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Niagara EMS leading in international policy on the use of lights and siren

‚ÄčNiagara Emergency Medical Services (Niagara EMS) Chief Kevin Smith and Deputy Chief Rick Ferron have been working with a group of leaders from various first-responder agencies across North America on the use of ambulance lights and siren (L&S).
A joint statement on Lights & Siren Vehicle Operations on Emergency Medical Services (EMS) Responses was released on Feb. 14, 2022 from 14 North American EMS organizations.
The National EMS Quality Alliance (NEMSQA) has started a quality improvement partnership project including more than 100 EMS services, with Niagara EMS as a lead agency on the initiative.
In the United States in 2009, there were 1,579 ambulance crash injuries, and most EMS crashes occur when driving with L&S. When compared with other similar-sized vehicles, ambulance crashes are more often at intersections, more often at traffic signals, and more often with multiple injuries; including 84 per cent involving three or more people.
In most settings, L&S response saves an average of about one minute during an emergency medical response or transport to a hospital. Given the risks to patients, paramedics and the public, it is up to EMS organizations to ensure that they are used for true time-sensitive medical emergencies where that short time makes the difference between life and death.
In 2019, Niagara EMS significantly revised policies for lights and siren use, limiting their use to responses where they are required to critical responses only. These time-sensitive emergencies, which account for less than 10 per cent of all EMS responses in Niagara, are best identified by using a high-quality medical call prioritization system. Combined with an evidence-based Clinical Response Plan, emergency resources can be used with the appropriate level of response. As a part of this quality improvement project, in the coming months Niagara EMS will be exploring further opportunities to minimize lights and siren use not only to a scene, but on the way to the hospital as well.


"Niagara EMS has transformed from a strictly time-based response system to one that provides the right care, at the right time, in the right place and by the right provider. Making sure ambulance warning systems are used for true emergency situations where minutes will make a difference in the clinical outcome of a patient, provides a balance of safety for the community and responders. Niagara EMS is proud to operate an advanced paramedic service that can make these improvements locally and contribute to this change in practice and EMS culture internationally."
~ Kevin Smith, Niagara EMS Chief

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Bryce Brunarski
Niagara EMS

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