Author: Tim Nowak
(2-3 minute read)
“Primum non nocere – first, do no harm.” This is the opening sentence in the 2017 report produced for the National Highway Traffic Safety Administration (NHTSA), Office of Emergency Medical Services (EMS)*. This study examines the use of lights & siren (L&S) by ambulances. Within this report, there are six key take-away points that both fire and EMS administrators should take to heart as they outline their standards for operations, benchmarks for performance, and factors toward error reduction. These key factors are also applicable to municipal leaders as they define service provider contracts and outline metrics beyond the traditional 08:59, 90% of the time anecdotes.
“While [the use of L&S] may be of clinical importance to patient outcome[s] in critical time-sensitive conditions like cardiac arrest, the consensus among the researchers in this field is that the time is not significant in most of the responses or transports.”
The patient’s actual condition – rather than the patient’s perception of their condition – should drive the use of lights & siren when transporting to the hospital.
“For most conditions, EMS professionals can provide appropriate care to reduce the importance of saving a few minutes by L&S transport.”
Prehospital care provided by EMS providers can certainly have an impact on a patient’s overall outcome, therefore, it’s important to focus on providing appropriate interventions rather than solely “driving fast” to get to the hospital. On that note, it’s also important to point out that lights & siren does not necessarily equate to “driving fast” … it merely asks other drivers for the right-of-way … and its use may not actually result in much time savings in some communities.
“… L&S use is a medical therapy. Like all therapies, it has potential benefits and potential risks….”
Yes! Lights & siren use is an intervention, and its use should be monitored just like other interventions – with close attention to detail in determining its appropriateness.
“Each agency should measure their L&S use during response and transport, and quality improvement processes should be used to reduce the use of L&S response and transport to the minimum effective rate.”
A goal for every EMS agency should be to review 100% of their patient care reports (yes, 100%!). If that cannot be achieved, then the goal should be shifted toward 100% of high-acuity calls … and there’s nothing more high-acuity than screaming “emergency, please move” and displaying flashing lights while doing so!
“Justification is given for using benchmark targets of reducing L&S use during response to less than 50% and during transport to less than 5%.”
If you’re looking for a benchmark to measure your agency against, here’s something concrete and very realistic! In the 9-1-1 response environment, if your agency is sitting at 100% for either one of these, the evidence is glaring at you to take a deep look at your practices and decision-making processes to shift these trends for the future (immediately).
“Myths and facts must be separated from tradition and emotion when discussing [the use of L&S].”
Doesn’t this seem like a common factor in the use of lights & siren? “What if this …” or “one time, this happened ….” Anecdote shouldn’t drive our practice – data should. Having said that, when’s the last time you had your data analyzed? What best practices are you not practicing (and why)?
Need help analyzing your data, making a change in your service agreement contract language, or creating a strategic plan for your future? Schedule a free consultation with one of our experts, today!
*To read more about this subject, you may find the case study here.