What happened: A confrontation between a police officer and paramedic outside an Ohio bar, captured on bystander video, went viral last week. It started a heated debate about who — if anyone — was at fault, and whether the short glimpse of action was enough to make a judgement about the paramedic or the officer’s actions being appropriate. While the debate raged, the police chief took heat for investigating the incident instead of jumping to a conclusion.
Why it’s significant: Paramedics and police officers are under constant pressure to be 100 percent correct all of the time. Any mistake or perceived slight can be quickly elevated to speculation of willful wrongdoing or negligence.
A relationship of mutual respect, looking out for one another and understanding the role of other responders is essential for effective joint response. There is an expanding expectation in many communities that police officers are part of an all-hazards response including cardiac arrest, narcotics overdose, behavioral emergency and trauma secondary to assault. In the vast majority of joint response, everything goes well and the exceptions can be learned from, but they should not define the relationship between police and EMS.
Top takeaways for EMS providers
1. Live broadcast
EMS has an obligation to protect patient privacy, but no incident is private. Always assume every action is being captured on smartphone video, CCTV as part of a business security system, dash cameras or body-worn cameras.
Slow motion video playback allows for judgement of decisions and actions that was impossible in real time. What might seem obvious on the 10th or 20th view of a confrontation might have been anything but obvious in the split second in which it happened.
2. Speak your actions on every call
Loudly, clearly and without acronyms or jargon; speak your assessment and treatment actions as you perform them. Announce your presence on scene and again as you approach other responders, especially if you are outside of their field of vision. The patient isn’t your only audience. Make sure other responders and bystanders are aware of what you are doing as you do it.
3. Ask for disagreement
One of my favorite patient lifting practices is to ask “Is anyone not ready?” instead of asking “Is everyone ready?”
Receiving confirmations from multiple people is unnecessary noise and obscures any dissenting voices.
4. Unified command for joint response
The number of responders at a violent patient incident can quickly scale from a single police officer and two-person EMS crew to multiple police officers, an EMS field supervisor and an additional EMS crew. Route communication to the top officers from each branch — police and EMS — rather than taking the chance that provider to officer communication is reaching all the people it needs to reach.
5. Assess, treat the underlying cause
When a TASER is deployed, EMS providers have an opportunity to prepare chemical sedation to continue the patient restraint. The TASER is not lethal, but the underlying cause of the patient’s violent or agitated behavior may be. Voice any concerns, driven by assessment findings, about the best course of treatment after the patient is restrained and prevented from further harming EMS providers, police officers, others or himself.
What’s next: In the pre-video era, an informal “keeping it blue” meeting might have been used to resolve a miscommunication stemming from a chaotic incident. If not for the video, this incident likely would have been solved with a discussion among the responders, might not have even come to the attention of the department chiefs and definitely would not have become a local and national news story.
Ubiquitous video cameras in smartphones, as well as CCTV monitoring of many businesses and officer body worn cameras, make any accidental or intentional confrontation potential fodder for the evening news. If any of us find ourselves in a similar situation, it behooves us to let go of the emotions of the incident and to quickly and plainly explain our actions to our superiors so the incident can be resolved.
Learn more: Use this incident to review joint response policies with local law enforcement. Discuss the best way for EMS providers to voice concern about use of force techniques if they believe there is a medical reason for the patient’s violent behavior. In addition, here are EMS1 articles to learn more about scene video and behavioral emergencies.
- Photojournalist: 5 tips for managing the media on EMS scenes
- When civilians hit record: Be on the news without becoming the news
- 4 lessons to learn from bystander video of medics, cops, and firefighters
- 4 ways to prepare EMTs for violent patients
- Remember 2 Things: Sedation for violent, restrained patients
- Why EMS providers should never tolerate being attacked
- Psych patient transport: 5 tips to make it safe for providers and patients
- Expert tips for EMS handling of behavioral emergencies
- Rapid response on PoliceOne: 3 key lessons from the cop, paramedic confrontation video
- Rapid response on FireResuce1: Lessons from a cop-on-medic attack
