With the recent spate of ambulance crashes, the importance of driver input on safe responses to incidents and medical facilities is greater than ever. As a former state trooper and technical accident investigator, I've learned that the greatest majority of crashes are caused by a limited number of factors.
The first is speeding. Remember not to speed too fast for roadway conditions, whether it's the weather or the operational capabilities of the vehicle you're driving. The second is inattention to driving, whether it's on the part of the striking vehicle or the hit vehicle. If you combine these factors with the nature of emergency response driving and the realization that, in reviewing recent ambulance-involved crashes, almost all were angle crashes, it becomes clear that, as an EMS driver, it's incumbent on you to keep your team, patient and yourself as safe as possible during all times of operation, not just running code.
The following are some tips and strategies to help keep you and your team from becoming a statistic.
Don't Assume Drivers Can See or Hear You
The fact is that, as much as we would like to believe that everyone can see and hear us in our big, brightly colored, stickered up, LED-emblazoned rig as we rumble down the roadway, physics, environmental conditions and human behavior are working against us. First, depending on the time of day, available light, traffic and roadway conditions, line of sight obstacles, road position and presiding speed limit, it may be difficult for a motorist to see you as you approach, and that's even if they're paying attention.
Remember that the world you see from the driver's seat is generally elevated, so while you may be able to see a car approaching from a side street, they may not see you because they're sitting lower. Second, depending on the type of light bar you have and where it's placed, it may not be very visible during the daytime, and the height placement may render it ineffective from an angle.
Finally, siren studies have proven that the ability to overcome ambient noise and the insulation capabilities of modern vehicles is very limited, so while the noise may seem ear-splitting in front of your rig, chances are it won't be heard by a motorist in a closed-window car until you're really close, which might be too late.
So, while the law requires motorists to yield to you under code-3 operations, and your rig is still a visual presence during routine driving, drive like nobody can see you. The extra cautiousness will pay off.
Don't Put Your Life in the Hands of Strangers
This sounds like I'm being anti-social, but this is something that gets a lot of drivers, even fleet and EMS drivers in trouble: they assume the "other" person will do the right thing. In my experience working with DrivingMBA, a private driver training company, which is unique in its use of the PatrolSim IV Driving Simulator for fleet and teen driver training, immersing adult fleet drivers in head-on and angle collisions almost always generates predictable results and justifications. When asked why they allowed themselves to be hit head-on or at an angle by a vehicle they saw approaching them with plenty of warning, the typical response has been, "I thought they would stop, swerve, see me," etc.
So, in other words, they placed their livelihood in the hands of a stranger by assuming they would do the "right" and "rational" thing. Unfortunately, because you don't know the mental, physical, psychological and emotional state of that person who's approaching you from a side street, you can't assume they'll see you and stop, and/or yield.
Unfortunately, many drivers assume incorrectly, and the price can be deadly, especially in intersections where a red light runner was seen before entering the intersection, but the wrong assumption was made that they would stop in time. So, no matter how clearly you can see another motorist, never assume they'll do the right thing and adopt a proactive driving strategy to address that.
In police driving, cadets are taught to drive at 70% of their capabilities, leaving a reserve buffer to address the issues in the previous paragraph. The same type of strategy should be employed in EMS driving, as the entire point of our job is to preserve life, and that includes our own and our crew. Contrary to law enforcement driving, EMS providers don't engage in the "pursuit of offenders," but more see themselves in "pursuit of time,"— that window of opportunity available to render effective treatment. But, as with law enforcement, you can't help if you don't get there, and you can't save a patient if your rig never makes it to the hospital.
While we can't control the actions of other motorists, you can give yourself a buffer by slowing down. Studies have shown that, in urban environments, the time saved running code 3 to a hospital is only marginal, with the risks being significantly higher. Because the average perception/reaction time of a human hovers around 1.5 seconds, this means that, at 60 mph, you'll travel approximately 132 feet before even touching the brake pedal, so that distance needs to be added to the physical stopping capabilities of your rig, which generally isn't very good given its size and weight.
Reduce that speed to 50 mph, and with an identical perception/reaction time, distance is reduced to approximately 110 feet. This means that extra 22 feet saved might make the difference between having room to maneuver or stop in time or striking something. So, while you can't change the suspension or brakes or engine on your rig, you can affect the speed at which you're traveling to increase your safety buffer.
I like acronyms because, while there seems to be a slew of them out there, some can prove to be beneficial. SIPDE is one of them. SIPDE stands for the following: Scan, Identify, Predict, Decide and Execute. It's an easy formula to remember and one you should commit to memory and say to yourself regularly as you drive. Scan means moving your eye point every two seconds or so and keeping your head on a swivel." Do NOT rely on your peripheral vision alone to locate potential hazards because you can't react to what you don't see, so scan, scan and keep scanning. Identify means recognizing any potential hazard that might cause you some peril, from other vehicles to roadway conditions, weather and obstacles.
Once you've identified any potential hazards, predict what could happen that would cause you to take action to avoid a crash. Based on those predictions, decide what the best course of action might be, whether it's slowing down, changing lanes, "covering" the brake pedal or something else. Lastly, if that predicted hazard becomes reality, execute your decision to maximize your safety and minimize the chances of a crash. Of course, you could have numerous SIPDE strategies going on in your head that basically address the "if this, then that" factors. SIPDE is simple, and it works, so it makes sense to make it a part of your daily driving protocols.
Be Aware & Stay Alive
Driving an EMS rig isn't easy, even when you aren't running code. Add that to the fact that the great majority of today's drivers have no formal training whatsoever. So, never assume, don't put your hands in the life of another, slow down and adopt SIPDE. Common sense? Yes, but even the most common skills can be forgotten if not practiced, so keep sharp and stay safe.