Lights and Sirens

[Paramedic2617]

Here in NJ (forsure Northern NJ) all 911 calls go lights and sirens to and from the scene. Whats the deal with other areas? Does your state have laws with regards to priority dispatching/lights and sirens usage?

I think its pathetic that BLS patients go lights and sirens and even some ALS babysitting jobs.

What do you guys think?


Herschel

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[carn311]

Here in NJ (forsure Northern NJ) all 911 calls go lights and sirens to and from the scene. Whats the deal with other areas? Does your state have laws with regards to priority dispatching/lights and sirens usage?

I think its pathetic that BLS patients go lights and sirens and even some ALS babysitting jobs.

What do you guys think?


Herschel

Yeah, thats a little odd. Here in NY, at least in my area, dispatch will advise us on the priority of a call but how we approach it is pretty much up to us. The one thing that I have heard recently however is apparently in our area whenever we have lights we also have to have sirens...oops.

 

[Paramedic2617]

Yeah, thats a little odd. Here in NY, at least in my area, dispatch will advise us on the priority of a call but how we approach it is pretty much up to us. The one thing that I have heard recently however is apparently in our area whenever we have lights we also have to have sirens...oops.

Same thing in NJ, we are supposed to have sirens going with lights on but that doesnt happen unless we want it too. I mean at 3am why wake everyone up?

 

[.edu-MD]

The one thing that I have heard recently however is apparently in our area whenever we have lights we also have to have sirens..

I thought most/all states (maybe even federal? - NHTSA?) required lights and sirens to be on together...I know in practice we don't do this, say at night in residential neighborhoods...my agency recently put in a road safety system on all our rigs and my understanding is that it'll record whether we have only one or both going. I'm sure if we got in an accident with only lights, it'd be both bad publicity (as if an accident wouldn't be bad enough) and the insurance company would have a field day...

 

[jonb12997]

the voly company I rode with in NY, we technically had to have sirens on when our lights are on, but in a rural area, with no traffic around, come on, who really needs to have the siren on, it's just going to make it hard to talk to the patient in the back... however any intersections we had to go through, if we had lights, it was sirens. We (as the EMT in charge) also could pull back the lights if we didn't think it was a bad problem (or if the siren stopped working one time like it did for me)... that was really dependent on who was in charge.

 

[f_w]

> who really needs to have the siren on, it's just going to make it hard to
> talk to the patient in the back...

Not to mention the increased stress level for the driver. There has been research indicating that the increased noise reduces the drivers ability to react to traffic related stimuli.

 

[fiznat]

We also are supposed to have sirens whenever the lights are on, although that does not happen all the time in practice. ...Especially at night.

We have the "fob" road saftey box thing as well, but it doesnt record whether or not the lights+sirens are on together or not. ...Mostly seatbelts, speed, turning force etc is recorded.

Thats pretty silly that you would be mandated to go pri 1 even on the trip to the hospital regardless of the status of the patient. Doesnt your system have any concern for your saftey and the saftey of other drivers on the road? Pri 1 is way dangerous when compared to a nice easy cruise to the ED for a BS "my finger hurts" patient.

 

[southerndoc]

Here in NJ (forsure Northern NJ) all 911 calls go lights and sirens to and from the scene. Whats the deal with other areas? Does your state have laws with regards to priority dispatching/lights and sirens usage?

Connecticut (where I live now) does not have a specific law about lights and siren.

Georgia (where I worked as a paramedic) states that lights and sirens may only be used in an emergency. The regional EMS coordinators investigate all complaints of inappropriate use of lights and sirens. There have been medics fired for inappropriate use.

I remember transporting cardiac arrests non-emergency to the hospital (before pronouncement caught on). The theory was that people standing in the back were at increased risk of being injured if involved in a collision, and the paramedics were providing the same level of care as an ED would provide.

The only thing that resulted in an emergency transport back to the hospital (a "STAT return" as some places call it) is uncontrolled bleeding, major trauma, stroke, active labor with complications, or an MI with >15 minute transport time. Sure, there are always exceptions to those not listed, but what's listed is the majority of STAT returns that we did.

 

[fiznat]

Connecticut (where I live now) does not have a specific law about lights and siren.

Huh thats interesting, I thought there was. Anyhow, I've worked for three ambulance companies across the state and the lights + siren rule has been at the least a company policy for all three. Ill have to do some research on that, I'd like to know what the exact wording is (if any).

The "stat" returns you listed make sense for a medic, but there are more if you are a BLS crew who cant get an intercept anytime soon. I've worked with a few long time medics and I swear its like they *never* go lights + sirens, sometimes even when they are dispatched to do so. ...I guess the feeling is that it is just so dangerous to do that, and the response time doesnt change enough to make it worth it in their eyes.

Personally I feel like its playing with fire to ever go slower than what might be necessary-- although that just may be my BLS CYA reflex acting up again.

 

[southerndoc]

Am I wrong about the topic of this thread? I was thinking it was about returning all patients to the ED and responding to all calls with lights and siren.

There seems to be a satellite discussion that has ensued about whether you can use lights with or without siren.

 

[Paramedic2617]

Am I wrong about the topic of this thread? I was thinking it was about returning all patients to the ED and responding to all calls with lights and siren.

There seems to be a satellite discussion that has ensued about whether you can use lights with or without siren.

You are correct. I was discussing Lights and Sirens to and from the scene.

In NJ, as far as i know there is no law mandating lights and sirens. Its just something everyone does and I think its pathetic. Most BLS here is volunteer and i think they do it so they can get back to what ever they were doing before hand.

I think that each system should have some priority for use of L&S. There actually is a study that was done in a city system that showed there was no major difference in response times when using L&S. Obviously this isnt accurate for every system, but there should be more studies done to make changes.

 

[Jambi]

Out here in SoCal all 911 calls are responded to with light and sirens (code 3). Transport to the hospital is up to the patient attendant and is rarely code 3, maybe <10% of calls will be transported code 3.

 

[Paramedic2617]

Out here in SoCal all 911 calls are responded to with light and sirens (code 3). Transport to the hospital is up to the patient attendant and is rarely code 3, maybe <10% of calls will be transported code 3.

Is this your services protocol? or is this mandated by the state?

 

[Jambi]

Is this your services protocol? or is this mandated by the state?

Not mandated, it's more county/services protocol. Here, all 911 call are treated as emergent and dispatched as 911. As for transporting, sole discretion lies with the paramedic.

 

[Oats]

Where I work, calls are dispatched on a priority level. Alpha: non-emergent Charlie: emergent (95% of calls), and Delta: emergent (think cardiac arrest, ped. struck, etc.). If we're told to downgrade to alpha and given the reason why, we have the right to continue emergency traffic if we don't agree. For instance, about a month ago I was dispatched on a seizure pt. Dispatcher told us we could downgrade to alpha response ref. pt. not currently seizing and has an altered mental status. It seemed completely ridiculous to us to respond non emergency on a pt. with an altered LOC so we continued emergency response. He turned out to be a priority pt. with a head bleed. Anyway, to answer the OPs question, we're told how to respond to the call. How we transport (i.e. lights and sirens) is our decision and is based on pt. condition.


~Oats