Because… Tradition!

HybridmediclogoTradition defined by Webster’s as an inherited, established, or customary pattern of thought, action, or behavior. This is especially true in the fire service and it’s local components, fire-based EMS is no exception. In many areas though, EMS is such a changing plain that tradition of thought never gets much of a root.

I love traditions that we have as firefighters. Pipes and drums are fun at events as a salute to the heavily Irish heritage in east coast fire departments (and the tradition of public service in the early immigrants as public service jobes were undesirable), as well as other traditions that endear firefighters to the service and to each other. My issue isn’t with tradition itself. My issue is with tradition interfering with the actual delivery of service.

As the defenders of the public welfare, it’s our job to be reactive as well as proactive. Proactive in that we should be ready and willing to adopt new practices that will increase our reactive ability. An organization that deals with the health and welfare of the public at large should not shun ideas or scientifically backed concepts because it doesn’t fit with our idea of what firefighting or medical service should look like. I’ll give an example.

Several weeks back I attended a class on modern residential fire attack. Granted, there hasn’t been much new construction in the areas of Memphis that I work, but with renovations abound such as additions, newer windows and doors, and the overall strive to be more energy efficient, combined with the overload of synthetic materials in every day living, the potential for high heat release rates and air tight environments increases dramatically. The class covered the differences in those synthetic materials and older materials and what burn studies and live tests have uncovered to fire behavior and how best to effect extinguishment. The ideas were scoffed at because it’s not “what we usually do.” I thought the whole point of a class was to teach new concepts, as opposed to old ones. Because… tradition!

In EMS, tradition can hurt patient care. Customary thought or behavior can impact pain management, for example. Another example is changes to the use of spinal immobilization. We’ve been told all our careers, preached to others, lived the tradiion, that opoid pain management of abdominal pain masks symptoms for physicians or that if a wreck looks bad then it was an indicator for a Level I trauma center. All of which have been proven to be false, but are still widely practiced because… tradition!

The point being, sometimes we need to evaluate what we practice and what we preach. Then we need to see if it fits with what we are doing now. I was in a Firefighter II class in Dayton, Ohio and a wise old fireman from Dayton relayed a story where Dayton used to require that firefighters get out in the afternoon and was the wheels of their equipment. It was a tradition with roots lost in time, until someone dug around and found that it stemmed from an old directive from the days when horses were still on the streets, and some of the streets were still dirt. The purpose of washing the wheels was to wash off an horse manure or mud that had accumulated on the wheels. It was a tradition that was quickly dropped because it no longer applied.

Examine your motives and your actions. If they don’t fit with the current state of science or practice, what use is it?