Lights and Sirens During Transport

Lights and Sirens During Transport

There are many reasons why patients may need to be transported with lights and sirens.  Some common reasons include time sensitive emergencies such as STEMI or stroke, traumatic injuries and other critical patients that may require faster transport.  Per the NHTSA report, they indicate the following conditions may warrant expedited transport 1) a tenuous airway (with complete or incomplete obstruction) and 2) a patient with rapidly decompensating vital signs.”  Some interesting studies have been performed and have shown that lights and sirens only save about 44 seconds to two minutes of time.

In 2017, we transported 33,870 patients to the hospital and, of those, 8% were transported with lights and sirens.  The National Highway Transportation Safety Administration (NHTSA) recommends that 5% or less of all transports should occur with lights and sirens.

Of the 2,648 cases:

  • 12% were listed as BLS patients
  • 19% had a scene time of more than 20 minutes
  • The average transport time for these patients was 11 minutes and 23 seconds
  • 33% documented patient improvement during EMS care

The COVB Administrative Directive: Emergency Response System/Vehicle Response Directive, VBEMS Operations: Response Policy and Code of Virginia discuss the issue of lights and sirens transport.  Links can be found at the bottom of this article.

Emergency Mode – Patient Transport (Ambulance only):

Emergency mode will only be utilized during patient transport to the hospital when the attendant-in-charge has determined that the patient’s condition is unstable or life-threatening. Since basic life support (BLS) patients will seldom meet these criteria, only an EMS supervisor can authorize the emergency transport of BLS level patients by a BLS crew.

Emergency transports will not be made simply to expedite returning the ambulance to service to be available for other calls. The EMS supervisor may authorize emergency transports during multi-causality situations or when another life-threatening situation exists without sufficient medical resources to respond otherwise.

12VAC5-31-1150. Emergency Operation of EMS Vehicle
EMS personnel are only authorized to operate an EMS vehicle under emergency conditions, as allowed by § 46.2-920 of the Code of Virginia:

  1. When responding to medical emergencies for which they have been dispatched or have witnessed.
  2. When transporting patients to a hospital or other medical clinic when the attendant-in-charge has determined that the patient’s condition is unstable or life threatening.

When deciding if lights and sirens during transport are necessary, please consider all of the factors.  Here are some good questions that you should be thinking about:

  • Will 2 minutes (or so) potentially make a difference in my patient’s outcome?
  • Is the driver very skilled and light on the brakes?
  • Will providers in the back be able to be belted in or moving around?
  • What time of day is it and what are the road conditions?
  • Will lights and sirens raise my patient’s anxiety level?
  • Can I shorten my on scene time to cover the time difference?

As always, be safe and be deliberate in your decisions!

 

Policy/Code/Links:

https://www.vbems.com/download/policies/reference_documents/Emergency-Response-System-Vehicle-Response-Directive.pdf

https://www.vbems.com/download/policies/operations/OPS-Response-Policy.pdf

https://law.lis.virginia.gov/admincode/title12/agency5/chapter31/section1150/

NHTSA report:     https://www.ems.gov/pdf/Lights_and_Sirens_Use_by_EMS_May_2017.pdf