Editor's Note: Tom has written in to say that he is undergoing treatment for cancer, and he apologizes to his readers for any delays until he is able to submit future articles. He invites readers to visit his blog to follow his progress at www.caringbridge.org, under the website paramedictom. Please consider stopping by his blog or our own forum thread to submit a message of support.

How many ambulance crashes can you or your agency afford this year? This column by T.E.A.M. Driving Concepts, Inc. focuses on driving safety to help emergency medical personnel attain the specific knowledge, skills and attitudes for today's highly specialized ambulance operator. Columns are written by the educational staff at T.E.A.M. Driving Concepts Inc.

Acceleration is the A portion of the ABCS of emergency driving safety. Just as the airway must be opened and properly maintained for our pre-hospital patients to survive, so to, acceleration is the first vital component of driving an emergency vehicle.

For the most part, we will only be looking at the concept of accelerating from a stop with a patient on board. Acceleration while in motion is considered a change in speed which we will discuss during the column on S for speed.

When beginning to accelerate, thoughts should immediately change to how and when the operator will stop the vehicle. The old saying of what must go up must come down, is the same for vehicle dynamics; what goes into motion (accelerates), must stop (eventually). Acceleration always involves deceleration at some point and time. But few ever give it a thought when accelerating to their next course of action, that being able to stop.

Accelerating from a stop (with a patient on board) should ALWAYS be performed slowly, smoothly and steadily. "Jack rabbit" starts NEVER benefit the patient. The patient and any passengers should barely know that the vehicle is accelerating. The smoother the ride the more confident and relaxed the patient is, along with better patient assessment, care and treatment. Sudden acceleration can cause equipment and supplies to fall onto the patient or other occupants, causing injuries. Your partner can easily be tossed to the back of the ambulance or within the patient compartment with rapid acceleration, again injuring them or the patient.

Any rapid vehicle movements, whether they be hard accelerating or hard braking indicates danger, excitement and the possibility of crashing. The patients' thoughts turn to "Why are we in such a hurry? Does the driver think I am going to die? Maybe I am really sick." Just as an EMS provider conveys confidence with their voice, body language and movements, so too does the emergency vehicle operator convey confidence, level headedness and maturity when properly applying the ABCS of emergency vehicle driving.

"Jack rabbit" starts indicate:

1) Probable immature driving skills and attitudes
2) The need to hurry and rush
3) Excitement is increasing
4) The operator is intense and highly emotional.

We are not drag strip race car drivers, who when the light turns green take our foot off the brake and slam on the gas. That is what racing is all about. We are first and foremost medical professionals focused on total patient care! I repeat: There are NO advantages to jack rabbit starts with a patient on board!

Realize when you slowly accelerate that you have a longer time frame in which to look about for possible traffic hazards. The operator should always be scanning the sides of the vehicle, left and right and also the rear. A jack rabbit driver has their eyes glued right straight ahead, focused and determined. A vehicle can easily approach from the left or right before the jack rabbit driver ever realizes they are there.

We discussed the disadvantages of jack rabbit starts; now let's look at our friend the turtle, who starts out slowly, smoothly and steadily.

Turtles have a chance to stick their head out and look around for dangers before their acceleration. What hurry is the turtle in as he carries his home and office with him? What big hurry do we have to be in when we are basically a mobile emergency room? Aren't we doing for the patient what the emergency room would be doing in the first 5-15 minutes anyway?

How do you know what a truly slow, smooth and steady acceleration is? Would a full, hot cup of coffee between your legs tell you? Try to accelerate slowly, smoothly and steadily to the point of barely moving, just try it once. How did that feel? Too slow? How few seconds did it cost in comparison to a jack rabbit start? Cause guess what, the red light ahead will catch you anyway.

Jack rabbit starts usually end up as jack ass stops. The faster you're traveling the more distance you'll need to stop without abruptly slamming on the brakes.

Now, try practicing in your own vehicle. Professional athletes practice their basic skills all the time and often daily. You're a professional prehospital care provider so practice your skills like a professional. Don't you want the best possible outcome for your patients? Practicing basic skills is an often overlooked concept. Look around your department or agency and you'll see that the professionals practice and the wanna-be's don't. The ambulance is often the one piece of EMS equipment used the most and trained on the least.

Stay tuned for the next column on the "B" (braking) of the ABCS of emergency vehicle operator safety.

So till next time: Keep both eyes on the road and both hands on the wheel.

Tom Mannisto has been in EMS since 1980 with his first "license" being an ambulance attendant card. He is now a Critical Care Paramedic (CCEMT-P) and a State of Michigan licensed Instructor Coordinator (I/C), as well as the founder and president of T.E.A.M. Driving Concepts Inc., an EVOC based emergency driving safety course. To learn more visit www.teamdrivingconcepts.com.

Related:

• EVOC-ing Safety: The ABCS of Emergency Driving