A Day In The Life Of An Ambulance Driver - Latest Comments in Hypothetical Situation for the LEOs and EMTs

Re: Hypothetical Situation for the LEOs and EMTs

Rick R. — Tue, 17 Mar 2009 15:26:00 -0000

< />< />the only reason for leaving teh gun in place is that you (the dude ON SCENE) have a good reason to believe you cannot get the gun safely (which is apparantly the conclusion AD reached, especially given the long police response time), and the risk of trying outweighs the real risk that Mr. Disoriented will get paranoid because someone moved too fast in his field of view or tried to start an IV and the patient isn't tracking real well.

Re: Hypothetical Situation for the LEOs and EMTs

Rogue Medic — Mon, 16 Mar 2009 13:29:00 -0000

Ray,< />< />Combat is a whole different kind of disorientation. You know what training the guys around you have had. You know whom to stay away from. This guy is a complete cypher. You choose to view him as harmless, apparently just because he has a gun and is disoriented. That is a mistake.< />< />When the person is disoriented, he should not be armed any more than hey should drive. With a report of becoming rowdy after seizures, that is a good reason for him not to be armed.< />< />Evacuate an area because a guy, who is too big to wrestle with, is reported to become rowdy after his seizures and is currently disoriented? Absolutely. < />< />I don't have any problem with guns. I do have a problem with disoriented people with guns. The two do not mix well. Those who advocate for disoriented people to have guns, give responsible gun owners a bad name. They also give plenty of ammunition to the 2nd Amendment opponents.

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Mon, 16 Mar 2009 11:05:00 -0000

Rogue Medic,< />< />I disagree with about everything you said except for where you quoted me. Disoriented people with guns do not bother me. If you have ever been in combat you will see an entire squad of disoriented people with guns. < />< />The man wasn't doing anything wrong. The weapon was holstered and not a threat. If you choose to disarm people before you treat them then that is up to you. I think you are wrong for doing so.< />< />Evacute the entire area because a guy has a siezure and is armed? I can't believe people would do that but hey, i live in Texas where everyone is carrying a weapon. < />< />Ray

Re: Hypothetical Situation for the LEOs and EMTs

Ted — Sun, 15 Mar 2009 11:34:00 -0000

The weapon has to be secured. Until it is, you're dealing with a confused, armed patient WITH A KNOWN HISTORY OF VIOLENCE.< />< />This guy doesn't get to have a firearm on my scene. He also doesn't get to have a taser, asp, knife, or pointy stick. < />< />Hell, when I treat perfectly alert and calm LEOs/armed citizens/soldiers/sailors/airmen/marines I still make sure their weapons are secured.< />< />In a perfect world, PD will disarm the patient before it becomes my problem. < />< />If not, hopefully he's alert enough to cooperate and willingly relinquish his sidearm once I've explained things in my Calm Reassuring Voice.< />< />If that doesn't happen, I'll look for him to seize again and secure the weapon while he's seizing (remember, scene safety comes before airway), then deal with the seizure.< />< />If he doesn't seize again, I'll explain to him that we need to start an IV, then take his gun arm (the left in this case) to start the line. While I have the arm distracted, the most gun-savvy person on my team secures the weapon. Before this move is made everyone on the team gets assigned roles in case things go pear-shaped.< />< />If I really think things are likely to go south, and I have a few seconds to work with, some nasal Versed might be a good idea. The risks of benzo overdose/adverse reaction here could be outweighed by the benefits of a calmer patient who isn't shooting anyone. Of course, local practice guidelines would have to be considered.< />< />Lastly, short of clearing the scene, is the brute force approach. For this I'd like at least 4 team members: strongest/heaviest on the gun arm, next strongest/heaviest on the pelvis, most gun savvy secures the weapon, last guy on the non-gun arm. If I can get two more guys for the legs and another one for the chest, so much the better. If I had to go this route I'd restrain the patient afterwards for his safety and that of my team.< />< />We had an EMS Fellow who would occasionally RSI severely combative patients, and may have done the same for this guy. I don't know if that's a great idea.< />< />Thanks AD for the great case. What did you do, did it work, and what would you do differently next time?

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Sun, 15 Mar 2009 02:57:00 -0000

Superglue. Follow w/ spray mist of water to set it up.< />< />Seriously, I prefer Ray's suggestion. It isn't a problem till it's a problem. < />< />Administrative firearm handling causes negligent discharges. You, the AD handling someone elses firearm is negligent. You have a responsibility to protect the patient, so allowing the PD or FD to endanger him is also a less than optimal solution. Administering drugs not directly related to treating the seizure is also reckless and negligent, as you don't know what he is sensitized or allergic to. < />< />I like solutions that keep the firearm secured in the holster.< />Communication if possible. If not, then. . . superglue, duct tape, will secure in the holster. Jaws of life / electric sheep shears, etc will make two short duty belts out of one long one.< />< />And of course, what ever you decide to do, you do it calmly and confidently. Cause you're the Ambulance Driver. :)

Re: Hypothetical Situation for the LEOs and EMTs

Rogue Medic — Fri, 13 Mar 2009 11:29:00 -0000

< />< />Some people play with their genitals when they are post-ictal. This does not indicate that they like you. The guy is not oriented. You do not know what he will do. You have jumped to the conclusion that he is behaving responsibly, even though he is disoriented and that is all we know about his current level of consciousness. If he agrees to have someone relieve him of the weapon, then you may be right about him being aware of it at all times, but jumping to that conclusion is not a safe thing to do. Not for you. Not for coworkers. Not for bystanders. Not for the patient. < />< />If you do not want to disarm him, the only responsible way to handle this is to evacuate the area. If this is in a busy area, that may involve shutting down streets and emptying buildings.

Re: Hypothetical Situation for the LEOs and EMTs

Mr. Fixit — Fri, 13 Mar 2009 11:14:00 -0000

AD,< />we had a policeman in our city who was diabetic. We would get called on him fairly often, usually he called himself and dispatch sent us and a couple other squads. < />< />Our rule was to get the gun. We assisted the cops, and let them take the gun. They knew how to work the holster, and it was just better that way. Sometimes the officer could talk to him as he was doing it, sometimes our assistance was to hold him while it was taken.< />< />He was a real nice guy, when he wasn't low in sugar. When he was, sometimes it got rodeo.

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Fri, 13 Mar 2009 10:49:00 -0000

Pheonixtoashes,< />< />Dood you do not need to be scared of armed citizens. You asked why i don't want to disarm him. Let me explain:< />< />Lets review the facts, he was not lucid, history of siezures and percieved as violent when he comes out of the siezure. He is 6'5" and 400 pounds. He is an armed security guard.< />< />I am 6'5" and 320 pounds. When i raise my voice people percieve me as violent. When you're our size, it doesn't take much to make people think we are violent. His employeer may just be reacting to something that scared him.< />< />He is an armed guard. If he has a history of discharging his firearm when recovering from a siezure, then he wouldn't be an armed security guard any more would he? All he is doing is what he was trained to do. He is aware of his weapon at all times!!< />< />He hasn't broken any law or given any reason why there is a problem and he needs to be disarmed. AD is well versed in dealing with people and guns as well. < />< />Just because he is big and armed has your tail between your legs and running scared. It is WRONG for people to want to disarm others because they are uncomfortable especially when no law has been broken. < />< />Your Quote (By the time it "becomes an issue," he's either going to have drawn and shot someone or something already, or he's going to be trying to shoot someone or something)< />< />< />I can't even believe you said this. Your assumptions and fear is what is driving you in this situation. < />< />Ray

Re: Hypothetical Situation for the LEOs and EMTs

Simbo — Fri, 13 Mar 2009 09:40:00 -0000

My original thought for the suggestion to the cops/supervisor would be for something along the lines of dislodging the magazine, with the hope that the gun's of a model that doesn't shoot with the magazine dislodged. But if it did, hey, at least there'd only be one shot right ;)

Re: Hypothetical Situation for the LEOs and EMTs

Ben — Thu, 12 Mar 2009 22:46:00 -0000

Get him in the ambulance and go as fast as you can to the closest border. Then, while your shopping at the duty free shop, the gentlemen from the canadian, or mexican, homeland security dept will disarm him. < />< />By doing so, you avoid yourself a complaint of unuseful use of strengh.< />< />But don't forget your passport...

Re: Hypothetical Situation for the LEOs and EMTs

rayanne — Thu, 12 Mar 2009 21:38:00 -0000

I say: bob and weave,unsnap and run. < />How many comments are you waiting for until you tell us how you resolved it? Tell us already!

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Thu, 12 Mar 2009 21:36:00 -0000

I forgot to mention DO NOT TOUCH HIS BELT!!!! This will feel to him like an all out assault. Just remove the weapon, keep talking in a calm b=voice, do not acknowledge what you have done, just talk about treating hime and making him well again.< />Capt. Tom

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Thu, 12 Mar 2009 21:32:00 -0000

A lot of whooosies out there. It's a weapon, not an atom bomb. He is a siezure patient, not a homicidal manic. You speak to him clearly and concisely in a direct, calm, professional tone. "Sir I need to treat you, but as before I can do that I need to make sure your weapon is secured. Do you understand what I am saying?" and with that you use your left hand (he is a lefty) and slide it down his slide and remove the weapon and hand it to his supervisor. No big deal.< /> Much easier than walking into a strangers house and finding a loaded handgun on the nightstand next to an altered mental status patient and trying to figure out how to get the gun out of the room. Now that is tricky.< />Capt. Tom

Re: Hypothetical Situation for the LEOs and EMTs

phoenixtoashes — Thu, 12 Mar 2009 20:42:00 -0000

to hold him down and remove the gun; they're paid to do that, and they do it on a regular basis - let them handle it.< />< />Later, though, you might want to submit a query to Dood's employer on the matter of why they're employing, in this particular line of work, a guy who seizes and gets violent right afterwards; doesn't sound like a safe guy to be handing a gun to, in my opinion.

Re: Hypothetical Situation for the LEOs and EMTs

Adam — Thu, 12 Mar 2009 20:21:00 -0000

If he's showing signs on what the supervisor has told you, where I work we have an agitated patient protocol which amongst other things, allows us to sedate a patient if there actions are going to harm themselves or others. Not ususally used for post ictal patients, but I don't think I'd have any problem justifying it in this case. Of course, you still have to give him enough midazolam IM for it to work, and there is a time delay.

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Thu, 12 Mar 2009 19:00:00 -0000

If he is to out to be talked into turning over the weapon and is instinctively guarding the weapon. Removing the whole belt would be a better option than just the weapon. If that's out, what about letting him keep the weapon but not control it. If you try to tape or zip tie it in place, your hands near his weapon is going to cause a problem, what about sliding a heavy article of material (smith cot, sweat shirt, sheet, triangle bandage) between the holster and hand covering the weapon and tie it off on the opposite side of the body make sure it covers the entire weapon. That way he still knows its there, but he is unable to draw the weapon because of the lack of control. Of course that's assuming that the situation delegates that EMS personal have to assume this responsibility.

Re: Hypothetical Situation for the LEOs and EMTs

MotorCop — Thu, 12 Mar 2009 18:26:00 -0000

If PD isn't there yet, it's on his dipshit boss who hired dude with a medical condition. Lord knows I can't carry a gun if I'm seizing all the time. < />< />If PD is there and he's lucid, I'd suggest the easy route. "Sir, these nice medical type guys and/or gals are going to treat you, but they're terrified of getting shot since they don't have these lightweight, comfortable, breathable, not-at-all stifling vest on. Would you mind if I secure your weapon?"< />< />If he's out and PD isn't there, refer to first answer. If he's out and PD is present...well I'd just have them do it. < />< />But ask them to put down the coffee first. Anything else is just plain rude.

Re: Hypothetical Situation for the LEOs and EMTs

Regolith — Thu, 12 Mar 2009 18:18:00 -0000

The only thing I can think of (if he is not lucid and cannot respond to reasonable requests) absent having the police do it is to get him onto a gurney, then get five or six really big guys to pin him down and get him into medical restraints, then remove the weapon.< />< />But I am not an EMT, police officer or firefighter, nor do I play one on TV...

Re: Hypothetical Situation for the LEOs and EMTs

The Happy Medic — Thu, 12 Mar 2009 17:10:00 -0000

Been in this spot with Police and trauma but never this tough spot.< />I can only rely on PD to secure the weapon for me.< />If he awakes and gets defensive, I'm toast.< />< />Or I can have my EMT attend...hmmm< />< />Good thinking situation, thanks AD.< />< />HM

Re: Hypothetical Situation for the LEOs and EMTs

RoaVaPD — Thu, 12 Mar 2009 16:47:00 -0000

I have a couple thoughts as I read the comments. Modern holsters designed for carrying a handgun for law enforcement and security have internal mechanisms to defeat gun takeaways. They tend to be a lot more complicated than unsnap and pull. If you try and take the gun out and the patient is not lucid you will probably have a pretty good fight on your hands. Somebody trying to take my gun is going to get shot by me. Especially if I'm not lucid and don't realize I'm a patient in an ambulance. Getting the police means you will have enough muscle to restrain the patient and the knowledge of how to draw the gun properly. You will probably have similar results trying take and apply handcuffs. Again, a couple cops restraining the patient and removing their gun belt, I think, is your best option. < />< />The several times I've been around seriously injured cops being transported, we've taken their whole duty belt off. Then we either had a police escort in the ambulance or following it.

Re: Hypothetical Situation for the LEOs and EMTs

firefighter4884 — Thu, 12 Mar 2009 16:03:00 -0000

my course of action would definitely be based on my perception of how he is acting (with some weight given to what his supervisor is saying).< />< />As far as disarming him, it would largely have to do with what kind of holster the gun is sitting in (as the retention devices on many modern holsters are meant to be actuated by the person carrying the gun, and are designed to prevent a gun grab (which is actually what we're attempting to do here.)< />< />In many cases, it may be best to try and secure the gun in the holster. I'm not certain that could be accomplished either.< />< />Removing the belt is probably out, because either he's got belt keepers hold it in place that need to be removed (all the way around his waist) or the belt is threaded through the loops on his pants (which means that all the gear has to come off to remove his belt anyway).< />< />I think having someone he knows and trusts is probably the best way to go. Short of that, talking him into giving up the gun is probably the best option, but I wouldn't really want to be there.< />< />What did you do AD?

Re: Hypothetical Situation for the LEOs and EMTs

Rick R. — Thu, 12 Mar 2009 15:55:00 -0000

I'm with Donnathedead and several others. And it's the same if if "wonky security guy" or "decorated 20 year police vet had an unknown seizure", or "armed civilian fall down go boom".< />< />Gently tell him you need to secure his stuff. Preferrably, the whole bloody belt as a unit -- nobody handling any guns, no discussions about taking away guns if we can at all avoid it.< />< />If he's tracking well enough to comply, great. < />< />If not, time for Plan B -- which does NOT involve a bunch of EMTs trying out the takedown and secure moves they've seen cops use. It should involve other cops handling it like they are trained to -- and in many cases, have done in real life with other armed good duys who were temporarily a bit whacky (officer after a car accident, colleague had a few too many at teh FOP, etc.)

Re: Hypothetical Situation for the LEOs and EMTs

Joe — Thu, 12 Mar 2009 13:14:00 -0000

I think I would try restraining the gun. Zip tie to the holster if possible. The other choice it to restrain the hand.

Re: Hypothetical Situation for the LEOs and EMTs

Anonymous — Thu, 12 Mar 2009 13:05:00 -0000

I'm not a professional, but I'd immediately take the weapon. Reach, unsnap and pull the weapon. By the time it registers, it's out and gone. I'd think he'd be as weak and uncoordinated as a kitten.

Re: Hypothetical Situation for the LEOs and EMTs

Sheri — Thu, 12 Mar 2009 12:47:00 -0000

What would I do? I'd hit him over the head to knock him unconcious then remove his weapon. But I'm sure that's not the correct route. I'm also pretty sure you would lose your license. So, enough about me, what did YOU do?< />< />BTW, did I mention I'm not an EMT? Or, did you guess that on your own?