Administration and Leadership, Ambulances & Vehicle Ops, Documentation & Patient Care Reporting, Training

Rig Ragging: How computerized monitoring systems have changed ambulance driving

Issue 3 and Volume 34.

“Drive! We got a call, #@%!” It was 8 a.m. I hadn_t even punched my time card for the first time as a new EMT, and already my grouchy, cigar-puffing mentor/partner was having me drive right out of the shoot to my first call. I remember smacking my head on the door frame and fumbling with the seat belt, failing to get the metal doohickey to clip. Damn! Where_s an airline attendant when you need one? I stared at the dashboard as if it held the same gadgetry of a space shuttle. “Well?” my partner puffed. “People are dying out there. Move it!” Those supportive words took me from wanting to throw up to only wanting to wet myself.

OK focus. Find the ignition switch,„ I thought, remembering this essential part of vehicular mobility. The keys jiggled, and my efforts were rewarded with them falling on the floor, not once but twice. Finally, I got them in, and the engine roared while I shifted from “P” to “D.” Alas, my wheels remained still.„

“Parking brake,” my partner sighed edgily. I released a lever, and the hood popped up. Fortunately, the patient_s fractured arm recalcified itself by the time we arrived at his residence, so no harm done.

I can_t recall the actual driving portion of that alarm, although I_m sure the drivers I encountered along the way can recall it quite vividly with much horror.

That was some 25 Ú uh, a few years ago. It was baptism by fire when it came to the art of ambulance chauffeuring, and only a clueless fool and hasty moron would_ve put themselves in such a position of instantaneous ambulance driver training, which is why I was perfect for this position.

Today, we conduct background checks on employees before they_re hired. We teach emergent vehicle driving on courses at training academies. We even install onboard, computer monitoring devices that supervise and collect data on driver behavior. These “black boxes” perform a continuous algorithmic evaluation of the driver_s performance. But if the bosses really want an algorithmic evaluation, why don_t they just place the rig_s cardiac monitor on the front seat? If the passenger goes into V-Tach, you_re driving too fast. If they_re in sinus bradycardia, you need to divert into a 7-Eleven for some coffee.„

Now, don_t get me wrong. I_m all for keeping ambulance occupants safe, along with the general public that we weave around. However, I must admit the free-spirited part of me suffers from paranoia of Big Brother. It was bad enough when GPS was introduced and restricted my ability to park near drive-in theaters at night to watch the movie„Airplane. (Don_t “tsk tsk” me. I was in my district.)

It_s the job of the black-box overseer to keep an eye out, record, scrutinize and punish drivers for brake-slamming, Mach 1 acceleration, centrifuge-speed cornering, signaling with only one finger, seat-belt application without the assistance of an airline attendant (refer to the movie„Airplane), use of fog horns and boom boxes instead of lights and sirens, and using pets as back-up spotters.

I remember when those black boxes were installed in my ambulance. Our first call with them was an MVC where I could position my rig only by making a tight U-turn in the intersection. Within seconds, the CPU (collar placement unit) sounded out a loud and obnoxious warning growl. So surprised was I by this abhorrent noise that I slammed on the brakes. A new set of warnings howled the computer_s displeasure. This was immediately followed by penalty tones, because the system felt I should have used my blinkers while making that turn. I took my eyes off the road to find my Maglight so I could beat this abomination of computer chips into oblivion, and that_s when I ran over my backer. I_m kidding. There was no backer, which is why I received additional penalty tones.

Like everyone else, I eventually figured out how to please “mother.” But, despite 25 years of an accident-free career (except for a drive-in speaker I ran over once), I still occasionally set off those warning tones.

From a psychological perspective, I don_t like the idea of this computer giving only negative feedback. If you put those warning and penalty tones to voice, they would say, “You screwed up. You_re stupid. Wow! You_re stupid, stupid.” Our computer patient care reports already give similar negative feedback, such as, “You can_t proceed to the next page until you correct the four patient billing errors. Jeez! Do you drive this badly, too?”

Again, I_m all for improving safety standards, but I gotta tell ya, I know some busy systems that don_t have a driver-monitoring system and have a better safety record per call volume than those that do. Sure, they have employee screening and driver training, but I think their real secret lies in their ability to retain employees. With experience and maturity, these employees evolve into some mighty fine ambulance drivers who feel mighty good about themselves. Now, put that in your computer and smack it.„

Until next time, drive safely.„JEMS

Steve Berryhas been a paramedic for the past 25 years in the southern Colorado region. He_s the author of the cartoon book series I_m Not An Ambulance Driver and invites you to join him and others of the EMS community to ride in the 2009 National EMS Memorial Bike Ride ( ). Visit his Web site at www.iamnotanambulancedriver.comto purchase his books or CDs.