Administration and Leadership, Columns

Pro Bono: Distracted Driving is an EMS Liability Time Bomb

Issue 10 and Volume 41.

If EMS personnel are seriously hurt or killed on the job, chances are that the injury or death was related to emergency vehicle operations.

Operating any vehicle carries inherent risks, however, those risks are amplified when emergency vehicle operators engage in unsafe, but avoidable, practices that should be substantially curtailed or completely eliminated. Driving is risky enough; don’t make it unnecessarily riskier.

Ambulance crashes have a high human cost. But the liability risks can also be astronomical. Verdicts, judgments and settlements can easily exceed the insurance policy coverage limits.

Worse yet, if a crash is found to have resulted from an intentional act, your insurance policy might not even cover the damages. Even if the crash resulted from ordinary negligence, in many states your insurer is within its rights to cancel or not renew your policy.

Typing & Texting

Every EMS agency should have a consistently enforced, written policy forbidding the use of personal electronic devices when driving—or engaged in any other EMS operations, for that matter. Nobody operating an ambulance or other EMS vehicle should be typing, texting, Facebooking, or web browsing. Infractions of this policy must not be overlooked, and should have immediate and serious consequences.

EMS agencies should also take a close look at the other numerous distractions that vehicle operators experience. The cab of an ambulance is a loud, active, urgent mishmash of distractions. There are lights to be operated, sirens to be activated, communications coming from the dispatch center and other responding agencies, discussions between crew members and—oh yes—all the regular hazards of operating a 12,000-lb. vehicle in the usual risk-laden environment of oncoming traffic, pedestrians and obstacles that await on the roads.

If possible, the emergency vehicle operator should be relieved of all collateral responsibilities in order to focus solely on driving, and hands-free technology should be utilized for tasks such as communications, operating lights and sirens, etc.

All of the vehicles in an EMS agency’s fleet should be crashworthy and contain safety features necessary to protect all occupants. Investing in physical safety shows employees that their health and wellness is a top priority of management.

With employee recruitment and retention being as difficult as it is in this day and age, it’s these type of nonmonetary benefits that employees and prospective employees will notice when they decide where they want to work. Make no mistake, EMTs and medics have pretty much free reign in deciding where they want to work in EMS.

Lights & Siren

Finally, I would be remiss if I didn’t climb on my anti-lights and siren soapbox. Any practice we undertake in EMS should be done only if it’s safe and effective. The use of lights and siren hasn’t been proven to really make any difference in patient outcomes. It’s typically the single biggest risk factor in EMS vehicle crashes.

If any practice in healthcare was ultra-high risk with little reward, shouldn’t it be curtailed or corrected promptly? So why are lights and siren the exception, possessing such a venerated place in daily EMS operations?

It’s likely as much a cultural issue as an operational issue. The use of lights and siren is an engrained part of the public safety culture. But we deliver a healthcare service, and in this age of evidence-based medicine, all our practices must withstand the scrutiny of being safe and effective.

EMS agencies should adopt progressive, forward-thinking policies that significantly curtail the use of lights and siren in all but the most extreme cases. The policy should be crafted in conjunction with your medical director, elected officials, and other local stakeholders.

It’s true that the public often perceives that “quality” EMS is tied to lights, siren and fast response times, but it’s our professional responsibility to educate the public and other stakeholders on why these types of dangerous practices need to be curtailed, and how the use of lights and sirens pays little, if any, dividends to public health.