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S.T.O.P. knee-jerk reactions in EMS

Any action taken based on emotion is not a decision, but a reaction

Any action taken based on emotion, as opposed to fact-based analysis, is not a decision at all – it is a reaction. Such a reaction based on an unqualified fear, concern, or prediction is commonly referred to as a “knee-jerk reaction.”

Knee-jerk reactions are the antiphon of the ill-informed, ill-educated, and/or ill-equipped EMS manager; it is the song they sing because they have not learned the words to any other.

Most of all, knee-jerk reactions are the antithesis of leadership; they demonstrate an absence of critical thinking and analysis, and they continue to kill any chance EMS has of transitioning from a job to a profession.

Offended EMS managers, you can send the hate mail to me at, but you know I am right.

In fact, anyone who has worked in or around this industry for more than five minutes knows that knee-jerk reactions are so common in EMS management that they have become the norm, the expectation, the standard. This has been true for as long as I can remember – at least since Reagan was still in office – and it has to STOP!

Reactionary helmet cam ban

The most recent and glaring example of this reality is the swift announcement of the ban on helmet cams in San Francisco almost immediately after the Asiana Airlines crash at SFO.

It seems that a passenger was fatally injured when she was struck by a responding emergency vehicle. The accident was tragic beyond words, and my most sincere condolences go out to both the girl’s family and the apparatus operator.

Nevertheless, the absence or presence of video recording equipment cannot be linked in any way to the occurrence of that specific event.

On the contrary, the existence of video documentation of the incident can only benefit both the investigation and the prevention of such an accident in the future. In fact, I suspect that, had the video exonerated the agency, helmet cameras would have instantly become standard issue.

So why react to this tragedy by banning video recording devices altogether?

Because, when you are afraid of lawyers and lawsuits and you have been programmed to panic upon any evidence of any negative thing, you take steps to prevent the creation of such evidence in the future. Thus, much like an ostrich or a toddler with closed eyes, your blindness effectively prevents the existence of any negative thing and all is right with the world.

Knee-jerk doesn’t work

You may be thinking that banning video to prevent being sued is counterintuitive. If you are, it’s because you are smart. Banning video to prevent being sued would be like not wearing a life jacket on a boat because you don’t plan to go in the water. (I feel dumber just writing that.)

First, this is America: anyone can sue anyone for anything at any time. If you are going to be sued, you are going to be sued. And if you are in EMS long enough, the odds are you are going to be involved in a lawsuit.

The real question is whether you will win or lose.

In the case of the accident after the SFO crash, the department was not likely to prevail under any circumstance – the video just confirmed it and makes the case easier to settle.

Thankfully, the department is reconsidering the ban.

Unfortunately, this example is but the tip of an industry-wide iceberg. Every day under-trained, under-skilled, and generally under-equipped EMS supervisors, managers, and executives still employ the knee-jerk reaction.

Humble mistakes and modest learning opportunities become hasty and draconian policy changes – simple accidents become career-ending events; the unsupported rantings of an incoherent scene bystander are converted into the collective voice of a frustrated and unforgiving public that must be placated at the expense of providers who have done nothing wrong. And if you don’t think this goes on where you are, then you are probably the one doing it.

Just STOP: Settle. Think. Organize. Present.

As a leader, when confronted with any possible, potential, or perceived difficulty: STOP before you impose any long-term action.


Let the dust settle before taking long-term action.

For some reason – maybe it’s the age of instant everything – any brief pause in our action causes anxiety and consternation that we are not responding properly. Get over it. Take the time necessary and available to see each situation for the facts, not the perception.

That is the only way you can actually fix any situation before you exacerbate it; it’s what will prevent you from trying to extinguish a grease fire with water.


Take the time necessary and available to process the facts as they are, not as they are perceived to be by the public or you.

Certain perceptions may be ugly in the moment, but at the end of the day (sorry for the cliché), the public will judge your operation and you on how the story ends.


With a clear view of the facts and after careful consideration of them, take the time necessary and available to organize a plan for solving, resolving, fixing, or preventing whatever issue is at hand.

Cogitate on the rationality of your response, the cause and effect of that which you are trying to manage. Does your proposed response actually answer the question, or are you simply painting over cracks?


Take the time necessary and available to present the question, the answer, and the rationale to those who will be charged with carrying it out.

Including the rationale with the conclusion is what professionals do.

When you include the “why” with the “what,” you will be far more likely to see success in the implementation of progress. And where there is progress, EMS takes another step closer to being professional.

Get it done

In the end, nothing good or productive has ever come from a knee-jerk reaction in EMS or anywhere else. As they say, “Somehow, there’s never enough time to do it right, but there’s always enough time to do it over.”

It is time to make knee-jerk reactions in EMS a thing of the past. If that means reeducating, retraining, or replacing those knee-jerk reactors where you are, so be it. EMS is counting on you to get it done. columnist David Givot, a seasoned EMS employee with three years of law school under his belt, is looking to the future of EMS. He has created as a first step toward improving the state of EMS through information and education designed to protect EMS professionals nationwide.