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Gadgets in ambulances pose growing danger to medics

With the most wired vehicles on the road, paramedics may be among the most distracted of drivers

Editor’s note: Journalist Matt Richtel turned to EMS1’s Greg Friese and FireRescue1’s Jeff Lindsey for expert opinion in the following article. Check our EMS1 Editorial Advisor Art Hsieh’s sidebar on impacts on EMS below – and tell us your views. Does modern technology help or hinder ambulance safety? How has it either benefited you or caused a near miss? Share your perspective on this issue in the member comments section.

By Matt Richtel
The International Herald Tribune

NEW YORK — Theirs are the most wired vehicles on the road, with dashboard computers, sophisticated radios, navigation systems and cellphones.

While such gadgets are widely seen as distractions to be avoided behind the wheel, hundreds of thousands of drivers — police officers and paramedics — are required to use them, sometimes at high speeds, while weaving through traffic, sirens blaring.

The drivers say the technology is a huge boon for their jobs, saving valuable seconds and providing instant access to essential information. But it also presents a clear risk — even the potential to take lives while they are trying to save one.

Philip Macaluso, a New York paramedic, recalled a moment recently when he was rushing to the hospital while keying information into his dashboard computer. At the last second, he looked up from the control panel and slammed on his brakes to avoid a woman who had stepped into the street. ''There is a potential for disaster here,’' Mr. Macaluso said.

Data do not exist about crashes caused by police officers or medics distracted by their devices. But there are tragic anecdotes.

In April 2008, an emergency medical technician in West Nyack, New York, looked at the Global Positioning System screen in the ambulance he was driving, swerved and hit a parked flatbed truck. The crash sheared off the side of the ambulance and left his partner, who was in the passenger seat, paralyzed.

What This Means
for EMS

By Art Hsieh, EMS1 Editorial Advisor

There are now numerous studies out to show that driving impaired skyrockets while using a variety of technology. In fact, you’re much more likely to crash while texting than while driving under the influence of alcohol or drugs.

My best EMS story is the young driver who flipped her SUV over while arguing with her boyfriend over the cell phone.

As an animated talker, she “forgot” that she was driving down a New England highway and went to give the “universal sign” to her soon to be ex — except somehow she got tangled up with the steering wheel and caused it to veer off the road and roll over into the median.

Fortunately she wasn’t seriously injured. I was amazed that she had the guts to admit to the cause of the MOI — guess she was still mad!

These stark statistics are the reasons why we cannot afford to be hypocritical while on the job.

As this article points out, many of us are responsible for the use of radios, computers, GPS systems, pagers and cell phones during the course of our duties (not to mention the MP3 player, satellite, FM radios and CD players!)

In addition, we have the burden of communicating with our crew, either riding shotgun or tending to a patient in the back.

While we might try to comfort ourselves as being extraordinarily competent at multitasking, it might not be the best idea to test that theory while driving a 10 to 14 thousand pound vehicle down an urban street at 55 miles per hour.

Many organizations forbid the use of mobile phones while driving. What about you? What does your agency do? Is there a policy in place to minimize the use of electronics during a response or transport? Share your thoughts in the member comment section.

Art Hsieh, MA, NREMT-P, is Chief Executive Officer & Education Director of the San Francisco Paramedic Association, a published author of EMS textbooks and a national presenter on clinical and education subjects.

In June 2007, a sheriff’s deputy in St. Clair County, Illinois, was driving 35 miles, or 56 kilometers, per hour when a dispatcher radioed with an assignment. He entered the address into his vehicle’s mapping system and then looked up too late to avoid hitting a sedan stopped in traffic. Its driver was seriously injured.

Increasingly wired
Ambulances and police cars in the United States are becoming increasingly wired. About 75 percent of police cruisers have onboard computers, a figure that has doubled over the past decade, said David Krebs, an industry analyst with the VDC Research Group in Massachusetts. He estimated that about 30 percent of ambulances have such technology.

The use of that technology by so-called first responders comes as regulators, legislators and safety advocates seek to limit the use of gadgets by most drivers. Police officers, medics and others who study the field say they are searching to find the right balance between technology’s risks and benefits.

The computers allow the police, for example, to check license plate data, find information about a suspect and exchange messages with dispatchers. Ambulances receive directions to accident scenes and can use the computers to send information about patients before they arrive at hospitals.

''The technology is enormously beneficial,’' said Jeffrey Lindsey, a retired fire chief in Florida who is now an executive with the Health & Safety Institute, based in Oregon, which provides continuing education for emergency services workers.

But Mr. Lindsey said first responders generally did not have enough training to deal with diversions that could be ''almost exponential,’' compared with those faced by most drivers.

The New York Fire Department, which coordinates the city’s largest ambulance system, said drivers were not supposed to use onboard computers in traffic. That is the role of a driver’s partner, and if the partner is in the back tending to a patient, the driver is supposed to use such devices before speeding off.

''There’s no need for our drivers to get distracted, because the system has evolved to keep safety paramount,’' said Jerry Gombo, assistant chief for emergency service operations at the fire department. Drivers get into accidents, he said, but he could not recall one caused by distraction from computer use.

Mr. Gombo also estimated that the technology saved 20 to 30 seconds per call. ''There’s no doubt we’re having quicker response time,’' he added.

But in interviews, medics and emergency medical technicians in New York and elsewhere say that although they are aware of the rules, they do use their onboard computers while driving because they cannot wait for certain information.

Exempt from bans
States that ban drivers from text-messaging or using hand-held phones tend to exempt first responders. And in many places where even they are forbidden to use cellphones behind the wheel, the edict is often ignored.

''My partner was checking baseball scores as he was driving a patient to the hospital. I looked through the passageway and said, ‘You’ve got to stop that right now,’'' recalled Greg Friese, a paramedic in central Wisconsin, who was treating a patient in the back of the vehicle. Mr. Friese also develops online training programs for medics, police officers and firefighters.

''We’re dealing with the carnage, which ranges from the trivial to the tragic, of distracted driving,’' he said. ''We should know better.’'

For police officers, there are reasons for constantly checking a dashboard computer. They might check the license plate of a car they are tailing by using a keyboard to call up a screen, typing in the plate number, then reading more about the owner.

''There’s no way you could do this without eventually running into something,’' said Officer Shawn Chase, a spokesman for the California Highway Patrol. And yet, he said, he has tried it.

''The first time you almost rear-end something, you say, ‘Whoa, I better not do this,’'' he said. ''You learn quick.’'

Reducing risks
Researchers are working to reduce the risk. At the University of New Hampshire, backed by $34 million in U.S. government financing, they have been developing hands-free technology for police cars.

The systems let officers use voice commands to operate the radio, lights and sirens and even speak a license-plate number into the onboard computer, which can then announce through a speaker basic information about a car. To activate voice commands, the officer must push a button on the steering wheel.

''I can literally drive down the road, speak without holding the microphone and turn on the lights and sirens without ever looking at the equipment,’' said Capt. John G. LeLacheur of the New Hampshire State Police, who has driven one of the 1,000 police cruisers in the United States, mostly in New Hampshire and elsewhere in the Northeast, equipped with the new technology.

Mr. LeLacheur said it sometimes failed to pick up his voice. ''If it’s not doing what I want, I bypass it and do things the old-fashioned way,’' he said.

Another system uses digital video systems that can automatically read license plates in front of and behind police cruisers and then check for things like unregistered plates and stolen vehicles.

The solutions are not cheap, particularly for struggling state and local governments. A license-plate reader system from Panasonic can cost $8,000 for each car, including a $3,000 to $5,000 laptop.

''We can barely get patrol cars and motorcycles,’' said Mr. Chase of the California Highway Patrol. Referring to the hands-free devices, he said, ''We’d love to get this technology, but there are trade-offs.’'

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