Siren Syndrome

“Why don’t you have the siren on?” the nurse practitioner asked my partner.

“Because this isn’t an emergency,” I answered.

“It is an emergency,” she insisted. “This is a 26-week preemie we’re dealing with here!”

“Who has yet to be delivered, and has an Ob-Gyn and numerous experienced nurses in attendance,” I point out.

“We need to get there fast! I insist you turn on the lights and sirens!”

“The hospital is maybe five minutes away, and it’s hardly even rush hour. Traveling hot will buy us maybe 30 seconds, if that. What it will do, is dramatically increase our chances of getting in a crash.”

“You can either turn on the lights and sirens,” she huffed, “or I’m calling Dr. So and So and she’ll make you turn them on.”

Now normally, that’s my red flag. You don’t climb into my rig and tell me how to operate. Ain’t happenin’. Just not done. And I could give a rat’s ass whether you’re a famous neurosurgeon or a nurse practitioner with delusions of competency. That rig is my domain, and no profession knows it better.

But in this case, I humored the ignorant heifer and turned on the woo woo box and the cherries. I knew that if she got the doctor on the phone, I’d win, because the doctor in this case was an eminently reasonable person, and not the type to second guess the EMT behind the wheel.

But all it would have accomplished was to leave to NP with egg on her face and bruised feelings, and after all, we were only talking about 30 seconds, one way or the other. It was also worth considering that I was the airway man on the NICU Transport Team that day – no respiratory therapist on duty. We’d need to work together smoothly, so I went along to get along.

As luck would have it, she got an object lesson in the use of seat belts and the dangers of emergency response driving when a black Toyota Camry panic stopped in front of us not thirty seconds later. My partner nailed the brakes and took evasive action, and managed to keep from making the Camry a hood ornament, but the nurse practitioner wound up kissing a little Formica – the hard way.

As she sat on the floor of the rig, blood dripping from her lips and nose, my partner and her co-workers explained to her why she should have had her ass perched in a seat and buckled in, and why we don’t run hot unless it’s absolutely necessary. My partner’s language was considerably less diplomatic than that used by her fellow nurses.

This little anecdote was prompted by a couple of e-mails from readers about the following incident:

A Wilton paramedic was killed early this morning when an ambulance he was riding in collided with a pickup truck at the intersection of Route 4 and Potato Road, police say.

Allan Parsons, 46, was tending to a patient in the back of the Med-Care ambulance, en route from the Rumford area to Central Maine Medical Center in Lewiston. Parsons died at the scene, according to the Androscoggin County Sheriff’s Department.

Now, I have never worn the uniform of one of our country’s armed services, and I’ve never worn a star or badge…

…but I do understand brotherhood, and thus any time we lose an EMT, cop, firefighter or soldier, I grieve the passing of a person I have never met. We weren’t partners, nor were we coworkers or friends.

But we shared a common ethos, and that makes us brothers.

I grieve the loss of Alan Parsons, but I also pray for his partner, the man they hit, and the patient they had in their rig. Their suffering has only begun, and some of them may yet die.

After such a tragedy as this, the natural reaction is to assign blame. In the comments section following the Sun Journal story, there are EMTs defending the actions of the ambulance driver, others assigning blame to the man they hit, and others still who are incensed at what they perceive to be a pattern of reckless driving among the local EMTs.

I could write a treatise here (or plagiarize a few oft-cited studies) on the risks and dangers of lights and siren response, how little time it actually saves, and how so few of our calls are actually that time sensitive. Emergency response is dangerous, period. We should only do it when it is absolutely necessary, and then only when we anticipate that the benefits outweigh the risks. EMS managers and public officials owe it to the EMTs that serve their community to develop a reasonable policy on the use of emergency lights and sirens.

I could also defend the EMTs, and cite local ordinances until I’m blue in the face. Problem is, most of the citizenry either don’t know those ordinances, or don’t care, and those ordinances often vary from one municipality to another. I will say this: in most cases, the use of emergency lights and sirens merely requests the right-of-way, and emergency responders must exercise due regard for the safety of other motorists. In some places, the top speed is defined by statute. In others, it’s more ambiguous – that whole ‘due regard’ thing. Under some road, weather and traffic conditions, you may be able to safely put the hammer down and see where the engine governor kicks in on your Powerstroke diesel. In others, practicing due regard may mean creeping along at 25 mph in a 45mph zone.

Until you’ve been behind the wheel of an emergency vehicle on a hot response, you have absolutely no idea of just how foolhardy, stupid and just plain dangerous other drivers can be. People absolutely lose their minds. Pick your worst day of road rage as a commuter, and you can multiply it times ten when you’re driving an emergency vehicle that has the handling characteristics of an ocean liner, knowing that a six-year-old isn’t breathing at your destination. My boy Jay G would have an aneurysm if he drove an ambulance.

On the other hand (what is that, three hands now?), I’ve been that motorist surprised by an ambulance. Sometimes sound can be hard to localize, and with today’s stereo systems and modern car soundproofing, the ‘bolance can be mighty close before you hear it. You don’t even have to be yakking on the cell phone to be taken by surprise. If you’ve ever wondered why an ambulance has to run through empty streets in a quiet neighborhood at 3 am, with their sirens wailing, waking the entire neighborhood, know this:

Some calls require lights and siren response per department policy. The EMTs have no choice in the matter. They can’t even turn off the siren and use the lights only. Insurance carriers and risk managers would have a cow.

Some companies have utterly ludicrous driving policies. I once worked for Huge Soul-less Corporate Conglomerate EMS, a company that had a zero-tolerance driving policy. Get caught driving without a seatbelt, or get caught blowing through a red light or stop sign, even on an emergency response, and you get fired. Period.

Now that in itself, I agree with. Only this company required you to stop and clear each individual lane of traffic.

Yeah, you read that right. With lights and siren blazing, we’d stop at the red light, look both ways, assure ourselves of the intentions of the other drivers, and only then could we proceed into the intersection…only to repeat the fricking process for each individual lane.

Stop-go-stop-go-stop-go.

I wanted to post a disclaimer on the side of the rig that said:

“No Ma’am, I’m not an idiot and I’m not trying to fake you out. My company policy requires that I behave like a blonde at a flashing red light, not to mention leave my ass vulnerable in the intersection four times as long, in the interests of safety.”

If you want to place blame for this tragedy, blame Fate. Don’t assume the EMTs were being reckless and don’t presume the other driver was drunk or careless. It was an accident.

All we can do is pray for the injured and the dead, hope to learn from the accident, and take reasonable steps to avoid them in the future.