Developing A New EMS and Fire Vocabulary

Like many of you, I found myself glued to the television during the first weeks of the Iraqi war. At one point, I found an imprint on my finger from the button on the remote control from switching between what I call the "tragedy channels" (CNN, Fox and MSNBC).

The more I watched the press briefings, the reports from the field and all the military retirees who have become "talking heads" on the various networks, the more it occurred to me that this war has generated a new vocabulary of words and phrases that undoubtedly will find their way into the American language. No longer did we have reporters traveling along with the troops; now they were "embedded." It was interesting to note that many of these new words and phrases are military jargon designed to put a spin on something bad. Phrases such as "friendly fire," "collateral damage," "daisy cutter" and "attrition of the enemy" help to soften the situation and make it not seem so negative.

The first hours after President Bush's 48-hour notice to Saddam Hussein to leave the country found us hearing new phrases - "targets of opportunity" and "decapitation strike." Then we waited for the long-touted "shock and awe" bombing as we heard about "flight packages," "deconflicting the airspace" and "shaping the battlefield."

All of these expressions, phrases and words are euphemisms - words or expressions that people use to find a polite or less direct way of talking about a difficult or embarrassing topic. Or in other words, euphemisms are the verbiage you use when you want to express something, but you really do not want to say it.

There are many ugly sides to war; therefore, military dialogue is full of euphemisms. The idea behind military euphemisms is to pacify the audience to make an unpleasant situation more acceptable. During World War I, traumatized veterans were said to be "shell-shocked." In the 1940s, the U.S. government changed the name of the War Department to the Department of Defense.

Euphemisms have made their way into our everyday life and it does not have to be a military event. In the early 1990s, President Clinton spoke of "growing the economy." Even though English teachers struggled with this term, it is still used today.

But then it suddenly occurred to me - the fire service can form a "coalition of the willing" and come up with our own EMS and fire terms to soften the negative or be more politically correct. As an example, no longer refer to yourself as a paramedic/firefighter. You can now be called a rapid suppression oxidation paramedical technician. A person who is "pharmaceutically gifted" is someone who has a permanently altered mental status as a result of prolonged drug use. A person who has had too much alcohol to drink is "spatially perplexed."

If you ever go on a shooting because a drug deal went bad, do not refer to it as a drug deal - it is now permissible to refer to it as a "nocturnal pharmaceutical transaction." If the "nocturnal pharmaceutical engineer" has been shot in the head, you can describe it as a "trans-occipital transplant." If shot elsewhere, it is just an "acute traumatic lead poisoning."

For those who like to abuse the EMS service in your community and frequently call 911 to take them to emergency room without any true emergency, the term "frequent flyer" still applies. However, on your patient care report, you can document that they had "positive Samsonite signs" - a suitcase in each hand, waiting at the curb, when you pulled up. However, and by chance, the dispatcher who screened the 911 call may have made an error. In this case, when the information you received on the dispatch does not match the actual situation when you arrive, you have received a "telexaggeration."

For those times when you are called upon to treat or transport prisoners, the term "Miranda angina" is certainly applicable to someone who was just arrested and is looking at a charge that will result in a prolonged prison term. "Sudden incarceration syndrome" refers to those who, given the option of going to jail or to the hospital, will always choose the hospital.

For all those bystanders or family members you encounter, euphemisms are also germane to them. The "pointer" refers to anybody standing next to a patient lying on the ground and points to the patient as you walk up - as though you cannot comprehend that the person lying on the ground is actually the patient. Finally, the term "medimute" can refer to any bystander or family member who constantly answers for the patient, even though your questions are directed to the patient.

Of course, there is always the bystander, police officer or firefighter who is so inclined to slap hard or bang on the back of the ambulance after the patient has been loaded and the rear doors have been closed. These slaps or bangs, which are intended to signal the driver of the ambulance to start rolling to the hospital, can be called "ambu-slaps."

Vehicles and patients who have been involved in an accident can be referred to as a "negative vehicle-to-vehicle interface" or "terminal deceleration syndrome." If a person was wearing a seatbelt or the airbag deployed, you can say the "impact management system" worked.

On a more serious note, even though the column this month is meant to be entertaining: Let us not forget the men and women of our armed services who are fighting in Iraq, Afghanistan and other countries where those who hate America have vowed to kill you, me and our children. May God watch over them.

Gary Ludwig, MS, EMT-P, a Firehouse® contributing editor, is the chief of Special Operations for Jefferson County, MO. He retired in 2001 as the chief paramedic for the St. Louis Fire Department after serving the City of St. Louis for 25 years. He is also vice chairman of the EMS Section of the International Association of Fire Chiefs (IAFC). He is a frequent speaker at EMS and fire conferences nationally and internationally, and is on the faculty of three colleges. Ludwig has a master's degree in management and business and a bachelor's degree in business administration, and is a licensed paramedic. He also operates The Ludwig Group, a professional consulting firm. He can be reached at 636-789-5660 or via