Showing posts with label Lights & Siren. Show all posts
Showing posts with label Lights & Siren. Show all posts

Monday, July 22, 2024

EMS Safety - Analysis of Ground Ambulance Crash Data


The "Analysis of Ground Ambulance Crash Data From 2012 to 2018" report by the National Highway Traffic Safety Administration (NHTSA) highlights that driver error was involved in 92.6% of fatal U.S. ambulance crashes during this period.

Common errors included improper intersection clearing, running red lights, and driver fatigue. Lights and sirens were active in 40.7% of these crashes, often inappropriately. The crashes resulted in an average of 28.4 fatalities per year, with 40.2% being ambulance occupants. Other contributing factors were speeding, unbelted occupants, and driver impairment or distraction.

“The SCI [the NHTSA’s Special Crash Investigations Unit] reports for 2012 to 2018 showed nearly all crashes (92.6%) involved ambulance operator/driver error,” said the NHTSA report.

“Improper clearing of intersections, traveling against red lights, and operator fatigue were noted as factors in the crashes. Lights and sirens were active in 40.7 percent of the crashes. The expert reviewers noted that lights and sirens were often used in situations that were not recommended according to best-practice guidelines.”

As for the human toll from these errors, “Ambulance-involved fatal crashes remained relatively rare from 2012 to 2018 with a national average of 24.7 fatal crashes per year and 28.4 fatalities per year reported in FARS [the Fatality Analysis Reporting System],” the NHTSA report said.

“Of the individuals killed, 40.2 percent were ambulance occupants (operators/drivers, front seat passengers, and clinicians or patients in the cabin), 52.3 percent were occupants of other vehicles involved in the crash, and 7.5 percent were non-occupants (e.g., pedestrians, bicyclists).”

To put it mildly, these statistics disturb NHTSA EMS Specialist David Bryson. Most of all, “We need to reduce operator error because in 92.6% of the 27 SCI crashes investigated, ambulance operator error was a significant factor,” he told EMS World. “Improper clearing of intersections was a big one.

Ambulances must come to a complete stop at red lights and make sure the way is clear before they proceed. But many of these emergency vehicles did not stop completely before traveling through the intersection.”

Other factors that contributed to these fatal crashes were speeding (14.8%), unbelted occupants (14.8%), driver fatigue (11.1%), impairment caused by alcohol or other drugs (3.7%), driver medical condition (3.7%), and driver distraction (e.g., GPS or cell phone use, 3.7%).

In conclusion, the NHTSA report underscores the critical need for improved safety measures and training for ambulance operators. Reducing driver errors, such as improper intersection clearing and driving against red lights, is essential to decrease the frequency of fatal crashes.

Additionally, addressing factors like speeding, unbelted occupants, driver fatigue, and impairment is vital. Enhanced protocols, adherence to best-practice guidelines, and a commitment to safety can help mitigate the risks and ensure the protection of both emergency responders and the public.

Further Reading:
Graham, L., Thomas, F. D., Finstad, K., Dennert, R., & Southcott, T. (2023). Analysis of Ground Ambulance Crash Data From 2012 to 2018 (Report No. DOT HS 813 480). National Highway Traffic Safety Administration. Accessed August 6, 2024

Thursday, February 29, 2024

EMS Discussion - Use of Lights & Sirens


EMS Providers should be aware of the ongoing discussion surrounding the use of lights and sirens during emergency calls. There is a growing concern about the risks associated with their use, such as an increased likelihood of accidents and harm to patients.

EMS Providers should stay updated on local and national guidelines regarding when to use lights and sirens to ensure the safety of both themselves and the public.

Those operating emergency vehicles must consider alarming statistics showing that ambulance crashes significantly impact clinicians, patients, and the public, with the risk of a crash increasing by over 50% when lights and sirens are activated.

It is crucial for EMS Leaders to implement well-researched guidelines supporting the restricted use of lights and sirens to enhance the safety of all individuals involved in emergency responses.

In an outstanding demonstration of collaboration on provider, patient, and community safety, 13 national and international associations have partnered on the release of a Joint Statement on Lights and Siren Vehicle Operations in Emergency Medical Services (EMS) Responses (NAEMT, 2022).

The statement articulates principles guiding the use of lights and sirens during emergency vehicle responses to medical calls and initiatives to decrease their use safely. EMS vehicle operations using lights and sirens pose significant risks to both providers and the public. Therefore, their use should be limited to situations where time saved is expected to be clinically important to a patient’s outcome (Merill, 2022).

Communication centers should utilize structured call triage and categorization to identify subsets of calls based on the response resources needed and medical urgency. Physician oversight is crucial in developing response configurations and modes for these protocols.

Agency Leadership should monitor the rates of lights and sirens use, appropriateness, compliance, and outcomes related to their use. Municipal Leaders should be aware of the increased crash risks, and quality care metrics should drive contract agreements.

States and provinces should monitor and report on emergency vehicle crashes to better understand the risks associated with lights and sirens use.

Collaboration between EMS and Fire Agency Leaders is essential in understanding public perceptions and improving education about the risks associated with lights and sirens to create safer expectations.

According to a recent presentation by NEMSQA, 87% of EMS responses were made with the use of lights & sirens, while transports nationally used them 51% of the time. The time savings averaged 102-216 seconds during a response and between 42-228 seconds for transports (from multiple recent studies); yet life-saving interventions are being done in only 6.9% of responses (according to an ESO study of 7.5M records).

At the same time, our odds of being involved in an accident increase by 53% in responses and 184% during transports (not to mention accidents in our wake that do not involve an EMS unit). Furthermore, litigations that involve ambulance incidents are 86% when using L&S.

The data presented highlights concerning statistics surrounding the use of lights and sirens in EMS responses and transports. While time savings are evident, life-saving interventions are performed in only a small percentage of responses.

The increased risk of accidents during both responses and transports underscores the need for a shift towards safer practices. Litigations involving ambulance incidents predominantly occur when lights and sirens are used.

It is crucial to view the use of lights and sirens as a clinical treatment and to follow the guidance to "use only as needed" to ensure the safety of patients, the community, and EMS providers. Prioritizing safe ambulance operations is vital for everyone's well-being and to ensure a safe return home after each shift.

Further Reading:

Merrill, L. (2022) 14 Groups Issue Joint Statement on EMS Use Of lights, Sirens https://www.ems1.com/ambulance-safety/articles/14-groups-issue-joint-statement-on-ems-use-of-lights-sirens-AAfswfKx2gaog3dy/ Accessed February 28, 2024

National Association of Emergency Medical Technicians (2022) Joint Statement on Lights & Siren Vehicle Operations on Emergency Medical Services (EMS) Responses https://naemt.org/docs/default-source/advocacy-documents/positions/joint-statement-on-red-light-and-siren-operations-with-logos---final.pdf?sfvrsn=e586e893_4 Accessed February 28, 2024

National EMS Quality Alliance (2024) Improving Safety in EMS: Reducing the Use of Lights and Siren https://nemsqa.memberclicks.net/assets/LSChangePackage/Improving%20Safety%20in%20EMS%20Reducing%20the%20Use%20of%20Lights%20and%20Siren.pdf Accessed February 28, 2024

Zavadsky, M. (2023) Culture Shift: Reducing Lights and Siren Vehicle Operation https://www.ems1.com/safe-transport-point-b/articles/culture-shift-reducing-lights-and-siren-vehicle-operation-XDonsygscixIghQT/ Accessed February 28, 2024