Lights and Sirens – How Often Does It Help?

Written by Clay Smith

Spoon Feed
Most 911 calls used lights and sirens to respond, but just a small percentage received a potential life-saving intervention (PLSI), which suggests that a more selective approach may be better and possibly safer.

Why does this matter?
Use of lights and sirens is associated with an increased risk of crashes. But it may reduce transport time by 1.5 minutes (urban) to 3.6 minutes (rural). Select clinical situations may warrant this risk. This paper was an analysis trying to get at the appropriateness of light and siren use by determining how often a PLSI was performed after light and siren traffic.

“Turn on your [red] lights…so pretty!” (anyone know this song?)
This was a retrospective look at a national EMS electronic health record database that included nearly 6 million 911 calls in 2018. The majority used lights and sirens – 85.8%. Even with a generous definition of PLSI – which included 42 interventions, such as medications, critical hospital notifications, as well as STEMI, stroke, sepsis, and trauma alerts – these interventions were performed in just 6.9% of calls. The authors checked to see if lights and sirens to the scene may have reduced the need for PLSI but found, on sensitivity analysis, the opposite; “The rate of PLSI actually trended downward with increasing response time, suggesting that any time saved with the use of [lights/sirens] did not mitigate the use of PLSI.” There is a risk vs benefit tradeoff. There are a few clinical scenarios in which lights and sirens could make an impact on outcome, but this study suggests that it should likely be used more selectively.

Source
Using Red Lights and Sirens for Emergency Ambulance Response: How Often Are Potentially Life-Saving Interventions Performed? Prehosp Emerg Care. 2020 Aug 7:1-7. doi: 10.1080/10903127.2020.1797963. Online ahead of print.

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