With so much crime and road crashes across South Africa daily, we need to consider the challenges facing our first responders.
Do they manage to provide a response that is fast and effective while safe not only for other road users but also to themselves?
We recently shared an afternoon in a response car with CrisisOnCall – an experience that confirmed the need for more insights from our emergency responders.
In this Q&A we strive to share some insights from paramedics as well as some advice on how the motoring public can share roads safer with the medical and emergency response teams.
What is the “Golden Guideline” to follow when performing Emergency Response / Driving to the scene?
- Not only must emergency vehicles drivers provide prompt conveyance of the apparatus, equipment, and personnel to provide a service to those in need, but as importantly, should do it in the safest manner possible
- Safety First – Respond by doing so Safely! You are of no use to the people you’re responding to if you have been involved in a crash yourself.
- Responding to an emergency scene takes a lot of concentration and you must constantly be aware of your surroundings and try to think for other road users.
- Emergency vehicle response drivers also have a higher standard of care to provide to the general motoring public and must make every attempt possible to provide for the safety of other motorists.
- Rather drive slower and know that you will arrive on scene than rushing and placing everyone at risk.
- When the paramedic responds to the scene, he should always consider and respect the safety of the public.
Will you always use a siren and flashing lights or what are the guidance as to when to use them? Does the nature of the call -out determine the decision on what to use?
- There are different guidelines among different emergency responders.
- For KZN EMS the nature of the call is what determines the use of lights and sirens. We only use lights and sirens if we have triaged the case as “red code” or critical case and an immediate and urgent response to the patient is required.
- Therefore, we ask questions (many people don’t understand why we ask questions to the caller and they get frustrated with us, saying” just send the ambulance”) to the caller regarding the patient, so that we can try determining the nature and seriousness of the patient’s condition.
- Generally, lights and sirens are used when responding to a priority emergency call. However, it is not always necessary to use sirens when there is no traffic. At night, sirens are not always used.
- All emergency vehicle drivers must understand that warning devices are not always effective in making other vehicle operators aware of your presence.
- Warning devices only request the right-of-way, they do not ensure the right-of-way.
Intersections are always high incident zones. What do you do to mitigate the risk of a road crash with the response vehicles at intersections?
Most crashes involving EMS vehicles that crash while responding, especially in the urban environment, occur at a traffic light and these are high-risk areas.
Most paramedics are trained in BERC (Basic Emergency Response Course) This is an internal course that provides basic training in response driving to our paramedics. This also addresses aspects of safety and guidelines on approaching intersections. For example, a steady red disc, the vehicle must come to a full stop before it can proceed, regardless of their siren usage.
- Approaching the intersection with caution.
- Driving with headlights on.
- Changing the tone of the siren.
- Coming to a complete stop and checking of vehicles.
- Paramedics stop and first they look at the first lane for traffic and then the second lane of traffic and finally the third lane. If all the lanes are clear then the paramedic will go through the intersection.
Are there a specific high-risk or difficult times for response – peak hour traffic, night time etc.?
- All emergency responses are considered as high risk.
- When there is congestion, be if, from the rush hour or road works, it slows the response.
- Most difficult times to respond is in peak traffic, normally in the morning between 7 am and 9 am, and then again in afternoon high volume traffic between the hours of 4 pm and 7 pm.
- It’s also very difficult to respond in wet weather.
- Late at night can be a risk when responding. There are road users that don’t always obey the road rules. For example, people don’t stop at traffic intersections because of safety reasons and members of the public drive under the influence of alcohol.
What have been the major difficulties you experienced in rendering assistance fast and effective?
People who decide to drive in the emergency lane when there is congestion severely delay paramedics while responding. It not only limits the response time but also puts the lives of other road users in danger.
Getting to an incident as soon as possible:
- Addresses provided to the call centre incorrectly.
- Road works
- Peak hour traffic
- Riots/protests blocking roads, etc.
Our roads in South Africa are not always up to standard with many roads having potholes. This can challenge the paramedic when responding especially in rural areas.
How do road signage, road conditions impact on emergency response?
- Rain and wet driving conditions are a risk to all road users and we must apply the same precautions as other road users, which includes to reduce speed and increase following distance.
- Road conditions play a very important role, more so when a patient is already on board. A patient with severe injuries is not always comfortable on a bumpy road or a road that is not well maintained.
- Especially in rural areas, the street names of the roads are stolen. This makes it very difficult for the paramedic to find the correct street when responding to an accident scene.
- In some instances, the community builds temporary speed humps which place the emergency responders at risk.
- There is also the major problem of roads that is not in proper driving conditions. For example, potholes and traffic lights that are not working.
How aware are South Africans of what to do when they hear Emergency sirens? What are the most common mistakes that they make?
- People are aware of sirens but their reactions to it are all very different.
- Most motorists are aware and allow us to pass them easily; some people realise too late that there is an emergency vehicle behind them, while others just plainly ignore us.
- There are even people that try and block us or take advantage of cars in front of them pulling to the side by then overtaking these vehicles.
- Even though people are taught what to do in their K53 when they hear sirens, it seems that people move all over the place.
- We often see people tailgating emergency vehicles and moving into emergency lanes when there is traffic backup. This ultimately delays a response.
- When a response vehicle approaches almost 80% of road users brake when they notice the response vehicle behind them.
- Many road users don’t use their rear-view mirrors. If road users will use their rear-view mirrors often they will notice the response vehicle approaching from a distance.
If you could offer a few points of advice to road users, what is it that they should focus on doing when hearing the Emergency Siren?
- When you hear the siren, don’t ignore it!
- Identify where the emergency vehicle is coming from.
- If at an intersection, please allow EMS crews/ vehicle to cross the intersection.
- If the vehicle is behind you, please do not just slam on brakes, move to the left and when the EMS vehicle starts to overtake slow down to let them pass.
- Move over to the left, but do not move into the emergency lane when the emergency vehicle is in that lane.
- Do not tailgate emergency vehicles or cross intersections with the emergency vehicle.
- Continuously monitor your rear-view and side view mirrors.
- Don’t listen to loud music while driving, you may not hear the siren of the response vehicle.
- If you are a pedestrian do not run back and forth in the middle of the road but continue to go in the direction you were initially going in.
When responding with multiple vehicles and an ambulance to an Emergency or from the Emergency to the hospital, is there a specific protocol on what to do to ensure safe passage?
- When there is a convoy of several vehicles the response driving style does change.
- Normally the vehicle in the front will stop in an intersection to block the intersection and allow all the vehicles in the convoy to pass and then rejoin the convoy at the back.
- The paramedics are trained to use a specific protocol such as convoy responding.
- Members of the public should follow normal procedure and always check their surroundings for more emergency vehicles once an ambulance or emergency vehicle passed them.
Is the manner and method of response on the road part of the training of a paramedic? Do you continuously address this with paramedics?
- It is continually addressed. Safety and the normal road safety messages apply to our staff as well.
- There is continuous training taking place.
- All paramedics are assessed before they can respond to an emergency. They must be found competent.
- Accidents are thoroughly investigated internally and corrective measures are taken.
Are paramedics sent to advanced driver training courses or are this recommended for them to do?
- There are basic and advanced driver training courses available – the most important factor when responding is safety!
- Specific driver training is done in-house for some emergency/ medical response services by trained advanced driver instructors.
- As part of the training to become an advanced paramedic, the training includes an advanced driving course.
- BERC – Basic Emergency Response Course
- The private ambulance services will always recommend the paramedic to do an advanced driving course.
Do you believe that the animosity among the motoring public towards the “blue light brigade” has a negative impact on how they respond to other emergency sirens?
- We have witnessed some animosity due to “blue light brigades”.
- However, be it the “blue light brigades”, a police vehicle or an ambulance, we ask people rather allow the vehicle to pass as they don’t know the situation at hand.
- Sometimes people think paramedics use their red lights only to get out of traffic.
- They are not aware that when the emergency responder get stood down on a call [ When the response is not required] they switch off their lights and sirens.
- The public does not always understand this and mistakenly think this was a method to get out of traffic for their own convenience.
If you could leave a message with the motoring public on the urgency and importance of their response, what would it be?
- While it may inconvenience you for a few seconds to allow an EMS vehicle to pass, this greatly helps when we respond to emergencies
- Safety lies with every motorist, including the ambulance driver.
- Monitor your surroundings and always obey the traffic rules.
- Take responsibility for your actions.
- Consider how you would like others to behave if it was your family member is in a life-threatening situation.
- Please obey the road rules, and make sure not to drive in the emergency lane, keep to the left and pass to the right.
- Use your rear-view mirror, and don’t drive with music that is too loud and distracting.
[A word of appreciation to the following people for the assistance with this Q&A]
Robert McKenzie, KZN EMS
Werner Vermaak, ER24
Ruan Vermaak, CrisisOnCall
Ceron Lennox, Rescue Care