EMS instructors are taking a fresh look at the dangers of operating a vehicle with lights and siren. Recent findings indicate that lights and siren usage creates a risk not only to the emergency medical professionals but also to the public and provides lifesaving benefit to the patient less than 5 percent of the time.

This spring 13 prominent EMS and firefighting leadership groups issued a joint position statement addressing the issue, which proposes several measures to reduce the unnecessary use of lights and sirens. With this many credible authorities behind the proposals, the use of lights and sirens in EMS response and transport is going to change.

Read on to find out what these agencies have to say about lights and sirens usage and how it’s likely to impact EMS and EMS training in the long run.

EMS Vehicle Collisions Are an Ongoing Problem

The statement begins by citing fire and EMS crash, injury, and fatality statistics from numerous sources. For example:

• Between 1996 and 2012, there were 137 civilian fatalities and 228 civilian injuries from fire vehicle accidents.
• The same period saw 64 civilian fatalities and 217 civilian injuries in ambulance incidents.
• Approximately 97 EMS professionals were killed in ambulance accidents between 1993 and 2010.
• 7.7% of EMS practitioners have been involved in a crash while using lights and sirens, according to one survey.
• “Wake effect” collisions, those caused by vehicles with lights and sirens but not involving them, appear to be four times as common as crashes actually involving an EMS vehicle.

The risk of lights and siren usage does not translate to a great reduction in patient transport time. A recent policy paper from the National Library of Medicine which compiles data from several studies on the topic shows that lights and siren usage reduces average response and transport times by only 42 seconds to an average of 3.8 minutes. The paper also says reduction in prehospital time produced a clinical difference in only about 5 percent of the cases. Some agencies have reduced lights and siren use by anywhere from one-fifth to one-third without a measurable impact on patient outcome.

New Guidelines on Lights and Siren Usage

The EMS system exists to save lives and improve patient outcomes by providing response, out-of-hospital health care, and transport. In rare cases, the decreased time with lights and sirens will make a difference. However, vehicles using lights and sirens can pose a risk to EMS professionals and the public that should not be dismissed.

The key conclusion of the joint statement is therefore that lights and siren usage should be restricted to those situations where it’s expected to make a difference in patient outcome.

To this end, the statement makes several proposals including:

• Emergency medical dispatch programs should be developed, approved, and maintained to categorize calls and identify those where lights and siren might improve patient outcome.
• Local agencies should implement emergency response assignments based on new, approved lights and siren protocols.
• There should be an emphasis on tracking use, appropriateness, protocol compliance, and outcome in lights and siren response and transport.
• EMS crashes and near misses should trigger reviews.
• Emergency vehicle drivers should complete a robust training program and maintain their skills with ongoing education.

How To Train EMS Professionals on Updated Lights and Siren Guidelines

The joint statement suggests that there will be significant change in policies and procedures. It will be critical for EMS practitioners to understand the new environment, and it is important that EMS safety instructors help them acquire this knowledge. The changes in lights and siren guidelines provide instructors an opportunity to take a fresh look at all aspects of EMS safety training.

EMS Vehicle Operator Safety

EMS Vehicle Operator Safety (EVOS) addresses the vehicle operations and transport safety knowledge gaps that lead to injury and death. Built on current research and featuring discussions of actual crashes and common driving scenarios—and the lessons that can be learned from them—it challenges emergency vehicle operators to consider if they truly know how to arrive at a scene safely.

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