When the general public thinks of ambulances, they imagine lights and sirens. Use of L&S, known as “running hot”, is simply part of EMS culture. But recent research shows that light and siren use should actually be reduced! Only about 5% of calls are life-threateningly urgent enough for a high-priority trip to the hospital. In recent years, more studies have investigated the risks of L&S during vehicle operation. “Running hot” in an EMS vehicle nearly triples the chance of crashing during patient transport. Since lights and sirens are often the norm for medical services, EMS responders are left wondering about the downsides.
Here are some lights and siren drawbacks for emergency vehicles:
Running hot can increase patient anxiety and provider anxiety! When a patient is more anxious, their oxygen demand and heart rate can increase. Patients may associate sirens with traumatic experiences, further upping their anxiety levels. In non-life-threatening situations, the overwhelming environment may not be worth saving a few seconds.
When you tone down your siren use, you can actually protect your team, too. Sirens are associated with increased risk of hearing loss in providers. Ambulance noise is often above the recommended decibel level, so consider your health when deciding on the use of L&S!
L&S response increases the chance of ambulance crashes in the United States by more than 50%! Sirens request the right-of-way, but their use doesn’t guarantee that others will move out of the way. “Wake effect” collisions, which occur in the wake of ambulances but don’t involve them, are four times as common as ones directly involving ambulances. These civilian injuries from ambulance operations also highlight the need for defensive driving from EMS professionals.
Warning lights and sirens may not actually save much time. A study from the National Library of Medicine showed that light and siren use actually only reduced average prehospital response time by as little as 42 seconds to 3.8 minutes. In non-life-threatening situations, focus on accident reduction and keep people safe. Those seconds may not be worth the risk of injuries or fatality resulting from vehicle collisions.
Many EMS agencies have been able to reduce light and siren use by up to a third without a significant impact on patient outcomes. The Lights and Sirens collaborative was launched, supporting 50 EMS agencies to lower use of L&S and prevent crashes. In the January 2024 National EMS Quality Alliance report, new guidelines surfaced for safer response. According to new findings from NEMSQA, EMS personnel need to be educated on the actual risks of using lights and sirens. Guidelines also stated that personnel should limit use to high-priority calls, regularly gather data on the true necessity of use, and develop new guidelines to determine when “running hot” is really necessary.
If you’re an ambulance operator looking to implement new L&S strategies, take a CEVO 5: Ambulance operator course. Coaching Systems’ CEVO 5: Ambulance training is a great way to up your knowledge of EMS systems in the changing landscape. If guidelines have changed since you got your certification, you can benefit from a new understanding of L&S safety.
