Fire EMS, Firefighter Training

Changing EMS Vocabulary

By Mike McEvoy, Ph.D., REMT-P, RN, CCRN

The term “ambulance driver” boils the blood of seasoned EMTs. Likewise, injury prevention specialists would remove the word “accident” from the dictionary. Emergency doctors would like the term “emergency room” to go away forever. As professions evolve, so does vocabulary. Knowing and speaking the latest terminology says something about your familiarity with other professionals you interact with.

Eons ago, an emergency room was a small space tucked in hospitals where moonlighting physicians saw patients who had no primary care provider. Consider the changes in just the past two decades: board certified emergency medicine specialists working in multimillion-dollar facilities caring for the whole spectrum of medical, surgical, and traumatic problems. Rightfully, it’s proper etiquette nowadays to use the term “Emergency Department,” or ED.

The word “accident” implies a chance occurrence, yet research has shown that injuries are anything but fate. Through injury surveillance, highly predictable patterns, distinct risk factors, and obviously at-risk populations can all be identified. The Centers for Disease Control (CDC) ranks injury as the leading cause of death for persons in the United States between the ages of 1 and 34 years. Despite this, we continue to refer to trauma as accidental. Trauma is no accident.

To reflect current science, the word “accident” must be erased from public safety vocabulary. Motor vehicle accidents (MVAs) have long been called motor vehicle crashes (MVCs) by medical and injury prevention folks. It’s time for dispatch centers and prehospital care providers to adopt new vocabulary. Trauma has causes other than motor vehicle crashes, and even these are not real “accidents.” Make it a habit to use the term “injuries” when describing traumatic incidents unrelated to crashes. This mindset will not only reset our own focus but also let the public know that trauma is not accidental and that injuries are preventable.

Safety and injury prevention are components of public safety and of medicine. As emergency medical service providers, we have a duty to model safe behaviors. That responsibility begins with knowing the kinds of injuries your service responds to and how they could be prevented. Make it a habit to learn the unique injury patterns in your community. Consider ways you might reduce the toll of injuries to citizens. There are innumerable national, state, and regionally based injury prevention initiatives with which fire and EMS can partner to reduce injuries. These include bicycle helmet and seat belt programs, child safety seat checks, and public access defibrillation, to name a few.

Change your vocabulary to reflect the fact that injuries are not accidental. The next time you respond to a motor vehicle crash or stop by your local emergency department, your new mindset will reflect a modern view of public safety and medicine.



Mike McEvoy, Ph.D., RN, CCRN, REMT-P is the EMS Coordinator for Saratoga County, New York. A former forensic psychologist, he now works in the Cardiac Surgical ICU at Albany Medical Center and teaches at Albany Medical College in NY. He is a paramedic for Clifton Park-Halfmoon Ambulance Corps and medical advisor for West Crescent Fire Department. He presently serves as a member of the New York State EMS Council and the State Emergency Medical Advisory Council and is the EMS Director on the Board of the New York State Association of Fire Chiefs.