RLS Syndrome

If I were to ask a layperson what they thought the greatest risk a firefighter faces, I am sure some of the answers would be: Being burned, falling off a ladder, caught in an explosion, lost in smoke, or even trapped by a building collapse.  Health conscience people would turn to the risks associated with cardio-vascular health and the stresses placed on the firefighter’s body as the major concern.  I imagine very few would even mention “responding to a call” as a dangerous activity.  The facts are clear that transportation accidents are one of the leading causes of death and serious injury among emergency responders, and it is the activity that takes place on every incident.  Today’s blog will address some of the reasons this activity presents such a risk.

The average citizen sees a fire engine roaring through traffic and dreams of the invincibility of carving, unobstructed, through rush hour, bypassing lines of stopped cars that pull aside to allow you to pass and disregarding pesky crimson signs and lights that require others to come to a stop.  Before I proceed, I need to dispel some misconceptions about man’s laws of the road and nature’s laws of physics. 

Fire engines are NOT permitted to disregard safety rules of the road while responding.  They may proceed past a stop signal ONLY when it has been deemed to do so safety.  They are required to maintain a safe speed which includes decreasing speed during adverse weather conditions.  Most importantly, they are often held responsible for mishaps that occur if they fail to respect these regulations.  From the scientific side of the analysis, a fire engine does not have “magic tires” that grip the road better than any other truck on the road, “super-braking powers” that allow them to stop quicker than other vehicles on the road of similar size, nor an “invisible force field” that protects them from the other vehicles on the road.  In fact, many fire department vehicles push the envelope of their designed weight rating because of the water and equipment they carry.  They are simply very bright, very loud versions of every other vehicle on the road. 

There are several other variables, however, that make these vehicles even more dangerous than others:

·         The skills and experience of the driver may not be very sharp.  Particularly in a volunteer department, where the driver of this 40,000 pound monster might be much more accustomed to driving his 3500 pound Honda Accord.

·         The driver may be focused on the details of the incident they are responding to and the urgency to arrive quickly due to on-scene reports of rapidly spreading fire, or victims in peril.

·         The unpredictability of what the other drivers on the road will do in their pathway.  For every 20 drivers that do the right thing, there will be one who makes a contradictory evasive maneuver.

·         Believe it or not, despite the flashing lights and the blaring siren, some drivers are oblivious to the approaching emergency vehicle due to loud stereos, well insulated vehicles, or driver distraction.

I have personally logged thousands of miles in the driver’s seat of an emergency vehicle during my career, and admittedly, my attitude toward maneuvering through traffic en route to an emergency has evolved over time.  I have had a few close calls, but fortunately have never unintentionally bent and metal because of my driving.  The one time I did, was with the permission of a county police officer, but I digress.  I have witnessed people do some crazy things in front of my fire truck, from driving over a curb to get out of my way, to slamming on the brakes and covering their eyes right in the middle of an intersection.  I always attempted to maintain what I call “smooth control” of my vehicle, whether I was driving a medic unit with a class 1 trauma patient in the back, a fire engine through suburbia, or a ladder truck through rush-hour “inside the beltway” traffic.  AWARENESS and CONTROL are the key words to safe response. 

Another portion of my career was spent in the “thinking chair”, more commonly referred to as the Officers Seat.  In this position, you share the responsibility of safe operation of the vehicle through your awareness, but unfortunately have zero control over the operation of the rig.  Believe me, there were more than a few times I stomped on the imaginary brake pedal on the right side of the fire engine cab.  That is the seat where your only control is the ability to coach the driver through a safe response by maintaining a calm atmosphere, and a focused attention on the road conditions.  This is an impossible task if the operator of the rig is experiencing an attack of RLS syndrome.

RLS, or “Red Lights & Siren” syndrome can occur with any emergency driver from time to time.  I admit there were times when I believed that my siren and air horns had the power to move cars out of my path, and I know there were times where I was thinking about everything except the road when I was en route to an incident.  Every driver is susceptible to RLS, and some suffer from it repeatedly.  It is a period of perceived invincibility, where poor judgment reigns supreme, and tunnel vision closes in tight.  It is dangerous, and it can be deadly.

Until scientists develop a vaccine, RLS syndrome must be controlled through diligent screening of potential operators, repetitive training and practice of driving skills, established standard department guidelines regarding vehicle operation, and respectful rapport development between drivers and officers alike.