But more and more research shows that running hot makes no difference in whether a patient lives or dies, and that speeding to hospitals increases the chance of crashes like the one in July by a Mosinee Fire District ambulance that killed the patient and left a crew member paralyzed.
A recent study published in the Annals of Emergency Medicine found that ambulance runs with sirens and lights save only 43.5 seconds compared with regular runs, and that amount of time is not significant in treatment except in the rarest circumstances.
And a number of national studies show that speeding to the hospital actually increases the danger of dying not only for the patient, but for the ambulance crew and the motorists and pedestrians they might encounter on their run.
Speed was one of three factors - worn tires on the ambulance and wet roads were the other two - cited by police in the Mosinee ambulance crash.
Police estimate the Mosinee ambulance was traveling at least 75 mph, 10 miles over the speed limit, when it rolled over July 31 on Interstate 39. The crew was taking David G. Nicewander, 52, of Mosinee to Community Health Care Wausau Hospital. The driver, Jason J. Toboyek, 27, activated the sirens and lights when Nicewander, who had a dislocated hip, lost consciousness, police said.
Bill Leonard, 69, an executive with an ambulance insurance company based in Scottsdale, Ariz., said that running hot rarely is necessary and often is dangerous. Crews should speed only if the patient is in imminent danger of death, and even then, ambulances should never travel more than 10 mph over the speed limit, and only if road conditions are perfect.
"I'll buy dinner at the finest restaurant in town for the ambulance crew that can find the emergency room doctor who says speed saved the life of a patient," said Leonard, who made his first ambulance run in 1950 and owned an ambulance service for 25 years.
Ambulance crashes in Wisconsin are rare. No fatal ambulance crashes occurred in the state from 1998 to 2001 - the state has not yet compiled data for 2002 - and only 38 that caused injury or enough property damage to require a report occurred in that time. In fact, ambulance crashes are so rare that they rank last in a tally of crashes sorted by 22 vehicle types compiled by the state Department of Transportation.
But the true number of crashes involving ambulances might be much higher. A survey of paramedic crews in Salt Lake City and Salt Lake County, Utah, published in the journal Prehospital and Disaster Medicine, led researchers to estimate that for every ambulance crash, there are 4.25 "wake-effect crashes" caused by the ambulance running with sirens and lights that do not involve the ambulance itself.
When ambulances do crash, they cause more damage than most vehicles. An investigation this year by the Detroit News found that there are 6,500 ambulance crashes a year that injure an estimated 10 people a day and kill at least two people a month, and many of those crashes are the result of unnecessary speeding, driver exhaustion from long hours and inadequate training.
Don Hunjadi, executive director of the Wisconsin EMS Association, a membership group that represents local emergency medical service workers and agencies, said sirens and lights should be used only when absolutely necessary, and most services find that it is absolutely necessary to run hot on only 10 percent of runs.
Ambulance services in Marathon County set guidelines for when drivers should go to sirens and lights, but it is the drivers who ultimately have the discretion about when to run hot.
Gerald Mijal, Wausau Fire Department assistant chief, said Wausau emergency crews decide on a case-by-case basis whether it is necessary to use sirens and lights. Wausau crews receive driver training from a Northcentral Technical College instructor every other year.
The last time Mosinee crews were given driver training was several years ago, NTC instructor Jim Palmer said in August.
Mosinee Fire District spokesman Dave Marg referred all questions about the district's rules for when to use sirens and lights to attorney Dick Zalewski, who was out of the office Tuesday afternoon. Mosinee Fire District medical director Dr. Winston Ryan was unavailable for comment Tuesday.
