NHTSA Office of EMS recently made recommendations and protocols for the use of ambulance lights and sirens for states regional authorities and local EMS agencies. The two main recommendations described by Douglas Kupas, MD, the lead author of the study, during an EMS webinar for EMS leaders are:
- EMS agencies establish a protocol to reduce lights and siren response as much as safely possible. A recommended benchmark in response to 911 calls would be to reduce the use of lights and siren by 50 percent for all 911 calls.
- EMS agencies should consider target lights and siren transport at a rate of less than 5 percent. The small amount of time saved will most likely be of clinical value in a small percentage of medical conditions.
The highlights of the study, “Lights and Siren Use by Emergency Medical Services (EMS): Above all Do No Harm,” included:
- Counterintuitive findings from commonly held beliefs about siren and lights use, including that the public expects ambulance to respond with lights and sirens. The research found that patients will opt to go to the emergency department themselves rather than draw attention to themselves in their neighborhood.
- Great variability in the use of lights and sirens. Two thirds of EMS agencies transport less than 50 percent of patients without lights and sirens, while 10 percent of EMS agencies use lights and sirens 90 percent of the time when transporting patients.
- Lights being used for different purposes including to request the right of way and to block the right of way. The research found that an amber color light that is constantly illuminated may be better to block the right of way rather than a rotating or flashing light. More research is needed, as well as more EMT and paramedic training to determine the light colors and patterns to use when an ambulance is blocking the right of way.
- The inherent risk to EMS personnel of hearing impairment and loss from high decibel noise when working in the patient care compartment when sirens are frequently used.
- Reducing use of red lights and ambulance sirens may reduce the risks of a crash and collision-related liability for the EMS agencies.
Source: “Investigation: Less ambulance siren use won’t impact patient outcomes,” by Greg Fierse, Editor-in-Chief, EMS1 News, September 15, 2017
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