The D.C. Fire Department has installed speed-monitoring devices on its 11 ambulances to insure that the vehicles are not driven more than 10 miles per hour over most posted speed limits - even if there is a critically ill passenger in the ambulance.
The crackdown, which also requires that the ambulances stop at all red lights and stop signs, is designed to cut down on accidents involving ambulances, according to Deputy Fire Chief Joseph Shelton, chief of the ambulance service.
The campaign, which amounts to tightening enforcement of existing speed regulations, was met with immediate criticism by emergency medical officials who contend that a by-the-book slowdown could endanger the lives of critically ill passengers.
"We feel that the time loss in a three-mile run is not critical in terms of patient care," countered Shelton. "We're talking about a 15- or 20-second delay."
The department's regulations state that, "At no time shall ambulance exceed 35 miles per hour except where the posted speed is more than 35 and then they shall not exceed the posted speed." There is no place within the District where the posted speed is higher than 45, and most places it is 25 miles per hour.
Dr. Sandor Mendelson, chairman of the D.C. Emergency Medical Services Advisory Committee, said the fire department did not consult with him, or his committee, before unilaterally deciding to crack down on the ambulances, which traditionally have exceeded permitted speeds and merely slowed down at red lights and stop signs.
"There's no question there is a possibility of ambulances crashing into each other," Mendelson said, "so they shouldn't go as fast as they want. On the other hand, this has to be looked at sensibly. What is our capability of response? What are response times?
"You can't just take one aspect out of context and fix it," said Mendelson, a cardiologist at Washington Hospital Center. "You can't say we're going to fix the speed limit without fixing the number of ambulances or where they re stationed or in general what response times are.
"We have very poor response times in the city. There are too few ambulances," Mendelson said. "There are more calls per ambulance than any other major city in the country."
When told of Mendelson's comments, Shelton responded that "With all due respect (Mendelson) is getting into the operational end of emergency medical services. He may be the greatest cardiologist in the world, but we have to consider whether you're going to get somebody killed in a traffic accident or kill some child."
When asked for statistics regarding ambulance accidents in Washington, Shelton said, "My desk is covered with paperwork now," and referred a reporter to the fire department's apparatus division. A spokesman for that division said it does not maintain such statistics.
Shelton said that if the regulations are not strictly enforced, "We're going to have personnel out there pushing the piece (of equipment) to the limits of its capacity and those pieces will do 80 miles an hour. We just can't have that."
Tachographs, the devices installed in the ambulances, consist of 24-hour clocks that record the ambulance's speed at any given moment, show when the engine is idling and also record information about the driver's breaking patterns, Shelton said.
"The men have looked at the tachograph like Big Brother," Shelton said. "They've looked at it like a regulatory device that regulates their speed. Well, that's true. The problem with the emergency ambulance service is that it doesn't have enough vehicles, not the speed they're traveling."
John D. Avery, one of the service's paramedics, complained that sooner or later a death certificate will "say, 'Cause of Death: Tachograph,'" because a patient will be delayed getting to a hospital.
Asked whether he had been informed of the new 'drive to rule' policy, Dr. Howard Champion, director of Washington Hospital Center's new Shock Trauma Service, said, "I knew they were getting tachographs. I didn't know about the speed rules. Obviously, I want the patient as soon after he's had his crisis as possible.
"It can make a difference to the patient's life," Champion said. "Five minutes out there, instead of in here, can make a difference."