QUESTION: It was necessary for me to wait for my wife at Thomas Square near Straub Hospital from 8:30 to 10:30 a.m. and 2:30 to 3:30 p.m. March 1. I noted that every ambulance arrived with lights and sirens ablaze. I was recently in Bangkok, in a hotel just outside the emergency room of the large Bumrungrad International Hospital. During 10 days there, and five days in San Diego, I heard only one siren. Reaching the hospital one to three minutes earlier does nothing to improve care, death rates or outcomes. Instead, studies have shown lights and sirens on ambulances cause more accidents and personnel deaths. Why is this constant attack on our senses continuing?
ANSWER: The city Emergency Medical Services Division implemented a policy last year to try to reduce the use of lights and sirens.
During the times you cite, six ambulances took patients to Straub: four used lights and sirens appropriately; one did not use either; and one’s use was “questionable,” said Patricia Dukes, the city’s chief of EMS. She said she “addressed that (questionable use) with the personnel.”
EMS’ new “Emergency Vehicle Operations” policy, implemented in September, requires ambulance crews to transport “stable” cases, based on the “best clinical judgment,” without lights and sirens on.
The policy is based on the Advanced Medical Priority Dispatch System, which specifies the mode emergency crews are to travel in while responding to or leaving the scene of a call.
Dukes described AMPDS as “a scientific medically sound and legally defensible program” with safety as its first objective.
The state Traffic Code allows emergency vehicles to respond to emergency calls, bypassing speed limits and red or stop signals — with caution — but only if lights and sirens are turned on.
Under the AMPDS, a “hot” response, with warning devices activated, is required when responding to an emergency, and drivers are allowed to proceed past a red light or stop sign/signal, but only after slowing down to check for safety; exceed the speed limit by a maximum 15 mph; and disregard regulations governing direction or turning, as long as there is no threat to life or property.
Since 2006, following AMPDS guidelines, EMS has allowed ambulances to respond in a “cold” mode, without activated warning devices, if it is determined there is no emergency. The driver is to proceed in a “normal manner, heeding all traffic laws.”
When transporting patients in “unstable” condition to hospitals, warning devices on ambulances are required to be activated. However, when transporting patients in stable condition, the driver is not to use warning devices and should drive in a “normal manner,” heeding all traffic laws.
The number of ambulances responding to calls with lights and sirens has remained about 94 percent, Dukes said.
(By comparison, Dukes said the Honolulu Fire Department, as a first responder, “goes lights and sirens to every call.”)
She said she hasn’t had a chance to dig up exact figures, but estimates the figure would be 60 percent for ambulances transporting patients to a hospital, “based upon the severity level of (a) patient’s illness and injury.”
“EMS wants to get the right resources, to the right place, in the right emergency mode,” she said. She said the AMPDS program has proved “steady, effective and accurate since 1994.”
MAHALO
To all the neighbors on Kaweloka Street who came to the aid of my husband when he fell during our morning walk. To Ryde and James, who were on their way to work, for offering assistance and calling the ambulance; and to Lynn, Jason, Iris, Lorraine, the Miyamotos, Greg, Mr. Nagata, all such wonderful people. — The Yuens
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