Every day, calls for emergency assistance come in, and ambulances respond with lights and sirens to assist the sick and injured. It would be a safe guess that many, if not most, of the EMTs and paramedics driving these vehicles never slow down to think about exactly what they are doing. They are, in fact, taking a vehicle that can weigh more than 10 tons, turning on its lights and sirens and, by the inherent nature of driving, placing themselves, their partners, their patients and the communities they serve at risk of injury.
In the relatively short time that EMS has existed, it has made many advances in the training and education of providers in clinical areas. New paramedics are mandated to have knowledge of cardiac care, advanced airway skills and a multitude of medications. However, nowhere in most curricula is training and education for the use of an emergency vehicle addressed. This leaves individual educational institutions to formulate their own training programs, or to use a program such as the Emergency Vehicle Operators Course (EVOC) or Coaching the Emergency Vehicle Operator (CEVO). In the rush to train students on the actual operation of the ambulance amid everything else that must be accomplished prior to the Registry exam, the educational portion pertaining to the responsibilities of the driver and the factors that contribute to poor driver performance are often neglected. This can lead to an important lack of knowledge, and without identification and further education by an employer, it may contribute to accidents involving ambulances.
What does it take to operate an emergency vehicle in a safe and defensive manner? First, the operator must formulate a proper attitude toward the process of driving a vehicle. According to work by Dr. Noel O. Mintz of Emporia State University, in almost every case of an automobile crash, there "appears to be an attitude or attention problem. The driver of an automobile involved in a crash has most likely ignored reduced-risk driving practices while driving into…a situation that could have been avoided." He goes on to state that, "It is far better to develop skills in anticipating and recognizing danger than to rely on dodging skills, responses in emergencies, or fast reaction time."1
Mintz also cites a 1994 report to Congress in which the Department of Transportation indicated that "In many cases, [traffic] crashes are not caused by a lack of knowledge of basic traffic laws or lack of basic vehicle handling skill."1
Both of these references speak directly to the need for drivers to develop a defensive attitude toward the process of driving. This is even more paramount when driving an emergency response vehicle. Simply having the skill to dodge an object is not enough. Having to dodge an object probably means the driver could have taken an action to prevent being in that situation in the first place. This is a key element of a proper driver attitude and is important to recognize in becoming a safer driver.
Driver and Attitude Types
Drivers have historically been placed into two camps. The first, aggressive drivers, we hear about all too often in the news. The New York State Police define an aggressive driver as one who "Operates a motor vehicle in a selfish, bold or pushy manner, without regard for the rights and safety of the other users of the streets and highways."2
Has anyone ever had a partner who, while responding to a call, would tailgate the car in front of the ambulance until that driver moved to the right? How about a partner who, during an emergency response, drove 20 or 30 mph above the posted speed limit in traffic or entered an intersection without stopping and fully checking for other vehicles first? These are indicative of an aggressive attitude and failure on the part of the operator to act with regard for others.