This Post can also be found at the First Few Moments website.  I will be doing some writing for Kyle David Bates and the rest of the FFM team, so those posts will be featured on both sites. While I have always been aware that ambulance accidents were occurring, my involvement with First Few Moments over the last eight months have really brought the issue into the spotlight for me.  It often feels like I can’t go a day or two without seeing yet another article about an ambulance crash, and they seem to be occurring more and more frequently. We’ve tackled this topic so many times on the show, and have come up with many different approaches to how reduce ambulance crashes.  We’ve talked about using simulators, the concept of sterile cockpits, increasing training time and frequency, and the effects of being overtired on drivers.  Above all of those though, there is one more topic I think we need to focus on more: Shut them off! I am of course, talking about our lights and sirens.  Why is there still such a desire to “run hot” to every call both to the scene and away from it?  How many actual complaints really warrant that lights and sirens response?  Priority Dispatch has done a good job of defining them, but in so many systems, we still insist on pushing the envelope and meeting what end up being unreasonable response times based on the staffing levels that most systems have. And what about transporting to the hospital with lights and sirens active?  What’s the point of all of our training if we are just going to treat each and every patient with a “diesel bolus?”  Very few patient dispositions are time sensitive.  I’d even go as far to argue that the only patients out there who would require “hot” transports to the hospital are those requiring emergency surgery, whether that be due to trauma or otherwise, those having a cerebrovascular accident, and those having an ST elevation MI.  The only other one that I would put a “maybe” on would be the failed airway, but that would depend on the degree and severity of the...