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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