EVOC-ing Safety: The ABCS of Emergency Driving

How many ambulance crashes can you or your agency afford this year? This column by T.E.A.M. Driving Concepts, Inc. focuses on driving safety to help emergency medical personnel attain the specific knowledge, skills and attitudes for today's highly specialized ambulance operator. Columns are written by the educational staff at T.E.A.M. Driving Concepts Inc.

This month's column is the first helping of the meat and potatoes of emergency driving. When we began our EMS education during our first emergency medicine course whether it be a CPR, First-Aid, Medical First Responder or EMT course, the ABC's were drilled into our head by our instructor like a jackhammer. Over and over and over the ABC's repeatedly became our calling, like a mantra, never ever to forget. Airway, Breathing and Circulation; assessing and treating these 3 vital areas of human life is our primary function as a medical professional.

We at T.E.A.M. designed and promote the ABCS of emergency driving safety to help the student recall and apply the essential skills of emergency driving. The ABCS of emergency driving is as vital as the ABC's of patient care. As critical as it is to maintain an open airway, adequate breathing and a pulse on your patient, just as critical is applying the emergency driving ABCS when a patient is being transported.

Correct application of the ABCS of emergency driving has a positive impact on patient care, patient comfort and patient outcomes. By not correctly applying the ABCS, the patient can suffer through the caregivers' inability to provide care during transport. Also, the patient's anxiety level can drastically increase causing unwanted stress on their already compromised body.

Let's now take an overview of the ABCS and delve into each one with upcoming columns. The ABCS represent Acceleration, Braking, Cornering/turning and Speed. The ABCS must be combined with the three S's for completeness. The three S's are Slow, Smooth and Steady. The three S's apply to each of the ABCS. Accelerating, Braking, Cornering and Speed must all be accomplished Slowly, Smoothly and Steadily for maximum effectiveness. When the 3 S's are properly combined with the ABCS, maximum patient care and increased patient comfort is the end result. Benefits to the patient are more than obvious.

Vehicle operator attitude has a direct impact on the way the operator applies the 3 S's of the ABCS. So let's divert into driving attitudes momentarily.

First; how you drive your personal vehicle is your business and your driving attitude is a direct reflection onto your driving record. Folks with numerous tickets and violations have an attitude different than the vehicle operator that almost never gets stopped by a law enforcement officer. If you choose to drive using jack rapid starts, take corners hard and rapidly apply the brake, that is your business in your own vehicle.

Secondly; the emergency vehicle operator drives with heightened awareness and increased vehicle speeds when enroute to the emergency in an attempt to arrive quickly to the sick or injured patient. When enroute to the emergency, Accelerating, Braking, Cornering and Speed are all increased and sometimes stretched to the extreme.

Thirdly; the vehicle must be operated even differently than the first two ways when a patient is being cared for while enroute to the hospital. Patient care and comfort must be the goal of the emergency vehicle operator, NOT how quickly the patient is transported.

In order to put the 3 S's and the ABCS into real life perspectives, let's imagine a couple scenarios. The first one is to imagine you are the emergency vehicle operator and you are to operate the vehicle in a manner that an egg will not roll off the cot. The second one is to imagine a full bucket of vomit sitting on the floor of the ambulance. Your goal is to drive in a manner that you won't have a smelly, slimy mess to clean up. Finally, imagine transporting your closest loved one as they are strapped onto a backboard with a likely spinal cord injury. I highly doubt that you would operate the emergency vehicle as you would operate your personal vehicle during these delicate situations.