First, do no harm

Despite extensive research finding lights and siren use makes little difference in patient outcomes, and in fact causes harm to patients, providers and the public, too many continue to respond hot


The Hippocratic Oath, often pledged by aspiring physicians, includes the Latin phrase “primum non nocere,” generally meaning first, do no harm. One translation of the Hippocratic Oath includes the following phrase:

“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”

This should be the goal of EMS leaders for our patients and our providers.

Thanks to the growing body of EMS research, and the Prehospital Guidelines Consortium, medical directors are increasingly using evidence to guide clinical protocols to achieve the goal of primum non nocere. Through this process, EMS clinical leaders objectively evaluate studies to judge the efficacy of the protocols they implement for the EMS system(s) for which they provide clinical oversight.

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