There’s an article here talking about scene safety and this kind of brings to mind that we do run into some unusual situations. It’s about a California Fire Department that is changing some of their safety policies regarding certain types of patients after a call where a patient actually pulled a gun on the engine company that responded to help take care of this patient. Now, there was a paramedic who came in to help a woman. They got a call for an overdose, when they arrived and went in to help the woman, she suddenly pulled out a gun and started it pointing it, waving it around at the four members of the engine company that showed up to provide EMS care for them.

They weren’t prepared for this obviously. We talked about being situationally aware, maybe if you go to an overdose call, you might expect a certain additional level of danger than you might expect from your inner chest pain call to a standard 80-year olds house but when you go to those overdose calls maybe you have a higher index of suspicion for there to be violence or some unusual situations but you go to help somebody and they suddenly jump up and start waving a gun around not the usual way that you would like to treat your patient. Now, they were able to quickly wrestle the woman to the ground and that was the option because some of them were trapped in the room where they were standing with this woman but they were able to get the gun away from here before she fired any shots thankfully. But it keeps in mind for me that we all need to be cognizant of the dangers out there and never put yourself in a situation where you have the patient or bystanders between you and the door if you can help it. I say never but sometimes you don’t have a choice but in situations where it could be more dangerous where you have, should have, or may have a heightened level of suspicion that there could be something bad happening. Go ahead and be aware of your exit routes. Make sure you have you radio, you should have it with you anyway but if you don’t have it and carrying it, make sure you have it on those calls.

Talk with your partners about how you might handle situations like that before you actually are in that situation. If you know that this is the way things are going to go- one of you decides to be a hero and the other one has decided it’s time to run, you can end up with a disaster on your hands because you might have different expectations for what the other person would do. Talk about these things in advance with each other and understand that hey you know listen, I don’t get paid enough to take a bullet, I’m not going to be a hero so we’re going to run and your partner goes oh it’s good to know because I would’ve jumped the person in that situation so now I’ll run with you and let’s see who can could go faster. You know, that’s the kind of thing and discussion you need to have and I know it doesn’t seem like it’s always the best discussion but use this article, use the MedicCast as a talking point, bring it out and have it as a discussion issue. If you’re a training officer, just do some assessments review with them for your regular training and then have this part of that assessment review a dangerous patient situation occur so that they remember hey wait a minute, this isn’t just a generic assessment review. I’m supposed to be paying attention to all of the aspects of my assessment including being aware of scene safety.

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This article has been featured in the news segment of the MedicCast podcast episode Antipsychotic Medication Review for EMS and Episode 246

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