ALS using Lights and Sirens back to the hospital

[Leener77]

It's typically a joint decision. On scene both are treating the Pt so the driver knows what condition the Pt is in and can decide from there or ask the one treating in back what they'd like to do. But sometimes if given the choice......the person treating will say L&S even when it isn't necessary, so I'd go ahead and make the decision and let the person treating know what I'm doing. Or in the case that ALS was with us, I will ask them what they want to do since they are in charge of PT care at that point. I'm sure that each place is different. This is just how it was normally done at the two places I worked at.

[akroeze]

Here in general the attendant determines the priority to the hospital as the medic who is driving likely was not there for the entire thing (gathering equipment, meds, getting stuff ready). Saying the priority just tells the driver how quickly you would like to get there, it's up to the driver to decide what they actually drive like.

[CBEMT]

My service hates me because when they told me I have to transport all patients L&S I asked for that order to be made in writing. I still have not been given that written order and so I still decide for myself when L&S is needed. They figured I would comply and if wreck they would deny deny deny, leaving me out to dry.

Unfortunately, at my part-time gig, that order IS in writing. :roll:

That said, depending on the time of day it could save us as much as 15-20 minutes. Still, I'll grant you, usually not clinically significant. I have no qualms about telling our drivers to slow down.

[ccmedic56]

I have worked in a sysytem where they did a study on using and not using L&S...and the difference most of the time is 2-3 minutes...so..just keep that in mind..and know that you are not just putting your safety in jeopardy, but the patient and innocent motorists

[RuralEMT-I]

Its our agency policy to not use L&S. The exception being up to the EMT incharge of patient care who will have to justify it to the EMS chief afterwards. One good thing about this policy is that if you let the ED know you are coming in L&S, they know its damn serious and will be ready for you.

[spenac]

At my soon to be former primary L&S we make the 90 miles in 60-64 minutes. W/o we make it in 72-80 minutes.

[FireGuard69]

Well, another NJ EMT chiming in.

The general "culture" of NJ EMS is to run L&S. For all prehospital runs. With very few educated exceptions.

I thought it was the thing to do as well. Until I found the liabilities of it, through sites like this, and I started to go "cold", and was ostracized by co workers, who spread rumors that I went cold on life threatening runs.

It is a culture that seems so embedded, that it will take generations of reeducation to change it.

When I worked AC EMS, we had 3 busses in the winter. For a fairly large city, it just aint enough. When MedCom is screaming at you, "1417, priority calls pending", you don't really have much of a choice BUT to go Code back to the hospital, cause your next due BLS unit (In my area, only BLS Busses can transport.) is at least 10 minutes away...if they aren't tied up.

GOd forbid Medic 1 (an SCT bus/backup Medic truck) transports.

Not to mention 3 front line Medic chase vehicles, and 2 backup for the whole county, ALS tends to run "hot" alot, just to get to the next call, let alone getting back into service.

Is it right? Hell no.

But that is what happens when EMS resources are dictated by private companies, who care about saving that all mighty dollar, and not public safety agencies, who care about spreading the resources out to strategic areas. :roll:

But hey, who am I to question 30 or so years of idiocy :twisted:

[katbemeEMT-B]

We don't run L & S very often. The patient has to be pretty critical. In 8 months on the ALS service I work for I have driven L&S once. Active MI about to arrest. The BLS service that I work for (only service in our area), we have ran L&S about 5 times in 17 months. Two strokes, ped. sez. after fifteen minutes of seizing, cardiac arrest, and semi vs auto mvc in which we had two helos waiting at the hospital, both critical one with assisted ventilations.

I do have a funny story from the other day. Our ALS truck was called to do a L&S transfer from the local hospital to a metro hospital, (60 mile drive). We questioned why they wouldn't just transfer the patient via air care. Told us they couldn't get a helo. We got to the hospital, took one look at the patient, medic told staff, noway are we taking her. We called our dispatch and they had us air care within half an hour. Took us that long to prep her for transport.

When I'm driving, I prefer not running L&S because it turns other drivers into idiots.

[rdenman26]

Has their been any proper reasearch that indicates how hot running to hosp affects patient outcomes?

[Just Plain Ruff]

well I'd suspect that if the patient dies then that patient was going to die anyway no matter how fast you got them to the hospital. An extra two minutes is not going to make a whole hill of beans difference.