One of the common concerns for new graduates and students is – “how do I improve my driving without exposure to cases?” Honestly the best experience is to get behind the wheel and drive to actual cases, however as with other paramedic skills there are opportunities to train. In this article we’ll discuss some of the changes you can make in your every day civilian driving which will improve your driving on shift.
First, some caveats: do not read any of this as suggesting you should break the road rules. Road rules exist to keep all road users safe and keep the roads orderly. Although they do not apply to emergency vehicles operating under lights and sirens conditions in Victoria, you should not practice driving illegally. Secondly its important to realize that during lights and sirens (Code 1) driving, achieving a high speed is not the goal. Driving at high speed increases risk and severity of collisions, plus it makes very little difference to your travel time. Below we’ll discuss the best ways to reduce time whilst driving.
Element 1 – Ensure your vehicle is fit to respond
In the same way as you check your oxygen and other equipment at the start of shift, its important to check your ambulance. Assess the outside for damage, check the fuel level, test the lights/sirens/horn and adjust the seat/mirrors at the start of shift.
Rationale: by preparing the vehicle beforehand you can immediately respond to a case
Practice Point: check your personal vehicle at the start of the day. Whilst the seat and mirrors will already be suitable for you, when was the last time you checked the oil? Aim to keep your personal car more the 3/4 full of fuel. Ensure regular servicing and fix faults immediately.
Element 2 – Ensure you are fit to respond
We know that you can’t drink and drive, but what about other elements? Are you hungry, fatigued or frustrated? These do not make for good driving. Particularly fatigue, where being awake more than 17 hours can equate to a blood alcohol of 0.05 (the legal limit). Whilst long shifts are unavoidable, preparing yourself before shift with adequate rest, nutrition and hydration is important.
Rationale: tired, hungry and unwell paramedics are more prone to collisions due to poor decision making and blunted reaction time
Practice Point: aim to get at least 7 hours sleep before driving. Maintain adequate hydration, eat nutritious food and know your limits.
Element 3 – Position your vehicle for easy egress
A common trait of paramedics is that we reverse in everywhere. Many people loathe reversing into parking spaces, so why do we do it? Firstly it is safer to reverse in and drive straight out than the other way around. But also it allows us to quickly and easily depart for a case. Positioning your vehicle in the direction you plan on heading when your return (what I refer to as orientating out) means you are not fighting against traffic and can leave immediately.
Rationale: orientating out reduces the risk of collision, allows rapid egress and is an overall smoother ride for vehicle occupants
Practice Point: start reversing your car wherever you park. I cannot overstate this – its the single biggest piece of driving advice I can give you. If you can reverse a car, you can reverse an ambulance. In addition, consider parking smart – the closest parking spot to your destination isn’t always the best one. If you’re parking in a court, consider parking on the side of the road facing out of the court. Practice these techniques in your own car so they become second nature on the job.
Element 4 – Be ready to respond
Earlier I mentioned that achieving high speeds isn’t really helpful to get us to cases quickly. Think about the impatient driver you see overtaking everyone, just to get stuck at the red traffic light with everyone else. However one area where paramedics do make a significant impact is in getting to the vehicle quickly. Responding to radio call, moving to the vehicle and departing for the job quickly is very different to finding your radio, finishing your coffee and wandering out to the truck.
Rationale: quick turnout time from branch is completely within the control of paramedics, unlike traffic and other factors.
Practice Point: have your keys, wallet, phone etc in a suitable place you can grab them quickly. Empty your bladder regularly, rather than waiting until its time to go out.
Element 5 – Read the traffic and look well ahead
Now we’re actually behind the wheel, its important to drive smart rather than fast. We talk about progressive driving – that is being assertive and moving with the flow of traffic, rather than driving fast. In fact driving fast reduces your margin for error, forcing you to focus on whats immediately ahead of you. This leads to sudden braking, lane changes and collisions. As a general rule you always want to be able to see five seconds ahead of you, that is, be able to see where your vehicle will be five seconds from now. This gives you plenty of time to make adjustments and avoid being surprised.
Can’t see five seconds ahead? You’re going too fast
Rationale: you can’t avoid collisions you can’t see coming. Scanning well ahead, seeing hazards and threats before they impact you, then making small adjustments early – this leads to a smooth, expedient drive
Practice Point: consider how far ahead you can see when driving. Aim for five seconds, and if you can’t see that far – you’re going too fast. Consider which lanes are moving faster, look for cues people are going to change lanes. Practice scanning the road ahead and behind.
Element 6 – Navigate traffic obstacles smoothly and smartly
We mentioned that getting into the vehicle quickly and reading the road improve response times – the other key element of Code 1 driving is navigating traffic obstacles efficiently. In order to do this we first have to identify the hazard well in advance. Once we’ve seen the hazard, we identify if there is any threat. Compare a multi-lane road with freely flowing traffic and a green light, versus a single lane in each direction and several cars stopped at a red light. Obviously these will require different approaches. Whilst this article won’t provide specifics on navigating each different traffic situation, some general principles apply.
- Make yourself as obvious as possible. This includes use of lights and sirens, as well as positioning the vehicle in a way that maximises visibility
- Approach slowly and plan your approach. Will you use a turning lane? Travel on the wrong side of the road (contraflow)? Will you wait for the red light to change?
- As a general rule the more unusual/unexpected a maneuver you are performing, the slower you should do it. For example you can travel down a turning lane at close to normal speed, but traveling contraflow should be done at a very slow speed
- Slow down to move fast. Slow is safe -> safe is smooth -> smooth is fast.
Rationale: navigating obstacles in a thoughtful manner is safest for paramedics and the most efficient method
Practice Point: do not attempt in your personal vehicle. But whilst you are sitting in traffic, consider how you would traverse it in an ambulance under Code 1 conditions. Think about how fast you would travel, what route you would take and where potential threats could come from.
Bottom Line
Driving is a basic skill of adulthood, but most drivers have an over-inflated confidence around their abilities. Paramedics are required to be professional drivers, making allowances for the poor driving of others. Although your induction into an ambulance service will include driver training, this article lists some basic practice points you can start today which will improve the safety of your colleagues, your patients and yourself. Safe driving.
Reference: Ambulance Victoria Low Risk Driving Model
