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Adverse Conditions & Crashing (Doing it right)
Collision Avoidance
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Adverse Conditions
Most ambulance crashes happen on bright sunny days. Clear skies, dry roadsEMS Drivers get overconfident
Let their guard down
Drivers don’t see lights in daylight
With windows up, radio on, and AC blowing,
may not hear sirens
Just not expecting to see you
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Murphy Law
Anybody who drives will drive in adverse conditions
EMS people are guaranteed to get stuck in them, often!!!
With experience and confidenceOnly another professional challenge
Challenge is in tackling a dangerous situation, Mountain climber, skydiver…
Can be rewarding
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Before entering into the dark and stormy night
Do everything to keep the odds in your favor
Windshield - clean, Inside and Out
Washer fluid
Rain X, etc.
Wipers - Get what you pay for
Will wear out with ice, snow and heat
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Before entering into the dark and stormy night
Defogger / Air conditioner
A/C in humid weather
Bug Screens
ECNALUBMA sign
Headlights
Mud collectors (Clean ‘em)
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OK, NOW GET READY TO
ENTER THE
AFOREMENTIONED
NIGHT
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Check yourself out, NOT LIKE THAT!!!
Are you overtired, drunk, healthy, rested?Are you relaxed?
Nervous drivers will pull themselves close to
the steering wheel
Relax, smoother movements and better control
Light grip on the wheel
Speed easier to control and not get disillusioned.
Visual Habits will be consistent
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Now the DARK part of that stormy night.
30% of crashes happen at night, 47% of fatal crashes at nightThe EYE
2 receptorsRODS - night vision, shades of gray, periphery of the retinaCONES – daylight, centrally located, color sensitive,
Vitamin A trivia ( RODS are made up of Vit A attached to
protein. Light source will cause the 2 to separate and a
period of blindness. Vitamin A is metabolized in the Liver,
same as Alcohol. Liver likes booze more than it likes
Vitamins. If drunk, more susceptible at night to being
almost completely blind among other things.
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Guidelines for night driving
Keep in mind the principle of the eyeMany people who use good visual habits
during the daytime do not at nightNot as stimulated, will stare straight ahead
instead of scanningBlind spots may be right in front of youContinuously scan, looking for variations of
gray
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Guidelines for night drivingBe resourceful
Look beyond your headlights for shades.Use front vehicle’s headlights, illuminating
the roadway further aheadLight doesn’t bend
Curves more hazardous at night.
Depth perception is distortedTruck pulling out will be difficult to judge speed
and distance
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To Maintain Night Vision
One bright light might take 30 minutes to recover fromAvoid looking at bright lights
Driver ed recovery testLook at the white line on road edgeCity intersections on mostly dark roads trash
night visionDashboard lights, Interior lightsRed light discussion
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To Maintain Night Vision
May need to FLASH high beams to get oncoming driver to lower theirs
500 feet oncoming, 300 feet behind
Dim high beams before a right hand turn
DO NOT RETURN FIRE
Lights in the trees, or on the road edge, guardrails
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Dangers of Twilight
1/3 MVC’s occur from 4-8 pm1/4 off all fatalities1/3 of all pedestrian accidents
Children are twice as likely to be hit during twilight
24-30 minutes of twilight twice a dayMorning, vision is continuously improvingEvening much worse, eyes are switching
from cones to rods
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Dangers of Twilight
Not going gently into that good nightEyes cannot adjust as fast as the
conditions are changingHighways are most crowded
Drivers tired, anxious to get home and visibility at it’s worst
Become irritated and make rash decisions
Known as “Twilight Narcosis”
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Driving in twilight
Use sun visor as much as possibleAngle towards the windshield, in the event of a
crash
SunglassesDon’t forget to take them off
HeadlightsParking lights only; forget to turn on the headlights
laterHighbeams will not help and will hurt others
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Fog
Magnifying effect on objects
Objects at 15 yards appeared to be 30 yards
Slow down
Use low beams only
No headlights if fog lights are properly
positioned
Amber fog lights, reflects less
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Fog
Emergency lights and sirens will only be
confusing and nauseating
Reflects back and will cause vertigo for the
people in front
The siren will be refracted in all directions
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Impaired traction
Rain, so common, most don’t give it respect it deserves
6 times as many people killed on rain slicked
streets than on snow and ice
Most dangerous immediately after rain starts
Oils rise to the surface and are not washed
away yet
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Standing water review
Puddles
If both front tires hit, entire vehicle will shift
off crown of the road
Only one side hits, vehicle pulled in that
direction
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Brakes
Soaked brakes have to be dried to work
well
One side gets wet, vehicle will pull to the
dry side
Left foot on brake while driving to dry
them
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Leaves
Avoid them
Slippery
May be hiding kids’ toys, sometimes
kids
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Ice
Can increase stopping distance X three, really mess up cornering
Shaded areas highly suspectMovements deliberate and slow
Gentle acceleration, decelerationRelease gas pedal slowlyDisengage transmission while coming to a stop
This will keep the front brakes and the rear tires from fighting
HillsDon’t stop if at all possible
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Maximizing TractionFull tank of gas (weight)
Sand and salt thrown to the side
Drive slightly off center
E-brake when pulling away from a stop
Limited slip differentials
Neutral while stopped at a light.
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StatisticsAmerican Ambulance Association reports
Common causes of Ambulance crashesFollowing too closelyFailure to use siren and/or lights appropriatelyFailure to use care in intersectionsDriving left of center line without reasonable notice
to other trafficDriving too fast for conditionsImproper backing or parkingFailure to set parking brake at sceneImproper passing techniqueU-turnsEmergency braking and acceleration
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Get Ready to CrashPre-crash planning
Always lock the doors, will withstand much more strain
Keep equipment securedOxygen bottles Lifepack secured to counter topSuction deviceBackboardsMed bags/boxesCabinets, closed & latchedFire extinguishers
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Get Ready to Crash
What do you hear? Find it and fix it!!!
Patients properly secured to gurney
Family members belted in front
EMT fastened in, if possible
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Practice Crash Planning and Develop Crash Habits
You should have a plan (SIPDE) (Scan, Identify, Predict, Decide, Execute)
Includes the best way to crash
Knowing how to crash will minimize
property loss and injury
What will I do if…????
Keep track of escape routes
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Actions to Avoid a Collision
BrakingMost commonly used
Driver Ed train track storyNot always the best optionProper braking must be usedLocking brakes will increase stopping distanceMost trucks have ABS
Maximum braking must be practiced in a controlled setting to get good at it
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Actions to Avoid a Collision
Acceleration
Person on a collision course for you!
Braking might be the wrong action
Steering away and accelerating might avoid
the collision
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Actions We Can Take to Avoid a Collision
Steering Away
Bend the vehicle from it’s original path.
Many are afraid to make quick moves
The inability of many drivers to swerve is the cause
of many accidents
Braking is instinctive, it will cause problems.
Upsets the weight distribution balance and stability
Look away from the collision and look where you
want to go.
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Off the Roadway Is an Option
Path of least resistanceGetting the ambulance dirty and stuck in the
mud is far better than a collision.
Drive all the way to a stop.No hands in the airNo eyes closedNo paralysisLoss of bladder and bowel function, BAD
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Off the Roadway Is an Option
If off of the road towards an embankment
Do not drive on an embankment, likely to
lead to a rollover
Turn more and point the front of the vehicle
down the hill
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When a Collision Is Unavoidable…
Choose the best angle to hitA head-on collision must be avoided!!!
2 vehicles going 55mph = 110 mphCertain recipe for death
If driver is in your lane Take the open oncoming lane, orIf/when the oncoming driver realizes they are in
the wrong lane, they will abruptly jerk back into their lane
Depends on the condition of the road, shoulder, visibility, obstacles
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When a Collision Is Unavoidable…
Identify objects that are impact absorbingConcrete bridge abutments are BADBuildings are BADBig trees are BADPower poles are bad too, better than a tree
of the same diameter
If you must hit, try to sideswipe instead of ramming, it will certainly win
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Standing Outside of the Smoldering Wreckage
Post crashOUT OF SERVICE
2nd unit dispatched to your initial call
Request policeCheck all ambulance occupantsNow in triage mode
All involved must have a primary survey before treatment begins
Request additional units
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Standing Outside of the Smoldering Wreckage
Non medical responsibilities Warning flares or triangles Driver license information
Registration numbers Insurance info
Assess vehicle damages Never admit fault or apologize
Police and accident investigators determine fault May have been circumstances you didn’t know Make comments only to officer in charge
Identify witness Names, numbers and comments on what they saw
Diagram the scene
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Standing Outside of the Smoldering Wreckage
Agency will typically do a case review of there own
Some units have tachographs
Review board will meet
Be ready for court
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Vehicle Malfunction
Even with careful inspections and routine maintenanceStuff happens
Tire blowoutNot as common anymore to have a blowout
(flats more common and slower process)Hold wheel firmly, minimal steering, just
maintain lane position, let vehicle slow itself, stay off brakes
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Vehicle MalfunctionBrake failure
Pump brakes a few timesDownshiftE-brake is not hydraulic
Not as efficient, will take longer to slow
Steering failureUsually result of engine stalling
Can usually still turn wheel, slower with more effort
Hood flies upLook through gap in windshieldLean head out window, maneuver to road edge
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THE END