Since the early 1990s, hundreds of research articles by fire departments, emergency medical services departments (EMS) and emergency room physicians have repeatedly shown that the use of lights and sirens (L&S) has been ineffective, even harmful.

Research on L&S has shown that:

» Their use has not significantly decreased transport times.

» The savings in time has not improved patient outcomes.

» They have contributed to worsening of some patient’s medical conditions by increasing the stress on their hearts and blood pressure.

» Their use has led to more vehicle crashes and pedestrian injuries with increased litigation and insurance costs.

It also has led to increased stress to emergency personnel, pedestrians, other vehicle operators and citizens exposed to the L&S noise.

Data shows that 10,000 injuries occur each year in the U.S. when L&S are in use, and at least one person is killed each week.

Honolulu uses the Medical Priority Dispatch System designed in the 1970s to categorize and prioritize emergencies. The system uses the first number (1-32) to indicate the 32 categories of emergencies. Examples would include 1-Abdominal Pain, 2-Allergic Reaction, etc.

The next is a letter priority to indicate the severity of the emergency, with the letter "A" the lowest priority and "E" the highest priority. For example, a 1D1 is an abdominal pain patient who is not alert and needs immediate response, and a 2A2 is a simple reaction to a spider bite.

Patricia Dukes, director of EMS Services, provided a copy of the 2013 policies, which state that only responses to emergencies graded "B" or worse require L&S. When transferring patients in stable condition, L&S are not to be used. However, if the patient is so unstable that the EMS personnel cannot control the situation, then L&S will be used, but they are to drive safely and be courteous.

By law, policies governing L&S is to be overseen by the EMS advisory committee, but the committee has never been formed.

Honolulu Fire Department spokesman Capt. Terry Seelig reports that every emergency will be answered with L&S. The Honolulu City Traffic Code 15-4.4 allows emergency vehicles to use L&S only when they exceed or disregard city traffic laws.

He said "while it may appear that there is no traffic, the use of L&S warn other drivers and pedestrians seen or unseen that an emergency vehicle is approaching and the right of way should be yielded."

That’s the way it’s done, he said, and for now, HFD is not changing its policy.

Many calls to 911 are from observers who report things such as a minor fender-bender with the parties unharmed, or an elderly person who trips and falls. Because these random calls are from a third party not involved in the incident, they are classified "B," so EMS and HFD respond with lights and sirens. So L&S responses also include the over-users and abusers of the system. This diverts EMS and HFD personnel from being able to respond to a true emergency.

The EMS department has made vast changes in its policies and is constantly reevaluating to improve them, but in the end, must respond when called. It recently developed a successful program to decrease misuse of the system, but the $160,000 yearly funding was cut by the current administration.

It is time for our City Council and Legislature to step in to change antiquated laws to adjust to 2013.

It is also necessary to again fund the EMS abuser program, institute the EMS advisory committee, and set up a quality-control process to evaluate and limit the use of the 911 emergency call system and L&S. Everyone’s safety is at stake.