Tuesday, August 3, 2010

Round Stretcher Discussion...Finally!

So here it is, the first Round Stretcher Discussion. Topic for this one was discussed a week or two ago. For your refresher, the topic was: "Should EMS/Fire Personell be allowed to carry some sort of weapon to defend themselves including but not limited to: Guns/Knives/Mace/Tasers/Ect..."

Medic Trommashere: Myself

Medic Dolphine: My partner for over five years. We have worked together from before we were both medics. We went to Paramedic School together and even managed to work in the same service before moving to pursue a new career. He has worked in all areas; urban, suburban, and rural. We share similar war stories, but he has many of his own.

EMT Doodle: Another partner. She spoiled me, being one of the better EMT's I have had the pleasure of working with. With an energy that can vibrate her surroundings, she's awesome!


Medic Trommashere: Thanks you guys for being willing to sit down and chat with me about this. The three of us have worked together in probably one of the most dangerous areas in our county at that time, and we also have worked separately in various areas, so hopefully this will be fun. So the question I am posing to the two of you is this: Should we be allowed to have something in the ambulance or on scene to protect us, things like a gun, or mace, or a taser, or something that is considered a 'weapon' under our EMS Weapons' Rule.

EMT Doodle: A gun? Seriously? Think of all the people we worked with, do you want to see any of them with a gun?

Medic Dolphine: We already look enough like cops, do we want to make it even worse?

MT: Point taken...so we'll pretend that we're not even considering fire arms anymore. So, what do you think about any other type of weapon?

ED: There needs to be some sort of training to help us defend ourselves. I'm trained in the Martial Arts, just like the both of you are, so we can defend ourselves if needed, but most haven't had much if any formal training. I'd be afraid that, for something as simple as a drunk getting a little aggressive, someone would pull out a Taser or a can of Bear Mace, or a Baton to beat them and possibly kill them.

MD: Yeah, most people who play on the ambulance or on the fire engine would take it too far, and the first time someone got killed, we'd have everything taken away. For a parallel example, look at Lasix. We got it, we used it like water, but after a major screw up, Lasix got bumped so far down the list it wasn't funny.

MT: But the question is, should we have a mechanical device to defend ourselves? (Shows a print out of Mark Zanghettis' comment on the original post) Also, how do you feel about this comment?

ED: He's right. We used to talk about it when we worked together, and even when we worked separately, that we didn't like looking similar to the cops. We're there to help, not hurt, if it can be avoided. I have to disagree with the non use of Mechanical Restraints like softs, leathers, and what not. Some times you just have to have them tied down. All that sometimes separates us from getting our ass kicked are seatbelts that we all know how to buckle and unbuckle. As a woman, I don't feel comfortable with the big behemoth patients who could kick my ass if they looked at me the wrong way to be without restraints if they even start getting aggressive.

MD: True. Mind sets are also important, but we can't smooth talk every patient. Someone gorked out on PCP who feels no pain and feels that they can take on the world can't pay attention to the calm talking of an EMS provider because of the psychosis that are raging. I wouldn't want to carry around a taser or a gun, but to be allowed to carry a can of mace would be great. The last time I had a severely psychotic patient, the patient tried to attack a cop and got tased...yet he still kept coming. The mace was the only thing that even had him pause long enough, because he was so disoriented from lack of sight, for us to retreat to safety. Now, I consider myself a big guy, but sometimes even I worry about my safety. (Authors' note; Yeah, he is. 6'2", 275, built like a brick shit house. Most see him coming and they back down from the fight, but I digress)

ED: I don't think I could work for a company that didn't have restraints. Sometimes just the threat of restraints to the patient can get them to calm down. Verbal assaults are one thing, but I do like the idea of going home every morning.

MT: I agree with both of you. I have played enough over the years with violent patients, each time the attacks have gotten worse. There's nothing like having that feeling of, 'I'm not going home today'coursing through your system to give you a wake-up call. Even with the cops around, anything can happen. I got grabbed by a patients' family memeber with three or four cops standing around because they were angry at the death of their family member. Now, nothing resulted from it except for frayed nerves, but it could've been worse.

MT: What would I have done if it were just myself and my partner surrounded by multiple family members? I take full blame for the incident; I should've been paying attention, but with an emotionally charged scene like a homicide, suicide, or overdose, there's only so much we can do. We can leave the scene if it becomes dangerous, but at some point, we have to go back, and now we've just pissed everyone off by re-involving the cops. It may not be that day they take their revenge, but we can't call the cops out on EVERY call, medical or otherwise. Two or three weeks down the line, that may be the day that the little brother of your shooting homicide patient that you pronounced decides to take it out on you.

ED: You brought up a point that wraps back into Scene Safety. I went through EMT school only a few years ago, and we had the quick, "If it doesn't feel safe, it's not" lecture, but past that, I learned on the fly. We didn't know which side of the door to stand on when knocking on a door of a house (Hinge side, btw), how to approach a vehicle so that they can't see you, but you can still see them, or anything like that. We need to have better training before we get out on the road. I'm not talking about a Master Belt in Brazilian Jiu-Jitsu or anything like that, but just some way to defend ourselves past, "Call the cops and run away quickly."

MD: True. I took my EMT class over eight years ago, and the best defensive technique I learned was throwing my jump bag at someone and running away, but that only works if you see them coming. Best thing I was taught on how to defend myself in the truck was to climb through the birth cannal...but I can't fit through there on a skinny day, let alone any other day of the week. Something needs to be changed in the teaching of how to keep yourself safe on scene and in the ambulances. Hours for Medic class and EMT classes have been lenghtened to cover more medical things, but we're started to skimp out on the important things; how to keep yourself safe.

MT: True. So to summarize so far; Guns and Tasers have no place on an ambulance, I agree. Things like self defense techniques should be taught, but we should be allowed to carry mace with us as a last resort,

ED: Pretty much. I don't think that guns and tasers could be used properly on the ambulance, number one, and number two, I don't trust anyone to be able to adequately defend themselves to keep an enraged person from taking the gun or taser and using it on us. The downside to mace is that, unfortunately, everyone is going to get a piece of it, but at the same time, I'd rather get a face full of mace like everyone else instead of a fist, bullet, or taser prong.

MD: Same here. I've caught the back blow of mace several times, hell, I think we've all walked into a jail-cell or an enclosed area where we've walked right into the lingering cloud of mace. I agree with everyone though that, facing a face full of mace is more desirable than getting my ass kicked.

MT: So I believe we have reached a consensus: While some would say that the only way to defend themselves would be to arm themselves with something that can cause fatal lead poisoning or low flow electrial therapy, the thought is that teaching of proper self-defense techniques, both passive and aggressive, would be beneficial to all. Not enough time is spent on diffusing hostile situations, or recognizing them, or getting us out of them safely.

MT: All they focus on is if we get in trouble, we call the cops and try to run. With people arming themselves more and more these days with guns, a metal clipboard, a heavy house bag, or an oxygen tank isn't going to serve us well when a 12-gauge shotgun is leveled at us. With more and more violent crimes happening across the country, we're going to find ourselves on more and more scenes with angrier and angrier patients and their families.

MT: With the addition of companies making their crews wear bullet proof vests with trauma (aka: Stab Plates as I've been told they're called), people have that bit of 'security' going into these bad scenes. Unfortunately, most companies cannot afford to buy them for even the on-duty crews, especially since crews have varying body sizes. The companies that do have them, have them in a 'one-size-fits-all' size, and none of them fit anyone well; not even close to how they should be worn to keep us safe, and they are usually well out of the range of when they were supposed to be replaced.

MT: While many say that the one through three thousand dollars that it would cost per vest is a drop in the bucket when it comes to trying to save someones' life, most companies are concerned with the almighty dollar; Bullet Proof/Stab Proof vests are not as important as making payroll or keeping the ambulances up and running.

MT: Other methods need to be taught on how to deal with agressive patients when in the ambulance. This is where it seems to be that most attacks happen. While we can't restrain every patient who looks at us cross-eyed, we need to teach the skills to those who follow in our footsteps on how to keep themselves safe; where to sit, how to seat belt them down to the stretcher, and overall communication between crewmembers to keep everyone aware of what is going on. With that, I am closing out the first 'Round Stretcher Discussion'. Have fun and be safe out there, everyone.


  1. Very interesting stuff - quick question on the vest section of the discussion. Does anyone ever buy their own vest and wear it? I suppose that would be mainly a "big city" thing, but does anyone do that?

  2. @Lizzie: Yes, you can buy your own vest, and I myself had even looked into one. What it comes down to is the price. With the different styles and coverages of vests. I've always been the one who has always leaned to the side of safety, I'd want to go for the best "Threat Level" of vests, but those can run into the thousands of dollars, especially for women. They have specially made vests for women that are supposedly the best things to go for in comfort. Having worn a "one size fits everyone" vest, and having a female officer let me wear an old one of hers to get an idea of what it was like for a good female vest, I would always be willing to spend that extra money on the female one.

    The upkeep is also the miserable part. A vest with the ceramic plates can't just be taken off at the end of a rough shift and tossed on the floor. Plates have to be taken out and cleaned and re-packed carefully, on hot days, the carriage (cover over the actually bullet proof part) has to be cleaned, and the actual kevlar portion needs to looked over for frays and weak spots.

    The last thing is, per a LEO (Law Enforcement Officer), their vests are replaced every 3-5 years due to normal wear and tear. For us non-LEO's who may or may not find ourselves in hairy situations every day, several thousand dollars every year for something that may or may not happen, especially with the economy the way it is just seems too much to part with.

    I decided not to buy one due to my move. I moved to a location that has very little crime overall, and it's an "older" community, so everyone respects the "Ambulance People". Where I worked before, I always wondered just how bullet proof the ambulance was...

    It doesn't have to be a big city thing, but usually that's where medics have vests bought for them. Places can get grants for vests, but they're hard to come by.

    All in all, if you want to have one, I say go for it, if you feel there is a need for one. One day of wearing of hot, sticky vest, and you may start to decide to go without it, and then it's doing no good sitting in your closet, or on the floor, or helping to hold up the exercize equipment you swear you're going to use.

    Have fun and be safe out there.