Q&A - Code 3 Driving Question

ambulanceWithin the BCEHS (bc ambulance service) our communications system has become staffed with new, non medically trained personell that use a computer system to triage calls. Due to many reasons we're being sent "code 3" (emergency driving mode) for calls that are at times ludicrous. For example I was sent in an emergency mode for a patient in a care home that had a fall 10 days ago and was now going to get x rays done in the local emergency ward.

Because of these kinds of calls, many of us are no longer going in an emergency mode to calls we're suspicious of being low priority calls mis-triaged and others whose comments added to the file leave serious doubt as to the urgency. Because of this, we're being threatened with insubordination, non compliance etc.

I was reading section 122 of the Act and specifically section 5:

Emergency response by a person other than a peace officer

5  (1) When a person other than a peace officer operates an emergency vehicle, the person may exercise the privileges granted by section 122 (1) of the Motor Vehicle Act if the person operates the following emergency equipment, as applicable:

(i) in the exercise of privileges described in section 122 (1) (a) to (c) of the Motor Vehicle Act, an emergency light and siren;

(ii) in the exercise of privileges described in section 122 (1) (d) of the Motor Vehicle Act, an emergency light or an emergency light and siren.

(2) When a person other than a peace officer operates an emergency vehicle, the person may exercise the privileges granted by section 122 (1) of the Motor Vehicle Act if the person has reasonable grounds to believe that the risk of harm to members of the public from the exercise of those privileges is less than the risk of harm to members of the public should those privileges not be exercised.

(3) In considering whether there are reasonable grounds under subsections (2), the driver of an emergency vehicle must consider the factors described in section 3 (2).

I interpret that (2) is clear that the operator (driver) needs REASONABLE grounds or they CANNOT proceed in an emergency manner or mode.

Is it also correct the the ultimate responsibilty and decision of the operation and mode of driving lies with the driver?

Sadly, I do not believe this has ever been questioned let alone challenged before; just those paramedics not going in an emergency mode to a call tagged as one were disciplined. I want to ensure I'm driving my unit in a lawful, safe and appropriate mode with ALL information given to me; BCEHS policy cannot trump provincial laws.

Comments

How do you know before arrival that the call isn't a Code 3?

When I hear that from an ambulance driver that "many of us are no longer going in an emergency mode to calls we're suspicious of being low priority calls mis-triaged and others whose comments added to the file leave serious doubt as to the urgency" it  makes me wonder what you're doing in that job, and what your priorities are.

Certainly errors may be made by personnel using a computerized system to triage calls.  In which case, complaints should be made to the authorities that they're responsible to, and retraining provided if necessary.  Nobody wants ambulances charging all over the place in emergency mode for what are actually low priority situations.

But trying to second guess the dispatchers is insubordinate behaviour, and disciplinary action should result.  And if a driver has been provided with a Code 3, that's an instruction as well as an authorization to drive according to the MVA Section 122 Exemption for Emergency Vehicles.

I had always thought that paramedics were dedicated professionals, who would put patient care ahead of petty politics, with the discipline to follow instructions given to them.  But you seem to think that the lunatics should be running the asylum!

Answer

911labrat has quoted directly from the regulation referred to by Section 122. It puts a finer interpretation on the blanket authorization granted in 122. He is quite correct that reasonable grounds are required to operate in code 3 mode and if he does not have them, he cannot legally do so.

Reasonable grounds amounts to presenting the circumstances to an average person and having them reach a common conclusion based on those facts. It does give a fairly wide latitude of action.

I sympathize with this person, especially if they work in an area of high traffic volume such as the Lower Mainland. It is dangerous to operate code 3 for both the ambulance and the other drivers on the highway. The lights and siren do not magically and safely "part the waters." On the other hand, of course I would want the ambulance there as quickly as possible if I needed it.

Liability is a great concern these days too. We are taught how to operate our emergency vehicle and told all about the laws that govern its use. I no longer have great confidence in the "system" protecting me if I make an error. Rather I fear being told "You knew that you could not do that! You're on your own, good luck..." Now what? You know you are supposed to do your job, you know that guidelines allow (and I specifically choose the word allow over authorize) you to operate code 3, but you doubt that this is a bona fide emergency. I would say you don't have the necessary reasonable grounds to operate code 3.

Now, there is nothing stopping you from trying to get there in the best time possible without taking risks, for yourself or others as long as your reasonable grounds are reasonable in general.

The authority experiment

This poster seems to strongly suspect that the urgency is mis-stated.



65% of people would act on the direction of authority when they are almost certain that the direction is no good.

I think everyone should know about the Milgram experiment.

informed legal choices vs just following orders

Thank you for your feed back Drivesmart, I apprieciate your take on the legalities of the application of the Act and will forward it on.

Paramedics (ambulance drivers to Competent) are dedicated professionals concerned with our safety, public safety and patient care. Safety and legality are not "petty politics" as Competent erroneously assumes.

There used to be a time when we didn't question driving code 3, but the changes in our communications system (staffing, training, experience, managment etc) and the comments added to our mobile data heads by the dispatchers puts many of these emergency responses into serious question.

How dare I question the non medically trained, semi automated dispatcher? How dare I question the legality of the application/authorization of the Act from this automated system strife with human and computer errors? "Just following orders" isn't a valid excuse. One wrong click of a mouse and the call goes from a routine one to a code 3, send two EMS units and a 50 tonne fire truck. I used to also be a medically trained dispatcher and know how the system (used to) and is supposed to work. It is failing badly.

Competent asks how do I know some calls don't meet the requirements in the Act to drive code 3? Here are real additional comments from mobile data heads:"fall 10 days ago, going for xrays, no priority symptoms (currently in a care home)"; "ran out of beer"; "depressed, sad, doesn't want to go to hospital, just wants to talk", "sore ankle for 3 days". Does this give me reasonable grounds to drive in an emergency mode as defined in the Act? I argue it does not despite being tagged as code 3 by the "ACE accredited" dispatch system.

I've been subpoenaed to a number of court cases involving motor vehicle accidents over the years and know I'd never want to be the accused trying to defend my actions.
I've seen fellow Paramedics go to court over incidences while driving code 3; it was hell for them, dragged through a long, ugly process without any legal or financial support from their employer until after they were proven not guilty. I wouldn't wish that on my worst enemy.

Competent believes that disciplinary action should result by us questioning the appropriateness and legality of some code 3 responses. Attitudes and assumption like that make them a strong candidate for one of our excluded supervisory positions. If they're not already one, please apply as they've fired a number and are always looking for more to fill the revolving door of managers in our struggling EMS system. 

There is a lot of literature available regarding studies of time saved by emergency driving vs routine driving, as well as statistics on the increased risks of accidents (direct and wake) while driving in an emergency mode. One would find these studies very suprising as little if any time is saved and that the risk of collision is higher regardless of speed.

I need to be clear here, no one is needlessly delaying any calls, just simply driving appropriately and safely with all information given to them. There are many calls where there is no question whatsoever about arriving as quickly and safely as possible.

Numerous ongoing complaints have been made but the system is reluctant to change (bogged down in politics, expenses, ignorance, etc); thanks for the tip. The lunatics have been running the asylum for years, some even with fancy degrees.  It's the government and we all know how fast and effective they are at making changes.

If anyone knows anything about government bureaucracy, their policies are most often based on reactive measures versus proactive; often as a result of negative legal action. I do not want to be that canary that causes a belated policy change. I do however want to know my legal obligations under the Act to make safe, informed legal choices for the safety of myself, my partner and the public I serve.

I've been a paramedic a long time and take immense pride not only helping those in need, but instructing, guiding and mentoring those new into the profession, with both clinical application of skills as well as driving instruction and assessment. This involves making informed, safe, patient focused, decisions both at the scene and on the public roads we travel on.
 

informed legal choices vs just following orders

Thank you for your feed back Drivesmart, I apprieciate your take on the legalities of the application of the Act and will forward it on.

Paramedics (ambulance drivers to Competent) are dedicated professionals concerned with our safety, public safety and patient care. Safety and legality are not "petty politics" as Competent erroneously assumes.

There used to be a time when we didn't question driving code 3, but the changes in our communications system (staffing, training, experience, managment etc) and the comments added to our mobile data heads by the dispatchers puts many of these emergency responses into serious question.

How dare I question the non medically trained, semi automated dispatcher? How dare I question the legality of the application/authorization of the Act from this automated system strife with human and computer errors? "Just following orders" isn't a valid excuse. One wrong click of a mouse and the call goes from a routine one to a code 3, send two EMS units and a 50 tonne fire truck. I used to also be a medically trained dispatcher and know how the system (used to) and is supposed to work. It is failing badly.

Competent asks how do I know some calls don't meet the requirements in the Act to drive code 3? Here are real additional comments from mobile data heads:"fall 10 days ago, going for xrays, no priority symptoms (currently in a care home)"; "ran out of beer"; "depressed, sad, doesn't want to go to hospital, just wants to talk", "sore ankle for 3 days". Does this give me reasonable grounds to drive in an emergency mode as defined in the Act? I argue it does not despite being tagged as code 3 by the "ACE accredited" dispatch system.

I've been subpoenaed to a number of court cases involving motor vehicle accidents over the years and know I'd never want to be the accused trying to defend my actions.
I've seen fellow Paramedics go to court over incidences while driving code 3; it was hell for them, dragged through a long, ugly process without any legal or financial support from their employer until after they were proven not guilty. I wouldn't wish that on my worst enemy.

Competent believes that disciplinary action should result by us questioning the appropriateness and legality of some code 3 responses. Attitudes and assumption like that make them a strong candidate for one of our excluded supervisory positions. If they're not already one, please apply as they've fired a number and are always looking for more to fill the revolving door of managers in our struggling EMS system. 

There is a lot of literature available regarding studies of time saved by emergency driving vs routine driving, as well as statistics on the increased risks of accidents (direct and wake) while driving in an emergency mode. One would find these studies very suprising as little if any time is saved and that the risk of collision is higher regardless of speed.

I need to be clear here, no one is needlessly delaying any calls, just simply driving appropriately and safely with all information given to them. There are many calls where there is no question whatsoever about arriving as quickly and safely as possible.

Numerous ongoing complaints have been made but the system is reluctant to change (bogged down in politics, expenses, ignorance, etc); thanks for the tip. The lunatics have been running the asylum for years, some even with fancy degrees.  It's the government and we all know how fast and effective they are at making changes.

If anyone knows anything about government bureaucracy, their policies are most often based on reactive measures versus proactive; often as a result of negative legal action. I do not want to be that canary that causes a belated policy change. I do however want to know my legal obligations under the Act to make safe, informed legal choices for the safety of myself, my partner and the public I serve.

I've been a paramedic a long time and take immense pride not only helping those in need, but instructing, guiding and mentoring those new into the profession, with both clinical application of skills as well as driving instruction and assessment. This involves making informed, safe, patient focused, decisions both at the scene and on the public roads we travel on.
 

Google Ads