Should EMS drive with red lights and sirens?

Whether you call it 'running hot' or going 'priority' or 'code-3' or anything else, driving with lights and sirens is serious, dangerous business

Updated May 26, 2015

It's tempting, I know. With the flip of a switch you can go from lumbering along in traffic to king of the road. Those lights and that siren; man, it's hard to resist...and let's face it, it's fun!

Whether you call it "running hot" or going "priority" or "code-3" or anything else, driving with lights and sirens is serious, dangerous business. In many cases, it is also very necessary. So how do you know when — and when not — to light it up?

Like with almost any other decision you make as an EMS provider, you must ask yourself: "How would I explain this in court?" The trick is to consider how the answer would sound to the person who is suing you, or a jury who knows nothing of your job — not to another EMS provider.

For example: "The patient was bleeding profusely. We were doing our best to control it, but what he really needed was a surgeon. His blood pressure was falling and his pulse was increasing, both signs of shock, so I knew the clock was ticking..." That is a solid reason to use lights and siren.

On the other hand, neither "I had to pee really bad!" nor "the patient was puking all over the ambulance!" (Read: and I didn't want to have to clean it all up) are going to convince a plaintiff or a jury that the lights were justified.

Trouble only has to happen once
Of course, if nothing happens then it's a non-issue. But, how many times can you run red lights or stop signs, cross into oncoming traffic, or exceed the speed limit before something does happen? I don't know and neither do you. All that is certain is that it only needs to happen once.

As an EMS provider, you have an absolute duty to act and behave as would a reasonable, prudent provider with the same level of training and experience, in the same area, and under similar circumstances. If you breach that duty and someone suffers damages as a result, you will be liable for negligence.

More simply, if you are running with your lights and siren without proper justification, and you hit something or someone, you are going to pay for it...and these days, the stakes have never been higher.

Review your agency's policies
Dispatchers, managers, and supervisors beware! Liability for unjustified lights and sirens is not limited to the driver. All too often, especially with private ambulance companies, dispatchers will direct crews to "upgrade" to lights and sirens in order to meet a quoted ETA. Surprisingly, it still is commonplace for private ambulance companies to send BLS ambulances with lights and sirens to skilled nursing facilities, urgent cares, and even hospitals in order to be there by the promised time.

More humorously, they often have ambulances respond with lights and sirens until they are a block or two away and then shut down so that they appear to arrive normally. In court, if you were telling the truth, it would sound something like this:

"Yes. I told them to run with their lights and sirens; at excessive speeds, against the flow of traffic, and through every stop sign and red light along the way... but Regional Hospital is an important contract and we promised that they would be there in thirty minutes. Yes, I realize that the patient was stable and that he was surrounded by skilled nurses and doctors. Yes, I realize he was only going back to the convalescent home. I didn't expect that they would hit that bicycle and kill that kid..."

In cases like that, the liability would likely shift from the driver, who is just following orders, to the individual dispatcher or manager or supervisor who sent them into harm's way. If your agency has such policies or procedures, I invite you to revisit them before someone gets hurt or killed and you end up homeless — or worse, in prison.

Treat lights and sirens like a tool
Whether you are the irresponsible dispatcher who sends an ambulance with lights and sirens for no good reason or you are the driver who does it on your own, liability for negligence is not limited to civil court, where all that is at stake is money.

If the act that causes the result is considered so unreasonable, so egregious, so appalling as to defy reason, then you can — and likely will — find yourself in criminal court facing charges of gross or criminal negligence for which the penalty could be time behind bars... and the loss of your money, the loss of your certification, the loss of your driver's license — and the loss of your life as you know it.

Just like a bandage, backboard, Oxygen, defibrillator, and countless other items, your lights and sirens are tools intended to care for and not harm others. However, they are only as helpful (or as harmful) as your decision on how to use them.

Recommended for you

Join the discussion

Get Paramedic Chief in your inbox

Thanks! You've been successfully signed up for the Paramedic Chief

Copyright © 2022 EMS1. All rights reserved.