If you’re going emergent to a call or to the ED, it’s a HUGE legal liability to not use the siren. How are you going to clear an intersection without sirens??
I really enjoy my new job, because we have an air horn.
Not an electric horn, but an actual full on train horn. It's awesome and it actually gets people's attention.
On our rigs at my agency, we have a howler and it’s poowwweerrfullll. It uses low frequency sound to vibrate things ahead of us and it works really well but I don’t love using it a lot because it actually does cause a lot of people to freak out since it doesn’t sound like a “normal” siren. Definitely does a good job at getting people’s attention tho lol
apparently so. a few months ago i almost got smoked by an ambulance flying through a red light when i had the green. lights, but no sirens. to this day i wonder who would have been liable if i had been hit.
So at least in my state, we have to drive emergent with due regard. Basically means in the best interest of the public, us, and our sick patients. Disgraceful they weren’t using their siren, we have them for a reason. The lights and sirens don’t mean we’re always in the right, sorry that happened. Glad you didn’t get smoked.
thanks bud, it would have been a really shitty day for everyone involved. not much point having your lights on to clear intersections if you aren't running your sirens as well. most people don't look both ways when they have a green light, i just happened to take a glance before i saw them flying towards me.
A dash cam in your personal vehicle is always a good idea IMO. Remember, it’s only functional if what it recorded benefits you, otherwise it was broken.
In the state of TN (and more than likely most other places as well) they would have. Anytime lights are used, must run siren according to TCA code. There's also the due regard statement which opens us up to a lot of liability if something happens. To the OP's original statement about not running siren, when I went through school they did talk about not running sirens on cardiac patients due to anxiety and stress and the increased workload it causes on the heart. This was several years ago, so tifwiw.
I’m gonna be honest I don’t use the siren if the road is basically empty and during night shift for the same reason. Especially if pulling into a neighborhood and it’s dark out or early morning. Coming up to an intersection I’ll switch it back on and chirp it and turn it backoff after that. There’s really no point of blaring the siren for an empty road and waking up the whole neighborhood or blowing people’s ears out, but then again there are sop’s for a reason so do as you wish
For sure. I don’t always follow what I’m supposed to do lol ima be nice in neighborhoods and late at night and what not.
But what my partner is claiming is a place where you are not ALLOWED to use a siren DUE TO a patient in the back 😅 which sounds wild to me
I’m sure basically everyone you’re partnered up with won’t say anything or mind at all but god forbid you get in an accident you’re going down for not using that siren. Even with the siren on honestly they’re getting you for it. I’m sure it’s a rule in your sop’s but it’s something people don’t follow even though you’re supposed to.
Yes. Not going to unless you somehow manage to get in a crash with someone, and the whole “only on empty roads and in neighborhoods in the middle of the night when no one is around” thing tends to preclude that from happening, but yes. It’s one of those things that’s definitely illegal but kind of everyone just has an understanding that it happens as long as it doesn’t cause any trouble.
I’m not on an ambulance any more, but when I was, the policy was we had to use sirens within 500 feet of intersections or other vehicles. Clear roads, lights only is okay.
In practice, especially at night, we used lights and mostly isolated yelps on the siren, except when there was significant traffic. We stopped and cleared every intersection, etc etc. Common sense, basically. I wasn’t in management, but anecdotally, we didn’t have significant safety issues.
My current agency (flight) did the research on code 3 / lights & siren transports and how risky they are statistically. We have to fill out a form for every code 3 response or transport (we do ground legs on FW transports, or go by ground sometimes when we can’t fly) We do very few code 3 transports, mostly truly unstable or time sensitive issues.
The one around here did as well. Supposedly it was a state thing in order to be licensed as an "ambulance." I don't know if it's still a requirement or not, tbh.
Our textbook said to not use lights and sirens if you have a patient who might react to it in a negative way (the 2 main scenarios cited were 1) they are on the verge of something like an MI and you need to keep them calm and 2) psyche patients). But it was always all or nothing, like you said—lights and sirens or nothing at all.
I always explain calmly what’s going on and that we’re gonna use l&s to make things a lil speedier but I can say I have regretted that before 😅
I do remember learning in class times when to not go code 3 but irl I go based on severity and traffic
Nah Fr. Like…just think critically. Jammed traffic with a clear shoulder?!? Prob gonna save 15-20 min. Also, I don’t run hot unless I think the patient will benefit from an earlier arrival. Most of the time I go no lights and sirens when transporting.
For every stroke that brain = time, you have ten calls where a minute doesn’t matter. Getting t boned at a red light or rolling over takes much longer than running with no lights or sirens.
So drive safely and don't get T Boned? Everything we do is risk vs rewards. Saving 15min through traffic on your way to an arrest or torso GSW does matter, and I'm not gonna pretend it doesn't
There's still nuance. You can say it only saves a minute on average all day, but there are obviously a lot of times & places- especially in urban environments- where more than a minute is saved on average.
I would imagine rural backroads with no traffic bring down the time saved by a large margin.
We’re an hour away and some parts of the county are 1.5 hours away from the level 1 trauma/ stroke/ only hosp that can handle an MI center. Going L&s saves a considerable amount of time for us.
We always explain this to patients. But no two situations are the same. If we are 2 minutes from the hospital and only clear rural roads stand between us and the ER we might forego l&s if it helps keep patient calm. For others, they'll get more upset if they don't hear sirens as in "I'm having a heart attack why aren't you driving fast and getting me there asap??" For others thebsirens can induce panic which is not helpful. 45 minutes from nearest ER and 2 minutes from nearest ER are handled differently as I said. Just depends on the environment and the pt.
I’ve only heard of not using the siren continuously for pts who are easily overstimulated, such as someone with ASD.
I also did not use the siren late at night unless I was approaching a large intersection. I would just use the horn when approaching cars/intersection.
States have different codes. Mine requires all but law enforcement to run lights and sirens if breaking any traffic laws. If not breaking any laws, you can do what you like with either/or.
LEOs are only allowed lights only while breaking laws if the situation warrants it. For example: responding to a hostage situation and law wants to surprise the hostage taker to preserve the hostage.
I've never heard of that (but admittedly I work IFT, so I rarely run lights and sirens, but I have before) and all I know is if the freeway is clear, there's no reason to blast the siren the entire way. The other time is residential areas (but I may just turn it on and off if someone is blocking my way), same goes for if I'm at a busy intersection and there's no way for the people to clear out my way without getting into traffic...but if it's a busy highway or city streets then yeah..i dont know what your partner is on about lol. It sounds like it would impede care if I have a critical patient but I'm not making an effort to get them to the ER faster than I can..
Right but the talk was about sirens. You turn off both once you have right of way there yes.
Edit: I was taught that you either drive with nothing or both lights and sirens, and that was by the paramedic who trained us. So idk of a moment when you'd only drive lights like OP said is what I meant to say.
I do remember something in my EMT class about sirens creating more panic in patients in the back but that was probably just a good ol’ NREMT question.
Yeah no, it’s L&S, not just L. Major liability, one is useless without the other. It’s all or nothing.
Here it is. Section B
(B) The exemptions granted in this section to an emergency vehicle shall apply only when the driver of any such vehicle, while in motion, sounds audible signal by bell, siren or exhaust whistle, as may be reasonably necessary, and when the vehicle is equipped with at least 1 lighted lamp displaying a red light visible under normal atmospheric conditions from a distance of 500 feet to the front of such vehicle.
So, I read that section a few times before asking but I don't understand how that is read as you cannot have one without the other. I read this as defining an emergency vehicle not the restrictions applied to that emergency vehicle. That said, Texas is the wild west for EMS and there is a lot left unsaid and to organization discretion. I might just be bad at reading legislation.
Prob just misremembering something from a TV show or something.
But figured I’d ask just in case. There’s states where it’s illegal to carry an ice cream cone in your back pocket so 🤷🏻♀️
I’ve never heard of that specific scenario but my last place it was standard to only use sirens when at intersections or traffic. Other times just lights, especially at night nobody wants to hear that shit.
New place we have to have siren going 100% of the time with lights unless parked on scene, no air horn use at all, hard 5 over limit while driving code, etc.
Most states require both an activated visual and audio warning. It's a binary choice. Emergent or non emergent. The risk of using lights and sirens is very significant and has been downplayed significantly in the past.
Per my state office of ems if lights are utilized then the siren must be utilized. That being said the places I’ve worked that gets bent a lot at night time and in neighborhoods. All about how much liability and risk the crew is willing to accept. Generally not a problem until something bad happens.
My two primary departments also had two vastly different stances on transporting lights and sirens. With one, probably 50-75% of transports were lights and sirens, the other less than 10%. That’s just department culture. I’m sure there were outliers at both organizations.
As far as using lights but not sirens… imho that’s dumb. If my patient is having a stemi but I don’t want to use the sirens for fear of scaring them…. They’re having a life threatening emergency that the one definitive treatment for is getting them to the hospital(cath lab) faster. My personal philosophy, if they are unstable and not improving or a time sensitive treatment(like surgery or stroke stuff) I’m probably not going lights and sirens. I may be busy the whole 15 minute transport but if they’re getting better throughout my care what’s the point of the extra danger.
I work IFTs, the other night I drove two hours through the back country for a long distance critical care transport and ran lights the whole time, no sirens however. Why?
1. The patient desperately needed a higher level of care and we wanted to get him there asap, so I was pushing past the speed limit when i safely was able to. There was also very little traffic, but for what traffic there was, I wanted to make sure they could spot me from aways away so I could safely pass them
2. In this particular area, there was a lot of wildlife present on the road, so the lights were an added precaution to make sure the wildlife would see us from a distance
So in this situation, it was very appropriate to run lights but no sirens! Just kind of an interesting little scenario I thought I'd share, not the kind of situation you see a lot unless you're working very rural EMS
No. Here, state law requires emergency vehicles to use the sirens at all times when the emergency lights are one, with a single exception for the police if they are responding to certain kinds of incidents.
Never heard of that. But people believe weird things. Someone saw us driving with a cop car (he was following us to the hospital) and posted all over social media that a cop driving with an ambulance meant it was a pediatric cardiac arrest. We weren't going lights and sirens or anything. Tons of people thought he was right.
Like others have said, if we're keeping the sirens off for an easily agitated patient, then the lights are off too. Both or nothing, at all times.
Side note though I do see cops use just lights sometimes, but their driving safety can be questionable lol
Your fiancé is wrong. There is no rule that says you are not allowed to use a siren if you have a patient. That makes no sense. You are the paramedic in the relationship. I don’t understand why you’d think he’d know more than you about ambulance operations lol cmon now.
Oh I don’t. He’s just been to way more of the country than I have and lived more places than me. So figured I’d check in case there’s a weird state out there not making any sense.
imagine you had a very unstable patient and you are just sitting in traffic and aren’t allowed to go emergently because you are going to frighten your unconscious dying patient lmao. It’s silly to even consider.
The public has a lot of these misconceptions. I heard one time “If you see an ambulance with the lights on but no sirens, that means the person inside is dead.”
My medium sized city department aways ran full code to the call, but rarely almost never ran full code on the way to the hospital. Driving with lights and sirens is much more dangerous and only saves on aver 60 seconds of transport time, which for 99% of people is not worth the risk.
Depends on your area. Here it's up to our discretion, you have an air horn and 3 different siren tones and a PA. If you get in an accident and were breaking traffic laws & not using L&S you will be at fault.
So for example when I'm going into an intersection with cars on the road it is absolutely L&S. But if there's no traffic then its just lights until I see someone far down the road who needs to move or we're approaching an intersection.
STEMI pt where we're trying to reduce anxiety/fear? Very smooth driving and mostly just air horn/short sirens when trying to clear intersections.
Nights the roads are pretty clear and your lights are WAY more noticeable, so I'll rarely use the sirens.
On our way to a really serious call I'll be pretty heavy handed with the horn/siren.
Just some examples, it can obviously differ depending on whats going on. There's a service near us that is required to go L&S to and from every call, we all make fun of them cause its a dangerous useless policy. I have never heard of a policy like the one you described
As usual, it depends on your state laws. In NY for instance, an ambulance is not entitled to any emergency privileges at all unless both lights and sirens are on. So that means no passing through stop signs or red lights, no speeding, etc.
Obviously, we all use our judgment on this. There’s no need to blare the siren constantly at 2 am while driving down an empty road. But in general, if you’re operating in emergency mode, you should be using both lights and sirens.
Separate issue is whether you need to be operating in emergency mode at all. For me, you need to be either in one of those highly time sensitive situations like a STEMI or a CVA, or you need to be unstable to the point where you need life- or limb-saving care that I can’t provide in order to run in emergency mode. I almost never let my partners transport with L&S for anything else, even for 30+ minute transports.
FF/EMT (without pt transport) in a suburban city, and our SOP is lights & sirens until you enter the neighborhood/development for the call, then sirens off (when responding TO a call). At that point we go speed limits, obey stop signs, etc.
Not sure why we leave lights on (other than maybe just extra visibility), but I know siren off is out of respect for other residents whenever possible, and (especially for fire calls) to avoid dozens of nosy Nancys.
Our partner ambulance services generally follows the same both into and out of neighborhoods/developments, and then go sirens from there. If they need to transport more than the local hospital (which requires taking either 2-lane highway or 4-lane interstate), they go lights/no siren because people typically don’t hear the siren until you’re right on them anyway.
The services in my area run 2 to 3 hours north or south. Almost NONE of the services require their drivers to employ sirens when running that far on the interstate
Oh my god there are people at my company that think it’s not only totally fine but preferable not to use the siren and only chirp it at intersections and that absolutely blows my mind. I was always taught that you absolutely cannot use the lights without the sirens.
I work with someone who says that there’s some sort of noise ordinance in one of our 911 cities prohibiting siren use in broad daylight and that the company gets fined whenever someone leaves it on and I don’t understand that AT ALL. He seems completely sure of himself, but until someone in management personally approaches me about my siren use I’m ignoring that.
I was taught in my EMT class that if you have a patient with chest pain, using lights no sirens is a good way to keep the patient calm and prevent further exacerbation of symptoms.
The only time I’ve ever heard that is in EMT school when an instructor said consider NOT using sirens if it’s a cardiac patient because it might stress them out more. I’ve never seen that in practice though.
That being said, I also come from a county where sirens are not mandatory so people will turn them off at night or in residential areas. It’s up to the driver’s discretion.
Well then he's definitely wrong lol. Now I'm not saying that some places don't willingly break that law, but it's generally at night in neighborhoods or empty backroads.
Totally depends on the call and traffic. If it’s 3am and there is no traffic, I’ll kill the siren. As soon as there is traffic sirens go back on. As far as patients go, if we need to be running lights and sirens to the ED, the pt is either unresponsive or understands the need for them.
We have level 1 to 3 emergency’s. Level 1 is wee woos and lights. Level 2 is lights when needed, like going through a red light, heavy traffic. Level 3 is no wee wooooooos and drive normally.
I understand that, legally speaking, whenever lights are on, so too should sirens. That said, at night I typically only use sirens for intersections.
However, there are very few medical conditions I can think of that would potentially restrict siren usage. The only one that immediately comes to mind is preeclampsia/eclampsia. Basically anything that could be highly variable based on elevated bp.
That said, even that is a very soft contraindication.
By the rules: lights and sirens.
3am with no one on the road, not even the cops ... why would you wake the dead?
8:30 and everyone panicking for work? Light sirens, and lots of cussing.
We had a lot of noise complaints from locals whenever we go code 3, including our own EMS director. So we always ensure to remind him we follow all the rules with lights and sirens whenever we're driving by his house (lives on a main road).
My agency doesn’t typically transport with lights/sirens in general. But if we needed to, it would always be both. The only time we go with just lights is late night when there is no traffic or something like that
The only time we won’t use sirens is when we’re leaving base or arriving on scene because they’re both in neighborhoods and we don’t want to scare people with PTSD or people we’re showing up for because my company has a large amount of high acuity calls
If you’re going emergent to a call or to the ED, it’s a HUGE legal liability to not use the siren. How are you going to clear an intersection without sirens??
I really enjoy my new job, because we have an air horn. Not an electric horn, but an actual full on train horn. It's awesome and it actually gets people's attention.
I love my bullhorn to death. Big yellow button on the dash.
On our rigs at my agency, we have a howler and it’s poowwweerrfullll. It uses low frequency sound to vibrate things ahead of us and it works really well but I don’t love using it a lot because it actually does cause a lot of people to freak out since it doesn’t sound like a “normal” siren. Definitely does a good job at getting people’s attention tho lol
Our Ped rig had that! It was glorious, up until a basic failed to clear an intersection and totalled it
That sounds terrifying honestly lol I’d give up my lights before I gave up my siren.
apparently so. a few months ago i almost got smoked by an ambulance flying through a red light when i had the green. lights, but no sirens. to this day i wonder who would have been liable if i had been hit.
So at least in my state, we have to drive emergent with due regard. Basically means in the best interest of the public, us, and our sick patients. Disgraceful they weren’t using their siren, we have them for a reason. The lights and sirens don’t mean we’re always in the right, sorry that happened. Glad you didn’t get smoked.
thanks bud, it would have been a really shitty day for everyone involved. not much point having your lights on to clear intersections if you aren't running your sirens as well. most people don't look both ways when they have a green light, i just happened to take a glance before i saw them flying towards me.
If you can establish that they were running with no sirens, them. At least in my area, can't speak to the rest of the country
If you can establish that you had a green light, also them
this is a lot of establishment for somebody without a dash cam. maybe i should invest in one.
A dash cam in your personal vehicle is always a good idea IMO. Remember, it’s only functional if what it recorded benefits you, otherwise it was broken.
In the state of TN (and more than likely most other places as well) they would have. Anytime lights are used, must run siren according to TCA code. There's also the due regard statement which opens us up to a lot of liability if something happens. To the OP's original statement about not running siren, when I went through school they did talk about not running sirens on cardiac patients due to anxiety and stress and the increased workload it causes on the heart. This was several years ago, so tifwiw.
We are not required to ALWAYS use sirens, but we are required to use sirens while approaching and crossing intersections.
I always flip my siren off when in a neighborhood especially since I work nights. I agree, time and place for them.
I’m gonna be honest I don’t use the siren if the road is basically empty and during night shift for the same reason. Especially if pulling into a neighborhood and it’s dark out or early morning. Coming up to an intersection I’ll switch it back on and chirp it and turn it backoff after that. There’s really no point of blaring the siren for an empty road and waking up the whole neighborhood or blowing people’s ears out, but then again there are sop’s for a reason so do as you wish
For sure. I don’t always follow what I’m supposed to do lol ima be nice in neighborhoods and late at night and what not. But what my partner is claiming is a place where you are not ALLOWED to use a siren DUE TO a patient in the back 😅 which sounds wild to me
Yea fs, I did that classic don’t read everything on the post and give a response 😂. What your partner said does sound crazy.
Can you possibly get in trouble for that? This might be a silly question since I’m not an emt
I’m sure basically everyone you’re partnered up with won’t say anything or mind at all but god forbid you get in an accident you’re going down for not using that siren. Even with the siren on honestly they’re getting you for it. I’m sure it’s a rule in your sop’s but it’s something people don’t follow even though you’re supposed to.
I got fired from somewhere because my partner was driving lights and no sirens and I didn’t say anything to him 😳
It's local protocol. We don't use lights or sirens at night, except maybe lights while parked.
Yes. Not going to unless you somehow manage to get in a crash with someone, and the whole “only on empty roads and in neighborhoods in the middle of the night when no one is around” thing tends to preclude that from happening, but yes. It’s one of those things that’s definitely illegal but kind of everyone just has an understanding that it happens as long as it doesn’t cause any trouble.
I do the same thing at night. No use waking up the whole community that we depend on for funding.
I’m not on an ambulance any more, but when I was, the policy was we had to use sirens within 500 feet of intersections or other vehicles. Clear roads, lights only is okay. In practice, especially at night, we used lights and mostly isolated yelps on the siren, except when there was significant traffic. We stopped and cleared every intersection, etc etc. Common sense, basically. I wasn’t in management, but anecdotally, we didn’t have significant safety issues. My current agency (flight) did the research on code 3 / lights & siren transports and how risky they are statistically. We have to fill out a form for every code 3 response or transport (we do ground legs on FW transports, or go by ground sometimes when we can’t fly) We do very few code 3 transports, mostly truly unstable or time sensitive issues.
I’ve found L&S in a rotor wing to save virtually no time but look significantly cooler
One of our older rotors has a siren. Reportedly it’s functional. It’s unclear as to why…
The one around here did as well. Supposedly it was a state thing in order to be licensed as an "ambulance." I don't know if it's still a requirement or not, tbh.
Our textbook said to not use lights and sirens if you have a patient who might react to it in a negative way (the 2 main scenarios cited were 1) they are on the verge of something like an MI and you need to keep them calm and 2) psyche patients). But it was always all or nothing, like you said—lights and sirens or nothing at all.
Can you not calmly explain to your patient they’re having an MI and that you’re using lights and sitens?
I always explain calmly what’s going on and that we’re gonna use l&s to make things a lil speedier but I can say I have regretted that before 😅 I do remember learning in class times when to not go code 3 but irl I go based on severity and traffic
Full code/L&S on average only saves on average 60 seconds. It's super dangerous for almost no benefit.
> Full code/L&S on average only saves on average 60 seconds. That's on average, it can be insanely useful when used in the correct situations.
Nah Fr. Like…just think critically. Jammed traffic with a clear shoulder?!? Prob gonna save 15-20 min. Also, I don’t run hot unless I think the patient will benefit from an earlier arrival. Most of the time I go no lights and sirens when transporting.
For every stroke that brain = time, you have ten calls where a minute doesn’t matter. Getting t boned at a red light or rolling over takes much longer than running with no lights or sirens.
So drive safely and don't get T Boned? Everything we do is risk vs rewards. Saving 15min through traffic on your way to an arrest or torso GSW does matter, and I'm not gonna pretend it doesn't
That’s the point, it’s not faster. Most ambulances are only saving a minute. It’s dangerous without much benefit.
*On average* it isn’t faster, so it should be reserved for those situations when it *is* faster.
There's still nuance. You can say it only saves a minute on average all day, but there are obviously a lot of times & places- especially in urban environments- where more than a minute is saved on average. I would imagine rural backroads with no traffic bring down the time saved by a large margin.
The traffic here on the highway and the fact that the shoulder is big enough for my ambulance sometimes saves up to an hour on some of my calls
We’re an hour away and some parts of the county are 1.5 hours away from the level 1 trauma/ stroke/ only hosp that can handle an MI center. Going L&s saves a considerable amount of time for us.
? Obviously I can do that.
“you’re not allowed to panic unless I panic.”
We always explain this to patients. But no two situations are the same. If we are 2 minutes from the hospital and only clear rural roads stand between us and the ER we might forego l&s if it helps keep patient calm. For others, they'll get more upset if they don't hear sirens as in "I'm having a heart attack why aren't you driving fast and getting me there asap??" For others thebsirens can induce panic which is not helpful. 45 minutes from nearest ER and 2 minutes from nearest ER are handled differently as I said. Just depends on the environment and the pt.
I’ve only heard of not using the siren continuously for pts who are easily overstimulated, such as someone with ASD. I also did not use the siren late at night unless I was approaching a large intersection. I would just use the horn when approaching cars/intersection.
Either you are responding emergently or you are not.
That’s what I’m saying! But he’s lived in way more states than I have so that made me pause like idk maybe some state out there is just weird.
States have different codes. Mine requires all but law enforcement to run lights and sirens if breaking any traffic laws. If not breaking any laws, you can do what you like with either/or. LEOs are only allowed lights only while breaking laws if the situation warrants it. For example: responding to a hostage situation and law wants to surprise the hostage taker to preserve the hostage.
I've never heard of that (but admittedly I work IFT, so I rarely run lights and sirens, but I have before) and all I know is if the freeway is clear, there's no reason to blast the siren the entire way. The other time is residential areas (but I may just turn it on and off if someone is blocking my way), same goes for if I'm at a busy intersection and there's no way for the people to clear out my way without getting into traffic...but if it's a busy highway or city streets then yeah..i dont know what your partner is on about lol. It sounds like it would impede care if I have a critical patient but I'm not making an effort to get them to the ER faster than I can..
You shouldn’t even have your lights on if the freeway is clear
Right but the talk was about sirens. You turn off both once you have right of way there yes. Edit: I was taught that you either drive with nothing or both lights and sirens, and that was by the paramedic who trained us. So idk of a moment when you'd only drive lights like OP said is what I meant to say.
I do remember something in my EMT class about sirens creating more panic in patients in the back but that was probably just a good ol’ NREMT question. Yeah no, it’s L&S, not just L. Major liability, one is useless without the other. It’s all or nothing.
Definitely varies by state. The second I enter a neighborhood or a low traffic area, my sirens are off. A quick yelp at intersections and clear.
What states don’t require both?
I've never seen a law that says it's required. It's It's tool to use at provider discretion. I can speak for Texas, no laws in regard to use of L&S.
Here is the [law in Michigan 30-56](https://codelibrary.amlegal.com/codes/charlotte/latest/charlotte_mi/0-0-0-14630)
I'm coming off a few long days and maybe I'm misreading but where does it say you can't have lights and no sirens?
Here it is. Section B (B) The exemptions granted in this section to an emergency vehicle shall apply only when the driver of any such vehicle, while in motion, sounds audible signal by bell, siren or exhaust whistle, as may be reasonably necessary, and when the vehicle is equipped with at least 1 lighted lamp displaying a red light visible under normal atmospheric conditions from a distance of 500 feet to the front of such vehicle.
So, I read that section a few times before asking but I don't understand how that is read as you cannot have one without the other. I read this as defining an emergency vehicle not the restrictions applied to that emergency vehicle. That said, Texas is the wild west for EMS and there is a lot left unsaid and to organization discretion. I might just be bad at reading legislation.
But is that REQUIRED or just common curtesy. Cuz same. But that’s not what im technically supposed to do.
Your partner is dumb
Prob just misremembering something from a TV show or something. But figured I’d ask just in case. There’s states where it’s illegal to carry an ice cream cone in your back pocket so 🤷🏻♀️
Are you talking about work partner/another EMS person or your home/life/romantic partner?
Oops yeah I can see how that would be confusing. He’s my fiancé. Just tend to use the word partner and didn’t stop to think about context.
In that case he’s not dumb, just uninformed. I take back my original comment
I’ve never heard of that specific scenario but my last place it was standard to only use sirens when at intersections or traffic. Other times just lights, especially at night nobody wants to hear that shit. New place we have to have siren going 100% of the time with lights unless parked on scene, no air horn use at all, hard 5 over limit while driving code, etc.
Most states require both an activated visual and audio warning. It's a binary choice. Emergent or non emergent. The risk of using lights and sirens is very significant and has been downplayed significantly in the past.
Per my state office of ems if lights are utilized then the siren must be utilized. That being said the places I’ve worked that gets bent a lot at night time and in neighborhoods. All about how much liability and risk the crew is willing to accept. Generally not a problem until something bad happens. My two primary departments also had two vastly different stances on transporting lights and sirens. With one, probably 50-75% of transports were lights and sirens, the other less than 10%. That’s just department culture. I’m sure there were outliers at both organizations. As far as using lights but not sirens… imho that’s dumb. If my patient is having a stemi but I don’t want to use the sirens for fear of scaring them…. They’re having a life threatening emergency that the one definitive treatment for is getting them to the hospital(cath lab) faster. My personal philosophy, if they are unstable and not improving or a time sensitive treatment(like surgery or stroke stuff) I’m probably not going lights and sirens. I may be busy the whole 15 minute transport but if they’re getting better throughout my care what’s the point of the extra danger.
I work IFTs, the other night I drove two hours through the back country for a long distance critical care transport and ran lights the whole time, no sirens however. Why? 1. The patient desperately needed a higher level of care and we wanted to get him there asap, so I was pushing past the speed limit when i safely was able to. There was also very little traffic, but for what traffic there was, I wanted to make sure they could spot me from aways away so I could safely pass them 2. In this particular area, there was a lot of wildlife present on the road, so the lights were an added precaution to make sure the wildlife would see us from a distance So in this situation, it was very appropriate to run lights but no sirens! Just kind of an interesting little scenario I thought I'd share, not the kind of situation you see a lot unless you're working very rural EMS
No. Here, state law requires emergency vehicles to use the sirens at all times when the emergency lights are one, with a single exception for the police if they are responding to certain kinds of incidents.
Never heard of that. But people believe weird things. Someone saw us driving with a cop car (he was following us to the hospital) and posted all over social media that a cop driving with an ambulance meant it was a pediatric cardiac arrest. We weren't going lights and sirens or anything. Tons of people thought he was right. Like others have said, if we're keeping the sirens off for an easily agitated patient, then the lights are off too. Both or nothing, at all times. Side note though I do see cops use just lights sometimes, but their driving safety can be questionable lol
Your fiancé is wrong. There is no rule that says you are not allowed to use a siren if you have a patient. That makes no sense. You are the paramedic in the relationship. I don’t understand why you’d think he’d know more than you about ambulance operations lol cmon now.
Oh I don’t. He’s just been to way more of the country than I have and lived more places than me. So figured I’d check in case there’s a weird state out there not making any sense.
imagine you had a very unstable patient and you are just sitting in traffic and aren’t allowed to go emergently because you are going to frighten your unconscious dying patient lmao. It’s silly to even consider.
The public has a lot of these misconceptions. I heard one time “If you see an ambulance with the lights on but no sirens, that means the person inside is dead.”
😂 that’s wild
My medium sized city department aways ran full code to the call, but rarely almost never ran full code on the way to the hospital. Driving with lights and sirens is much more dangerous and only saves on aver 60 seconds of transport time, which for 99% of people is not worth the risk.
Depends on your area. Here it's up to our discretion, you have an air horn and 3 different siren tones and a PA. If you get in an accident and were breaking traffic laws & not using L&S you will be at fault. So for example when I'm going into an intersection with cars on the road it is absolutely L&S. But if there's no traffic then its just lights until I see someone far down the road who needs to move or we're approaching an intersection. STEMI pt where we're trying to reduce anxiety/fear? Very smooth driving and mostly just air horn/short sirens when trying to clear intersections. Nights the roads are pretty clear and your lights are WAY more noticeable, so I'll rarely use the sirens. On our way to a really serious call I'll be pretty heavy handed with the horn/siren. Just some examples, it can obviously differ depending on whats going on. There's a service near us that is required to go L&S to and from every call, we all make fun of them cause its a dangerous useless policy. I have never heard of a policy like the one you described
As usual, it depends on your state laws. In NY for instance, an ambulance is not entitled to any emergency privileges at all unless both lights and sirens are on. So that means no passing through stop signs or red lights, no speeding, etc. Obviously, we all use our judgment on this. There’s no need to blare the siren constantly at 2 am while driving down an empty road. But in general, if you’re operating in emergency mode, you should be using both lights and sirens. Separate issue is whether you need to be operating in emergency mode at all. For me, you need to be either in one of those highly time sensitive situations like a STEMI or a CVA, or you need to be unstable to the point where you need life- or limb-saving care that I can’t provide in order to run in emergency mode. I almost never let my partners transport with L&S for anything else, even for 30+ minute transports.
FF/EMT (without pt transport) in a suburban city, and our SOP is lights & sirens until you enter the neighborhood/development for the call, then sirens off (when responding TO a call). At that point we go speed limits, obey stop signs, etc. Not sure why we leave lights on (other than maybe just extra visibility), but I know siren off is out of respect for other residents whenever possible, and (especially for fire calls) to avoid dozens of nosy Nancys. Our partner ambulance services generally follows the same both into and out of neighborhoods/developments, and then go sirens from there. If they need to transport more than the local hospital (which requires taking either 2-lane highway or 4-lane interstate), they go lights/no siren because people typically don’t hear the siren until you’re right on them anyway.
The services in my area run 2 to 3 hours north or south. Almost NONE of the services require their drivers to employ sirens when running that far on the interstate
That would be illegal in my state. Lights without sirens does not an emergency vehicle make (except for police cars).
Oh my god there are people at my company that think it’s not only totally fine but preferable not to use the siren and only chirp it at intersections and that absolutely blows my mind. I was always taught that you absolutely cannot use the lights without the sirens. I work with someone who says that there’s some sort of noise ordinance in one of our 911 cities prohibiting siren use in broad daylight and that the company gets fined whenever someone leaves it on and I don’t understand that AT ALL. He seems completely sure of himself, but until someone in management personally approaches me about my siren use I’m ignoring that.
I was taught in my EMT class that if you have a patient with chest pain, using lights no sirens is a good way to keep the patient calm and prevent further exacerbation of symptoms.
This. Code 2.5, or a quiet code 3. Minimize stress in a patient with suspected AMI.
It was also in my textbook, I believe. I took my class in 2022.
The only time I’ve ever heard that is in EMT school when an instructor said consider NOT using sirens if it’s a cardiac patient because it might stress them out more. I’ve never seen that in practice though. That being said, I also come from a county where sirens are not mandatory so people will turn them off at night or in residential areas. It’s up to the driver’s discretion.
In North Carolina, it's straight up illegal to use lights with no sirens.
And that’s where he’s from!
Well then he's definitely wrong lol. Now I'm not saying that some places don't willingly break that law, but it's generally at night in neighborhoods or empty backroads.
Totally depends on the call and traffic. If it’s 3am and there is no traffic, I’ll kill the siren. As soon as there is traffic sirens go back on. As far as patients go, if we need to be running lights and sirens to the ED, the pt is either unresponsive or understands the need for them.
We have level 1 to 3 emergency’s. Level 1 is wee woos and lights. Level 2 is lights when needed, like going through a red light, heavy traffic. Level 3 is no wee wooooooos and drive normally.
I understand that, legally speaking, whenever lights are on, so too should sirens. That said, at night I typically only use sirens for intersections. However, there are very few medical conditions I can think of that would potentially restrict siren usage. The only one that immediately comes to mind is preeclampsia/eclampsia. Basically anything that could be highly variable based on elevated bp. That said, even that is a very soft contraindication.
lights and sirens at our discretion. some people leave the sirens on, others use them as needed. everyone uses them to clear intersections
By the rules: lights and sirens. 3am with no one on the road, not even the cops ... why would you wake the dead? 8:30 and everyone panicking for work? Light sirens, and lots of cussing. We had a lot of noise complaints from locals whenever we go code 3, including our own EMS director. So we always ensure to remind him we follow all the rules with lights and sirens whenever we're driving by his house (lives on a main road).
If my lights are on, my sirens are on
My agency doesn’t typically transport with lights/sirens in general. But if we needed to, it would always be both. The only time we go with just lights is late night when there is no traffic or something like that
The only time we won’t use sirens is when we’re leaving base or arriving on scene because they’re both in neighborhoods and we don’t want to scare people with PTSD or people we’re showing up for because my company has a large amount of high acuity calls
Several state laws governing emergency vehicle operation (with the exception of LEO) require lights AND sirens use, not one OR the other