No doubt you have read about the Northwest Airlines jet that sort of missed their airport by a few miles. By now, they are saying stuff about laptops, schedules, and what not. So they were not paying attention, and I have to ask the question-
“JUST WHAT IN THE **** WERE YOU GUYS THINKING UP THERE?”
There. Done.
OK. So what does that have to do with situational awareness (SA)? Actually, nothing. But one of the fire service blogs I read from time to time tried to compare the Northwestern incident to situational awareness back before we found out they just were not paying attention.
There are a lot of definitions out there of SA. Having read them, to me SA can be defined as a combination of knowing and understanding what is happening around you, being able to predict how this activity may/will change what is going on around you, and understanding how that (those) change(s) will affect you. There is also the essence of “being at one” with your environment and the dynamics that are driving it.
The military learned a long time ago that sometimes fighter pilots were overwhelmed with everything going on around them. Think about it. For a fighter pilot in an F-15 or F/A-18 in level flight there is a lot going on. There are all sorts of inputs that provide information to the pilot. Now, throw in a couple (or more) enemy aircraft, maybe a SAM or two, and the dynamics of the situation have changed. Dramatically. And the pilot has to be able to manage all of that information in order to keep flying and neutralize these threats. Being over loaded with input had some detrimental effects on SA. So the military did some things to alleviate it, in a fashion. As an example, the “heads up” displays in the cockpit were a part of this situation.
Now, operating an ambulance is not as dramatic. Or is it? Think about it- when we are responding to a call we have all sorts of information that is being fed to us, whether we are paying attention or not. From the driver’s perspective, think about these-
1. The vehicle’s instrumentation. There is the speedometer (hopefully you are paying attention to this), the tachometer (can tell you a little about your vehicle’s performance; pay attention), the fuel gauge (which you should have been paying attention to before now), the oil pressure gauge, temperature gauge, and volt meter (you need to pay attention to them, too).
2. The radio (not the AM/FM). Hopefully there is information coming to you this way, whether it is from the dispatcher, the first responders, or other EMS units that are on scene.
3. Your partner. He/she should be calling out traffic situations on his side and to the front. He/she should also be paying close attention to the radio (you have your hands full driving the vehicle).
4. Your own senses. Obvious you have to be keeping a sharp lookout to your side, to the front, and to the other side, as well. After all, you are the driver and you are responsible. There are things you hear (radio, your partner calling out traffic, other vehicles’ horns or sirens, etc.)
In my EMS system, we also have a mobile data terminal (MDT) that provides in-vehicle navigation (IVN) and computer-aided dispatch (CAD) interface. IVN is a good tool, and the program we use is OK, to a point. I think there are some things that could make it better, but that is another day. Also, the CAD interface we have can provide good information, at times, but there are some things that need to be improved with there, also.
So with all of this information coming in, you have to sort it out and prioritize it. If you are driving, you have to ‘limit’ your ‘heads up display’ so to speak (no, we do not actually have a HUD and I would hate to see the incarnation of it on an E450). When I am driving, I concentrate on six things- the traffic on my left, the traffic ahead, the speedometer, the traffic on my right, my partner, and to a degree my other instrumentation. When I am riding in the right front seat, I limit my attention to the traffic on my right, the traffic ahead, the radio, and the MDT. If I need it, I also concentrate a map book (but I always know where I am going BEFORE the ambulance moves).
Yes, there is a certain amount of overflow between the driver and the passenger. I guess that is a way of the two positions becoming “one with the situation”. But I am amazed at the low level of overflow when each is maintaining their own ‘sphere of responsibility”. For example, if I am driving, I always look right, even when my partner calls “clear right”. I may not take a long look, because I am depending on them, but I at least take a quick look. It’s the safe and prudent thing to do.
But back to the subject, what are some of the things that can be challenges to SA?
Well, there is the siren. No, I am not talking about the big screaming Q2B found on most fire trucks around these parts. No, I am talking about the multi-tone, multi-position electronic sirens that most ambulances use. You know, the ones with wail, yelp, phaser, hi-lo, ex-wife nagging, screeching cat-in-heat, etc. A lot of times the driver seems to want to control the siren. To me, that is a no-go. First, both of your hands should be on the steering wheel. Second, your gaze should be focused on traffic, the speedometer, your gauges (occasionally), and traffic. You are responsible for moving 15,000+ pounds of steel, aluminum, plastic, rubber, and my flesh and bones through traffic. Safely. So, if you are working the siren (and you shouldn’t be if you have a partner up front, set it on wail and forget it. It is one less thing to distract you from what is going on around you.
MDT updates. I know not everyone has MDT’s, but my system does. And they have two annoying habits. First, they are ‘updated’ every few moments, which requires you to depress a button on the screen to get the latest information (which may or may not be relevant). Second, there is a lot of other stuff that comes up on the screen that is totally irrelevant to what we are doing. The reason that I say this is distracting to the driver is that we have a natural tendency to want to know what is going on; what kind of information is being passed along. Is it now a ‘code’? Are police on the scene? What’s going on? It’s distracting. I try and always turn the MDT away from me when I am driving. And if I have to view it for directions on IVN/MARVLIS, I STOP THE TRUCK. What more can be more distracting to my situational awareness as the driver than looking at a computer screen?!?!?
If I am not driving, the MDT is turned towards me. I’ll call out directions.
The radio can be distracting. Sometimes the radios are on scan. In my system, it is desired that we switch at least one portable radio over immediately to the appropriate TAC channel. But then someone else may say something on the main channel that your mobile is still tuned to, that is not relevant to your call, but sounds like it is, then you get distracted, then you are filling out incident reports on the wreck you just had. Some people may disagree (and that’s alright, you can’t help it), but I work to set all of the radios to the assigned TAC channel. Leaving the main radio on the dispatch channel can even be distracting to me in the passenger seat. Nothing like turning your head and saying “What did they just say?” as a minivan plows into your side.
I won’t even mention much about cell phones, iPods, and Blackberries. Unless God personally is calling you, you do not need to be talking on some other
communication device while you are driving my ambulance ‘hot’ to anywhere.
So much for SA while driving. I could talk more, but you get the idea. Do what you can to make your job SAFE. Your ultimate goal must always be going home at the end of your shift. All other concerns are secondary.
M914
