If you need to make your way through a crowded room, saying things like "excuse me" and "make way" will generally clear a path. The more urgent the need to get through, the louder the person says "make way" and the faster the path opens. That's pretty much the basis of running lights and sirens on apparatus and ambulances: make a lot of commotion and folks scatter.

Yet the dynamics of pushing a stretcher through an airport is worlds apart from hurling tons of iron into an intersection. There's no shortage of anecdotal evidence of how dangerous it is driving emergency vehicles. And statistically, vehicle crashes are the second-leading cause of firefighter deaths.

St. Louis Chief Dennis Jenkerson knows just how wrong things can go while responding to a scene. Last August two of the department's apparatus collided at an intersection while responding to a fire; both were running with lights and sirens. The problem in that case was that the intersection was the scene of the fire, and both drivers were looking for the best place to position the rig and not watching for cross traffic. Compounding matters were reports of trapped people and a traffic signal control system that didn't handle the competing signal changes.

"It was bad," Jenkerson says. "On film, everything pointed the finger at us, which it should have. We also have police responding on these calls and they are running lights and sirens. I would hate to see a fire truck hit a police car."

As dramatic as incidents like this are, they are still the exception to the rule. Billy Goldfeder is deputy chief of the Loveland-Symmes (Ohio) Fire Department, an EFO, chair of the International Association of Fire Chief's Safety, Health and Survival Section, and probably the nation's most-informed person when it comes to firefighter deaths and injuries. He says that when you remove emotion from the equation, the overall report card for the fire industry regarding apparatus crashes is very good.

"The fact is that in the millions of runs that fire departments do everyday, in the great majority of cases, we are doing fine," Goldfeder says. "We are not crashing on a daily basis. There are 1.1 million firefighters in the United States and there are 30 or so fatal crashes per year."

However, Goldfeder says vehicular deaths are the most preventable of all the ways firefighters die. "We need to slow down, put our seatbelts on, stop at stop signs and red lights, and we'll pretty much wipe that [death category] out," he says. "There are a couple of line-of-duty deaths each year where everything was done right. If you are doing everything right and a vehicle slams into yours, there's nothing you can do about it. [But] almost all of our vehicular line-of-duty deaths were preventable. Overall, the class is doing well. But some people are wearing dunce caps and we need to deal with those problems."

Several chiefs believe running lights and sirens contribute to these accidents.

"I'm not sure there is any research that will substantiate it, but in many cases, it will increase [drivers'] adrenalin," says Jeff Lindsey, a retired fire chief and currently the director of graduate studies at George Washington University. He co-authored a book on emergency-vehicle operations and wrote his Ph.D. dissertation on the use of simulation in emergency-vehicle driver training. One thing the statistics do bear out is that it is not the new drivers getting in the collisions.

"We looked at it and it was the individuals with five to 15 years of experience who were involved in most of the incidents," Lindsey says. Near the beginning of their careers, drivers are more cautions. Later, he says, they develop a halo effect where they believe nothing bad can happen to them in their bubble.

The National Fire Protection Association offers some guidelines in NFPA 1500, Chapter six. What it largely says is that all drivers are responsible for operating the apparatus safely and that departments need to establish policies on how that operation is conducted. It does say that an apparatus should not roll until all passengers are seated and buckled in with seatbelts. It also gives eight scenarios when a complete stop is needed.

Goldfeder places less emphasis on lights and sirens and more on training and responsibility. It comes down to risk management, he says. He says departments need to develop a driving policy, train their drivers both in class and in the rig on that policy, have supervisors in place to enforce the policy, and use corrective actions when the policy is broken. He also says it is important for the driver to have the discipline or restraint to understand and follow the policy.

"We can't control what happens outside the cab, but we totally control what happens inside the cab," Goldfeder says.

And what's happening outside the cab is that passenger vehicles are getting more soundproof and have more gadgetry to distract drivers from driving. Another problem is the effectiveness of lights and sirens. Sirencide, Lindsey says, is when an emergency vehicle is driving too fast for the siren to be heard — that's about 60 mph on the highway. It is a similar effect to driving faster than the headlights' reach; the siren becomes useless. Lindsey says for highway travel, it is best to run with no lights and sirens and simply go with traffic. In an urban setting, he says, the siren reverberates so much off buildings that motorists become confused about the siren's direction.

Common sense says that the proverbial cat in the tree or the lift and assist are not emergencies. So some departments have stopped treating them as such.

Jenkerson's department has been running what it calls "on the quiet" for about 10 years. Running on the quiet is no lights, no sirens and obeying all traffic laws. It basically works like this: St. Louis dispatchers categorize a call based on the information they get and some predetermined conditions. The call can be pegged as urgent or quiet. If the emergency is questionable, such as an alarm in a high-rise with no other calls, the first-in company runs urgent and the other two run quiet. If more information comes into dispatch while the companies are en route or if the first-in company sees smoke, the call is upgraded. Jenkerson says about 25% of the city's 100,000 fire calls per year are on the quiet.

Jenkerson says the difference in response time is less than two minutes when running lights and sirens versus driving with traffic. During the first two or three years of the program, collisions involving apparatus declined. But now that the policy is the norm, that decline has leveled off.

One unexpected effect of the policy in St. Louis has been the number of trash can fires. "Some of the people who were starting these fires got a bigger kick out of the lights and sirens than they did the fire," Jenkerson says. "Their thrill wasn't the thrill of the arson, like most people thought … it was the excitement of all the firemen coming." When the urgency dropped, so too did the number of those fires.

Ann Arundel County, Md., just south of Baltimore has 510,000 people living across 460 square miles, 500 of which are linear miles of coastline. In 2006, its combination fire department adopted a "hot, warm, cold" policy where either all units run lights and sirens, the first-in unit runs urgent, or no units run lights and sirens. Those calls can be upgraded or downgraded as more information is available. And like St. Louis, Ann Arundel's dispatch center uses specific guidelines to determine the level of response. For instance, both fire departments identify structures with a high risk for loss of life, such as a nursing home, that always get an urgent dispatch. Other dispatches are situational. The trash can fire will get quiet or cold run in both jurisdictions unless that trash can is near a building.

Ann Arundel does not have data comparing apparatus collisions before and after the new policy, but running cold has not compromised its response time.

One advantage both departments share is that the dispatch center falls under the fire chief's control.

"Not only do they report to the fire chief, but some of the staff in our communication center are uniform fire personnel and the supervisor is a fire lieutenant," says Ann Arundel Chief John Robert Ray. "They have fire field experience."

That's not a luxury Chief Shane Ray has with his all-volunteer department in Pleasant View, Tenn. He too started a no lights and sirens policy in 2007, but he doesn't have oversight over dispatch. Part of the problem is that the department covers two counties with separate dispatch jurisdictions. One of the dispatch centers is unwilling to make the emergency or nonemergency determination out of fear of legal liability, Ray says. Therefore, he's put the decision in the hands of the officer in the rig. In fact, the program is named "you make the call." The officer will question the dispatcher and use his or her judgment on running lights and sirens.

The policy is nonpunitive, meaning the officers' decisions are reviewed but there is no punishment for making the wrong call.

"When I told them, 'You respond to an emergency when you feel it is right,' our number of calls with emergency traffic went down to 21% of the total calls," Shane Ray says. One assistant chief told Ray that he was giving the officers too much power and that they'd run lights and sirens more often. That wasn't the case. "Our people will do the right thing if you empower them to do it."

PVVFD has seen its vehicle accidents drop from an average of four per year to zero since the policy was implemented.

PVVFD covers 200 square miles with 14 miles of interstate in what is becoming a bedroom community for Nashville. The department has four stations and 40 active firefighters.

And as Chief Shane Ray discovered, no policy discussion is complete without talk of who can get sued by whom and for how much. Phillip Stittleburg, fire chief in LaFarge, Wis., a lawyer and president of the National Volunteer Fire Council, says there are some legitimate concerns regarding lights and siren use.

He sees little to no criminal liability for a department that runs without lights and sirens to what later proved an emergency. "Assuming we can establish the reason we felt the response was a low-risk and responded in that fashion, I don't think anyone who is claiming to be injured based on that choice is on very solid ground," he says. "That's a really tough case to make for the plaintiff."

A department's risk for criminal or civil suits increases if it runs lights and sirens on a good-intent call and a collision occurs, Stittleburg says. This becomes even more difficult to defend if the department has a policy about when to and not to run with lights and sirens.

Goldfeder agrees and warns chiefs to be prepared to be held accountable in the legal system when things go bad. There were cases where the driver was terminated for violating the department's driving policy. "That's a nightmare," he says. "The apparatus driver didn't mean to hurt anybody, he was going to help somebody. But if you blow a red light and it is against the law, the law will look at it as if you did it intentionally."

Stittleburg recommends that departments have a clear and formal policy when it comes to running emergency and nonemergency responses. And that policy should be made at the highest level in the department to provide the most legal cover. That's because decisions made at that level are discretionary and are often afforded immunity.

"The law divides decisions that governments make into discretionary and administrative," Stittleburg says. "Discretionary decisions are typically protected or enjoy immunity from suit. Discretionary immunity tends to be most successful at the higher levels of government. It is best if this policy be clearly established and be established by the chief."

For departments that rely on its officers to make the lights-and-sirens decision, such as Pleasant View, Stittleburg advices that the officer has clear directions on how he or she makes that call.

"The setting of a general policy is probably going to enjoy discretionary immunity," Stittleburg says. "The application of that policy in a specific instance by the captain probably is not. We want to limit the number of situations where there is going to be a gray area."

And certainly what all chiefs would like to do is eliminate or at best limit the number of collisions involving apparatus.

For more information

To obtain a copy of the Ann Arundel Fire Department's apparatus response policy, e-mail Chief John Robert Ray at firechief@aacounty.org

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