One of the things you learn working in EMS is there are so many things that can happen to people unexpectedly. It’s all fun and games until it isn’t. This experience can be a benefit or a curse, depending on how you look at it.
In almost any activity, there are risks of personal injury. This isn’t necessarily a problem as long as you take steps to prevent it. This is known as risk management, something that is very familiar to pilots, for example. If potential problems are considered ahead of time, then a safer strategy for the activity can be planned.
Most people would agree that wearing a seat belt or riding a bike with a helmet makes sense, and it is something they do without thinking anymore. But often we overlook routine everyday activities that actually have the potential for serious injury. We are lulled into complacency.
Take the case of a teenage girl I saw who decided to deep fry some chicken on her stove.
She arrived by ambulance, crying with severe pain after spilling hot oil on her bare feet. Yes, she was cooking in the kitchen barefoot. She never considered the possibility that what was on the stove could end up falling to the floor. Both of her feet had 3rd degree burns.
After copious amounts of IV morphine, we finally got her pain under control and transferred her to the burn unit, where she eventually had skin grafts. I am sure she had a long and painful recovery that disrupted her life. There is a reason professional cooks wear closed-toe shoes or clogs.
The ability to consider risks is impaired by excitement. When excited, our brain’s focus shifts from, “Is this dangerous?” to, “How good will this feel?” This is because excitement activates the dopamine reward system in the deepest part of the brain, which signals anticipated reward, increases motivation, and enhances approach behavior.
The potential reward feels amplified. Threat signals may be deprioritized. Impulse control from the prefrontal cortex is tamped down, reducing top-down control of behavior. Decisions are more impulsive. Excitement also activates the sympathetic nervous system, resulting in increased adrenaline, which leads to increased confidence and arousal, narrowing the field of attention.
This is especially true in adolescence, at a time when the brain is still developing. The ventral striatum, a deep brain structure (reward sensitivity), is hyperactive, and the prefrontal cortex is still maturing. This can result in risk-taking, higher injury rates, and thrill-seeking behavior. This helps explain the recent high number of electric throttle bike injuries in this age group. The faster you go, the faster you think you can go without injury.
Many injuries are preventable if people consider the possible hazards and adjust their behavior accordingly. Every time I start a new activity or use a new tool, I ask myself, “What could go wrong?”
I still enjoy life and do some “risky” things, but take every step I can to mitigate the risk. But if we don’t even take time to consider what might go wrong, we won’t take simple precautions. The alternative is to avoid all risk and never get out of bed, but that is not living.
References:
Elliott, M.V., Johnson, S.L., Pearlstein, J.G. et al., 2022. Emotion-related impulsivity and risky decision-making: A systematic review and meta-regression. Clinical Psychology Available at https://www.sciencedirect.com/science/article/pii/S0272735822001179?utm_source=chatgpt.com Accessed February 20, 2025
Steinberg, L., 2008.
A social neuroscience perspective on adolescent risk-taking. Developmental Review, 28(1), pp.78–106.
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396566/ Accessed February 20, 2026
Casey, B.J., Jones, R.M. and Hare, T.A., 2008.
The adolescent brain. Annals of the New York Academy of Sciences, 1124(1), pp.111–126.
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2475802/ Accessed February 20, 2026
