This is the first revision of the "Quick-Guide to Effective Injury Prevention, Saving Lives with Proactive Emergency Services". The original Quick-Guide was written for use by EMT’s who serve Native American tribal communities. This version is for all rural and frontier emergency service providers. Rural and frontier EMS districts face many of the same difficulties and challenges that confront tribal EMTs.

I’ve spent almost 20 years during my EMS/Fire/Rescue career advocating proactive emergency services. I do this because of my own experience with fatal trauma. It took eight years of rural EMS experience, trying everything I could think of, to come to the realization that there were some things that I just could not fix with EMS, no matter how fast we were, how good, or how lucky. When Rick Smith (see acknowledgements) showed me a proactive way to do what we could not do with EMS alone, I jumped on it. Within two years, six hazards that were killing our people were eliminated, our worst fatal trauma problem disappeared, and multiple fatality events went from common to rare.

In talking to EMTs about proactive EMS, I have found that one of their chief complaints has always been that injury prevention somehow steals thunder from the really important work of responding to emergencies. Nothing could be farther from the truth! Proactive EMS is meant to enhance your emergency services, to do something that you currently cannot do, to save the trauma patients that you cannot save with EMS alone. In essence you respond to a hazard that you know exists in your community, a hazard that you know will kill more people, and before it kills again, you eliminate it. As always the bottom line is saving lives, which makes this a perfect addition to your emergency services. EMS saves lives, with proactive EMS; you’ll save more, perhaps many more.

Having done both many times, I can tell you it’s much more rewarding to backboard a family out of a vehicle that has hit a guardrail which you’ve helped install then to rappel down an unprotected, high embankment to retrieve their bodies.

For trauma patients who are going to die no matter what we do, and some will, injury prevention and injury control can be very effective alternatives.

I sincerely hope that you will find something in these pages that will help you save the lives of some people that your EMS currently cannot help. If something in this text helps you to do that, I will have done my job.