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Collision Course

Collision Course

Once upon a time, I was a young EMT. Like a lot of young EMTs, and too many older ones, I liked to drive fast. Being an EMT for a municipal 9-1-1 service, I got to do that very often. Of course, 40 years ago the roads of Sort Big City were less congested, there were fewer traffic lights, and we could drive at speeds that are now really impossible to attain.

For whatever reason, getting into crashes wasn’t as big a deal as it is now. It should have been, but it wasn’t. Today, we’d probably call that a “cultural” thing, but labels don’t really matter.

One thing that does matter is the wide spread, but false, belief that we respond to a lot of emergency calls. For years, EMS told the world that if they thought it was an emergency, then we’d respond as if it was and then sort it out when we got there.

There’s some ever decreasing amount of truth to that, since phone triage, no matter which “card” system your agency uses is part guess, part pseudo science. All of them are built in the premise that non medically trained people, who are calling EMS under stress, can give accurate answers when asked medical questions.


Medical people often can’t give accurate answers to medical questions when they are on the phone, so how do we expect non medical people to do so. For this reason, there is some justification to responding to some emergency calls with lights and sirens.

The hard part is figuring out which ones are emergencies, which is why card systems are weighted more heavily to worst case scenarios.

Which still doesn’t justify driving like a maniac to a call. The few seconds or minute or so that you will shave off of your response time are not worth the carnage that you risk causing by getting involved in a collision.

Let’s look at the following video. I believe that the ambulance might have been transporting, but for the sake of this post, let’s stipulate that these two vehicles are responding to an incident.

How embarrassing! Embarrassment is the least of the concerns here, but you can be sure that this played on the local Miami TV stations about 10,000 times in the days after this happened. No civilian vehicles were involved, which makes this legally less complex, but it is certainly not without cost.

Financial costs. Neither ambulances nor fire trucks are exactly cheap. Nor is repairing them. Then there is the cost of injury and time lost by the crews.

Notice also that the ambulance had the red light. I’m not familiar with Florida traffic laws, so I don’t know if the ambulance is required to come to a complete stop at red lights. In my state, they are and then can proceed if it’s safe to do so. People don’t always do that and with the ubiquity of dash and traffic cameras, someone is very likely to catch your actions on camera. The driver may well suffer financial loss from suspension or maybe termination.

The accident investigators at my former agency (no police, but still investigators) always looked for video when one of our units was involved in a crash. First, from city owned traffic cameras, then if there were none, from privately owned cameras that were hooked into the city network.

I’d be remiss in mentioning that the disciplinary penalties were always worse if one lied on an official report.

Operational costs. Now, instead of responding to whatever call they were on their way to, the rescuers have become victims, at or at least potential victims. Another fire engine and ambulance have to be sent to them. Also, another fire engine and ambulance have to be sent to the original call. The police now have to respond to the crash. In a smaller system, that will ripple through out the entire system, in a larger one less so, but there will still be some impact.

Here is an example of what I mean,

One ambulance, seven patients, three critical, four separate fire departments on the response. The stakes get even higher when there is a patient on board. It’s very rare that a patient requires a lights and siren transport. A battle I frequently had because my former agency had a poorly written policy from the mid 1990s that was still in effect when I retire. It specified that all responses required lights and sirens and implied that all transports required lights and sirens as well. So, we were often treated to the spectacle of an ambulance driving into the ambulance bay with lights ablaze and siren ablaring, only to have the patient alight and get into a wheelchair for a trip to the non acute triage area.

One last video for your consideration,

A non emergency response for a “Check the welfare” call.

Responding to emergencies is inherently dangerous, but the laws of physics don’t care about that. The laws of physics also don’t suffer the effects of crashes, people do. The most important thing that providers can do is drive safely, which mostly means driving more slowly and paying attention to what is going on around you. The lights and sirens impart no special protection against other drivers who aren’t paying attention or are just plain stupid. Nor do they magically make roads less slippery.

Be careful responding, because you do no one any good if you’re injured or killed.

Slow down. After all, this isn’t the kind of publicity your agency wants.

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After a long career as a field EMS provider, I'm now doing all that back office stuff I used to laugh at. Life is full of ironies, isn't it? I still live in the Northeast corner of the United States, although I hope to change that to another part of the country more in tune with my values and beliefs. I still write about EMS, but I'm adding more and more non EMS subject matter. Thanks for visiting.


  1. Those happen way too often. My daughter (Batt Chief Paramedic) was constantly on her crews about SAFETY. They had a few minor accidents, thankfully no one injured, but that was one of her sore points.

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