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Well, for Major Incidents, there is clearly a need for a senior ED person to be onsite (as many as possible I suppose) and if it happens out of hours a speedy response is important. Whether that would require Blues 'n Twos is obviously the debate at hand. As for trauma calls out of hours (or I suppose we should include serious medical problems too) I think this is another debate, one which I'm sure we've had before. Should the running of a serious clinical problem in the ED rely upon a consultant driving in at high speed from home? Surely by the time one arrives (usually at least 15-30minutes from the time of the call) many of the life saving decisions have been made, and indeed if they haven't couldn't advice on those decisions have been given over the phone (not while driving obviously). If it is about doing life saving procedures I'm afraid again, shouldn't that be available on site? I have to say, most of the time when I am called out of hours my presence is to help with 'patient flow' (ie liaising with the multiple specialties/egos) and advice on prioritising investigations. The basic clinical management is usually sound and needs only a little expert tweaking. After that it is often about resettling the department which may have spun out of control in the last couple of hours. None of the above requires me to risk my own or another road user's life by driving abnormally to work, in my opinion. Simon -----Original Message----- From: Adrian Fogarty [mailto:[log in to unmask]] Sent: 13 April 2006 13:39 To: [log in to unmask] Subject: Re: Blues 'n Twos Just to hospital for incidents and/or trauma calls. "McCormick Simon Dr, Consultant, A&E" <[log in to unmask]> wrote: Adrian, Are you talking about making your way to out of hospital incidents, coming in to major incidents, or just coming back on call for trauma calls etc? I think there is a significant difference between each of these. Simon -----Original Message----- From: Adrian Fogarty [mailto:[log in to unmask]] Sent: 12 April 2006 17:32 To: [log in to unmask] Subject: Blues 'n Twos After battling through traffic at our last few major incidents, and with nocturnal trauma calls becoming more frequent (and set to become commonplace in my Trust with a new "pilot"), I wanted to ask those list members who do frequent out-of-hours calls or who do pre-hospital work: what method of "traffic conditioning" do you use? Does the traditional physician's green light actually work? Don't you need something that makes lots of noise?! Any practical suggestions are welcome, including how and where you procure your equipment. Regards Adrian