How skilled are Paramedics when it comes to response driving ?

[Kiwiology]

What's goin' on in the up in here?!

vs

Hello, love, how are you this evening? That's all right, you don't need to go to the hospital.

I'll pick the one that's safest for everyone involved every time.

You can still turn up in your gargantuan monstrosity of an ambulance brimming with lights and six tone siren and air horn that rivals the opening weekend at the Indy 500 and takes up two freeway lanes ... but just drive it safely duh

[mikeymedic1984]

Kiwi and Oz, do you guys really have REAL traffic to deal with, seriously I have no idea what your traffic is like, but I doubt it rivals any major american city. And as far as big ford ambulances traveling at high speeds; they are mostly diesels (although there are some gas burners out there now), so high speed is not really realistic. But I agree, more training is always a good thing, and no one under age 25 should be allowed to "drive" an ambulance (the children can "tech calls")

[Kiwiology]

Kiwi and Oz, do you guys really have REAL traffic to deal with, seriously I have no idea what your traffic is like, but I doubt it rivals any major american city.

I don't honestly think that's really that important; certainly we have a little bit less traffic I suppose in most places but then again cities like Auckland, Melbourne and London are some of the most congested in the world.

Age does not determine competence although the two may be coincidently correlated

[paramedicmike]

And as far as big ford ambulances traveling at high speeds; they are mostly diesels (although there are some gas burners out there now), so high speed is not really realistic.

Speed is not the sole issue here. These vehicles are big, heavy and have a lot of mass behind them. Their center of gravity is different from a car. If one doesn't know how to handle the differences between one of these vehicles and a car, which is what most people know how to handle not just teenagers, then there will be problems.

[triemal04]

Would it then be safe to say that many "Paramedic" response motor vehicle accidents happen due to inexperience, skill retention in the case of paramedics not working operational for a period of time. Should formal driver training not be included in the curriculum of paramedic courses ??

Mostly yes. Probably less an issue with skill retention as it is with never having learned the skills in the first place.

Learning how to drive an ambulance, even a larger truck type ambulance, under normal road conditions really doesn't take a lot of skill. Practise yes, and how much will vary from person to person, but it really is not that difficult. Learning where the center of gravity is, how the vehicle responds to braking/accelerating, if/when it sways, what the turning radius is, how much responce moving the steering wheel causes, where the blind spots are, how to use the mirrors (especially if equipped with truck/bus mirrors), none of that is extraordinaryily difficult. It just takes time and practise, and often times there isn't a lot of that before people are tossed into the drivers seat.

Once the basic knowledge is there, even driving emergently shouldn't be a large issue and the learning curve shouldn't be that steep.

The problem comes with evasive driving, and not understanding how different weather conditions will affect the vehicle. If you are driving emergently to a scene and are a competant driver under normal conditions, there shouldn't be a problem...until someone anchors their car directly in front of you or cuts in front of you and you have to quickly manuever around them. This is where the problems come up. And let's face it, most EVOC courses won't teach you squat about this. At best there may be some info given about how weight transfers, but actually putting it to practise...probably not.

Probably the best thing that could happen would be to go through a class that was based on/instructed by people who teach cops and the like how to drive, but are familiar with the type of ambulance you'd be using. Going out to a skid pad, getting to actually practise high-speed lane changes (or as high speed as you'd want to be doing them in a box), serpentines at speed, 90 degree turns at speed, evasive braking...all that would be invaluable.

Of course, it would also take more time, cost a lot of money, and the service would have to be willing to trash one of their rigs, so it probably won't happen except in rare agencies. (whoever knows of one that does it please share)

So yeah, many ambulance accidents are probably caused by operator error, or could have been avoided with the proper prior training. As far as making driver training part of a paramedic course...not at this time. A lot of things would have to change before that would be a good idea.

[BushyFromOz]

Kiwi and Oz, do you guys really have REAL traffic to deal with, seriously I have no idea what your traffic is like, but I doubt it rivals any major american city. And as far as big ford ambulances traveling at high speeds; they are mostly diesels (although there are some gas burners out there now), so high speed is not really realistic. But I agree, more training is always a good thing, and no one under age 25 should be allowed to "drive" an ambulance (the children can "tech calls")

I guess its a matter if opinion.

My answer though, is that if ambulane officers are over represented in crash statistics comared to the general population in any individual service ot state or whatever, then either your guys have inadequate training and so dont drive to the conditions or have a cultural problem where they ignore training and dont drive to he conditions.

[triemal04]

I guess its a matter if opinion.

My answer though, is that if ambulane officers are over represented in crash statistics comared to the general population in any individual service ot state or whatever, then either your guys have inadequate training and so dont drive to the conditions or have a cultural problem where they ignore training and dont drive to he conditions.

I don't think ambulance driver's are overrepresented; of course I also don't know that the data has ever been looked at. Anyone who drives emergently is probably a little more likely to be involved in an accident than the average person, but, even looked at proportionally, I wouldn't say that we account for a higher rate of accidents.

I wouldn't even say that the lack of emergent driver training or a cultural problem is the root cause, though those things definetly increase the likelihood of a wreck. You need to bear in mind that, even with recent increases in the requirements (at least where I live), it is very, very easy to get a drivers licence in the US. I can remember talking to a friend from the UK about that; he hated driving in the US and was shocked at how little went into get a driver's licence here compared to back home. If you're looking for a root cause, that's probably it.

People have to learn very little initially just to drive on a daily basis, and then combine that with the average lack of training in how to drive emergently...is it any surprise that ambulance get in wrecks?

[craig]

Kiwi and Oz, do you guys really have REAL traffic to deal with, seriously I have no idea what your traffic is like, but I doubt it rivals any major american city. And as far as big ford ambulances traveling at high speeds; they are mostly diesels (although there are some gas burners out there now), so high speed is not really realistic. But I agree, more training is always a good thing, and no one under age 25 should be allowed to "drive" an ambulance (the children can "tech calls")

mikey...sydney is a city that is roughly the same size as chicago, and the has the same traffic problems that go with it.

look at it this way..do you guys have to deal with semi trailer trucks that have 4...yes 4 trailers in tow? (about 45 foot long each) on dirt and dusty roads?...all things are relevant aren't they?

[BushyFromOz]

People have to learn very little initially just to drive on a daily basis, and then combine that with the average lack of training in how to drive emergently...is it any surprise that ambulance get in wrecks?

If thast the root cause then you dont need a course on resonse driving, you need a course on everyday driving.

The theory that somehow to teach people to drive in "response mode" or something similar is mind boggling to me. Teach them to drive well under normal conditions and the same skills can be carried over to "Resonse driving" lets face it, there is no significant difference beteen the two except one is noisier and flashier. If the jerk behind the wheel puts the foot down and drives like a fool when the whirlybirds go on then he needs re-education of a different sort

[triemal04]

If thast the root cause then you dont need a course on resonse driving, you need a course on everyday driving.

The theory that somehow to teach people to drive in "response mode" or something similar is mind boggling to me. Teach them to drive well under normal conditions and the same skills can be carried over to "Resonse driving" lets face it, there is no significant difference beteen the two except one is noisier and flashier. If the jerk behind the wheel puts the foot down and drives like a fool when the whirlybirds go on then he needs re-education of a different sort

I'm not going to argue with the first part, believe me.

There is still a need to teach people how to drive an ambulance though. Aside from the differences between driving the average car and a large, truck like vehicle (even van types take getting used to), there is a much higher need for evasive (or defensive if you like) driving skills while driving emergently than there is for the average driver. Not to say that everyone shouldn't know these things, or that having a solid foundation in driving fundamentals wouldn't help immensely when you first get behind the wheel. But a much higher skill level is, or should be, required. And that takes time, and practice, which is often hard to come by.

The bolded portion...while it isn't the root cause in my opinion, that is the culture that needs to be changed to increase safety. Of course, there is a lot that would go into changing that, beyond changing the mentality of new EMT's and paramedics.