QUESTION: My complaint is about why our ambulance sirens are so loud. I think sirens on the mainland or Europe or Asia intermittently go "beep-beep-beep," which is less painful on our ears than the constant blare that is irritating, painful and annoying. And I think the loud noise is causing damage to people’s hearing. Can they put in a new system where it’s not as noisy and loud as it is now?

ANSWER: The type of siren used is not going to change, at least in the foreseeable future, but moves to reduce the use of sirens on ambulances are continuing, here and nationally.

"We’re doing what we can with what we’ve got and within the law," said Patricia Dukes, chief of the city Emergency Medical Services.

Sirens are meant to warn other drivers on the road about an approaching emergency vehicle for the safety of both those drivers and the emergency responders.

There is no national noise standard for the use of sirens, Dukes said.

But she said studies are showing that "sirens don’t work the way they should" in providing that warning, since drivers often are insulated in their vehicles and distracted by other sounds.

She provided a link to a public-service video put out by MONOC, a New Jersey hospital service corporation, showing that the common practice of ambulances using lights and sirens to and from every call was not enhancing safety.

It cited the National Highway Traffic Safety Administration as estimating there are 10,000 ambulance crashes a year nationally, resulting in one fatality a week of an EMS responder, patient, bystander or occupant of another vehicle. (See www.monoc.org/sirenPSA2.cfm.)

The conclusion is that ambulances do not always have to respond with sirens blaring and lights flashing and that the manner of response should depend on how critical the patient’s condition is.

Honolulu’s EMS has embraced that policy for the past two years. (See is.gd/ITN5Zv.)

Dukes said every emergency medical technician and paramedic recently went through training on EMS’ policy that if a patient is stable and being taken to the hospital, "we don’t use our lights and sirens."If the call is deemed a critical one to respond to, "then, yes, indeed, we will do our lights and sirens."

EMS’ siren policy boils down to turning sirens on "when reasonably necessary." So on a crowded freeway, the sirens would blare; on an empty street in the middle of the night, likely not.

"Basically, we’re doing our best to reduce the siren noise more by allowing the paramedics discretion on when they’re going to use their sirens and when it’s reasonably necessary," Dukes explained. "If there’s a complaint, we’ll research it, and if it wasn’t reasonably necessary, we’ll take action to re-educate."

There’s no problem in using the sirens intermittently, so that they go "beep, beep, beep," Dukes said. "That’s what we’ve told our paramedics to do in the middle of the night or even during the day," when possible.

MAHALO

Belatedly, to the Emergency Medical Services techs and Honolulu firefighters who responded to my call for my wife, Wendy, who went into cardiac arrest July 15. They all worked furiously on her at our home and en route to Straub Clinic & Hospital.

I regret not getting their names, let alone thanking them personally. Mahalo also to the doctors and staff in the ICU south unit. All the nurses and staff gave my wife the most compassionate care and gave our families such wonderful support. They were all such a blessing.

Unfortunately, my wife passed away, but with their help she was comfortable and out of pain. — Kevin Fitzgerald

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In "Kokua Line" Monday: The Honolulu Fire Department uses lights and sirens on every call.

Write to "Kokua Line" at Honolulu Star-Advertiser, 7 Waterfront Plaza, Suite 210, 500 Ala Moana Blvd., Honolulu 96813; call 529-4773; fax 529-4750; or email kokualine@staradvertiser.com.