Thank you for taking the time (and having the passion) to submit your own “Insights”… 

While it is true that many trade journals have covered this issue in the past, there has been very little change in the practice of excessively using red light and siren (RLS) response modes for logically unnecessary reasons. 

In his book, “Managing at the Speed of Change”, Daryl Connor describes a situation in which a worker is faced with the choice of either burning alive in a fire aboard his offshore oil platform, or jumping into the shark infested waters below.  People will not change unless they are uncomfortable where they are. 

Many industry experts talk of the need to change RLS use policies, but few are actually doing it.  Perhaps we need to just keep seeing stories like the one yesterday in Garfield Township, NJ in which a fire truck responding RLS to a CHIMNEY FIRE crashed in the intersection and killed someone in order to make system managers uncomfortable where they are.

The comparison between urban settings and rural settings is somewhat moot.  I agree with your assessment about transporting a trauma victim on a congested two-lane highway, but I’d put money on the fact that the scenario you describe happens on less than 1% of the calls.  I’d also be willing to bet that the 15 minutes you save using RLS are wasted in the hospital waiting for the O/R team to get ready.  As you surely know from working in these areas, even though cities like Orlando, Los Angeles and New York may have more hospitals, the additional traffic and congestion still makes the hospital 15 – 30 minutes away. 

Further, although the rural areas have greater distances, they also have dramatically less traffic and virtually no traffic controls.  Having worked as the EMS Director in Lincoln, Nebraska, I recall many very long distance responses through nothing but cows and cornfields.  In these areas, a RLS response is usually meaningless because you don’t typically need to move people out of the way.  Additionally, it’s a basic EVOC principle that higher traveling speeds overrun the efficacy of the siren.  Hence, the “advance notice” benefit of a siren is diminished with emergency vehicle speed.

Perhaps it’s better to look at ways to reduce the in-hospital patient processing time to the O/R or Cath Lab to improve patient outcome as opposed to killing more women at intersections.

My “home-town” of Volusia County, Florida has many rural areas.  Our county fire department serves most of the rural areas and their time difference between emergency and non-emergency responses for the most recent three-month period was 1 minute, 11 seconds.

The point of my topic was not that we should eliminate RLS responses altogether, but rather control its use WAY more than we are doing now.

Thanks again for your response!!

Matt Zavadsky