Leaving aside the debate about whether the risk of using lights and sirens is validated by the savings in out-of-hospital time for our patients, as well as whether late-night noise increases the risk of health problems, we have a basic question. Is it appropriate in the later-evening hours, with little traffic on the road and most of the public at home and resting, to turn off your sirens and only use your ambo's lights as you respond to an emergency?
Those who say yes- kill the siren at night unless it's completely necessary- have a couple good points, the primary one being the maintenance of public goodwill. People are more likely to view us in a positive light (and to value our presence in their neighborhood) if we don't constantly wake them up in the middle of the night with loud sirens. Public goodwill can translate into contributions to a volunteer rescue squad, support for a career fire department tax increase, or willingness to back ambulance billing- not to mention a general positive relationship with the community.
Others argue that, wider community concerns aside, it's simply not necessary. Why blare the siren on an empty road, when the only people who will hear you are probably in bed? The only savings (I've heard this argued) are in the wildlife community; you'll probably scare nocturnal critters off the highway and create less roadkill for the local highway department. If you blare your siren on an empty road and there are no drivers to hear you, are you making a sound? And if so, why?
And we all know that prolonged exposure to siren noise (as with any other high-decibel activity) is correlated with hearing loss. Yet another reason to just turn the damn thing off if you don't need it.
Yet the pro-siren crowd has some valid points. First, in many states (including mine,) you don't qualify as an emergency vehicle unless your emergency lights and siren are activated and functioning properly. That means, if you get into a crash, you lose a lot of liability protection- you may have been speeding and responding to an emergency, but you can be found negligent if you weren't giving other motorists the full benefit of your warning equipment.
Outside of the liability argument, some EMS providers just put it in terms of safety. We all know that drunk, distracted and just plain dumb drivers haunt our roads and highways. We never know when someone is going to pull out of a blind driveway, off a highway shoulder, or blow a red light that puts them directly in our path. EMS providers die in on-duty collisions every year. Regardless of community concerns, why wouldn't we protect ourselves with every tool that we're authorized to deploy?
Some agencies have nonemergency dispatch procedures, which are widely acknowledged to cut down on the number of collisions and to help curb unnecessary lights-and-siren use. The implication being, if you're running your sirens late at night, it's for a good reason. Other communities have designated "quiet zones" applying to emergency sirens as well as train and truck horns- but these often correlate with an increase in grade crossing and highway accidents.
So personally, I come down on the "pro-siren" side of the fence. Doesn't matter when the call goes out; if we're expected to respond to an emergency, our ambulance ought to demonstrate it, and to warn the rest of the public that we're coming. I'm not psychic; I don't know what's around the next bend or waiting in that driveway. But whatever it is, I want it to hear me coming, because I want to go home the next morning.
But what do you think? Do you spare your local citizenry the full blast of the siren when they're in Dreamland? Have you got policies that govern siren use? Let's hear your thoughts...
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