spacing and lane changing patterns of surrounding traffic. Riding too fast is one of the most common things that motorcyclists do to make lane splitting unsafe.[2]

Since lane splitting is legal in California, why do so few car and truck drivers not know that lane splitting is legal?

That was not one of the questions.

For some reason, the survey did not include a question along the lines of, Why do you mistakenly assume that lane splitting is illegal? Maybe next time. Part of this has been addressed by Dunning and Kruger,[3] but that is a topic for another time.

The survey did ask if drivers approve of motorcycles splitting lanes and asked for the reason(s) for that approval/disapproval.

The answers are interesting. The people who disapprove of motorcycles splitting lanes overwhelmingly believe think that lane splitting is unsafe. There does not appear to have been an attempt to determine how common the perception of lane splitting as unsafe is among those who mistakenly believe that lane splitting is illegal.

The other common objections mostly have to do with inattention and/or incompetence of the car/truck driver. – It startles/surprises/scares me and might cause me to crash.

Is there any information about the relative frequencies of lane splitting crashes vs. crashes while stopped in traffic?


Motorcycle Accidents In Depth Study.[4] This is far from definitive, but lane splitting is legal in 4 of the 5 participating countries. If a stopped motorcycle is 7 times more likely to be involved in a collision, is it wise to sit in traffic, or is it wiser to split lanes?

What about the outcome of these collisions?

The police officer was splitting lanes between the fast and carpool lanes when a Toyota Carolla crossed the double yellow line to exit the carpool, striking the officer and throwing him from his motorcycle.[5]

This would probably produce a much better outcome.


Image credit.

Clearly, this is safer than lane splitting crashes.


 

Why would a driver intentionally drive a lethal weapon at a motorcyclist?
 


 

If lane splitting is unsafe (in their opinion) it becomes safer by driving at the motorcyclist?

It is OK to be upset with motorcyclists for using a more efficient form of transport? Should we expect these drivers to try to block trains and planes as well? Is it really unfair for a motorcyclist to get ahead of traffic that is less practical and less efficient? Is it also unfair that doctors make more than paramedics? Aren't these the same rocket scientists who do not pull over for ambulances, because they are more important than everyone else?

If lane splitting might cause me to have an accident, how is driving at a motorcyclist making that any less likely?

Currently, lane splitting is only legal or tolerated in Oregon, Washington State, California and now, Arizona, so be sure to check out your state’s official policy on the practice before trying it yourself.[6]

Footnotes:

[1] 2012 Motorcycle ‘Lane Splitting’ Intercept Survey
California Office of Traffic Safety
Regular Vehicle Driver Responses Section
Survey download in PDF format

[2] Survey Shows What Riders and Drivers Think of Motorcycle ‘Lane Splitting’ – “Share the Road” is the Message During Motorcycle Safety Awareness Month
California Office of Traffic Safety
May 3, 2012
Press Release in PDF format

[3] Dunning-Kruger effect
Wikipedia
Article

Kruger and Dunning proposed that, for a given skill, incompetent people will:

  • tend to overestimate their own level of skill;
  • fail to recognize genuine skill in others;
  • fail to recognize the extremity of their inadequacy;
  • recognize and acknowledge their own previous lack of skill, if they can be trained to substantially improve.

[4] Excerpt from Table 5.7: PTW pre-crash motion prior to precipitating event
MAIDS (Motorcycle Accidents In Depth Study) Final Report
September 2004
European Association of Motorcycle Manufacturers
p. 49,
Free Full Text Download in PDF format

[5] Long Beach Motorcycle Cop Injured in Crash
Riderz Law
December 16, 2011
Article

[6] Lane Splitting On Your Motorcycle – Time Saver or Disaster Waiting To Happen?
August 7, 2011
by Todd Halterman
MotorcycleInsurance.com
Article

.

They Don’t Make Them Like They Used To

 

These new cars are just made out of plastic.

These new cars fall apart in a crash.

Give me a nice solid metal car, like the ones I grew up with.

40 miles per hour – metal vs. plastic – which one do you want to be in?
 

[youtube]joMK1WZjP7g[/youtube]
 

Both cars have engines, so don’t pretend otherwise.

Yes, the new car is a wreck after the crash, but so is the solid metal car. The heavier solid metal car is even more of a wreck. The new car is designed to deform and absorb the impact, so that the occupants have fewer injuries and so that any injuries are less severe.
 


 

The fiction of good old solid metal.
 


 

The reality of improved technology.
 

Oh, but the Bel Air is 50 years old!

Then find a brand new 1959 Bel Air to crash and see if that does any better. Any 1959 Bel Air on the road is over 50 years old, so you should be very, very careful if you drive in one.

The safe old metal car is a myth.
 

Crash avoidance is also much better on the newer vehicles.

Crash avoidance is much more important on all vehicles.
 

Six air bags are also now standard: two dual-stage front bags, two side-impact curtain air bags protecting the heads of both front and rear passengers, and two side-impact thorax bags mounted in the front seats. Traction control, electronic tire pressure monitoring system, four wheel disc brakes, antilock brakes, and daytime running lamps are now all standard included safety features on all Malibus. GM’s StabiliTrak brand electronic stability control is standard on all models including the very base LS model.[1]

 

I’d like to see them try that with a much newer solid metal car. For example 20 years old.

OK. Early 90s Volvo 940 GLE vs. mid-2000s Renault Modus at 40 MPH. The Modus is the first supermini[2] (subcompact) to receive a 5 Star rating from Euro NCAP.[3]
 

[youtube]HCecdOBCFjI[/youtube]
 

Again, both cars have engines, so don’t pretend otherwise.

The Volvo 940 is supposed to have at least a driver’s side airbag, but none deploys. Is it a malfunction? Was it disabled at some point in its life? They do not mention any examination of the Volvo for airbag problems. Should we expect reliability from a 15 to 20 year old airbag? The 940s did have recalls for airbag problems.[4]

The safe old metal car is a myth.
 

Never mind a 40 MPH offset crash. What about 60 MPH?
 

[youtube]TFIYS20Dj5o[/youtube]
 

Even good safety equipment cannot protect us from everything.
 

Newer cars are designed to be safer. Newer cars are more reliable. Newer cars last longer.[5] Newer cars have better fuel economy. Newer cars pollute less. We get a lot more for the same amount of money, but some people prefer to imagine that the good old days were better. Maybe I shouldn’t wake them from their fantasies.

The safe old metal car is a myth.
 

Whereas five people were killed per 100 million vehicle miles traveled in 1960, that number had plunged by nearly 75% to 1.36 fatalities per 100 million vehicle miles traveled in 2008. Put differently and in the terms where the rubber literally meets the road, it’s four times safer to be on America’s highways and bi-ways today than it was a half century ago despite a quadrupling in the number of vehicles on the road and a 10-fold increase in miles driven.[6]

 

Part of that may be due to EMS, but this makes it pretty clear that just going by Mechanism Of Injury is not a concept that considers patient assessment.

Oooh! Look at all of that front end damage!

The front end is destroyed on all of these cars. The newer cars were designed to sacrifice the front end to protect the occupants, while the older cars were designed with less consideration of the occupants. The cars behave pretty much as designed. Some protect the occupants and some do not.

Does the exterior damage tell us anything about the injuries? So why do doctors worry more about the damage to the cars, than they worry about the damage to the occupants?
 

Finally, what about 120 MPH into an immovable object?
 

[youtube]LmRkPyuet_o[/youtube]
 

Humpty Dumpty drove too fast.

Footnotes:

[1] Chevrolet Malibu
Wikipedia
Seventh generation 2008–2012
Article

[2] Supermini
Wikipedia
Article

A supermini is a British term that describes automobiles larger than a city car but smaller than a small family car. This car class is also known as the B-segment across Europe, and as subcompact in North America.

[3] Renault Modus
Euro NCAP
Ratings page

[4] 1991-1998 VOLVO 940/960/S90/V90: Full Review
Updated: 11/13/10
ConsumerGuide Automotive
NHTSA Recal History
Review

Volvo 940 Recalls

1991-93: If car has been subjected to flood conditions, attempting to start the engine could cause airbag deployment.

1995: Driver-side airbag may not deploy properly in a collision.

[5] Age of vehicles in operation
Wikipedia
Citing Median age of vehicles
Article

The median and mean age of automobiles has steadily increased since 1969. In 2007 the overall median age for automobiles was 9.2 years, a significant increase over 1990 when the median age of vehicles in operation in the US was 6.5 years and 1969 when the mean age for automobiles was 5.1 years.[6]

[6] Insurance Institute for Highway Safety 50th anniversary speech
Robert P. Hartwig, Ph.D., CPCU
President & Economist, Insurance Information Institute
IIHS Vehicle Research Center, Ruckersville, VA
September 9, 2009
Transcript

.

Response Times Lights Sirens and Liability



Last night on EMS Office Hours Jim Hoffman, Josh Knapp, Tom Bouthillet, and I discussed response times, but really wandered off into the topics of whether a full stop should be required at a red light and how we can balance judgment with fear of litigation.

Responding Lights and Sirens, Due Regard and Expectations

Our main point of disagreement was the topic of a mandatory full stop at a red light.

I think that we need to require that drivers be responsible for the operation of the vehicle. An important part of any responsibility is the use of judgment.

Tom suggests that this is similar to the use of checklists, which is something that we agree is helpful. I do not see the connection. Checklists are to make sure that we remember essential things that we might otherwise forget.

Are we going to forget to slow down to a safe speed to cross the intersection if we do not come to a full stop?

No.

The only real differences are that when we approach a full stop, we often do not pay attention to cross traffic. When we approach a yield, we should be looking for the appropriate rate of travel to merge seamlessly with the traffic. This is more complicated with lights and sirens, since people behave less predictably when they notice the lights and sirens.

There is also an obligation for any emergency vehicle operator to use judgment, rather than to assume that, As long as I come to a full stop, I do not have any responsibility. We are always responsible for our actions. We need to get drivers to think about the way they are driving and the way that they are interacting with the other vehicles on the road.

Currently, many places require a full stop at a red light during lights and sirens driving.

Do these rules prevent drivers of emergency vehicles from driving through the lights without slowing down?

No. And nobody on the podcasts suggests that they do.

They do claim that these rules allow some sort of legal protection, which may be true, but it is probably greatly exaggerated. Assume that an organization has a rule that forbids driving through a red light without a full stop, but there are plenty of cases of the organization’s vehicles being driven through red lights without slowing down.

Is a plaintiff’s lawyer going to say, I won’t sue them. They have a rule that they do not enforce.

I don’t think so. If anything, this may provide evidence that the organization created an environment that encouraged employees to ignore the rule. The lawyer is probably going to focus on whether management was aware of the lack of enforcement of the rule.

On the other hand, suppose the organization requires that the driver of an emergency vehicle use judgment while traveling through a red light with the lights and sirens on, and educates the drivers about the difficulty in stopping a large vehicle suddenly, even at moderate speeds. Suppose that organization puts cameras in the vehicles to review the driving patterns, not for punishment, but for education and improvement.

Is the second organization going to face greater liability than the first?

Nobody knows. The same case can be presented to different juries and have different outcomes. The way the case is presented also affects the outcome. Individual bits of evidence will also affect the outcome.

It is suggested that an organization has a limited budget and might not think that training and/or cameras is an appropriate use of funds. Since vehicular collisions are at the top of the liability exposure for emergency organizations – police, fire, and EMS – this appears to be a silly argument.

Money spent to prevent crashes is money well spent.

Less time with experienced personnel out of work on disability. Less overtime to cover those shifts. less repair/replacement cost for emergency vehicles. Less of a black eye in the perception of the public for a preventable collision. Less of the costs for the injuries to civilians and damage to their property. And then there is the problem of the emergency response being complicated by fewer responders and a greater need for responders with the multiplication of incidents. If the vehicle was responding to a cardiac arrest, we should assume that the patient will not be resuscitated due to the prolonged response of the next due vehicle.

Will better oversight and better judgement eliminate collisions?

No, but it should result in fewer and less serious collisions.

Has anyone studied different organizations using different rules to see what the effect on the number of collisions and the severity of collisions would be?

This research is something that we should do.

Go listen to the podcast.

.

Risk Management and Driving

STATter 911: Did company closings create the conditions for Philadelphia fire truck wreck? Union thinks so। Mayor’s office calls idea “utterly ridiculous”.

An interesting, apparently contradictory, pair of explanations.

The union claims that the fire trucks would not have been in the collision if not for the budget cuts, because these trucks would not have been dispatched. There is some truth to this. As the number of trucks decreases, they have to travel farther per response. The average number of miles traveled per response will increase, especially if the number of calls stay the same, or increases.

One of the stories is titled Fire Trucks Crashed Racing to False Alarm. In the video of another report, one of the brass is stating that they were responding to a fire. So, there are some inconsistencies, but what can be observed directly tells us something about the crash.

Philadelphia, PA 19146

This takes you to Google Maps for the address. Click on the Street view (not here, on the address bubble on the map) and use the navigation controls in the upper left of the to see what the intersection looks like. Nice straight roads. Apparently no major obstructions to vision, except for the buildings, but it isn’t as if buildings jump out in front of traffic. Clear traffic signals on each corner. 4 corners, each with a traffic signal pointing in the direction of oncoming traffic. One of the better designed intersections in Philadelphia, which leads me to suspect that there has been a well publicized accident here before. That is just a combination of the cynic in me and the amount of time I’ve spent driving in Philadelphia. Sometimes these are the directions I give, to get to one of the local hospitals. Drive down to the second intersection without any traffic signs, then turn right.

Engine 43 vs Ladder 9. We’ll call it a draw, because there were no real winners. 9 fire fighters injured, but at least nobody seriously injured or killed.

What if it had been Engine 43 vs Little Girl On A Bike? How would that have worked out? LGOAB would have her very own memorial right there on that corner.

What? You think that if Engine 43 (the little truck) can’t see Ladder 9 (the big truck) coming down the street, there will be some sudden awareness of LGOAB?

Should she be riding in the street?

Yes.

Should she pay more attention?

Yes.

Should she have to go out of her way to make it OK for fire trucks to drive through a red light without stopping?

No.

In Philadelphia, as far as I know, fire trucks are required to stop for red traffic signals. Clearly, unless the traffic light was indicating green in both directions (rarely, people will turn the lights to cause accidents), somebody ran a red light.

But what if the light was not working properly?

Unless you see a green light, or yellow light, pointing in your direction, legally you are supposed to treat it as a stop sign. You don’t know what the light shows in the other direction. It does not matter if you are on a main road and the other road only occasionally has traffic. If they have a green light, they have no reason to stop. Anyway, there is no good reason for these two trucks to enter the intersection with out being able to stop. None.

But they have to get to a fire!

Maybe. They are responding to a report of what may turn out to be a fire, may turn out to be a false alarm, may be to assist EMS.

None of these are good reasons for creating a dangerous situation, just to get there a minute or two faster. Should we allow ambulances to just ignore red lights, because they are also dealing with potentially life threatening emergencies? No. The amount of time saved is unlikely to be significant, but the increase in danger to the public is likely to be significant. If you look at the picture at the top of this post, the traffic signal is on the ground in front of one of the trucks. They may have had an up close view of it, as they knocked it down.

So how did this happen?

My guess is that there was no attempt to do anything other than sound the air horn to warn everybody to get out of the way. Everybody who can hear the air horn and react in time.

Sort of like the apocryphal story in the video below.

There is a very interesting and full history of this story at Snopes.com.[1]

I do not favor coming to a full stop at every red light, but it should be mandatory to slow down enough, that you can stop if necessary. If necessary. This involves critical judgment. A lot of people are uncomfortable with fire fighters, police, or EMS using critical judgment. Critical judgment is essential to the job. It does not matter if it is the police, fire, EMS, or the US Postal Service, there is a responsibility for the safety of others on the road. Even those not on the road, who might be hit during a brief off-road excursion, due to a loss of control.

Back to the original topic. Which cause is correct? Budget cuts or . . . well I don’t think they have released the official cause, yet. The union is probably correct in putting some, but only some, of the blame on the budget cuts.

More to blame are the union and the administration. They have tolerated this kind of driving. If the union truly cares about its members, they should stop this practice, even if it is rare. If a fire fighter is killed, is that taking care of union members? If a fire fighter kills someone else, how is that fire fighter going to deal with that guilt? What about the rest of the fire fighters on the truck? The administration will probably sound exactly like the union on this.

Momentary oversight.

Rare occurrence.

Freak event.

Unpredictable.

We don’t tolerate this.

Of course they do. They encourage this by diverting attention from it and by making excuses.

If anybody is interested, please record video of any lights and sirens responses that you can. You can send the video to me, or post it somewhere else and send me a link. I will try to do a post showing the kinds of responses that happen regularly in Philadelphia and other cities. This is something that is endorsed by many of the brass, since they respond on these calls, too. Police response, fire response, and ambulance response, but keep the postal workers out of this.

roguemedicblog@gmail.com

Footnotes:

^ 1 The Obstinate Lighthouse
Snopes.com
Article

.