Safety on the Road when Responding to an Emergency Call

 With so much crime and road crashes across our country 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?

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 emt 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 our 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 EMTS are trained in EVOC (Emergency Vehicle Operation Course) This is an internal course that provides basic training in response driving to our Emts. 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.

Mitigation includes:

• Approaching the intersection with caution.
• Driving with headlights on.
• Changing the tone of the siren.
• Coming to a complete stop and checking of vehicles.
• EMTS 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 EMTS 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 EMTS 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 KENYA are not always up to standard with many roads having potholes. This can challenge the EMTS 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 EMTS 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 kenyans 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 give us hard time 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 vehicles 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 Afric