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Old 09-04-2003, 06:27 PM
Hail Ants is offline
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EMTs - if the guy dies do you turn off the siren?


When we were kids there was always a rumor that if you saw an ambulance driving with its lights flashing but no siren that meant that the victim inside had croaked.

Any current or former EMTs know if there's anything to this?
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Old 09-04-2003, 06:39 PM
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An ambulance would not be transporting a dead body. If the person dies en-route to a hospital, then, I would assume that advanced life support was in progress. Only a doctor can pronounce death in a situation like that.
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Old 09-04-2003, 07:12 PM
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I doubt there's much to it. The ambulance crews do not need to transport every dead person to hospital, but once in the ambulance, the crew would certainly do everything possible if the patient had no DNR order, if (and not) only for legal purposes. Especially since the transfer time may not be long.
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Old 09-04-2003, 07:25 PM
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Ambulances around here seem to use their sirens as required, so if they're approaching some trafic they'll turn on the sirens, if they're dtiving through empty streets, they won't.
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Old 09-04-2003, 07:34 PM
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UL. Ambulances turn off thier sirens in low risk traffic situations becasue they are loud and annoying. Most fire departments turn off their sirens once they enter a residential area or just upon leaving the station so that the one block around them isn't bugged senseless by it.
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Old 09-04-2003, 10:08 PM
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Also, some states (Michigan for example) do not require siren use on freeways. As a result an ambulance can be operating as an authorized emergency vehicle using only lights.

If for some reason an ambulance was transporting a body, there'd be no need for the lights, either.

Lastly, in some jurisdictions paramedics can pronounce deaths in consultation with medical control. That would happen on scene, though, not while the ambulance was enroute.

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Old 09-04-2003, 11:25 PM
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Our ambu;ance turned the sirens off at night, and occasionally for a queit stretch of road, only because it's so loud. If a person went into cardiac arrest and 'died' we'd be even more frantic to get them to a hospital where a full staff of people could try to resusitate.
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Old 09-05-2003, 12:24 AM
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The lights and sirens are mostly used for getting to the patient. The sirens are turned off when the ambulance gets to the scene, if not sooner. The lights are turned off, at least in my jurisdiction, when the ambulance leaves the scene (with or without a patient). Only in the rarest circumstances would the siren be used with a patient on board.

In the State of Washington, emergency vehicles are given four priveleges when operating in emergency mode (indicated by use of lights for sure, and siren "when necessary to warn others of the emergency nature of the situation"). These are
  1. exceding the posted speed limit
    going the "wrong way" in traffic
    proceding through stop signals without stopping
    parking anywhere in the road
If you're not doing any of those things, you don't need the warning signals. And most ambulance personnel I know don't usually do any of those things once they've got the patient stabilized.

Peregrine (former EMT and Emergency Vehicle Accident Prevention Instructor)
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Old 09-07-2003, 05:56 AM
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I don't think it's the ambulances call. They have to transport the patient to the hospital, sirens blazing and trying like all hell to rescussitate the patient.

I think only a doctor can say "he's dead" or pronounce them DOA.

Just my thinking...

D.
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Old 09-07-2003, 07:21 AM
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Quote:
Originally posted by threemae
UL. Ambulances turn off thier sirens in low risk traffic situations becasue they are loud and annoying. Most fire departments turn off their sirens once they enter a residential area or just upon leaving the station so that the one block around them isn't bugged senseless by it.
I live about a block away from a fire station, on a one way street, and I hear it every time they pull out. It's only for about fifteen seconds or so though.
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Old 09-07-2003, 07:40 AM
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You see, using the siren is more than annoying. It is a bit dangerous.

When you have it on, you cannot hear traffic noises and so on. A large number of crashes happen between ambulances near hospitals. Both may have their lights and siren agoin' and both might not realize the other is there.

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Old 09-07-2003, 07:53 AM
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In the UK I was following an ambulance down the road with my mother, who used to be an ER nurse. It was doing about 30 in a 60 limit, with the lights on but no siren. My mother said "probably CPR". After about 10 minutes the lights went off and the ambulance sped up to 60. She said "oh dear, that's a DOA".

While death can only be officially declared by a doctor, it's human nature to make your job easier. If the patient is utterly beyond hope, I wouldn't doubt that the paramedics might give up. "Thou shalt not kill, but needst not strive officiously to keep alive."
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Old 09-07-2003, 08:06 AM
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Here in Dallas I saw an accident (or the aftermath) a few years ago. The accident didn't appear very bad but the driver of one car was elderly. The Life Flight helicopter landed on a busy street but she ended up in the ambulance with no lights or siren. I'm pretty sure that she was deceased at that point.
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Old 09-07-2003, 06:49 PM
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Quote:
Originally posted by jjimm
In the UK I was following an ambulance down the road with my mother, who used to be an ER nurse. It was doing about 30 in a 60 limit, with the lights on but no siren. My mother said "probably CPR". After about 10 minutes the lights went off and the ambulance sped up to 60. She said "oh dear, that's a DOA".

While death can only be officially declared by a doctor, it's human nature to make your job easier. If the patient is utterly beyond hope, I wouldn't doubt that the paramedics might give up. "Thou shalt not kill, but needst not strive officiously to keep alive."
In the U.S., the paramedics would not 'give up', until custody of the patient was handed over to the next step in the process of advanced life support. In the way this thread is going, that would be the ER doctor. Once CPR is started, it must continue until a higher authority intervenes. (MD)
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Old 09-08-2003, 09:39 AM
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I take it you're referring to a "higher authority" as in a medical professional and not in a spiritual sense.
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Old 09-08-2003, 12:55 PM
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When I took CPR training from an Ohio EMT lo, these many years ago, he told us that there were only four circumstances where an EMT (rather than a doctor) was allowed to assume that the patient was "dead" (meaning beyond recovery, not just heart stopped). Those four situations are decapitation, blood pooling, rigor mortis, and decomposition of the body. None of those four is likely to occur while the patient is in the ambulance en route to the hospital.
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Old 09-08-2003, 03:46 PM
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Quote:
Originally posted by acsenray
I take it you're referring to a "higher authority" as in a medical professional and not in a spiritual sense.
Good one. The 'pass on' progression would work as follows;
A civilian with CPR training.
A Certified First responder.
An EMT.
A Paramedic
An MD
..and then God.
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Old 09-08-2003, 04:12 PM
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Quote:
Originally posted by Peregrine
In the State of Washington, emergency vehicles are given four priveleges when operating in emergency mode (indicated by use of lights for sure, and siren "when necessary to warn others of the emergency nature of the situation"). These are
  1. exceding the posted speed limit...
Heh. This reminds me...

In Colfax, Washington (in the east of the state, about an hour south of Spokane) in the late 1980s as I recall, there was a particular stretch of the road into town from the south that was notorious for being used as a de facto speed trap. The speed limit signs were clearly posted, but if you followed them precisely it would require heavy application of the brake pedal (rather than coasting or moderate brake use) on a steep downward grade. There was plenty of room to slow down at a more normal rate, if that's what the sign-posters had wanted. But the cops would getcha if you were going the least bit over the posted limit immediately after the sign.

I'm sure they started doing this because so many idiot rugrat undergrads from Washington State U were speeding through poor li'l Colfax on their way to Spokane or Seattle. (They also made the easiest path through town impossible to follow without executing an illegal left turn; they forced traffic instead to go through downtown and directly past most of the Colfax businesses.) But it got a little out of hand.

The Colfax cops actually stopped and ticketed a Colfax ambulance for speeding on that stretch of road. Apparently the sanctimonious cop determined that the ambulance was exceeding the speed limit excessively, and was therefore endangering the life of the victim more than the victim's heart attack (or whatever) was.

God help the poor victim, but word got around, and folks got reeeal careful driving through Colfax after that.
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Old 09-09-2003, 09:30 AM
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When I drove an ambulance in Syracuse, NY, all calls went out lights and siren regardless of the type of call (in case the original caller didn't give the right information). When transporting to the hospital, life threatening and serious calls went with lights and sirens. Non life threatening calls (90% of them) went without. Sirens were typically used (by law) when going through intersections. Driving along the street there is no need, unless there are cars on the road.

Ditto on declaring death. In NY we were able to in obvious instances, but much better to leave that up to a doctor.
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Old 09-09-2003, 04:20 PM
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I'll mention something else, as it was brought up in a few posts. When I got promoted and attended first line supervisors school (fire dept.) Part of training was being familiar with vehicle and traffic laws as they apply to emergency vehicles. At NO time is the emergency vehicle allowed to blow stop signs, blow red lights, or exceed the posted speed limit. That is the choice of the driver. In my case, as supervisor of the apparatus, it was my responsibility to keep my driver under control. A department lawyer told us that there was no legal defence if an accident occured, and it was deemed that you disobeyed the laws in the code. It may be one thing if an emergency vehicle is speeding down a road where only the horizon is in the distance, but another thing entirely if you are on congested city streets.
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Old 09-09-2003, 08:56 PM
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Quote:
Originally posted by ltfire
I'll mention something else, as it was brought up in a few posts. When I got promoted and attended first line supervisors school (fire dept.) Part of training was being familiar with vehicle and traffic laws as they apply to emergency vehicles. At NO time is the emergency vehicle allowed to blow stop signs, blow red lights, or exceed the posted speed limit. That is the choice of the driver. In my case, as supervisor of the apparatus, it was my responsibility to keep my driver under control. A department lawyer told us that there was no legal defence if an accident occured, and it was deemed that you disobeyed the laws in the code. It may be one thing if an emergency vehicle is speeding down a road where only the horizon is in the distance, but another thing entirely if you are on congested city streets.
This is fascinating to me, that ANY state would permit blowing a red light. Under any circumstance. Period. In NYS, you risk losing your right to operate an ambulance if you blow a light. I don't care if the patient is about to deliver a baby ( and, when I was "just" a driver many years ago, I HAD one of those calls. She delivered roughly 3 minutes after rolling her into Maternity ). It is against the law.

Stop. Make eye contact with ALL drivers. Proceed with caution. Period. If you are alone at the light, stop. Then go. Period.

Anyway, as to the O.P. In New York State, you arrive and unless the patient exhibits the signs described above, you start CPR and Defib attempts and you don't stop the cycling until A) Paramedics arrive, and/or B) you get to the hospital so a Dr. can call the death. You may not stop once you start.

To stop is to abandon a patient by interrupting care. It's simply not done. Of course, at least where I live, it's also illegal.

Cartooniverse, NYS EMT.
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Old 09-09-2003, 11:40 PM
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Shortly before I moved off Long Island, NY a lot of the traffic lights were being fitted with a device so that the emergency vehicle going through it would have a green light, but no other traffic would. So you wouldn't be running any red lights. It was a joy.
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Old 09-29-2003, 01:23 PM
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Now, that is a nifty piece of hardware/software. Let's say you are going 55 mph in a 45 zone, lit up and rockin' like there's no tomorrow. In NYS you can proceed with lights and sirens no more than 10 mph over posted speed limit.).

You are a block from a standard boring 4- way intersection. No special turn lanes or anything. This idea mentioned by Morelin means that your ambulance would transmit a code to the upcoming light set, and turn 3 out of 4 lights red- DESPITE the fact that there may be traffic proceeding already through that intersection.

I'd be darned nervous about the driver who was coming towards me, kept on since they had a green light as they started to enter the intersection, then you get a green and nobody else has one, they turn left and are t-boned by your truck/ambulance.

What's the excuse? " Hey, we hit our little transmitter, and we had the only green light in the 4-way ! Tough on them ! " ????

I'd stop anyway. It sounds great only in a perfect world. Then again, in a perfect world, nobody dies in car accidents anyway, do they?
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Old 09-29-2003, 02:39 PM
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I didn't say we just zoomed through the intersection. It just made things easier for us. I know, because I often was in the passenger's sea, acting as the 'spotter' in especially congested areas and blind turns.

As I understand it, the lights go through the normal, yellow to red cycle so that everyone but the incoming amublance is red for long enough to clear the intersection.
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Old 09-29-2003, 03:10 PM
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Quote:
Originally posted by Morelin
Shortly before I moved off Long Island, NY a lot of the traffic lights were being fitted with a device so that the emergency vehicle going through it would have a green light, but no other traffic would. So you wouldn't be running any red lights. It was a joy.
It's called OptiCom and it's made by 3M.

St. Urho
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