Summer bummers

A survey of drivers revealed that 82% thought driving in winter is more dangerous than in summer. Some named New Year’s Eve as the deadliest driving day of the year. They were wrong on both counts. One third of road fatalities occur in June, July and August: the deadliest quarter of the year. The average number of a fatalities on Independence Day is 148, while the average for other days is 114. New Year’s Eve ranks number seven for fatalities. The six outranking days occur from May to early September. Who dies in fatal ambulance crashes?  The ambulance driver has a 1:25 chance of dying, while a non-occupant has a 1:8. That’s right. An innocent bystander has a three times greater likelihood of dying during a fatal ambulance crash than the person driving the ambulance. Since more people are out during nice weather, there are more potential victims.

Pedestrians, motorcyclists, bicyclists, and skate boarders can be anywhere at any time. We must use exceptional situational awareness when running with EWS activated, but can’t be lulled into a false sense of security when not running hot. Pedestrians are not confined to sidewalks. We cannot assume that they are aware of our presence and will react reasonably. Due to the dangers of distracted walking, some jurisdictions have made it illegal for pedestrians to use electronic devices. As professionals who drive, we must recognize that all driving situations are hazardous. It is our job to create a driving environment which affords the public the highest achievable level of safety. During the summertime that can be tough.

Roads are chronically overcrowded. The increase in number of miles driven actually exceeds the number of new roadways created by a factor of 35:1. How many of us view our rigs as an extension of our homes? This creates territoriality. What standards do we set for our driving behaviors, or at least our perception of our driving behaviors, that are more likely to be violated by other drivers, particularly when there are more drivers available to violate them? How do we respond to these intruders, who can make our jobs more stressful? Noise and temperature have been shown to impact levels of aggression. If we become more aggressive when stressed in a crowded, uncomfortable environment, will we achieve peak driving performance? To mitigate the dangers of the summertime work environment, we must be physically and mentally at our best.

To be safe we must have situational awareness. It is defined as “The state of being aware of what is happening to understand how information, events, and a person’s actions will affect his or her goals and objectives, now and in the near future.” I contend that you can’t have situational awareness without first possessing self-awareness. This is not some mystical, philosophical concept. Particularly in the summer, you must have physical self-awareness. Are you adequately rested, hydrated and properly fed?

Fatigue has gotten much needed attention. When we don’t get adequate sleep or become fatigued, neurons fire more slowly and weakly. This is particularly true in the temporal lobe, which controls memory and visual perception. Do you think that impairs your ability to react?

It’s hot. You’ve got back to back transports. There’s no time for a meal. Your mouth and lips are dry. You’re sweating and starting to get a headache. If you grab a super-sized sugar laden whatever, you’re setting your brain up to fail and make yourself more aggressive. How? You can get reactive hypoglycemia. Reactive hypoglycemia occurs in non-diabetic people who get recurrent episodes of hypoglycemia within four hours after ingesting a high carbohydrate load. Simply you take in a lot of sugar and your body reacts in a manner that takes your sugar level below normal, functional levels. Symptoms of low blood sugar include: double or blurry vision, unclear thinking, fatigue, dizziness, nervousness, irritability, panic-attacks and confusion. Interestingly, how you respond to a drop in blood sugar is in part determined by how frequently it happens to you. If it happens often enough you may develop hypoglycemia-associated autonomic failure (HAAF). What’s scary about this is your brain stops working and you don’t get the warning symptoms associated with low sugar. Don’t misinterpret this as an endorsement of sugar free beverages. They are terribly dangerous. People who drink them have higher cardiovascular morbidity and mortality than those who don’t.

We are aware of the biologic hazards of summer. When you’re working hard in the heat you get tired quickly, you must come to work well with rested and have adequate opportunity for rest during the work day. This is not unrealistic. It is a mandatory safety measure. We already know that water is the best fluid for hydration. To provide adequate energy:

  • Eat small meals and snacks about every three hours
  • Avoid or limit sugar intake
  • Exercise regularly
  • Eat a variety of foods (meat, poultry, fish, whole grains, fruits, fibers, vegetables, and dairy products)
  • Choose high-fiber foods

Remember, a healthy life style is another 24/7 concept. You can’t turn it on and off to match your shift.


  • Accessed April 23, 2017
  • Accessed April 23, 2017.
  • Cryer, PE “Mechanism of Hypoglycemia-Associated Autonomic Failure in Diabetes” NEJM 2013.369: 362-373.
  • Szczygiel, M (ed), EMS Safety, Burlington, MA: Jones & Bartlett Learning, 2017
  • “Lack of sleep can cause mental lapses similar to alcohol intoxication, researchers say” Safety + Health. Page 12, January, 2018
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