The Next Great Tradition

More than 200 years of tradition, uninterrupted by progress.

I’ve heard that phrase often to describe how some firefighters hold strong to their rituals and practices. But truth be told, the same could be said of EMS. Since the days of Napoleon, ambulance services have existed primarily to transport the ill and injured from where they fell to a hospital where they could be treated.

More than 200 years ago, tradition dictated that local townsfolk would transport injured soldiers to the closest hospital in their hay wagons, but only once the battle moved away. At the hospital, surgeons would begin their lifesaving interventions on those who survived that long. But one surgeon, Dr. Dominique Jean Larrey, was different. He believed the surgeons should be deployed into combat to retrieve the injured even while war raged around them. He argued that by beginning care sooner, he could save many more lives. Despite a belief that was undoubtedly unpopular with his peers, Larrey persevered and invented the ambulance, the modern system of triage and many other surgical innovations.

While you may have heard of Larrey’s contribution to our beginnings, think about this: He could not have done it alone. He had to find colleagues courageous enough to risk breaking with tradition to join him in his cause. Larrey’s followers undoubtedly faced opposition but were brave enough to embrace the new role despite the personal risk they encountered. As brilliant as Larrey was, he could not have put his idea into motion without the help of others willing to gamble on a new model to help save more lives.

Today more than 1,000 EMS providers have been trained to help save lives differently than in the past: in new roles as community paramedics and mobile integrated healthcare practitioners. That’s a small portion of all EMS personnel, but enough to convince the editors of EMS World that it is time to support these brave new providers by dedicating a series of articles over the coming year to this new type of patient care. While articles on the finance and administration of these programs remain critically important discussions, EMS World recognizes that those serving in this new role also need articles focused on the aspects of patient care they will encounter that are different than those faced in their traditional roles.

We start the new series this month discussing substance abuse. Instead of describing the traditional approach to treating an overdose, the article focuses on the terminology and treatment paths available to those who suffer from either addiction or pseudoaddiction caused by their chronic pain. While the topic may not be popular among those holding strong to our EMS traditions, those practicing in this new role will encounter patients needing these treatments regularly.

I applaud EMS World Editorial Director Nancy Perry and Senior Editor John Erich for dedicating time and space to help these new providers. Thanks to their efforts and the bravery of the 1,000-plus providers willing to break from their traditional roles, we are looking at the start of the next great tradition of EMS.