Not a gun thread

[JPINFV]

Zoe: Preacher, don't the Bible have some pretty specific things to say about killin'?
Book: Quite specific. It is, however, somewhat fuzzier on the subject of kneecaps.

Simon: I never - never shot anyone before.

Book: I was there, son. I'm fair sure you haven't shot anyone yet.

 

[ffemt8978]

Might be time to get back on topic.

 

[Akulahawk]

Thanks to the efforts of DT4EMS and one or two others I have seen spring up, coupled with some very big names in the business calling the issue of assaults and injuries to EMS providers to the front and center, the hot topic in EMS right now seems to be what to do about it.

On FB, one of the groups I belong to has a very pointed discussion on what exactly EMS providers should and shouldn't do to defend themselves.

Nobody in that discussion brought up a gun and I think it is safe to say everyone in that discussion is of the mind that a gun is not the answer.

I would like to open such a discussion here. (because you don't need 20+ years of experience to join this group)

I thought about making a poll, but decided against it, because it restricts the ability to be creative.

So, without further adue, without a firearm, what do you think you need or would like to have in order to prevent injury to yourself or coworkers while doing your job?

You don't have to restrict yourself to a single item, if you think your agency needs cops riding the rig with you or pay you to go to Japan and learn Kobudo, let's hear it.

So to get back to the topic at hand: I would have to say that the biggest and best thing that EMS providers can do to reduce the possibility of injury to themselves or coworkers or even the patient is to engage in ongoing training in management of the violent patient. I'm not necessarily advocating any particular tools for defensive purposes, that is something that with the proper mindset, anything can be effectively employed as a defensive weapon. That can be anything from the vehicle itself to the pen in your pocket. This is something that they teach law enforcement - the proper mindset for self-defense. It can also be simply using verbal judo or "how not to be an Adam Henry" but the point is that the training should be continuous and ongoing and available to everyone on staff at the EMS providers, you can't become good at this by simply attending a two or four hour seminar on an annual basis. One does not have to be a full and complete master of a specific discipline in order to be able to protect oneself. One simply has to learn the concepts and be able to employ them effectively.

Another poster earlier on the idea that the provider should be allowed to stage out anytime that they feel they need to without any sort of repercussions. Being able to do that is something that is absolutely necessary, and should be fully understood by all parties, that staying away from the scene for purposes of avoiding injury to the crew, based on what the crew knows should be supported, rather than vilified.

There is much that could be expounded upon with this topic. Probably enough that a book could probably be written and then some and still not cover the topic adequately. At least this is a start.

 

[waaaemt]

I skimmed this thread pretty fast so I may have missed it but personally a police-style TASER would be a viable option in my mind for EMS personnel.

plus, if the AED craps out, you got a back up!

 

[EMDispatch]

This brings up an interesting point.

Is there something you could do prior to calls in bad neighborhoods that would reduce the danger there?

Is it the whole neighborhood or can you actually narrow it down to a specific street, location, or address where the most danger is likely?

Your dispatch should be doing their part to be aware

A good dispatch center:
-monitoring PD channels to be aware of current events on the street.
-checking past address history for calls, and ideally have house flagged in the system where there have been problems. Ideally you can even keep a mental record of callers that cause problems too.
- dispatchers that go beyond face value of caller statements... It's pretty obvious to me after interrogating a caller that things just aren't right

 

[Handsome Robb]

I touched on it in my first post but I think it's worth bringing up again. I would think having a unified comm center for EMS, PD and Fire would help as well. In my experience it seems like this is usually only the case with FD-based EMS services. How is your comm center set up? Here we have four separate centers...each city has it's own FD/PD dispatch, SO/County Fire has their own and we have ours. It makes for difficult communication sometimes, especially when everyone's busy and the phones are ringing off the hook. They all have dedicated lines to each other and the ability to make the calls between them "emergent" but I still think it could be setup better. It's not uncommon for me arrive on scene, make patient contact and cancel fire then have them show up 10 minutes later anyways. Not a huge deal, just an example of how communication between all the centers breaks down sometimes.

A unified comm center allows for better/easier communication between the dispatchers for the different services. Much easier for a dispatcher to talk to the person in the next desk over rather than have to call them on the phone, wait for them to answer, request LE respond code/non-code, have the person answering the phone relay the request to the dispatcher then have them dispatch whatever resources are being requested.

To add on to my statement before, we have addresses that are flagged for whatever reason. History of violence/non-compliance with EMS/PD/Fire in the past, repeat callers, things of that nature. Those addresses with either be an automatic stage for PD clearance or "enter on your discretion" and we will be provided either digitally on our pager or verbally on the radio as to why the address is flagged, what kind of issues crews have had in the past, an ETA on PD/SO and details on the current call to allow us to make an informed decision on whether we're going to wait for LE or if we're going to enter then either continue them or cancel them.

Crews also have the ability to request PD. If something sounds funny to us in the dispatch we can ask if PD is responding then upgrade them to code 3 if we are close and it's potentially life threatening or we can request the respond either emergent/non-emergent. We get along very well with PD and Fire for the most part. With that said, PD and Fire usually don't get along with each other.

 

[Bullets]

I touched on it in my first post but I think it's worth bringing up again. I would think having a unified comm center for EMS, PD and Fire would help as well. In my experience it seems like this is usually only the case with FD-based EMS services. How is your comm center set up? Here we have four separate centers...each city has it's own FD/PD dispatch, SO/County Fire has their own and we have ours. It makes for difficult communication sometimes, especially when everyone's busy and the phones are ringing off the hook. They all have dedicated lines to each other and the ability to make the calls between them "emergent" but I still think it could be setup better. It's not uncommon for me arrive on scene, make patient contact and cancel fire then have them show up 10 minutes later anyways. Not a huge deal, just an example of how communication between all the centers breaks down sometimes.

I am surprised that this is the case. We have always had county based dispatch but i was optional to have the sheriffs office do the service. With the economy being what it is and the stress on shared services, more and more towns have moved of the county. Now about 2/3 is on the county system. This is PD, FD, EMS and Sheriffs. Only the state police are on some crazy band, but most countys are doing the same, so instead of having 50 channels we have 26, one for each county

 

[mycrofft]

I touched on it in my first post but I think it's worth bringing up again. I would think having a unified comm center for EMS, PD and Fire would help as well. In my experience it seems like this is usually only the case with FD-based EMS services. How is your comm center set up? Here we have four separate centers...each city has it's own FD/PD dispatch, SO/County Fire has their own and we have ours. It makes for difficult communication sometimes, especially when everyone's busy and the phones are ringing off the hook. They all have dedicated lines to each other and the ability to make the calls between them "emergent" but I still think it could be setup better. It's not uncommon for me arrive on scene, make patient contact and cancel fire then have them show up 10 minutes later anyways. Not a huge deal, just an example of how communication between all the centers breaks down sometimes.

A unified comm center allows for better/easier communication between the dispatchers for the different services. Much easier for a dispatcher to talk to the person in the next desk over rather than have to call them on the phone, wait for them to answer, request LE respond code/non-code, have the person answering the phone relay the request to the dispatcher then have them dispatch whatever resources are being requested.

To add on to my statement before, we have addresses that are flagged for whatever reason. History of violence/non-compliance with EMS/PD/Fire in the past, repeat callers, things of that nature. Those addresses with either be an automatic stage for PD clearance or "enter on your discretion" and we will be provided either digitally on our pager or verbally on the radio as to why the address is flagged, what kind of issues crews have had in the past, an ETA on PD/SO and details on the current call to allow us to make an informed decision on whether we're going to wait for LE or if we're going to enter then either continue them or cancel them.

Crews also have the ability to request PD. If something sounds funny to us in the dispatch we can ask if PD is responding then upgrade them to code 3 if we are close and it's potentially life threatening or we can request the respond either emergent/non-emergent. We get along very well with PD and Fire for the most part. With that said, PD and Fire usually don't get along with each other.

Vital. Hard for IFT"s.

 

[Imacho]

I hope you never have to try that because I already know how it is going to work out and it will likely not go the way you want it to.

Why/how do you know it wont work out? Prior experience? Or are you relying on statistics? I know my capabilities and how others fight. So no need to worry about me here. I'm confident in my abilities and training.

 

[ItsTheBLS]

PD response to all psychiatric and assault calls. EMS waits for PD before entering scene.

 

[systemet]

Why/how do you know it wont work out? Prior experience? Or are you relying on statistics? I know my capabilities and how others fight. So no need to worry about me here. I'm confident in my abilities and training.

I'm trying to write this post in a polite and respectful manner, but I think that you require a reality check. After 17 years you may be very good at Tae Kwan Do. After a year of MMA you are not very good at grappling. You may be a big strong guy, you may be 250lbs and 6'8, I don't know. But I think you need to reflect objectively on your skillset and the nature of the violence that's out there.

Your posts read as if you are very overconfident. This is probably going to get you hurt. It may well get whoever has the misfortune to be standing next to you hurt.

Consider for a second the ramifications of actually winning a fight in the back of the ambulance; losing your job, injuring yourself severely, and being at risk for civil suit or criminal prosecution. You may want to reconsider your attitude. It's unlikely that you're the biggest baddest person who gets into the back of your ambulance, and your skills may not be that helpful if you find yourself in a situation where you're ambushed, face multiple assailants, or there's weapons at play.

It's great to have these skills as a last resort option for when you think that you're about to get seriously hurt, or killed. They're not a replacement for respecting your environment, being cautious, and developing basic street sense.

 

[mycrofft]

Custer had a positive outlook too.
Y'all take care, I'm off this thread.

 

[Imacho]

I'm trying to write this post in a polite and respectful manner, but I think that you require a reality check. After 17 years you may be very good at Tae Kwan Do. After a year of MMA you are not very good at grappling. You may be a big strong guy, you may be 250lbs and 6'8, I don't know. But I think you need to reflect objectively on your skillset and the nature of the violence that's out there.

Your posts read as if you are very overconfident. This is probably going to get you hurt. It may well get whoever has the misfortune to be standing next to you hurt.

Consider for a second the ramifications of actually winning a fight in the back of the ambulance; losing your job, injuring yourself severely, and being at risk for civil suit or criminal prosecution. You may want to reconsider your attitude. It's unlikely that you're the biggest baddest person who gets into the back of your ambulance, and your skills may not be that helpful if you find yourself in a situation where you're ambushed, face multiple assailants, or there's weapons at play.

It's great to have these skills as a last resort option for when you think that you're about to get seriously hurt, or killed. They're not a replacement for respecting your environment, being cautious, and developing basic street sense.

Im confident cause I'm good at what I do. I'm not cocky or arrogant. Which is a pet peeve of mine. I do not walk around with a chip on my shoulder. There is always someone bigger, better, stronger etc. than you/me. However, those that we encounter would not necessarily have the intelligence or ability that I possess. And, I'm not trying injure or disfigure anyone, just neutralizing the threat with simple techniques.

 

[Outbac1]

For safety we have a panic button on the radio. Police go to violence/suicide calls first and we stage. I haven't felt the need to have a personal "defensive" weapon. I find that with age on my side the careful use of my mouth can dissapate most situations.
We also wear white shirts and the bright yellow jackets so as to not look like cops. We also work hard at maintaing a neutral non confrontational attitude. This has worked out quite well. Even the hard asses tend to give us respect. We had one customer who was very well known to police who had a sign on his door " Police F... O.., Paramedics Welcome".
We have our questionable neighbourhoods and streets like everywhere. We have gangs and dealers and guns. Just not to the extent of the USA. It is hard to flag specific residences as the dealer who lived there last month has now been replaced by a single mom with three ankle biters.
Always maintain awareness and be prepared to leave hostile patients and their families/friends. They're what supervisors and police are for.

 

[EpiEMS]

"Police F... O.., Paramedics Welcome".

Now that's funny!

 

[DrParasite]

PD response to all psychiatric and assault calls. EMS waits for PD before entering scene.

I'll go one step further. PD responds to all psych calls, drunks, and conscious assault calls.... EMS doesn't even get dispatched until PD gets there, secures the scene and waits for EMS to arrive. in some places, PD can have a delayed response, and all staging does is tie up a unit (which in some places can be more than an hour). or they can get tired of waiting and get nosey, or get flagged down by a bystander.

always walk into a scene carrying something. if you need to leave in a hurry, put as many items between you and reason you are leaving. and if you can't stop them, do what you can to slow them down. then leave the scene, and don't return until PD is there waiting for you. if you feel unsafe, leave, if the patient dies, oh well, I want to go home, and he or she was sick before they called me.

oh, and for those who say PD responds to all bad neighborhoods, what happens when you don't have enough cops to accompany EMS on those "bad neighborhood" EMS calls? it happens all the time in urban cities. Also remember, the families of gang members get sick, and if you take them to the hospital, they will be grateful, if you take forever because you are waiting for the cops, they might not be so happy next time they see you driving down the street.

oh yeah, and we all know only the bad neighborhoods and known gang member have assaulted EMS crews, so there is no need to worry about what happens in suburbia....

I would love to see 3 people on all EMS crews, so you always have someone watching your back while two people treat the sick patient.

 

[SloEd]

I think most of the answers are fairly common sense, and already implemented by good EMS systems:

* A good radio net that fully covers the response area, with a panic button system on the portable radios.

* Dispatchers with a dedicated police line

* Mandatory crew checks after a specified time elapses

* Mandatory staging on certain high risk calls, assaults with assailant on scene, stabbings, shootings, etc.

* A culture where both dispatch and the crew can initiate a stage without fear of punitive measures if it turns out to be justified.

* A management that will defend the staging policy to the media, punish those who breach it, and encourage crews to be responsible for their own safety.

I second his thoughts.

In addition I would like to be allowed to be provided a taser like the X2. I would be willing to pay the $700 or whatever they cost for one if my company would allow me to carry one. I don't want a contact stun gun type zapper.

 

[CentralCalEMT]

What if in many areas, the police received medical training and responded on all medical calls. One of the towns we cover, all the PD has medical training and they respond on all medical calls. The citizens know this, and expect the cops on every 911 call. This has several advantages.

First, the non compliant patient will not get all mad and ask why we called the cops on them. I have had potentially hostile patients become extremely hostile when the cops walked through the door. However, in this town the patient expects it. (It has also cut down on BS calls from what I am told.) Family members also can get hostile when the cops show up. Especially since many of our "customers" as well as their families engage in activities that are slightly less than legal.

It cuts down on response times. While we have excellent response times in this town, the cops are still on scene before us almost all of the time. They mitigate many potentially violent situations before we even get on scene. Also, because of their EMT training and AEDs in the patrol cars, this works out well in cardiac arrests.

It also helps immensely with crowd control. People tend to back up when told to by a cop rather than a paramedic or firefighter. Some people may disagree, but in my opinion, one or two police officers often do a better job of scene and crowd control than a 4 person engine company.

The cops in this town have greater community support. Even if all they do is first respond and put grandma on O2 before the ambulance arrives, at least they did something positive in the communities eyes rather than just write tickets.

Another thing my company does that I like is program the police frequencies into all our radios. That way, when we respond to a call PD is responding to, we can monitor the frequency and get an idea of whats going on before we get there. Some nights, when all hell is breaking loose, we monitor the PD frequency to get an idea of whats going on in the cities and towns we cover. It's amazing the number of times someone gets injured in a fight and the RP calls it in as an unknown medical or asthma attack because they don't want the cops coming. More than once, our crews have been responding to a address and heard a call on PD go out for a fight at the same address called in by a neighbor or passer by. Situational awareness can go a long way in preventing potentially violent incidents.

 

[EMT B]

So, without further adue, without a firearm, what do you think you need or would like to have in order to prevent injury to yourself or coworkers while doing your job?

paramedic with an IM injection of halodol pre-drawn.

i also have a spring assisted rescue knife on me all the time to cut whatever it is i need to cut. i suppose if my life was in immediate immanent "oh my god im actually gonna die" danger i could use that.

however, in my system we usually have a pd unit respond anyway.

 

[mycrofft]

Valuable comment

What if in many areas, the police received medical training and responded on all medical calls. One of the towns we cover, all the PD has medical training and they respond on all medical calls. The citizens know this, and expect the cops on every 911 call. This has several advantages.

First, the non compliant patient will not get all mad and ask why we called the cops on them. I have had potentially hostile patients become extremely hostile when the cops walked through the door. However, in this town the patient expects it. (It has also cut down on BS calls from what I am told.) Family members also can get hostile when the cops show up. Especially since many of our "customers" as well as their families engage in activities that are slightly less than legal.

It cuts down on response times. While we have excellent response times in this town, the cops are still on scene before us almost all of the time. They mitigate many potentially violent situations before we even get on scene. Also, because of their EMT training and AEDs in the patrol cars, this works out well in cardiac arrests.

It also helps immensely with crowd control. People tend to back up when told to by a cop rather than a paramedic or firefighter. Some people may disagree, but in my opinion, one or two police officers often do a better job of scene and crowd control than a 4 person engine company.

The cops in this town have greater community support. Even if all they do is first respond and put grandma on O2 before the ambulance arrives, at least they did something positive in the communities eyes rather than just write tickets.

Another thing my company does that I like is program the police frequencies into all our radios. That way, when we respond to a call PD is responding to, we can monitor the frequency and get an idea of whats going on before we get there. Some nights, when all hell is breaking loose, we monitor the PD frequency to get an idea of whats going on in the cities and towns we cover. It's amazing the number of times someone gets injured in a fight and the RP calls it in as an unknown medical or asthma attack because they don't want the cops coming. More than once, our crews have been responding to a address and heard a call on PD go out for a fight at the same address called in by a neighbor or passer by. Situational awareness can go a long way in preventing potentially violent incidents.

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