During the past year, I’ve been involved in a product training project that has resulted in my driving nearly 20,000 miles around the U.S. In doing so, I have and will ultimately travel through nearly 40 states with visits to nearly every major metropolitan area. These visits and accompanying miles across the interstates, highways and streets have allowed me to view countless EMS rigs from varying public and private entities.
One thing that resonated clearly was that there are many agencies out there that could do much more to make their EMS rigs more conspicuous as such, therefore increasing public awareness and hopefully reduce collisions. Although there has been little research in the U.S. performed on civilian behavior at crash scenes, there has been comprehensive work performed on strategies for increasing the ability for drivers to more quickly recognize an EMS vehicle traveling down the roadway. What’s even more appealing is that many of the findings in this research could be implemented at a reasonable cost. One major source for this information is contained in a comprehensive study performed by the Federal Emergency Management Agency (FEMA) several years ago. Their comprehensive look into improving the visibility of EMS vehicles is contained in a report known as FA-323, the Emergency Vehicle Visibility and Conspicuity Study. The following is a condensed version of the study’s findings, all of which I suggest you compare with the current state of EMS lighting and marking configurations on your rigs.
Active vs. Passive Visibility & Conspicuity
In order to understand the summary findings of the study, it’s important to first know the difference between active and passive communication strategies for notifying surrounding drivers of the presence of an EMS vehicle and its operational status. Active strategies include overhead lights, sirens, spotlights, wig-wags, intersection lights and other devices that rely on some sort of mechanical activation.
By contrast, passive communication includes markings, lettering, paint schemes and use of retroreflective materials that collectively identify the vehicle as being EMS. The combination of both strategies, when applied correctly, clearly and repeatedly, identify an EMS rig to surrounding drivers in hopes of eliciting proper behaviors, such as slowing down, moving the right, yielding, etc.. One of the challenges in determining the best combination of active and passive devices, the study notes, is that strategies for communicating that an EMS vehicle is stopped versus moving may be vastly different. However, what is consistent, and something that EMS agencies aren’t doing well enough from my observations this year, is that a better job needs to be done to standardize EMS rig markings so that surrounding drivers can quickly recognize and identify it as such and take the appropriate action.
Although some debate exists as to how important it is that the civilian driver recognizes what type of emergency vehicle they’re approaching versus just identifying the vehicle as a hazard, there is no debate that the earlier the driver can recognize a vehicle as EMS, the better. The following are strategies for improving visibility and conspicuity recommended by the study.
Retroreflective materials are unique in that they reflect light directly back at the originating light source. As an example, if you look into a mirror from an angle, the light waves that reflect off the mirror at the same angle return the image you see. For example, if you angle a mirror around a hallway corner the degree of the hallway you see around the “blind” corner depends on the angle at which you have the mirror tilted.
By contrast, if you aim a flashlight at retroreflective material, the light waves from the bulb will be reflected directly back at you. In practical terms, this means that headlights from approaching vehicles will illuminate this material from any angle, with the intensity of the reflectiveness depending on the intensity of the originating light source. Because of this, using this material to outline an EMS rig to define its size and shape can be advantageous, as can highlighting its sides and rear. Some debate exists about the use of “Chevron” markings on the back of EMS rigs, but in general, retroreflective markings have been shown to reduce crashes.
Consistency in Visibility & Recognition
This is one area where EMS rigs, in my observations around the U.S., fall way short; there is simply no consistency among EMS providers when it comes to uniformly identifying their rigs. Yes, there are those that may cite tradition and agency identification as factors, but the bottom line is that the easier you can train civilian drivers to recognize a rig as being EMS, the better. The study agrees, citing the importance of using large, clear lettering and consistent colors.
Although the study cites research about the effectiveness of lime green and fluorescent orange paint schemes in reducing crashes, it also mentions that although no particular color may be the most effective, what is important is that standardization occurs, so every driver can be trained to immediately identify that color with an EMS vehicle. For example, look at the use of black and white for police vehicles. Although studies have shown that combination to be less than ideal in terms of visibility, there can be no doubt as to the reaction elicited when a civilian sees a vehicle in that paint scheme. Consistency matters. Have a look at your EMS rigs. Can you clearly read the lettering on the sides, back and front of them from a distance, or are they confusing because of a fancy font or inadequate size? Does the color of your rig clearly say “EMS” or “box truck with stripes”?
Not Like the Others
In short, contrast works. The more something stands out from its background, the easier it is to identify. This applies with EMS rigs as paint and graphic schemes that cause the vehicle to be brighter than the surrounding background have proven to be effective, the study says. This means using colors that aren’t normally found in nature, like fluorescents.
When in Doubt, Go Day Glo
The study found that fluorescent colors significantly increased visibility, mostly because they’re much brighter because they intensify light reflection by absorbing less light waves on their surface. It’s important to note that since fluorescent light relies on ultraviolet radiation for its effectiveness, it is no more effective at night than other colors. However, regardless of the color choice, they’re much more effective than ordinary colors in the daytime. So, if your rig isn’t Day Glo orange, red, green or yellow, you’re missing out on some advantages during daytime hours.
Draw on the Edges of the Box
Several years ago, the Arizona DPS lost an officer tragically after his patrol vehicle was struck from behind while he was stopped on the side of the freeway. From that, a comprehensive analysis was performed to increase patrol vehicle visibility from all angles with vehicle contouring being one result. In short, contouring meant using retroreflective material along the vehicle creases and edges to clearly define its outline at night. Because EMS rigs are fairly standard in configuration, doing the same with an EMS rig will identify its outline to approaching drivers who may immediately recognize it as an ambulance.
So, if the sides, back and fenders of your rig aren’t contour-marked, you should consider it an easy and reasonably priced visibility upgrade. Furthermore, as the study suggests, concentrate additional retroreflective material along the lower half of your EMS rig as many modern vehicles use advanced headlight systems that use clearly defined lighting patterns that focus light low and wide with minimal light spillage upward.
As EMS professionals, our greatest risk is being involved in a crash while we’re on duty. Although lights and sirens certainly help, we need to use every inch of our rigs effectively to clearly communicate who we are and our intentions. So take a look at your rig and ask yourself if you’re doing all you can to make sure there’s no mistaking your ambulance as anything else but that—in the most effective way possible.