Another query re emergency lighting on private vehicles, this time from a doctor in NSW who says:
The majority of emergency calls are to private hospitals (where I am not a paid employee). I wonder if I fit the definition of an ’emergency worker’ and can fit (say) red-white flashing LED lights which would operate when the vehicle is moving. From the RTA…. may fit a red light when…. “Other emergency vehicles not referenced above that are driven by an emergency worker in the course of their duties, where an ‘emergency worker’ is a person (or one of a class of persons) approved by the RTA.”
There are a lot of doctors responding to emergencies on any given day. Unfortunately the general public doesn’t always understand the need for what may appear to be aggressive driving, with a certain element reacting in a dangerous manner.
It is undoubted that others will not ‘understand the need for what may appear to be aggressive driving’ when they would have no way of knowing who is driving the vehicle or why. It has to be remembered that whatever the emergency, it does not justify putting the lives of other road users at risk and if the responder has an accident then their ability to assist in the emergency is defeated. Hence the need for emergency vehicles to have warning devices but also the need to drive, at all times with due care.
One also has to query how much of an emergency is it if it’s occurring in a hospital? Whilst the doctor’s presence may be essential, there should already be health professionals on site, so what is gained by ‘aggressive driving’? The first legal lesson is that absence any emergency warning devices (red/blue lights and/or siren) doctors proceeding to a hospital should not be engaging in aggressive driving; it only puts others, unnecessarily, at risk and is not justified by law.
So can they fit warning devices? As we have noted before an emergency vehicle is a vehicle driven by an emergency worker in the course of their duties related to an emergency (Road Rules 2008 (NSW) Dictionary, definition of ‘emergency vehicle’). (What is an emergency, for these purposes, is not defined so for fire brigades/police/ ambulance services it is really a matter for their own internal processes to determine when members may proceed on ‘urgent duty’.) An emergency worker is
(a) a member of the Ambulance Service or the ambulance service of another State or Territory, in the course of providing transport in an emergency associated with the provision of aid to sick or injured persons, or
(b) a member of a fire or rescue service operated by a NSW Government agency, a member of the State Emergency Service or a member of a fire brigade (however referred to) or rescue service of the Commonwealth or another State or territory, providing transport in the course of an emergency, or
(b1) a member of Airservices Australia providing transport in the course of a fire or rescue emergency, or
(c) a person (or a person belong to a class of persons) approved by the Authority. (Road Rules 2008 (NSW) Dictionary, definition of ‘emergency worker’).
A doctor, therefore, is not an emergency worker unless the Roads and Maritime Authority has approved them, either personally or as a class as emergency workers. That is the approval could be given to an individual doctor or a class of doctors eg ‘all registered medical practitioners who have completed an approved driving training course’ or the like.
As for fitting emergency lights, without going through clause 124 of the relevant vehicle standards (that are set out as Schedule 2 to the Road Transport (Vehicle Registration) Regulation 2007 (NSW)) in detail, they say in effect that if the vehicle is not operated by the recognised emergency services it can be fitted with flashing warning lights if approved by the authority (see also the Roads and Traffic Authority ‘Vehicle Standards Information #8, Flashing Lights and Sirens, 24 November 2010 (http://www.rms.nsw.gov.au/registration/downloads/vsi/vsi_08_flashing_lights_and_sirens_rev_4_1__nov_2010.pdf)).
So the answer is that a doctor does not fit the definition of an emergency worker unless he or she has approval from the Roads and Maritime Services (formerly the Roads and Traffic Authority) and can also fit emergency warning devices if so approved. I would expect however, that the RMS would never give such approval or authority and certainly not to allow a doctor to proceed to an emergency at a hospital. The answer may be different if the doctor is a specialist in emergency trauma medicine and who’s duties require him or her to respond as part of a counter disaster team, but even then you would expect that they would respond to an appropriate ‘base’ and collect there a marked and approved emergency vehicle rather than respond in their private car.
An interesting post – may I comment on the driving aspect, especially in relation to the description of ‘aggressive driving’?
I am a driving trainer within Ambulance Victoria; we have adopted what is now an almost national standard of driver training for ambulance paramedics (NSW is in fact the only state or territory that does not subscribe to this standard). Ambulance emergency response driving has evolved over the last 10 â 15 years, with Victoria making the largest moves since two paramedics were killed in 2004 on an emergency response. We have adopted the Low Risk Driving Model for all ambulance driving, with the mantra of ‘stable platform’ for driving with a patient on board. This model has 4 simple points 1] see the hazard 2] assess the risk 3] make early adjustments 4] continue to adjust until safe to do so. We establish this model in all new staff and give them a week of practical driving with a classroom component. They are then permitted to drive in non-emergency mode; at around 3 to 5 months on road experience they are then given the next component which allows them to drive ambulances in emergency response (code 1) mode. This is then referred to as Quick Low Risk: all aspects of the original Low Risk Model are reinforced however we explain the exemptions available under section 306 of the Road Safety Road Rules 2009 (Vic). The legal terminology of REASONABLE is stressed at every opportunity, with the general understanding that if a crash occurs during this response that it may well turn out to have not been REASONABLE to have taken whatever exemption has been used, e.g. excessive speed, red light breach etc. The aim is not to speed to a location per se, but to simply make progress at all times.
As you can see we are now moving very much away from the ‘aggressive’ mode of driving that many people think we undertake. I was a policeman prior to joining the ambulance service, and we certainly did drive aggressively in the 70â’s and 80â’s but those days are gone. The VicPol model of driving now also errs on the side of caution.
My rather long winded point is that for any sort of emergency driving to be considered by any person, there must be an associated level of training and understanding in the responsibility taken on by that individual, as the general public perception of high speed as the primary method of emergency driving is false and therefore requires correction in any individual prior to them undertaking any form of emergency response.
I hope this note has been of interest,
Team Manager – Mirboo North | Gippsland Region
Ambulance Victoria | P.O. Box 363 | Mirboo North VIC 3871
T: 03 56681553 | F: 03 56682890 | M: 0412723267|
firstname.lastname@example.org | http://www.ambulance.vic.gov.au
There are a number of issues that your doctor does not seem to understand.
I agree with your expression of defining an emergency even in a hospital
It is little appreciated that “lights and sirens” does not reduce the travel time by a significant amount. Even in Ambulance it only reduces the time by a few minutes at best
To have hidden lights etc the vehicle must be registered and recognised as an emergency vehicle as you state. It also requires that the driver(s) must also receive and maintain appropriate advanced driving skills. As you mention all care must be taken when driving lights and sirens. You as the driver are responsible when you are driving eg through a red light or on the wrong side of the road and there is injury or property damage to others. Ambulance , police and fire have been prosecuted for this.
It all falls back to the old adage ” whose pulse do you take in an emergency? ……… Your own. Calm down and take care for the good of our patients and ourselves
Hi Michael, I wonder if the doctor asking the question works in a rural area. While it may be reasonable to ask what’s the emergency if the patient is already in a hospital, the reality is that smaller hospitals often rely on on-call medical staff who may not be present when the emergency occurs. I believe even larger centres rely on on-call staff for very time-critical procedures such as urgent cardiac catheterization. However perhaps the best example is the obstetrician, who only attends when required. There are quite a number of life-threatening obstetric emergencies that cannot be managed (effectively or legally) by midwives or other health professionals. As you know, these emergencies can occur without warning. The irony is that an ambulance crew will transport a patient urgently to a hospital for ‘definitive care’, yet definitive care cannot be provided until a doctor is present. Meanwhile, the key person in that care is the one who is not afforded any of the privileges available to ’emergency workers’. Of course, there are sometimes arrangements where doctors, or donor tissue, are transported by police or ambulance, however I’m sure there are plenty of situations where the community simply relies on the fact that doctors will respond in their private cars and just do the best they can. I feel this is an important issue that should be addressed in legislation or regulations. Kind regards, Malcolm.(Ambo)
Date: Mon, 31 Mar 2014 22:49:52 +0000 To: email@example.com
I wonder if this post should have been posted this afternoon…:->, anyway I often found it a bit curious to find myself as the ambulance officer being driven to a scene by another ambulance officer under emergency conditions because the call warrants it, but also implicitly that no-one else is able to help and I am the “key person”. When the distance got larger, say on an overnight shift that got busy, this becomes a bit strange as surely there must be someone else within 15km of the scene in a metropolitan area?
Malcolm (Knight) above makes some interesting points, but the obstetrician can be replaced by “any obstetrician” who is probably on site or nearby in any case. When someone needs resuscitating your not going to get your own doctor and the staff treating you may not even know who you are or any history, they are trained to handle arrests. The donor tissue/blood is an interesting issue. I wonder if Michael would like to comment on the legality of urgently transporting a blood sample in an ambulance to a hospital based blood bank and then transporting an esky of matched blood to another hospital? (The weirdest and easiest urgent case I ever did, medically necessary but was it legal?) The life-threatening part was there but no actual person was transported, just a sample of them and later something that would go into them.
“The weirdest and easiest urgent case I ever did, medically necessary but was it legal?” There is no definition of what constitutes an emergency. In NSW the State Emergency and Rescue Management Act 1989 (NSW) s 4 defines ’emergency’ as:
but that is clearly not the relevant definition for the Road Rules 2008 (NSW). If it was, then most things the emergency services go to most of the time are no ’emergencies’.
An emergency vehicle is a vehicle driven by an emergency worker ‘driving the vehicle in the course of his or her duties as an emergency worker’. It is up to the emergency service to determine what their duties are and when they should respond on ‘urgent duty’. That decision is subject to review by a Magistrate should the driver be prosecuted and the Magistrate will have to decide whether ‘ it is reasonable that the rule [that they are alleged to have breached should or] should not apply’ (Road Rules 2008 (NSW) r 306.) I suspect a Magistrate would focus on the nature of the driving, the surrounding conditions and the like when determining whether ‘it is reasonable that the rule should not apply’ rather than the task that the worker’s were engaged in, particularly where they had been instructed by their co-ord to proceed on ‘urgent duty’ or where otherwise working within the service’s accepted norms. So if it was normal practice, or a specific instruction, to carry the blood sample by ambulance with lights and sirens, then I suspect no Magistrate would really question that in a prosecution of the driver. It would be a different matter in a Coroner’s inquest if someone died in the resulting accident or a Work Health and Safety prosecution but then it would be the policy norm and the service that would be subject to scrutiny, rather than the driver.