Silent Approach

August 25th, 2008

Every month I get several people coming to my blog after searching for something like “what does it mean when ambulances have flashing lights but no siren?” or “ambulance lights flashing no siren dead?” - these are actual searches that pointed to this blog in the past three weeks.

I have never actually heard anyone say this, but there is obviously a misconception that ambulances which are driving with blue lights on and no sirens are transporting a dead body. There are a number of reasons why this would never be the case, let me explain as many as I can think of:

1.) First we need to define dead. Medically, a person is dead when their heart is not producing a perfusing rhythm. In other words, if it’s not pumping (enough) blood to sustain life, the person is dead.

2.) But death isn’t as easy as that. Death has to be confirmed or pronounced (there’s a difference) by a medical practitioner qualified to do so. Ambulance service clinical staff can confirm death (recognition of life extinct) in specific circumstances. If we believe there is a chance that a recently deceased person could possibly be ‘brought back to life’ (or resuscitated), this person is medically dead, but not legally dead. This is when we start doing CPR, and alert the receiving hospital with ‘cardiac arrest, resus in progress’ - ironically, the abbreviation used by ambulance control for ‘resus in progress’ is often RIP. In these circumstances, we will use blue lights and sirens to get to the hospital and won’t be sparing the horses.

3.) Persons who have been confirmed dead by the ambulance service are not routinely transported. The only place we would take them would be to the public mortuary (not a hospital mortuary). We do this following a death in a public place (e.g. a shopping centre), or from a private home when there is noone present who is able to take charge of the body and arrange a funeral.

4.) When we use blue lights and sirens, we have to be able to justify any traffic laws we claim exemption from. These are covered by the Road Traffic Act, and include such rules as:

“No statutory provision imposing a speed limit on motor vehicles shall apply to any vehicle on an occasion when it is being used for fire brigade, ambulance or police purposes, if the observance of that provision would be likely to hinder the use of the vehicle for the purpose for which it is being used on that occasion.”

Similar rules exist for red traffic lights etc., however, if we are transporting a body that we have confirmed dead to a mortuary, in what way would - for example - observing statutory speed limits hinder our journey? So why use blue lights?

5.) There is nothing in law that says sirens must be used at all times when blue lights are on. In fact, I do not believe there is anything in law that states blue lights must be used at all, as long as you can justify the exemption you were claimed. But you’d be ill advised to drive through red lights without blue lights on - all emergency drivers can still be prosecuted for Dangerous Driving, irrespective of the emergency.

6.) Attitudes towards sirens appear to vary between services. The police generally use sirens constantly throughout their journey. Our training officers encourage sirens to be used only when necessary. My emergency driving instructor would wind the window down if you left the sirens on for longer than required.

7.) Certain medical emergencies may require a quiet journey. A pregnant woman suffering from severe pre-eclampsia/eclamptic fits should be exposed to as little noise and flashing light as possible, but the condition is a serious medical emergency. Therefore, we close the blinds to ensure she doesn’t see any flashing blue lights and use the sirens as little as possible - but never to the point where we could compromise the safety of ourselves and other road users. Personally, my approach would be brief ‘beeps’ of the horn to alert a driver who hasn’t seen us behind them, resorting to siren use if they still don’t see us.

8.) Most people drive proportionally to the speed of response necessary. So if we’re responding to a 25 year old who has had belly ache for three weeks, we won’t be driving particularly fast - but current ambulance service policy states we must have blue lights on. A policy which only came about in 2006 and is a bit of a contentious issue.

So there you go. Ambulances driving around with lights but no sirens could be doing so for many different reasons, but you can be fairly certain there is no dead body on board!

Entry Filed under: Work