Saturday, July 17, 2010

A new EMS Debate...

Hopefully I can get people eager to read my next post series. By the way, I am currently living with two other EMS professionals. I will call them Medic Dolphine and EMT Doodle. We get together and have our own round table discussion, and they have graciously allowed me to post their comments about a given topic. This next round will be about....

"Should Paramedics, EMT's and Fire Fighters be allowed to carry a side arm/taser/mace/self defense weapon on them while they are performing their duties?"

I'm sure this will be the start of something awesome. Look for a post tomorrow regarding the conversation. I'd also like to hear from what you think about this topic.

Have Fun and Be Safe,
~Medic Trommashere~


  1. Hum, interesting question... I guess I can see both points of view
    One way we earn our patients trust, and de-escalate some situations is emphasizing that we are not the police, and do not have any weapons. Carrying a gun or a taser, or any other visible weapon would negate all of this... I think that it also may put as in more danger... people are probably more likely to shoot someone who they think of as a threat (although at least if you have a weapon, you can shoot back)... or make providers go into more dangerous situations than they should

    That said, I do carry a small (2.5" I think) pocket knife in my pants pocket, pretty hidden, but I know where it is. Useful for opening thing/ getting them unstuck. I have never been in a situation where I needed to defend myself other than restraining a pt., but if I did, and the situation was right to where I would want to use a knife (although generally, I don't think I would want a knife as a weapon at all), I would use it. If it is me or them, I am going to choose me, every time.
    Now that I am thinking about it, I do think it would be great to carry a small thing of mase in your pocket. It can be pretty much hidden, so only you know you have it, and it doesn't really do permanent damage. I might go out and get a small thing of pepper spray now to add to my pockets :)

    Along the same lines, I do think that EMS should be allowed to restrain pt.s who are uncooperative/ have a real potential to become violent, with mechanical restraints, and possibly chemical restraints, if the situation warrants it, and there is a medic on board. I am always surprised when I hear of places that don't let their providers restrain pts. What do they expect them to do when transporting a violent patient? Just this week, another pt. jumped out of the back of an ambulance on the highway and killed himself, in Rochester NY.

    Sorry for the essay I just wrote you.. I actually just wrote a post on my opinions on restraining pts, and keeping providers safe, so my mind has just been going on this topic for some time.

  2. The very first agency i was part of had everybody wearing very similar uniforms so that from a distance agency identification was impossible. I HATED IT! We NEED to be able to show people that we are not there to hurt them but there to help them. That means we don't need to carry weapons or mechanically restrain patients. I am not saying that soft or even leather restrainst aren't usable but when it gets to the level of a mechanical device I think we have crossed a line we don't need to cross as EMS providers. If you feel you need to carry a weapon then your agency needs to revamp it's protocols. (I know that needs to be done in many areas!) I carry a knife and would use it if I found it neccesary but don't carry it as a weapon but a tool to provide care, it is a very different mindset. Maybe that is what is needed, a look at the mindset you are going into situations with and do you need to change it?

  3. Without laying down comments from the talk, I'm going to try and breifly answer some of these comments, as is my rule for getting them. (You post them, I answer/respond to them...)

    @FP: I love long comments like that, so go ahead and keep them coming. Yes, we don't want Joe Schmoe who wants to kick our ass/kill us/whatever to think we are the cops and that'll make them lash out even more. Same goes for the coke dealer who's having chest pain. They definately don't want the cops around, but the "Ambulance Drivers" are okay.

    I've been fortunate to have never worked anywhere where you aren't allowed to restrain patients. I think without mere Physical (Through this conversation and through the posts, I will refer to Leathers/Wrist/Ankle/Poseys'/Police assisted handcuffs/ as Physical Restraints where Vitamin H (Haldol)/Versed/Valium/whatever will be refered to as chemical restraints).

    Not too far from my home base, there was a situation when a patient actually killed themselves in the ambulance, but that'll be touched on in the meat of the post.

    @Mark: Once again, thanks for posting and commenting on my blog! It's awesome to have many varying opinions here.

    Now, with your comment being as awesome as it is, forgive me for not fleshing out a long and indepth answer because we have touched on a situation like this during the "Round Stretcher Discussion". I'm going to throw a question back to you, and I'd love to see your answer on this one.

    You have a combative patient who may or may not be in a Psychotic rage or if the combativeness is due to an Urban Pharmaceutical Reps' free sample of product. He also has obvious injuries that require a trip to the hospital.

    The police won't take him in their vehicle in their custody for fear of him passing out/catching dead, in the back of their cruiser with no one watching him. Your patient, "Tiny", is not going to go without a fight, and he is signifigantly bigger than you or your partner. Also, there will only be one, maybe two people in the truck with you if your agency can get you a back-up unit.

    Your agency has provided a set of Physical Restraints and the protocol for use is that it's up to the Primary Care Provider or Highest Trained (Who's riding in back). You are the PCP. What would you do?

    @Everyone: Now mind you, I'm not advocating that MedTech or Wheeled Coach or whomever manufactures your ambulance start installing gun racks in the front and back of the truck. (Although, a wonderfully mounted 500 Super Bantam Slugster by Mossberg would cut down on frequent fliers...the noise one of those rifles make is very distinctive at 3 am...that'll fix drunk in a heart beat.)

    What I am advocating for is some sort of happy medium. We need a way to protect ourselves outside of just running away and hiding when someone tries to do something bad to us. Most everyone knows that we are unarmed, and it doesn't take a rocket scientist to figure out that we don't have much in the way of protective gear on as well. (Yes, I know some agencies hand out Bullet Proof Vests (BPV from now on), but they seem to be few and far between.)

    I can't count how many times I've taken the 'wait and see' approach with my violent patients and have ended up with an injured crew member, or having to stop somewhere and wait until an officer (or 12) arrived to help subdue the patient.

    Whew! I'm getting too far ahead of myself. I promise, I'll answer these comments in a long form in the posts, and Medic Dolphine and EMT Doodle will weigh in as well.

  4. No. I do not believe so. We need to be entirely independent-- and if we are able to cause physical harm, we lose that. I am coming from working in Israel, where it is common to see EMTs with sidearms, but that is likely because they are on active duty with the military, and working civillian jobs...
    I have no problem, however, with an officer accompanying a patient to be armed, or a CO accompanying a prisoner. The bearer just needs to be very well trained in how to keep control of their firearm.
    I think the larger question is about what we do when a patient is armed (legally). I do not allow non-LEOs to carry in my ambulance. Even if the patient is A&Ox4, that could change, and I do not them to be able to kill me-- we are in a small box, travelling at high rates of speed.
    I will allow the patient to hand the weapon over to a friend on scene (but the friend needs an LTC), or a Police Officer, so it can be secured, and returned after the patient's hospital stay. I am not trained to disarm and stow a weapon, and as such, will not be doing so. At least in me area, it is illegal to be armed inside a hospital...

  5. I'd have to echo the sentiment that we're not the police and our patients need to understand that. While I have guns at home - I have a CCW and carry on my personal time - I wouldn't want to be packing on the job.

    I've been in martial arts since childhood (not for competition, either) and I've got absolutely no issue defending myself if the situation calls for it. If someone has a gun and is within arm's reach of me, he's not going to have that weapon for very long. If he's not, I'm gonna be doing my best impression of Babe Didrickson Zaharias. I would hope, though, that by the time I arrive on scene officers would have secured that scene and I'm not going to have to question my own safety.

    In my first due, the rules are simple: calls for GSW's or any person with a gun require us to stage at a safe distance until PD secures the scene and we can be sure we're not walking into an ambush.

    I left corrections for a number of very good reasons. I don't want to be a cop and I don't want to be mistaken for one. I love my PD friends to death but they get paid to carry guns for a living. I don't.