It was a chest pain call on a hot July afternoon.

And when he heard it dispatched on the radio of his Pro Ambulance command unit, field coordinator Tom Cottrell was a good half-hour's drive away from the patient in another town.

He turned on his red lights and siren and picked up his pace a bit in Campustown traffic.

Several drivers pulled over and let him by. Some kept right on going.

So much for the Rules of the Road, which dictate drivers must pull to the right edge of the road and stop when an emergency vehicle is approaching with red lights and siren on.

"See, now here's an intersection where everything is blocked," Cottrell complained, approaching a traffic light where every lane in his direction had a car or a van in it.

He kicked his siren to the more urgent-sounding "hyper yelp" mode, the one meant to let drivers know he's right on their tails, and cautiously inched around a van sitting in the left-turn lane.

Nothing an ambulance driver doesn't have to do just about every day.

Cottrell said most people at least try to clear the way for an ambulance rushing to an emergency.

But there are those few: The ones who pull into the left lane instead of the right lane. Those who try to outrun the ambulance so they don't have to pull over and wait. Those who just come to a standstill in whatever lane they're in. Those who are too busy talking on cell phones to even see the red lights or hear the siren.

The errors and distractions take their toll. In 2005, the most recent year for which data is available, 49 people – including 11 ambulance passengers – were killed in ambulance crashes across the country, according to the National Highway Traffic Safety Administration.

There were also several thousand nonfatal ambulance crashes that year.

Cottrell remembers being in a bad crash himself several years ago, when he was in an ambulance racing up U.S. 45 to an emergency in Rantoul.

Three vehicles were directly ahead, and one of them, a van, suddenly pulled into the passing lane and collided with the ambulance frame-to-frame, he said.

Fortunately, nobody in the van was hurt, Cottrell said, but he sustained injuries to his back, neck and ankle that put him out of work for a month.

"My foot was on the air horn so hard, I sprained my ankle," he said.

In his 27 years in the emergency medical field, Arrow Ambulance Director Larry Sapp said he's been in two ambulance accidents, and both of them happened while he was "running code" – ambulance lingo for running with red lights and siren on.

Sapp continues to marvel at some of the driving he sees out there.

"You'll see it on almost every response, something that amazes you," he said.

Given their high volume of calls and the miles put on each ambulance a year, Pro and Arrow ambulance services are in relatively few accidents, Sapp and Cottrell said.

Arrow, for example, gets 10,000 calls for service a year, and about 40 percent of them are red-lights-and-siren responses, Sapp said.

Pro handled more than 11,000 calls for service last year, Cottrell said, estimating some 60 percent to 70 percent were run red-lights-and-siren.

"I'll have an ambulance put on 60,000 miles a year without an accident," Sapp said.

Cruising in an ambulance through Champaign recently, Sapp has an eagle eye out for potential dangers should he suddenly get an emergency call – the pedestrian too close to the curb, the bicyclist who might not be paying enough attention to traffic, the drivers who seem to be in a big hurry.

On hot and cold days, when people are driving with their windows rolled up and their heat or air conditioning on, Sapp can count on fewer folks hearing his siren.

"Today, it's not bad," he said. "A lot of people have their windows down."

To avoid startling those drivers who aren't paying enough attention, Cottrell said, ambulance drivers try to provide plenty of visual warning when they're approaching, positioning the ambulance where it can be spotted in rearview mirrors.

"If they're on a cell phone, they're not going to hear you," he said.

To the rescue

Despite what you may have seen on TV, ambulances don't generally race to emergencies at breakneck speeds, leaving traffic parted in their wake like the Red Sea.

Sure, everybody in a medical emergency wants the ambulance there RIGHT NOW.

But not all ambulance calls are dire emergencies, and even if they were, ambulance drivers don't have carte blanche to flout the traffic laws, Cottrell and Sapp said.

That's not to say that they won't push the speed limit sometimes or roll through red lights – after making sure nobody is in their path. But that all depends on the nature of the emergency and the condition of the roads.

Emergency dispatchers in the area code ambulance calls using the first five letters of the alphabet, with "A" for the least urgent calls and "E" for the most urgent.

And only those calls ranked ranked "C" through "E" get a red-lights-and-siren response from the ambulance, the two ambulance services say.

The difference to a patient in Champaign-Urbana in terms of how fast the ambulance gets there is a mere four minutes, tops.

City ordinances require ambulances to reach patients on those less urgent calls in 12 minutes, and ambulances have eight minutes to get there on the more urgent ones, Sapp and Cottrell said.

Arrow applies a bit of science to help beat the clock and stay safe.

One way is by tracking when and where most emergencies occur and posting ambulances throughout the area accordingly, so they have less distance to travel when the calls arrive, Sapp said.

Arrow also uses a GPS monitoring system to help ambulance drivers find their way anywhere and "DriveCam" technology in the ambulances. The latter produces a video recording of how the ambulance is being driven, so supervisors can review it and spot drivers in need of coaching, Sapp said.

Sound of sirens

Driving through an Urbana neighborhood with the siren wailing, Cottrell said a certain edge-of-your-seat feeling is a natural response to the sound.

Outside the ambulance, the siren can startle some drivers and pedestrians so much, they just freeze in place, he said, and ambulance drivers learn to watch out for that reaction – especially in the University of Illinois campus area where international students may not know what to do.

Seasoned emergency responders like him and Sapp get used to the sound, though ideally, Cottrell said, you want your ambulance driver to be feeling somewhere in between relaxed and anxious.

"You don't ever want to get to the point where you're comfortable," he said. "That's when accidents happen."

Ultimately, emergency responders evolve into super observers, always on the lookout in traffic – even when they're off duty in their own cars – and always aware that the average driver doesn't function quite that way.

Sapp remains a believer in most drivers' good intentions when they spot an ambulance.

"Most people are good at heart. Most people care about what we do," he said.

"There are always those few. Our people understand they have to watch for those few."

Make way

Some advice from Pro and Arrow ambulance services to help keep everybody safer during ambulance calls:

Think right

When an ambulance is approaching with red lights and sirens, pull into the right lane on your side of the road. Don't pull into the left-turn lane or come to a standstill in the left lanes, if possible.

Wait a few seconds

After you pull to the right to make way for an approaching ambulance, pause a few seconds before merging back into traffic to make sure another emergency vehicle isn't approaching right behind.

Listen

Air conditioners, loud radios and talking on cell phones can prevent drivers from hearing sirens. Keep your car radio at a reasonable volume and keep your window cracked to hear what's going on outside.

Pedestrians, take care

Walking with headphones can prevent you from hearing an approaching ambulance and other traffic. And if you're standing on a corner when an ambulance is approaching, step a couple of yards back off the curb.

Slow down

Approach a traffic accident scene with caution. Emergency medical workers, firefighters and police may be on the road.

Don't chase

If it's your loved one on the ambulance and you're heading to the hospital in your own car, don't attempt to chase the ambulance. It's illegal and dangerous; your car doesn't have a siren and red lights.

Help the crews

Don't hang up after you call 911. Stay on the line.

Never exaggerate symptoms in an attempt to speed up an ambulance response.

Make sure your house numbers are visible day and night.

Don't move anyone who's fallen.

Move furniture inside the house that might be in the way of getting a cot in and out the door.

Move pets into another room, away from where the ambulance crew will pick up the patient.