Change in fire-based EMS is evolutionary, not revolutionary

Each new step in the history of EMS brings innovation, as well as new roles, challenges and responsibilities for paramedics

Chief Gary Ludwig previews his EMS World Expo session: "What Fire Service-Based EMS Will Look Like in 2025."

By Gary Ludwig

I am a student of history – especially 19th and 20th century history. I love listening to or reading books of 19th and 20th century leaders, wars, geopolitical struggles, and other historical events such as the influenza epidemic of 1918.

As the philosopher and novelist George Santayana said, "Those who cannot remember the past are condemned to repeat it."

One thing I have come to learn through my study of history is that nothing seems to be revolutionary — everything seems to be evolutionary. This seems to be true when it comes to the evolving delivery of fire-based EMS. Each step seems to bring new and innovative ways of doing things. 

It is amazing to think of where we have been and where we might be going. What will fire-based EMS look like in 10 years — in the year 2025? I can only guess. But I have a good idea — because everything we do is evolutionary and not revolutionary. 

First, expect firefighters and paramedics to rarely respond to vehicle collisions in the future. Several companies are already working on advanced driver assistance systems to prevent collisions. Other companies with big names and deep pockets are using this technology to develop driverless cars.

Ten years from now, it might be common to see a car with the front and back seats facing a table in the middle of the vehicle for working, reading or watching a video while the car drives itself to your destination. Some even contend there will be no need in the future for auto insurance or a driver’s license.

Second, the ongoing exploration of Mobile Integrated Healthcare by fire-based EMS systems will continue. We’re still developing and defining MIH. But in 10 years, MIH will probably focus on three different services delivered by paramedics and dispatchers.  

  • Caller screening at the 911 center and determining an appropriate care pathway.
  • Field treatment and release programs.
  • After-hospital discharge visits to prevent readmissions..

What evolutionary changes do you see in fire-based EMS?

About the Author
Gary Ludwig is recognized as a respected national fire and EMS author, public speaker, and consultant/expert who has managed two award-winning metropolitan EMS systems (Memphis and St. Louis). Ludwig has over 37 years of fire, rescue and EMS experience – and over 35 years of experience as a paramedic. He currently serves as the fire chief of Champaign, Ill., and has a master of science in management and business. He is also a member of the FireRescue1/Fire Chief editorial advisory board.

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