When I Say Stay, I Mean It!


CarolinaFireJournal - Jonathan Olson
Jonathan Olson
08/07/2015 -

In the old west there was a code of honor that applied to the horse that was tied up outside of the local saloon — if it wasn’t yours, you left it alone. Today, the unfortunate reality is that the same code doesn’t always apply to our ambulances. Periodically, there are high profile stories in the news of ambulances not staying where we left them and an end result that none of us want to experience ourselves.

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Just this past May in Frazier Park, California, an EMS crew responded to a call. There was nothing that appeared to initially be out of the ordinary — just a run of the mill response. The female patient refused transport and, as the crew loaded their equipment back onto the rig, she approached wielding a knife and threatened the safety of the crew. In accordance with their policy, the crew rightfully removed themselves from the area of the threat, only to watch the lady enter their now unsecured truck and drive away. Several miles later, she collided head-on with a tractor-trailer truck at an estimated speed of 100 mph, killing herself along with the innocent driver of the other truck. Was this an isolated event? Was this merely one of those things that we can casually write off as “happening to someone else somewhere else?” Absolutely not.

Several years ago in Wake County, we experienced two such events, both of which had unfavorable outcomes. In the first event a patient at a local hospital, who was awaiting admission for a psychiatric emergency, eluded his caretaker and exited the hospital through the doors to the ambulance bays. An ambulance just happened to be innocently idling there while the crew was inside delivering their patient. The subject seized the opportunity to escape the facility by way of the unsecured and idling ambulance. Fortunately for us, his escape ended shortly thereafter as the truck attempted unsuccessfully to enter a parking deck. The only losses sustained were the damage to the ambulance and the sprinkler piping that it impacted.

It was a significant event, but more importantly this incident was a wake up moment for us in regards to the hazard that unattended — and often idling — trucks presented. In conversation with the ambulance vendor that we were using at the time, we started looking for a functional and practical solution. A relatively new technology designed to allow one to remove the ignition keys from a truck, while leaving it running and stationary, was adopted into the specifications for the next procurement. Unfortunately, the systemic implementation of this solution did not come fast enough.

Shortly thereafter, an EMS crew was dispatched to a convenient store for a subject that reportedly had a seizure. After getting the patient to sit on the cot for some additional assessment, the crew turned and was getting equipment from their portable bags when the patient bolted off the cot, out of the store, and into the driver’s seat of the ambulance. The patient quickly locked the doors as the crew attempted to restrain him and then proceeded to drive off recklessly from the scene. Less than a mile later, the vehicle left the roadway in a crash that resulted in a fatal injury to the driver.

While it was fortunate that no one else was injured or killed in the event, it again highlighted the need to implement measures to ensure that it was not again repeated.

The system that was implemented, when properly utilized, ensures that the truck remains where it is left, until such time as the EMS personnel are ready for it to move. Marketed by Sound Off Signal, this system interfaces with the OEM ignition system to allow the user to remove the key while leaving the unit idling. Should someone without the key attempt to move the vehicle by depressing the brake and/or attempting to engage the gear shift, the vehicle cuts off and remains in this state until time the proper key is reinserted and the engine restarted. The device can also be configured to engage the vehicle horn for audible notification of the situation.

It’s objective is clear — to make sure the vehicle remains where it is left, eliminating the drive off potential. A small investment for the peace of mind to avoid the scenarios described above. But the solution to the problem does not have to rely solely on technology. Good policy and procedures can act in place of the technology or in conjunction with such systems. A securely locked and running vehicle should yield the same peace of mind, but in the heat of the moment, vehicles often do not get properly locked. And locking the vehicle can often be a barrier to other responders retrieving equipment or supplies when they may not have the correct keys or fobs. And the mind-set of “we are just going to be right there” as a rationale for not locking a vehicle while on a scene can, and will, be a dangerous assumption.

For now, we must look seriously at implementing solutions that will address this problem from multiple directions. Such a feature as well is deserving of inclusion in the new Ground Vehicle Standard — a standard that is focused on creating reliable and safe ambulances for EMS in the United States.

One day soon advanced technology and connectivity will exist that can effortlessly manage these situations for EMS personnel that have more important things, like patients, to worry about. Imagine a system that will require driver authentication before engaging the transmission. You get behind the wheel and have some type of wireless interface to tell your “smart truck” that you are authorized to move the vehicle. Or a system where the vehicle’s on-board computer is interfaced with the computer aided dispatch system so that it won’t permit the transmission to engage until the vehicles status is changed to one that would logically assume it’s safe to move the vehicle. I have not yet heard of a case in which an ambulance was stolen that I can deduce the thief had the intellect to interface with the MDC or CAD to check en route to the hospital prior to driving off with the truck.

Or how about something even simpler that would give users, either remotely or through dispatch console electronics, the ability to “kill” a vehicle when commanded to do so. Imagine the scenario where you and your partner are inside a second floor apartment watching your truck pull away from the curb. You pull a wireless device from your hip, open the designated application, and press the big button on the screen. Seconds later, the truck automatically cuts off, the doors all lock, and law enforcement is automatically summoned to the GPS coordinates of the disabled vehicle — where the perpetrator is anxiously awaiting their arrival and before anything more serious has the opportunity to take place. Many components of such a solution are available today, but getting them all together into a single user-driven app are in the not too distant future.

But for today, we have to be smarter. We have to ensure that these mobile weapons of mass destruction are no longer available to be used in such a manner as the cases above illustrate. We have to be proactive to ensure that we are doing all that we can do to safeguard our employees, our community and our patients. Take the necessary measures today to make sure that you are not the owner of the next case to hit the media.

Jonathan Olson is the chief of operations for Wake County Emergency Medical Services and assistant fire chief with the Wendell Fire Department. He is a graduate of the NFA Executive Fire Officer program, has over 25 years of experience in EMS and fire operations, and is a co-author of “Management of Ambulance Services” by NEMSMA.
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Issue 33.3 | Winter 2018

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