On self defense and being a medic

On the issue of armed medics, it's clear that we are very passionate about the topic, and that there is no clear direction to follow

My Tuesday editorial about arming EMS personnel really lit up the member comments and Facebook page. It's clear that we are very passionate about the topic, and that there is no clear direction to follow. There are several developments to report and some more context to add.

First, Dr, Jason Pickett, Associate Director of Operations, Division of Tactical Emergency Medicine at Wright State University, is one of the authors of Ohio bill. He posted information about the bill that authorizes non-sworn peace officers such as physicians, nurses, and EMTs to handle firearms as part of an organized tactical response.

It does not speak to the everyday EMS provider in the performance of his or her daily activities. I stand corrected and appreciate the information hat Jason provided. You can see what he posted at the original thread.

Second, Washington DC Fire and EMS personnel were once again in the news in their role as a crime-deterrent force in unarmed patrols. I'm still dubious about the concept.

As EMS providers, we are woefully underprepared to defend ourselves if attacked. We receive little training in verbal or physical defensive tactics in our initial education. Very few continuing education courses in self-protection, that are adapted specifically for an EMS environment, are available. We rely heavily on soft controls such as policies and protocols to provide guidance in potentially dangerous situations. These don't help when a seemingly safe scene suddenly erupts into chaos, and the potential for injury becomes significant.

To reiterate several comments written by EMS1 members: avoid these situations in the first place. Not just physically by staging or retreating to a safe space, but by creating an environment that reduces tension rather than exacerbates it.

No matter how trivial or nonsensical the reason why EMS was called, it's not personal. You might be frustrated, angry or bitter about the call. It's not personal. The patient may not be educated, may be relying upon the bad advice of others, may be frightened, anxious, or in fact may be uncaring and selfish. It's not personal.

Overcome the reflex to chew the patient's ear off because it's 2 a.m. and he wants to be seen at the emergency department for a three-week-old earache.

Patients can be unruly, verbally abusive, upset, and angry about their lot in life. You become a terrific target to unleash all of that unhappiness. Why bother playing into it? Count to ten and keep your body language neutral, relaxed and ready to respond to a threat if necessary.

Personally, I've walked out on scenes after warning the patient I would do so. It certainly felt easier, and safer than to get into a shouting match.

I do encourage EMS providers to learn how to verbally defuse situations. I don't think it's the normal response of humans to listen and negotiate a highly charged situation. It's not easy to do, but it is a skill one can learn.

I also recommend learning how to safely perform physical defensive techniques. We recently held an all-day course at my organization, taught by state troopers who were also EMS personnel and martial arts experts. The participants thought it was very useful to learn how to do basic maneuvers to break a physical hold or disable a violent patient.

What I don't recommend is being equipped with a firearm while performing the day-to-day activities of an EMS provider, not when there are alternatives and options. Too crazy, too permanent, too simple to make a mistake that can cost another person's life.


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