The EMS classroom is the place where ideas, concepts and theories relative to the practice of quality prehospital care are introduced. Skills labs help turn the knowledge being acquired into practical application, but, in the end, you really can't learn the job until you hit the streets. It doesn't matter how much you know if you can't get it out of your head and then out of your hands to actually help someone in need. One area in particular that comes up short in practical experience is learning to safely operate an emergency vehicle. This is typically taught after graduation by the employer, who offers EVOC training to new hires. Listed below are some helpful tips that allowed me to drive emergency vehicles for over 20 years without ever being in a crash.
1. Know your rig is in working order
If it's your day behind the wheel, make certain you do a thorough rig check. While gas and oil levels are important, they are less likely to cause a crash than worn tires, uneven tire pressures, unstable steering or mushy brakes.
Never forget that the moment you turn on the ignition you have to think about your safety, as well as that of your team, your patient and the public. Be as meticulous about checking out your rig as you would your drug box.
Report any unusual sounds or noises to vehicle support staff immediately, especially those from the engine compartment, transmission, rear end or brakes. Your attentiveness to details can save costly repairs in the long run, or save you from a vehicle failure and possible involvement in a crash in the short run.
2. Red lights and sirens mean little, if anything
While the language may change a bit, most red lights and siren laws in our country read about the same: You can exceed the posted speed limit, go the wrong way down a one-way street, park just about anywhere you want and break many other traffic laws while responding to an emergency with lights and sirens. However, the bottom line on all of the red lights and sirens laws remains the same: No matter what you do with your emergency vehicle, you cannot put life or property at risk.
In truth, red lights and sirens really mean very little. At absolute best, you are asking the public "please"--no more, no less. Please give me the right of way. Please pull to the right and stop. Please avoid me as I drive south in the northbound lane.
It can actually be a fatal error to assume that the moment you crank up the lights and siren everyone is going to pull to the right and stop until you safely pass.
3. High-speed driving means even less than red lights and sirens
It has been a slow lesson to learn in our profession, but the fact remains that driving fast rarely gets you anywhere faster. What it does do is increase the risk to you, your team, the patient and the public. The faster you drive, the less time you have to react to an unanticipated event, increasing the risk that you'll crash. Should a crash occur, the higher your velocity, the more likely that serious injuries or a fatality will occur.
Maintaining a controlled, even speed has been shown repeatedly to get you to your destination in almost the same time it would take you in the speed-up, slow-down, speed-up mode of driving. More important, you are far safer.
4. Assume the other driver will do the dumbest thing possible
The light is green in your direction, and as you enter the intersection, you see a car inching forward in the "right turn-permitted" lane. You are doing almost 40 mph and think "There's no way that guy will make a right turn in front of this ambulance." Either you are right or wishing you had been.
When I was 16 and just learning how to drive, my dad explained defensive driving: "Just assume that fella in the other car is going to do the dumbest thing possible. Rarely will you be disappointed." Time and again, my father's words have rung true. When you work under the assumption that something dumb will unfold right in front of your eyes, you are a moment ahead of the curve. If and when it happens, anticipation gives you a slight edge in the reaction time game, and sometimes that's all it takes to avoid a crash.
5. Always leave yourself an out
As you wait to see if the guy who's speeding toward the intersection will stop or do something dumb, ask yourself, "If he runs the stop sign, what should I do?" Remember, whatever evasive maneuver you decide on directly impacts the patient and caregivers in the back of the box.
Constantly checking your mirrors for what's to your left, right and behind is essential to safe driving, as it leaves you with avoidance options. Again, thinking through those options in advance instead of at the moment the crisis occurs can give you that split-second edge.
Being a safe and conscientious emergency vehicle operator carries with it great responsibilities. Here's hoping these tips help make you just a little bit safer out on the mean streets.